Medicine and Health Sciences Commons^™

Improving The Assessment And Treatment Of People With Low Back Pain, Kayla Krueger

WUSM Theses and Dissertations – All Programs

Low back pain (LBP) is a significant and continually growing public health problem. While some people recover from an initial episode, a proportion will develop chronic or recurrent LBP that limits their ability to perform daily functional activities. The variable and often function-limiting course of LBP underscores the clear need for improved methods of assessment and treatment. One way to improve the assessment and treatment of LBP is to develop a more comprehensive understanding of factors that contribute to LBP. In this dissertation, we investigated two categories of factors that may contribute to a person’s LBP: (1) spinal movement impairments …

Multiple Interest Holder Perspectives Of The True Grit Sci Residential Program: A Mixed Methods Program Evaluation, Keara Mcnair

Seton Hall University Dissertations and Theses (ETDs)

Young adults with spinal cord injury (SCI) face significant challenges during the transition to adulthood, including barriers to independence, community participation, and psychosocial adjustment (Ingimarsdóttir et al., 2023; Zebracki et al., 2010). Current rehabilitation models in the United States prioritize short-term physical recovery and offer limited support for the developmental and contextual needs that shape long-term outcomes after SCI, particularly during transitions from inpatient rehabilitation to the community (Anderson et al., 2024; Bryden & Gran, 2024). Community-based programs may help address these gaps, though few have been rigorously evaluated using implementation science frameworks that attend to health equity, contextual influences, …

Feasibility Of A Functional Reach Tool For Individuals With Lower Extremity Amputations, Neil Bongolan, Dustin Hoy, Ashlyn Strange

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: Patients with lower extremity amputations are at increased risk of falls due to decreased balance ability between amputated and sound side. The purpose of this study was to examine the usefulness of a reaching tool for practitioners to assess balance in an inpatient rehab facility. It was anticipated that clinicians will find the reaching device useful when administering the Functional Reach Test (FRT) in a clinical setting, given the frequent use of these assessments and the device’s demonstrated reliability.

Participants: Physical Therapists and patients at an Inpatient Rehab Facility in Henderson, Nevada

Materials/Methods: A prototype reaching tool was provided …

Developing A Health Education Program For Adults Reentering The Community After Incarceration, Tiffany Ayame Kinugawa-Larsen

UNLV Theses, Dissertations, Professional Papers, and Capstones

Justice-impacted adults often experience challenges in confidently managing their health due to limited autonomy, disrupted health routines, and limited access to health education during incarceration. Studies have shown that incarcerated adults have a higher likelihood of developing chronic health issues, yet have limited access to resources that promote health and well-being after release from incarceration. Given that health management falls within the scope of occupational therapy (OT), the profession is positioned to promote health and well-being by applying OT principles that emphasize individualized, holistic care tailored to a justice-impacted population during community reintegration. A 5-week health education program grounded in …

Psychological Impact Of Nexus Program On Persons Living With Mild Dementia, Kaleigh Gailynn Quinlan

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: Dementia is a global health concern due to the rapidly growing aging population (WHO, 2023). A wealth of evidence exists to support the notion that lifestyle interventions not only slow cognitive decline but improve cognition (Ngandu et al., 2015; Rosenberg et al.., 2018; Meng et al., 2022). However, there is a distinct lack of qualitative evidence examining the experience of being in a lifestyle redesign program. Lifestyle interventions require a large overhaul of an individual’s habits and performance patterns, and as such, there must be a subjective experience attached. Methodology: Through convenience sampling of the residents participating in the …

Application Of Occupational Therapy Task-Oriented For Chronic Post-Stroke Rehabilitation: A Case Study, Gia Nghi Vu

UNLV Theses, Dissertations, Professional Papers, and Capstones

Stroke remains the leading cause of long-term disability, with persistent upper extremity (UE) impairment limiting engagement in daily tasks, reducing quality of life and contributing to learned non-use in the chronic stage among stroke survivors. The Occupational Therapy Task Oriented (OTTO) approach is proposed to optimize occupational performance through the use of meaningful, functional and highly individualized tasks that enable clients to fulfill their valued roles and participate in desired daily activities. The purpose of this capstone project was to advance clinical skills by applying the OTTO approach to examine its effect on occupational performance and UE motor function in …

