Medicine and Health Sciences Commons^™

Cardiac Rehabilitation Education Module For Entry-Level Occupational Therapists, Bonnie Hoff

Occupational Therapy Capstones

According to the American Heart Association (2007) statistics, it is estimated that 79,400.000 American adults have one or more types of cardiovascular disease, or one in every three people. It is estimated that 37,500.000 are over the age of 65 years. (AHA, 2007). Heart disease and stroke are the first and third leading cause of death for both men and women in America and accounts for 40% for all deaths, according to the Center for Disease Control and Prevention (CDC, 2005). Approximately one individual will die from heart disease every thirty-three seconds (CDC, 2005).

According to the CDC (2005), a …

Occupational Therapy: Meeting The Needs Of Individuals Diagnosed With Cancer, Kim Jones, Lonnie Music

Occupational Therapy Capstones

When an individual is diagnosed with cancer, he or she can experience their physical and emotional well-being threatened by fear, isolation, anxiety, depression, fatigue, disfigurement, and pain often resulting in a diminished quality of life (Rosenbaum, Gautier, Fobair, Neri, Festi, Hawn, et al. 2004). Dealing with cancer can result in the loss of independence in basic daily routines and occupations such as: dressing, cooking, taking care of the home, eating/feeding oneself, etc. While all of these challenges can diminish quality of life, they can also be minimized by ancillary intervention services such as occupational therapy (OT).

The problem is that …

Evidence-Based Practice Guidelines For Complementary And Alternative Medicine In Occupational Therapy, Kristin Murch, Angela Olson

Occupational Therapy Capstones

Complementary and alternative medicine (CAM) within the scope of occupational therapy has the potential to add to the holistic treatment of clients with a wide range of disability or dysfunction. It has been suggested that a variety of complementary and alternative methods may be appropriate to use as an adjunctive treatment by occupational therapists with proper training and consideration of various client needs (Giese, 2005). A comprehensive literature review was conducted regarding the use of CAM with populations commonly seen by occupational therapists. Myofascial release, guided imagery, meditation, and yoga were determined to be most prevalent in the literature concerning …

Train-The-Trainer Office Ergonomics Program, Aaron Schenck

Occupational Therapy Capstones

It may be a common perception in the general public that the daily tasks carried out in an office environment are not typically considered physical demanding. Office tasks, such as typing, filling out forms and filing paperwork typically do not require a significant amount of force. Work tasks associated within an office environment, especially computer use, can increase stress on the soft tissues of the body, such as muscles, tendons and nerves over time (Department of Labor, 2005). This can result in what is called musculoskeletal disorders (MSD),s.

The negative impact of MSDs affects employers through decreased work attendance, productivity …

Alzheimer's Toolbox: A Caregiver's Guide, Kristen Eastwood, Gerry Smith

Occupational Therapy Capstones

“Alzheimer’s disease is the most common cause of dementia in North America and Europe” and “accounts for sixty percent of all irreversible dementia cases” (Moore, 2003, p. 50,126). Along with the 4.5 million Americans who suffer from Alzheimer’s, there are also the caregivers who are suffering alongside their loved one. The stress of caring for a loved one with Alzheimer’s can be overwhelming. This affects the quality of life for those with Alzheimer’s and the health of the caregiver.

A comprehensive literature review was conducted to explore and identify effective techniques and interventions, pertinent to both the caregiver and patient's …

The Development Of A Sensory Integration Room For Individuals With Developmental Disabilities, Christine Foy, Samantha Schepers

Occupational Therapy Capstones

Current literature has identified that there is an increasing population of individuals experiencing sensory integration dysfunction. The current literature tends to focus on the use of sensory integration therapy for the use of treating sensory integration dysfunction with children. There has been a gap in the research on the effectiveness on the use of sensory integration therapy in adults experiencing sensory integration dysfunction.

