Medicine and Health Sciences Commons^™

Addressing Challenges Related To Community Reintegration Following A Traumatic Brain Injury, Alexia Rose Gallagher

Occupational Therapy Capstones

Title: Addressing Challenges Related to Community Reintegration Following a Traumatic Brain Injury

Introduction: The purpose of this scholarly project was to create a guide of resources and tools available in and around Bismarck, North Dakota that individuals after a traumatic brain injury (TBI) can utilize to assist in their successful return to their community. The Rancho Los Amigos Scale was utilized to effectively guide which resources and supports were needed based on the functional level the individual is currently presenting at. The Person Environment Occupational (PEO) Model theoretical framework was utilized to guide the creation and implementation of this community …

Promoting Adherence To Lymphedema Manageemnt: A Resource Guide For Ot Practitioners In Interprofessional Teams, Marissa Louise Dreiling

Occupational Therapy Capstones

The chronic condition of lymphedema continues to be poorly recognized and managed by healthcare providers due to limited knowledge and education, which poses barriers for patients trying to manage from a personal, occupational, and environmental standpoint. The barriers experienced by patients include complex and time-consuming management approaches with little attention towards health literacy causing poor self-efficacy, lost independence in occupations, increased distress and frustration, isolation, and withdrawal (Boyages et al., 2016; Keast, Despatis, Allen, & Brassard, 2015; Ostby, Armer, Smith, & Stewart, 2018). The purpose of this product is to provide occupational therapy practitioners with educational strategies and materials to …

Video Game Rehabilitation For Outpatient Stroke (Vigorous): A Multi-Site Randomized Controlled Trial Of In-Home, Self-Managed, Upper-Extremity Therapy., Lynne V Gauthier, Deborah S Nichols-Larsen, Gitendra Uswatte, Nancy Strahl, Marie Simeo, Rachel Proffitt, Kristina Kelly, Roger Crawfis, Edward Taub, David Morris, Linda Pax Lowes, Victor Mark, Alexandra Borstad

Neuroscience Articles

BACKGROUND: Integrating behavioral intervention into motor rehabilitation is essential for improving paretic arm use in daily life. Demands on therapist time limit adoption of behavioral programs like Constraint-Induced Movement (CI) therapy, however. Self-managed motor practice could free therapist time for behavioral intervention, but there remains insufficient evidence of efficacy for a self-management approach.

METHODS: This completed, parallel, five-site, pragmatic, single-blind trial established the comparative effectiveness of using in-home gaming self-management as a vehicle to redirect valuable therapist time towards behavioral intervention. Community-dwelling adults with post-stroke (>6 months) mild/moderate upper extremity hemiparesis were randomized to receive one of 4 different …

Telehealth Delivery Of Acceptance And Commitment Therapy And Recreational Therapy: Supporting People With Chronic Pain During The Covid-19 Pandemic, Grace L. Roy

Honors Theses and Capstones

Chronic pain is a significant public health problem that requires person-centered and comprehensive care to address the many socioecological factors that contribute to pain. Within the context of the COVID-19 pandemic, telehealth options for chronic pain management can help more people access the care that they need. The purpose of the current pilot study was to investigate the efficacy and feasibility of delivering a 6-week Acceptance and Commitment Therapy (ACT) and recreational therapy intervention via telehealth for a group of seven participants with chronic pain. It was found that TeleACT-RT was associated with positive behavioral outcomes including increased psychological flexibility, …

Is S-Adenosylmethionine (Same) An Effective Drug To Help Treat Patients With Depression?, Cassidy M. Flanigan

PCOM Physician Assistant Studies Student Scholarship

 Objective: The objective of the selective EBM review is to determine whether or not “Is Sadenosylmethionine (SAMe) an Effective Drug to Help Treat Patients with Depression?”

Study Design: A systematic review of three randomized controlled trials (RCTs) published between 2016-2020.

Data Sources: All three RCTs were discovered using PubMed. The articles were published in English in peer-reviewed journals and selected based on applicability to the clinical question.

Outcome Measured: A reduction in depressive symptoms was the outcome measured in all three studies using the Montgomery-Asbery Depression Rating Scale (MADRS). The mean change in baseline was calculated once intervention was received. …

Is Botulinum Toxin Effective At Reducing Sensory Symptoms In The Hands Of Patients With Raynaud’S Phenomenon?, Maria C. Dicioccio

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this systematic review is to determine, “Is Botulinum Toxin Effective at Reducing Sensory Symptoms in the Hands of Patients with Raynaud’s Phenomenon?”