Supporting Staff Social-Emotional Learning Through An After-School Program, Alexis Monique Molina

UNLV Theses, Dissertations, Professional Papers, and Capstones

This doctoral capstone project aimed to develop and implement an occupational therapy- informed social-emotional learning (SEL) training program for after-school staff at the Hollywood Recreation Center in Las Vegas, Nevada. The project addressed a critical gap in the skills and competence of staff needed to manage emotional and behavioral challenges in community-based youth programs. Guided by the Person-Environment-Occupation (PEO) model, adult learning theory, and the Collaborative for Academic, Social, and Emotional Learning (CASEL) framework, the fourteen-week program incorporated weekly lessons to enhance self-awareness, emotional regulation, and relational competence among staff. Through interactive lessons, reflection promotion, and feedback surveys, participants engaged …

Identifying Well-Being Factors For At-Risk Young Adult Women: A Scoping Review, Carolina A. Quinonez

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose

This scoping review has systematically explored and mapped the range of literature that pertains to the influences of well-being for at-risk young adult women, to inform occupational therapy practice, guide future research, and enhance the knowledge of holistic well-being.

Methodology

Four online databases, including Google Scholar, were searched to identify publications, in the past 20 years, on relevant data for at-risk women and their well-being levels. Data was tracked using a PRISMA-ScR diagram with guidance from JBI protocol.

Results

There were 39 studies that met all the inclusion criteria. The studies were categorized into the types of well-being and …

Exploring The Biological Basis For Exercise Neuroprotection In Parkinson’S Disease: A Cross-Sectional Study Of Exercise And Physical Activity On Inflammatory Cytokines And Neurotrophins, Leah Isabelle P. Alegre, Jacob M. Brewer, Adeline Florschutz, Kate E. Hamiltonthompson

UNLV Theses, Dissertations, Professional Papers, and Capstones

Regular exercise and physical therapy are known to increase production of neurotrophins, including brain-derived neurotrophic factor (BDNF), and anti-inflammatory cytokines. These changes combine to theoretically protect and slow the progressive loss of neurons in Parkinson’s disease (PD). The purpose of this study was to examine the effect of exercise and physical activity on various anti-inflammatory and pro-inflammatory cytokines and neurotrophins in people with PD (PwP). This was a cross-sectional design involving PwP (n=37), aged 43-85 years, who participated in two 30-minute bouts of exercise (with brief rest breaks during and pre/post blood draws) separated by a week. Measures collected prior …

Effect Of An Exercise Protocol On Balance In Adults With Down Syndrome, Juan Bernal, Natalie Sato

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis: Down syndrome (Ds) is a complex genetic condition that can impact multiple systems of the body, including functional balance. Ds-specific impairments such as muscle hypotonia, ligamentous laxity, and decreased muscle strength, coupled with a sedentary lifestyle can result in poor motor control, altered proprioceptive function, static and dynamic instability. Visual and vestibular impairments are also common in this population, increasing fall risk and fear of falling, and discouraging participation in physical activity. The aim of this study is to analyze the impact of a physical therapy-based exercise program on the functional balance of adults with Ds.

Number of Subjects: …

Uneven Terrain Treadmill Training For Lower Limb Prosthesis Users: A Feasibility Study, Brian Diep, Keegan Feroah, Ani Gasparyan, Nevena Jovanovic

UNLV Theses, Dissertations, Professional Papers, and Capstones

Individuals with lower limb amputation (LLA) face an increased risk for falls which may limit mobility, confidence, and participation in daily activities. Current rehabilitation programs for this population rarely integrate surface training as an intervention, despite walking on different surfaces being a necessity to participate in the real world. This feasibility study aimed to evaluate the practicality, acceptability, and preliminary efficacy of an uneven treadmill training protocol for individuals with LLA. Five adults with LLA (P1: transfemoral, 38 years old, 1.75 m, 88.8 kg; P2: hip disarticulation, 38 years old, 1.60 m, 106.7 kg; P3: transfemoral, 53 years old, 1.81 …