An extensive review of current literature regarding sensory integration dysfunction and the use of sensory integration therapy was conducted and through this information a sensory room protocol was developed. This sensory room protocol includes: guidelines for use, …

Post-Surgical Rehabilitation Of A 12-Year-Old Female Athlete After Medial Patellofemoral Ligament Reconstruction, Jonathan E. Arntson

Physical Therapy Scholarly Projects

Background and Purpose. The treatment of adolescents with lateral patellar instability has changed greatly in recent years. For surgical treatment of recurrent dislocation, the intervention of choice has become medial patellofemoral ligament (MPFL) repair or reconstruction. The purpose of this case study is to discuss recent trends in management of patients suffering from chronic patellar instability, and particularly to describe the post-operative management of this adolescent female who underwent medial patellofemoral ligament reconstruction.

Case Description. Having failed a trial of conservative rehabilitation, a 12-year-old female athlete with a history of recurrent patellar dislocation underwent MPFL reconstruction. Her postsurgical rehabilitation program …

Competencies And Physical Agent Modalities: An Investigation Of Clinical And Ethical Implications, Casey A. Lambert

Master's Theses and Doctoral Dissertations

Occupational therapy has evolved from its early inception in diversional therapy to incorporate technologically advanced modalities into the professional domain. Over the last thirty years the profession has increasingly incorporated physical agent modalities (PAMs) into the treatment process. Throughout this process there has been both opposition and support for the inclusion of PAMs in occupational therapy. There are concerns from both sides regarding the proper training of therapists in the use of PAMs, how competency should be assessed, who is responsible for ensuring competency, and the ethical concerns with the use of these modalities.

This phenomenological study analyzed six therapists’ …

Electromyographic Data Do Not Support A Progressive Recruitment Of Muscle Fibers During Exercise Exhibiting A Vo2 Slow Component, Daniel T. Cannon, Fred W. Kolkhorst, Daniel Cipriani

Physical Therapy Faculty Articles and Research

The origin of the slow component (SC) of oxygen uptake kinetics, presenting during exercise above the ventilatory threshold (VT), remains unclear. Possible physiologic mechanisms include a progressive recruitment of type II muscle fibers. The purpose of this study was to examine alterations in muscle activity through electromyography (EMG) and mean power frequency (MPF) analysis during heavy cycling exercise. Eight trained cyclists (mean±S.E.; age=30±3 years, height=177±4 cm, weight=73.8±6.5 kg, VO2max=4.33±0.28lmin−1) completed transitions from 20 W to a workload equaling 50% of the difference between VT and VO2max. VO2 was monitored using a breath-by-breath measurement system, and EMG data were gathered from …

Influence Of A Functional Knee Brace And Exercise On Lower Extremity Kinematics During Jogging, Brian M. Campbell, Daniel Cipriani, James A. Yaggie

Physical Therapy Faculty Articles and Research

ABSTRACT Context: Functional knee braces (FKB) are used prophylactically and in rehabilitation to aide in the functional stability of the knee joint. Objective: To determine if alterations in sagittal plane lower extremity kinematics remain evident throughout a one hour period in healthy individuals. Design: 2X5 repeated measures design. Setting: Biomechanics Laboratory. Subjects: Twenty subjects (14 male and 6 female, mean age 26.5±7 yrs; height 172.4±13 cm; weight 78.6±9 kg), separated into braced (B) and no brace (NB) groups. Intervention: A one-hour exercise program divided into three 20 minute increments. Main Outcome Measures: Synchronized three-dimensional …

Stress And Anxiety In Adhd: Links To Sensory Over-Responsivity, Stacey E. Reynolds

Theses and Dissertations

Sensory Modulation Dysfunction (SMD) is characterized by an inability to consistently and accurately grade responses to sensory information. SMD, and specifically sensory over-responsivity (SOR), has been correlated with stress and anxiety in some developmentally delayed populations and has been associated with structures and functions of the hypothalamic-pituitary adrenal (HPA) axis. Recent attention has been given to HPA functioning in children with Attention Deficit Hyperactivity Disorder (ADHD), with a majority of studies identifying blunted or diminished cortisol patterns. In contrast, elevated cortisol has been associated with anxiety and anxious behaviors in both animal and human studies. The purpose of this study …