Study Design: A systematic review of two randomized controlled trials (RCTs) and one prospective case series published between 2017 and 2019.

Data Sources: The articles were discovered using PubMed or Academic Search Premier. The articles were published in English in peer-reviewed journals and selected based on pertinence to the clinical question.

Outcome Measured: A reduction in sensory symptoms was the outcome measured in all three studies using the VAS pain score (0-10/100) or McCabe …

Does Hippotherapy Improve Gross Motor Function In Children With Cerebral Palsy?, Victoria I. Bockius

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not “Does hippotherapy improve gross motor function in children with cerebral palsy?”.

STUDY DESIGN: A systematic review of three randomized controlled trials (RCTs), with one being a randomized crossover trial. All three were published between 2015 and 2018.

DATA SOURCES: Three RCTs published in peer-reviewed journals were chosen from PubMed. The studies were selected based on their relevance to the clinical question.

OUTCOMES MEASURED: The outcome measured was improvement in gross motor function. Either hip adductor spasticity using Modified Ashworth Scale (MAS) or the Gross Motor Function …

Meaningful Work And Remote Employee Engagement During The Covid-19 Pandemic, Monique Foster

Walden Dissertations and Doctoral Studies

The COVID-19 pandemic accelerated the remote working trend, causing workplace leaders to be challenged and remote employees to feel meaninglessness and lose interest in their work. The subjective nature of meaningful work and enforced remote work is a relatively recent socioeconomic phenomenon, creating a gap in the literature regarding how middle managers foster meaningful work for employees in a remote work environment. The purpose of this qualitative narrative inquiry study was to understand how middle managers fostered meaningful work for employees in a remote work environment during the COVID-19 pandemic. Data were collected from semistructured interviews with 10 middle managers …

Mindfulness And Pain Regulation: The Role Of Acceptance And Commitment Therapy For Individuals With Chronic Pain, Ariana C. White

Honors Theses and Capstones

Chronic pain is a significant and widely prevalent health condition which requires comprehensive care to address the many facets contributing to symptomatology. In 2016, 20% of American adults (about 50 million) reported experiencing chronic pain, of which 7.4% indicated that chronic pain frequently limited their life and participation in activities within the past 3 months (CDC, 2018). As a result, many individuals with chronic pain turn to opioid-based medication for pain relief, but long-term use of opioids actually increases pain sensation (Tobin, 2019). Moreover, opioid medication is unable to target underlying mental health components which emerge as part of chronic …

Self-Care: An Occupational Therapy Student Perspective, Isabelle Laposha, Stacy Smallfield

Journal of Occupational Therapy Education

Health professional students, including occupational therapy students, report increasing rates of stress, anxiety, depression, and burnout while completing their academic programs of study. Self-care is one potential solution to this crisis, as engagement in evidence-based self-care practices has been found to improve the health and well-being of various student populations; however, the self-care practices of occupational therapy students have not been well studied. Therefore, this study explored how occupational therapy students understand and practice self-care, and how self-care correlates to perceived stress. Twenty participants engaged in a focus group and completed a 72-hour time diary. Focus group results indicated that …

Impact Of An Interprofessional Student-Led Concussion Clinic, Anne W. Hunt, Kathryn Parker, Nick Reed

Journal of Occupational Therapy Education

This article describes the impact on the learners and health care institution of the OnTRACK-Concussion program, an innovative student-led clinic at a children’s rehabilitation hospital. The clinic, developed and operated by occupational therapists, serves the community full-time year-round. Interprofessional health care learners work together to provide education and intervention for youth with concussion and their families and to support research and community outreach initiatives. To determine the program’s impact on student learning, a post-placement questionnaire was used to capture feedback about their clinical education experience. To determine the program impact more broadly, the most significant change method was used to …

Cross-Cultural Adaptation And Psychometric Evaluation Of The Myanmar Version Of Oswestry Disability Questionnaire And Roland-Morris Disability Questionnaire For Individuals With Low Back Pain, Phyu Sin Oo