Assessing The Reliability And Minimal Detectable Change Of Frontal Plane Projection Angles During Functional Tasks In Individuals With Patellofemoral Pain, Isabella Keefer, Derrick Smith, Brendan Yawn

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis: Single-limb dynamic weight-bearing tasks are frequently used to evaluate lower extremity and trunk movement patterns in individuals with patellofemoral pain (PFP). These individuals frequently exhibit abnormal frontal plane projection angles (FPPAs) at the trunk, pelvis, and lower extremities, indicative of altered movement patterns such as knee valgus, pelvic drop, and lateral trunk lean. While test-retest reliability and minimal detectable change (MDC) values for various FPPAs have been established in pain-free individuals, comprehensive data for individuals with PFP remain limited. Therefore, the purpose of this study was to evaluate test-retest reliability, as well as the standard error of measurement (SEM) …

Enhancing Psychosocial Well-Being And Quality Of Life In Parkinson’S Disease: Integrating Patient Experiences And Physical Therapists’ Expertise, Adetayo Adeoti Babarinde

UNLV Theses, Dissertations, Professional Papers, and Capstones

Parkinson’s disease (PD) is characterized by a wide range of non-motor symptoms that often affect the quality of life of persons with Parkinson’s disease (PwPD) even more profoundly than the motor symptoms typically associated with the condition. These non-motor symptoms include olfactory and gastrointestinal dysfunction, cognitive impairments, sleep disturbances, and psychological and social concerns. Psychosocial concerns include the mental, emotional, and social impact of PD on an individual’s functioning and, overall well-being. They reflect the interplay between symptoms of the disease, psychological development and functioning, personal relationships, and environmental factors. Mental health and psychosocial concerns such as depression, anxiety, fear …

Enhancing Accessibility And Inclusivity In The Performing Arts With Occupational Therapy Frameworks, Carmela Clarice Tabora Clave

UNLV Theses, Dissertations, Professional Papers, and Capstones

In live theater performances, there are numerous sensory demands, including unpredictable noises, lighting, crowd movement, vocalization, and transitions in and out of the theater. Teachers, support staff, and chaperones who attend these performances may face barriers in supporting their children in unfamiliar environments, and community volunteers who have never assisted during these shows may not know how to support children who need it if they have not had prior exposure to children with diverse needs. This capstone project provides families, teachers, and volunteers with pre-visit resource guides with occupational therapy perspectives on sensory processing for student matinees and sensory-inclusive performances …

Feasibility Of High-Intensity Training (Hit) For Academic Engagement In Young Adult Women, Raleah Tenorio Kastner

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: This feasibility study aimed to identify the impact of a high-intensity training (HIT) exercise protocol on healthy behaviors related to academics to decrease stress levels and enhance academic engagement and overall quality of life in young adult female students, measured by a modified version of the National Survey of Student Engagement (NSSE) and the Occupational Experience Profile (OEP).

Methodology: One young adult female student enrolled at UNLV who is 18-25 years old was recruited via convenience sampling to engage in a 12-session HIT exercise program, developed by a certified personal trainer and licensed occupational therapist, with the participant’s target …

Postural And Load Dependent Modulation Of Lower Limb H-Reflex Excitability After Stroke, Daniel Bamiro, Matthew Berdiago, Ethan Hunter, Tia Nguyen

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis

Leg stiffness is regulated by reflexive, intrinsic, and passive mechanisms, which are influenced by posture, body weight loading, and motor task demands. After a stroke, the capacity to modulate these mechanisms is often compromised. The H-reflex is a widely used electrophysiological tool to assess the excitability of the Ia afferent pathway within spinal circuitry. Although prior studies in healthy individuals have examined limb loading effects, results have been variable, and the role of postural and loading changes during standing remains underexplored, particularly in individuals post-stroke. This study investigated how different postural and limb loading conditions, specifically prone, standing, and …