Long-Arm Splinting For Lateral Epicondylitis: A Case Study, Crystal Wolters

Masters Theses

Lateral epicondylitis is a debilitating condition that has a significantly negative effect on the occupational lives of many people. There appears to be no recognized ideal treatment method for the condition. Long-arm splinting for lateral epicondylitis has not been addressed in the literature. A case study was used to thoroughly describe one participant’s experience with long-arm splinting to treat her lateral epicondylitis. She was interviewed, observed, and measurements were taken of her affected arm’s range of motion and strength. The seven themes which were identified through these methods include a description of how her lateral epicondylitis developed, her description of …

Visual Contributions To The Vestibulo-Ocular Reflex During Balance Recovery Tasks, Mark D. Diehl

Theses and Dissertations

Introduction: The Vestibulo-ocular reflex (VOR) is quantified by computing the ratio of head angular velocity and eye angular velocity (VOR Gain). This measure only includes head angular movements; linear translations are not accounted for. These investigations postulate an alternative method of VOR quantification, one that assesses retinal image stability during head angular and linear movements (Foveal fixation (FF)). This method was used to assess the role of vision in balance reactions. Methods: Experiment 1 : Ten Young subjects were fitted with an eye tracker linked to an EM kinematic recording system. This allowed for the recording of head, trunk and …

Therapeutic Effect Of Air-Jet Therapy In Breast Cancer-Related Lymphedema: A Preliminary Report, Wan-Chia Lee, Cheng-Liang Chou, Cheng-Min Chiu, Tcho-Jen Liu, Rai-Chi Chan

Rehabilitation Practice and Science

Lymphedema is a common sequela of breast cancer therapy. The decreased arm function with swelling, pain, numbness, and a limited range of motion, is associated with a psychological distress that affects the quality of life. There is no cure for breast cancer-related lymphedema. Complex physical therapy is currently the mainstream of therapy, combined with manual lymphatic drainage, pneumatic compression pumps and compression bandaging. The purpose of this study is to evaluate compressed air therapy as a new approach to lymphedema management.Eleven women with breast cancer-related arm lymphedema were recruited into the study. Air-jet therapy was performed to massage limb in …

Acute Neuropathy Mimicking Guillain-Barré Syndrome After Diabetic Ketoacidosis: A Casereport, Po-Hong Chen, Hsiu-Fang Hsueh, Chang-Zern Hong

Rehabilitation Practice and Science

A 42 year-old woman was admitted in a comatose state after exhibiting polydipsia and progressive body weight loss of 4-week duration. Diabetic ketoacidosis was diagnosed due to an increased blood glucose level (956 mg/dl), metabolic acidosis, and positive urinary ketone bodies. On the fourth hospital day, despite recovery from the critical state of ketoacidosis, the patient suffered from progressively ascending paresthesia and weakness in the lower limbs. On the basis of clinical and electrophysiological findings, axonal Guillain-Barré syndrome presenting as a paraparesis variant, a very unusual neuropathy related to diabetic ketoacidosis, was diagnosed. The patient reached satisfactory functional outcome after …

Mirror Writing After Left Anterior Cerebral Artery Infarction: A Casereport, Rong-Bin Hong, I-Hsien Wu, Yi-Ming Lo, Hui-Chun Juan, Mei-Ju Ko, Willy Chou

Rehabilitation Practice and Science

Mirror writing is characterized by the writing of alphanumeric characters in the direction opposite to normal. It has been reported infrequently in patients with stroke. We present a 67-year-old male patient who is left-handed but writes with his right hand. He developed sudden onset of right side weakness. CT scan and MRI both revealed acute left anterior cerebral artery infarction involving cingulated gyrus and corpus callosum. His right side weakness gradually improved after rehabilitation. Mirror writing was found when he wrote with his left hand but not with his right hand. The frequency of his mirror writing gradually dropped and …