Chulalongkorn University Theses and Dissertations (Chula ETD)

This study aimed to develop cross-culturally adapted Myanmar versions of the Oswestry Disability Questionnaire (M-ODQ) and Roland-Morris Disability Questionnaire (M-RMDQ), and determine their psychometric properties in individuals with low back pain (LBP). In accordance with the previous guidelines, the original ODQ and RMDQ were translated and cross-culturally adapted into a Myanmar language. The psychometric evaluation of the adapted M-ODQ and M-RMDQ were conducted on 102 individuals with LBP for assessing reliability, validity, and responsiveness. Reliability was assessed using the intraclass correlation coefficient (ICC 2,1) while concurrent and construct validity were examined using the Spearman rank correlation coefficient and correlations with …

Neurophysiological And Psychological Characteristics Of Individuals With History Of Lateral Ankle Sprain, Katherine Bain

Theses and Dissertations--Rehabilitation Sciences

Lateral ankle sprain (LAS) is among the most common lower limb musculoskeletal injuries impacting both the general and sport populations. Even more problematic is that approximately 70% of individuals who sustain an LAS develop residual deficits. Of that subgroup, roughly 40% develop chronic ankle instability (CAI). Chronic ankle instability is a clinical diagnosis defined by the presence of ongoing impairments following the initial LAS which may include perceived instability, pain, mechanical instability, and episodes of giving way during physical activity. Not all who sustain multiple ankle sprains or experience residual deficits fit the clinical diagnosis criteria for CAI; yet may …

Content Validation Of A Patient-Reported Outcome Measure For Pediatric Clients With Hand And Upper Extremity Impairment, Jenny M. Dorich

Theses and Dissertations--Rehabilitation Sciences

Occupational therapists and physical therapists practicing in hand therapy have adopted routine use of patient reported outcome measures (PROMs) for evaluating treatment outcomes. However, the PROMs currently used in pediatric hand care are limited in clinical utility for the pediatric population. Thus, a need exists for developing a PROM that is tailored to the pediatric hand therapy population. The overarching purpose of this dissertation is to establish the content validity of a novel PROM for children with hand and upper extremity impairment – the Upper Extremity Life Impact Measure-Youth (UE LIM-Y).

This three-part dissertation applies published standards for PROM development …

The Experience Of Meditation, And Its Effects On Attention, For Adults With Stroke Or Attention Deficit Hyperactivity Disorder: A Three-Part Dissertation With Qualitative And Quantitative Evidence, Cheryl Carrico

Theses and Dissertations--Rehabilitation Sciences

Impairment of attention is common after stroke; is a defining characteristic of attention deficit hyperactivity disorder (ADHD); and has been shown to correlate significantly with difficulties in daily life for individuals with these conditions. More research is needed to establish effective interventions addressing impaired attention in such cases. Meditation is not a standard-of-care intervention for this purpose but may have therapeutic potential. Meditation has been broadly defined as an activity which has self-regulation of attention as its main aim. In other words, it can be considered a training of attention. To shed light on the therapeutic potential of meditation, including …

Increasing Social Inclusion For Children With Disabilities In Faith-Based Settings: A Four-Part Dissertation, Valerie Miller

Theses and Dissertations--Rehabilitation Sciences

The aim of this dissertation is to increase the body of research in occupational therapy about how to increase the social inclusion of children with disabilities in faith-based settings. Even since the advent of important legislation like the Americans with Disabilities Act, which paved the way for community participation for individuals with disabilities, individuals with disabilities continue to face barriers to participating in society. Decreased inclusion for individuals with disabilities is seen throughout all sectors of society. One area of regular societal participation for many Americans is in faith-based settings such as churches, synagogues and temples. It has been reported …

Programming To Help At-Risk Youth Find Success In And Outside Of The Classroom, Nora Carlson

Occupational Therapy Capstones

Title: Senior Portfolios: A guide to Help Students Plan for the Transition to Adulthood Nora Carlson, OTDS, Dr. Andrea Young, OTD, OTR/L, Faculty Advisor, Department of Occupational Therapy, University of North Dakota School of Medicine Health Sciences, 501 North Columbia Rd, Grand Forks, ND 58202