Integrating Social-Emotional Learning To Foster Regulation And A Positive Classroom Climate, Klarika Meghan V. Alquisada

UNLV Theses, Dissertations, Professional Papers, and Capstones

Social-emotional learning (SEL) supports the development of emotional regulation, interpersonal skills, and meaningful participation in academic environments. Increasing regulatory demands within classrooms highlight the need for structured approaches that support both educators and students in maintaining engagement and fostering positive learning environments. Occupational therapy (OT) practitioners are uniquely positioned to collaborate with educators to integrate regulation-focused strategies within daily classroom routines.This quality improvement project aimed to develop and implement an OT-informed SEL program for educators serving students with diverse learning needs. Teachers received consultation and tailored SEL strategies, implemented them for 5 weeks, and provided feedback on their effects on …

Enhancing Independence: A Home Environmental Safety Program For Stroke Survivors, Ka'iulani-Joy Genevieve Conlu

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Stroke is a common cause of physical limitations, leading to decreased independence and participation in daily activities. Individuals post-stroke transitioning from inpatient to outpatient care typically do not receive in-person home safety recommendations to decrease environmental challenges and improve overall well-being. Methods: Participants were recruited conveniently during the inpatient and outpatient care process at Post Acute Medical (PAM) Health Rehabilitation Hospital of Henderson. The Home Falls and Accidents Screening Tool (HOME FAST) was administered to identify environmental hazards and to guide individualized home safety recommendations. Participants will complete a questionnaire before and after the program within 14 weeks to …

Postpartum Depression Protocols In A Neonatal Intensive Care Unit: Benefits And Outcomes, Myrnnda Miller

UNLV Theses, Dissertations, Professional Papers, and Capstones

This capstone project aimed to reduce postpartum depression symptoms in mothers with infants admitted to the University Medical Center (UMC) of Southern Nevada’s neonatal intensive care unit (NICU) by integrating early screening with occupation-based, trauma-informed support. The intervention combined the Edinburgh Postnatal Depression Scale (EPDS) for early detection with occupational therapy–facilitated maternal support sessions, providing emotional validation, education, and strategies for coping and parent–infant bonding. Guided by Trauma-Informed Care and Backwards Design frameworks, the project prioritized maternal safety, empowerment, and confidence. A paired sample t-test was conducted to compare pre and posttest EPDS scores and showed that the participant’s EPDS …

Sense Of Belonging And Professional Identity In Acute Care Occupational Therapists: A Phenomenological Study, Shania Marion D. Novilla

UNLV Theses, Dissertations, Professional Papers, and Capstones

Occupational therapy practitioners (OTPs) play a crucial and demanding role in acute care, addressing complex diagnoses and facilitating safe discharge; however, the fast-paced biomedical environment often pressures them to compromise their occupation-based philosophy, potentially leading to professional burnout and low retention rates. Although professional identity (the self-perception of one's role) and a sense of belonging (feeling valued and connected) are recognized as correlated concepts vital for professional resilience, this relationship remains critically underexplored within the acute care OT population. Guided by the Occupational Adaptation Model (Schkade & Schultz, 1992), this qualitative study explores how experienced occupational therapists working in an …

Expanding Neurological Interventions: An Aquatic-Based Occupational Therapy Toolkit For Inpatient Rehabilitation, Kate Jannelle Rye

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: The objective of this project was to develop an evidence-informed aquatic therapy toolkit aimed at improving occupational therapy practitioners’ self-efficacy in planning aquatic interventions for individuals with neurological injuries.

Methods: This project utilized a quality improvement approach, involving the development of a toolkit, an in-service educational training, and a hands-on skills session. Practitioner self-efficacy was measured using a modified General Self-Efficacy Scale, which was administered before and after the educational training and hands-on skills session. Guided reflections and feedback from occupational therapy practitioners were also utilized to evaluate self-efficacy and the applicability of the toolkit.