Gabapentin For Treatment Of Neuropathic Pain In Patients With Spinal Cord Injury, Chao-Min Wang, Yen-Ho Wang

Rehabilitation Practice and Science

The patients with spinal cord injury suffer from motor and sensory impairment with bowel and bladder dysfunction. However, chronic neuropathic pain is also a common complaint after spinal cord injury and is usually refractory to many therapies. The exact mechanism of relieving hyperalgesia and allodynia is still unknown, but most believed it is related to N-methyl-D-aspartate (NMDA) receptor and voltage-dependent calcium channel. Gabapentin is supposed to be an antagonist of NMDA receptor complex which mediates an influx of calcium ions when activated. In addition, gabapentin inhibits neuronal calcium influx in a calcium channel by binding to the α2δ subunit of …

Rehabilitation Problems In An Adult Patient After Acute Disseminated Encephalomyelitis: A Casereport, Hsiao-Huei Chen, Lin-Fen Hsieh, Feng-Chu Tseng

Rehabilitation Practice and Science

Acute disseminated encephalomyelitis is a monophasic disorder of unknown pathogenesis, characterized by demyelination of the central nervous system. The possible T-cell immune-mediated inflammatory process, affecting mainly children and young adults, typically follows a recent infection or immunization. Meningeal symptoms are common early in the course and often begin 1-3 weeks after infection. Abnormalities of motor, sensory, gait, visual, and cognitive function are variable and depend on the location (cerebral white matter, brainstem, cerebellum, or spinal cord) of the most severely damaged areas of the nervous system. Acute disseminated encephalomyelitis is unusual in middle-aged or elderly adults. The mortality rate is …

Comparison Of Thermal Effect With Ultrasound In Rat Calf Muscles After The Application Of Five Non-Steroidal Anti-Inflammatory Drugs, Yueh-Ling Hsieh, Chen-Chia Yang, Hui-Wen Kuo

Rehabilitation Practice and Science

Background and Purposes: Phonophoresis has been defined as the migration of drugs through the skin under influence of ultrasound (US). The phonophoresis of nonsteroidal anti-inflammatory drugs (NSAIDs) was studied in vivo through hairless rat skin to determine the temperature changes in superficial and deep tissues in response to NSAID phonophoresis.Study Design and Objectives: To measure and compare the temperature changes in tissues in response to five NSAIDs under phonophoresis. Methods: Male Wistar rats weighing 250 to 350 g had one of five drugs; i.e., piroxicam (Feldene), indomethacin (Indocin), etofenamate (Rheumon), methylsalicylate (Salomethyl), or diclofenac (Voren) applied to one hindlimb followed …

Survey Of Spinal Cord Injuries Due To Diving Accidents In Taiwan, Ya-Wen Tu, Huey-Wen Liang, Yen-Ho Wang, Jiunn-Horng Kang, Liu-Ing Bih, Fuk-Tan Tang

Rehabilitation Practice and Science

Objective: To examine the clinical characteristics of diving-related spinal cord injuries (SCI) in Taiwan.Methods: This study is a retrospective reviewarticle of all hospitalized patients with spinal cord injuries due to diving accidents in three rehabilitation centers between January 1982 and July 2002. Demographic data and clinical features were presented and analyzed. Results: A total of 1216 spinal cord injuries were reviewarticleed, and 16 cases (1.3%) met the inclusion criteria. Their mean age at the time of injury was 26.8 years and 15 (94.0%) of the cases were male. All of the injuries resulted in tetraplegia and 11 (69.0%) were neurologically …

The Influence Of Nasogastric Tube To Post-Stroke Depressive Tendency And Functional Outcome, Nai-Chiung Huang, Ta-Sen Wei, Sen-Yung Liu