Outcomes: Participation in the …

Mid- To Long-Term Recovery After Non-Traumatic Lower Limb Amputation: A Scoping Review Of Longitudinal Research Studies, Chloe Akiona-Bannan, Jocelyn Contreras, Kayla Cheyenne Bonsol Francisco, Kentaro Lee

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective

Longitudinal research studies are essential for understanding the time course of functional recovery after lower limb amputation (LLA). The purpose of this scoping review was to evaluate the existing evidence base regarding mid- to long-term outcomes following non-traumatic LLA.

Data Sources

A scoping review was conducted per Joanna Briggs Institute and Open Sciences Framework guidelines. Based on purpose, seven databases (PubMed, CINAHL, Embase, Scopus, Web of Science, SportDiscus, and Google Scholar) were searched for studies published between 2000–2024, in English, Mandarin Chinese, Tagalog, Persian, or Spanish.

Study Selection

Eligible studies must include at least 50% of participants with non-traumatic …

Anatomy Academy: An Interdisciplinary Approach To Enhancing Youth Health Literacy, Roselle Antikoll, Jonathan Nakamine, Jessica Tran

UNLV Theses, Dissertations, Professional Papers, and Capstones

To enhance health literacy among the underserved youth population in Las Vegas, Nevada, Anatomy Academy (AA) is an eight-week, seven-lesson program that educates students through structured and interactive lesson plans covering basic anatomy, physiology, and nutrition. Our program was implemented in three different Title-I elementary schools between five different classrooms across Las Vegas. These lesson plans highlighted specific body systems including the cardiovascular, musculoskeletal, and gastrointestinal systems. Our primary aim was centered around involvement of more interdisciplinary healthcare professions including occupational therapy, dental medicine, osteopathic medicine, and nutrition to aid in the delivery of the AA program. Our secondary aim …

Golden Steps: A Dance-Based Program To Improve Balance In Older Adults — A Feasibility And Acceptability Study, Ramyr Bognot, Sophia Botelho, Nolan Caberto, Lauren Valerio, Joshua Yu, Jason Zeidman

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background

Falls are a leading cause of injury and loss of independence among older adults. Evidence-based programs such as Otago and Tai Ji Quan reduce fall risk, yet barriers to access and adherence remain. Dance-based interventions may offer a practical, enjoyable approach to engage older adults in balance training.

Purpose

This formative pilot study aimed to develop four dance routines grounded in evidence- based balance principles and evaluate their feasibility and acceptability among older adults, including factors influencing enjoyment and willingness to continue participation, to inform future clinical and community implementation.

Methods

Four routines (Polka, Country, Rockabilly, Salsa) were developed …

Unlv Pt Admissions: The Relationship Between Mismatched Gender Or Race Of Applicants Compared To Interviewer On In-Person And Asynchronous Interview Scores, Sarah Dudley, Calvin Kwok

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis:

Despite a growing push for diversity in healthcare, the impact of interviewer-applicant demographic alignment on scoring remains under-researched within the specific context of physical therapy admissions, particularly across different interview platforms. A sex or race concordance bias has the potential to compromise a program’s reliability of applicant evaluations and conflicts with the ethical standards of equity and nondiscrimination that guide healthcare education and practice. In this study we aimed to determine the relationship between sex and race concordance of interviewers and applicants for both in-person and asynchronous virtual interview scores at the University of Las Vegas Physical Therapy (UNLV …

College Of Fine Arts Outreach And Health Promotion For Injury Prevention: A Service Learning Project, Andrea Bejaran-Choto, Emily Horner, Marlene Quirarte, Shaye Robles, Dora Segura, Duc Tu, Trevor Williams

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction: This community-based academic initiative targeted a significant deficiency regarding rehabilitative care and wellness assets for Southern Nevada's fine arts practitioners. Despite possessing trauma frequency rates similar to those of collegiate-level athletes, this demographic lacks sufficient infrastructure for health support. The endeavor sought to bolster the University of Nevada, Las Vegas College of Fine Arts (CFA) and the regional performance art sector utilizing the UNLV College of Fine Arts Physical Therapy Clinic (CFA-PTC).