Rehabilitation Practice and Science

Depression is reported in a portion of stroke patients during the period of their stay in acute and rehabilitation hospitals. Depression may influence the patient's motivation to participate in the rehabilitation program and result in slower functional recovery and poor functional outcome. In addition, patients with prolonged usage of nasogastric tube for food intake experience a stronger degree of physical impairment, slower functional recovery, and less motivation. The purpose of our study was to determine the correlation between prolonged usage of nasogastric tube and post-stroke patients' depression tendency, and their effects on the patients' functional outcome. Eighty-six patients participated in …

Bilateral Sciatic Neuropathy Due To Drug Overdose With Coma, Susan Y Fan, Chang-Zern Hong, Lin-Fen Hsieh, Yii-Jiun Shao, Hsu-Yi Chen

Rehabilitation Practice and Science

Limb compression in an unattended comatous patient often results in peripheral nerve injuries; however, bilateral sciatic neuropathy in these patients has rarely been described in literature. A 37-year-old woman with bilateral numbness and paralysis of the lower limb after drug overdose with coma was reported. After onset of unconsciousness, she was in a seated position with trunk and hips flexed and knees nearly fully extended for approximately ten hours. In the department of emergency, she was found to have bilateral thighs and buttocks swollen as well as myoglobulinuria. Electrodiagnostic studies supported a diagnosis of complete denervation bilaterally in the distribution …

The Relationship Between Nasogastric Tube Feeding And Hemineglect In Patients After Right Hemisphere Stroke, Kwo-Shieng Tuo, Shu-Fen Sun, Ken-Hao Hsu, Jue-Long Wang

Rehabilitation Practice and Science

The purpose of this study was to evaluate impairment of swallowing, nasogastric tube feeding, feeding function, and complications of pneumonia in 42 patients hospitalized following a right hemispheic stroke with or without hemineglect. Twenty-three patients with diagnoses of right hemispheric stroke and left hemineglect, as demonstrated by computed tomographic scan or magnetic resonance imaging, comprised the experimental group. The diagnosis of hemineglect is based on the Schenkenberg test (i.e., line bisection test) of greater than 10% right deviation. Nineteen age-, lesion-, and Brunnstrom stage-matched right hemispheic stroke patients without hemineglect were designated as the control group. The 23 patients with …

A Forty-Year Retrospective Of Assessment Of Activities Of Daily Living, Hsi-Ying Chang, Yu-Wei Hsieh, I-Ping Hsueh, Ching-Lin Hsieh

Rehabilitation Practice and Science

Background and Purpose: The term activities of daily living (ADL) refers to the basic skills that a person needs in order to carry out the fundamental physical functions of self-care and independent living. In this survey paper, we reviewarticle the studies on ADL that involve theories of ADL, the concepts and items of measurement, and the test theory developed for ADL assessment. Unfortunately, the issues mentioned above have not been well integrated systematically. With this reviewarticle, we would like to provide a picture of past and current trends in ADL assessment.Method: We searched literature reviewarticles and rehabilitation or measurement textbooks …

The Impact Of Nhi Co-Payment Policy On The Utilization Pattern Of Hospital Outpatient Rehabilitation Services, Huang-Chung Chen, Fei-Lin Chang, Jui-Fen Rachel Lu, Ngok-Kiu Chu, Wen-Chung Tsai, Lin-Na Shih, Yiu-Chung Lau, Fuk-Tan Tang

Rehabilitation Practice and Science

In response to pressing financial distress as a result of escalating health care expenditures, Bureau of National Health Insurance (NHI) has adopted various deliberate policy interventions to increase the sources of incomes and meanwhile enhance cost containment. Co-payment policy is one measure often taken when focusing on demand-side mechanism, which aims to reduce the potential misuse of medical resources by the insured through cost sharing. The co-payment policy for outpatient rehabilitation services implemented since August, 1999 is one good example.The purpose of this study is to assess the impact of the co-payment policy on the utilization pattern of hospital outpatient …

The Effect Of Transcutaneous Electric Nerve Stimulation On Local Skin Temperature, Chien-Ting Liu, Pei-Ying Chao, Shin-Liang Pan, Chein-Wei Chang, Yen-Ho Wang

Rehabilitation Practice and Science

Previous reports have shown that transcutaneous electric nerve stimulation (TENS) can accelerate the rate of chronic wound healing, but the mechanism for such is unknown. It has been proposed that TENS may enhance healing by increasing cutaneous blood flow. In the present study, we investigated the effects of TENS on local skin temperature. Infrared thermography was used to measure the changes of local skin temperature after treatment with TENS. Twelve subjects, 6 men and 6 women, were enrolled and underwent the following four different TENS modes in random sequences: (1) sham stimulation (control), (2) perception threshold TENS, (3) below motor …

Analysis Of Speech Motor Control In Children With Normal Development: Preliminary Report, Liang-Yi Yang, Chai-Ling Chen, Wei-Hsien Hong, Hsieh-Ching Chen, Ching-Yi Wu, Alice M.K. Wong

Rehabilitation Practice and Science

Speech is a complex motor skill. It requires the coordination of articulatory and phonation systems, including the chest wall, larynx and oral system, to produce precise oral motor control. Treatment of motor speech dysfunction is based on understanding the mechanism underlying normal speech development and motor control. The purpose of this study is to establish speech motor control patterns in children with normal development (ND) by kinematic analysis.Twenty-eight children with ND (16 males and 12 females) aged 4 to 12 years participated in this study. The children were split into three groups based on age: group A aged 4 to …

Metastatic Tumor In The Atlantoaxial Spine: A Casereport, Hsin-Chi Wu, Chieh-Tsai Chiu, Pu-Sheng Yeh, Yi-Shiung Horng

Rehabilitation Practice and Science

Atlantoaxial involvement is rare in metastatic tumors of the spine. We report a case of atlantoaxial metastatic adenocarcinoma of pulmonary origin, which was treated as cervical spondylosis because the first clinical manifestations were cervical pain followed by limitation of rotation. In the literature, most authors stated that in patients with cervical spine metastases but without neurological signs, pain may be the only complaint. Most metastasized tumors of the atlantoaxial spine originate in the lung or breast. The goal of treatment for these cases is palliative. Posterior fixation is indicated for patients having intractable pain or whose cervical spine is unstable. …

Constraint-Induced Movement Therapy For A Child With Hemiplegic Cerebral Palsy: A Casereport, Wen-Chi Wu, Yee-Hwa Wu, Hsueh-Feng Chang, Chih-Wei Huang, Jen-Wen Hung

Rehabilitation Practice and Science

Non-use of the affected hand is a common symptom of children with hemiplegic cerebral palsy (CP). This report describes the effects of constraint-induced movement therapy in a child with hemiplegic CP, focusing on function and use frequency of the affected hand. Additionally, possible harmful affect on the non-affected hand is also assessed. This study concerns a five-year-old male, with right hemiplegic CP, who received constraint-induced movement therapy for 8 weeks. Throughout the therapy period, the boy wore a splint for at least 8 hours per day to limit movement to the non-affected hand. Functional changes of the affected hand were …

Follow-Up And Treatment Of Neurogenic Bladder Dysfunction With Compromised Upper Urinary Tract: A Casereport, Su-Ju Tsai, Yu-Hui Huang, Yu-Pei Chien, Fan-Fei Tseng

Rehabilitation Practice and Science

In spinal cod injury (SCI) patients with neurogenic bladder dysfunction (NBD), detrusor hyperreflexia and poor bladder compliance may lead to increased intravesical pressure and other adversities, including urinary tract infection, hydronephrosis, vesicoureteral reflux, and impairment of renal function. The primary objectives of urologic care after SCI are to provide an acceptable method for managing the lower urinary tract, to prevent urinary complications, and to preserve renal function. Because urologic status can change or deteriorate many years after the initial injury, sometimes without symptoms, lifelong urologic follow-up is fundamental for all SCI patients with NBD. Strategy of bladder management in individuals …