Description: The initiative focused on three essential objectives: (1) augmenting student consciousness and utilization of therapeutic care at the CFA-PTC, (2) broadening health-related guidance for the artistic …

Effects Of A 12-Week Physical Therapy-Based Exercise Intervention On Gait In Adults With Down Syndrome, Samantha Betts, Stephen Kiraly, Paige Lucero, James Malabanan

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Individuals with Down Syndrome (Ds) frequently have sedentary lifestyles and Ds-specific physical impairments such as ligamentous laxity and hypotonia. These impairments often contribute to gait deviations that reduce the efficiency of ambulation. Purpose: The purpose of this study was to examine the effects of a 12-week exercise program on spatiotemporal characteristics of gait and kinematic variables at the hip, knee, and ankle in adults with Down syndrome (Ds). Methods: A randomized control trial of 40 participants was conducted with two groups: one group of adults with Ds who participated in a 12-week exercise program, and a control group who …

Effectiveness Of Cognitive Stimulation Therapy On The Quality Of Life Of Adults With Dementia: A Secondary Analysis, Evelyn Airam

UNLV Theses, Dissertations, Professional Papers, and Capstones

This secondary analysis study evaluated the effectiveness of Cognitive Stimulation Therapy (CST) on quality of life (QoL), depressive symptoms, and cognitive function in 108 community-dwelling older adults with cognitive impairments, including dementia. Outcomes involved Quality of Life (QoL) measured by the Quality of Life in Alzheimer’s Disease (QoL-AD), symptoms of depression by the Cornell Scale for Depression in Dementia (CSDD), and cognitive function using the Saint Louis University Mental Status (SLUMS). After the CST, significant improvements were observed in QoL (p = .004), depressive symptoms (p = .002), and cognitive function (p < .001), with small effect sizes. Additionally, a significant interaction between sex and dementia diagnosis status was found in predicting cognitive changes, suggesting that the relationship between dementia diagnosis and cognitive improvement differs by sex. No between-group differences were found for QoL or depression. Findings support CST as a multidimensional, non-pharmacological intervention that improves cognitive, psychological, and social outcomes. Although effects were small, consistent improvements are clinically meaningful given the progressive nature of dementia. This study extends existing literature by demonstrating CST’s effectiveness in a community-based setting and reinforces its alignment with occupational therapy’s emphasis on participation and holistic care. Results highlight the need for early intervention and expanded access to CST programs to enhance quality of life in this population.

Fostering Adolescents’ Social-Emotional Skills In A Community Setting, Elizabeth Benitez

UNLV Theses, Dissertations, Professional Papers, and Capstones

Adolescents face growing emotional, behavioral, and social challenges, especially in community recreation settings with high energy, peer interaction, and sensory demands. These environments often expose difficulties in emotional regulation, communication, and conflict management, highlighting the need for structured social-emotional learning (SEL). This capstone project aimed to develop and implement an occupation-centered SEL program integrating the Zones of Regulation (ZOR), CASEL competencies, and Developmental, Individual Differences, Relationship-Based (DIR) Floortime principles within the Clark County Hollywood Parks and Recreation after-school program. Guided by the Person–Environment–Occupation (PEO) model, the project sought to help adolescents practice emotional awareness, self-management, and interpersonal skills in their …

Got Sleep?: The Introduction Of Sleep Hygiene To Justice Involved Individuals, Charisma Lynn Cato

UNLV Theses, Dissertations, Professional Papers, and Capstones

Individuals transitioning out of incarceration often experience challenges with sleep due to the residual effects of confinement. Although this is common among justice-involved individuals, there is limited research on how to address their sleep hygiene self-efficacy after release. Furthermore, despite the wide use of social-emotional learning (SEL) across multiple disciplines, little is known about its influence on sleep-related behavior change in re-entry populations. To address this, the Got Sleep program, designed and implemented at Hope for Prisoners (HOPE), a community site geared toward re-entry assistance, integrated occupational therapy (OT) principles and an SEL approach with practical sleep hygiene strategies to …