Purpose: The purpose of the project was to assist at-risk students attending an alternative learning center (ALC) with secondary transition planning into adulthood to promote a successful first year out of high school. Planning is essential to ensure a smooth transition (Mankey, 2011). This project also aimed to showcase occupational therapy’s role in transition services, …

Care For The Caregiver: A Rural Perspective, Michaela Claire Gerving

Occupational Therapy Capstones

Title: Care for the Caregiver: A Rural Perspective

Background: Informal caregivers in rural communities have multiple challenges. First, they have limited access to caregiving training yet are expected to perform tasks at skilled levels (Morelli, Barello, Mayan, & Graffigna, 2019). Second, they have limited access to supportive services, such as respite, which keeps them on-call 24 hours a day (Pfankuch, 2018). Finally, this continual status of caregiving around the clock encroaches on their own engagement in personal health management (Hewitt & McNiesh, 2019).

Purpose: The product of this scholarly project is an interprofessional (IP) telehealth wellness program for informal caregivers …

Safety, Feasibility And Initial Efficacy Of An App-Facilitated Telerehabilitation (After) Programme For Covid-19 Survivors: A Pilot Randomised Study, Jacob J. Capin, Sarah Jolley, Mary Morrow, Meghan Connors, Kristine Hare, Samantha Mawhinney, Amy Nordon-Craft, Michelle R. Rauzi, Sheryl Flynn, Jennifer Stevens-Lapsley, Kristine M. Erlandson

Physical Therapy Faculty Research and Publications

Objectives Determine the safety, feasibility and initial efficacy of a multicomponent telerehabilitation programme for COVID-19 survivors.

Design Pilot randomised feasibility study.

Setting In-home telerehabilitation.

Participants 44 participants (21 female, mean age 52 years) discharged home following hospitalisation with COVID-19 (with and without intensive care unit (ICU) stay).

Interventions Participants were block randomised 2:1 to receive 12 individual biobehaviourally informed, app-facilitated, multicomponent telerehabilitation sessions with a licenced physical therapist (n=29) or to a control group (n=15) consisting of education on exercise and COVID-19 recovery trajectory, physical activity and vitals monitoring, and weekly check-ins with study staff. Interventions were 100% remote and …

Size-Weight Illusion With A Squatting Task (Poster), Amanda Laron, Maryssa Becker, Mason Flores, Mikaela Raudsepp, Nicole Seidl, Robin Dorociak, Andrew Meszaros

Faculty Publications - College of Physical Therapy

Hypothesis:

The SWI will be observed during a squat movement, resulting in initially a larger GRF through the lower extremity on the side of the larger cube and more vertical displacement of the side of the bar with the large cube.

The bilateral GRF and bar displacement will become symmetrical after 10 repetitions.

Participants will initially predict the larger cube is heavier and after completing the squatting task will perceive the smaller cube as heavier.

Improving Interpretation Of The Patient-Reported Outcomes Measurement Information System (Promis) Physical Function Scale For Specific Tasks In Community-Dwelling Older Adults, Jeff Houck, Ryan Jacobson, Michael Bass, Chris Dasilva, Judith F. Baumhauer

Faculty Publications - College of Physical Therapy

Background and purpose: New generic patient-reported outcomes like the Patient-Reported Outcomes Measurement Information System (PROMIS) are available to physical therapists to assess physical function. However, the interpretation of the PROMIS Physical Function (PF) T-score is abstract because it references the United States average and not specific tasks. The purposes of this study were to (1) determine convergent validity of the PROMIS PF scale with physical performance tests; (2) compare predicted performance test values to normative data; and (3) identify sets of PROMIS PF items similar to performance tests that also scale in increasing difficulty and align with normative data.

Methods: …

Trust In Human-Robot Interaction Within Healthcare Services: A Review Study, Dedra Townsend, Amirhossein Majidirad

Mechanical & Aerospace Engineering Faculty Publications

There has always been a dilemma of the extent to which human can rely on machines in different activities of daily living. Ranging from riding on a self-driving car to having an iRobot vacuum clean the living room. However, when it comes to healthcare settings where robots are intended to work next to human, making decision gets difficult because repercussions may jeopardize people’s life. That has led scientists and engineers to take one step back and think out of the box. Having concept of trust under scrutiny, this study helps deciphering complex human-robot interaction (HRI) attributes. Screening essential constituents of …

The Effect Of Concussion History On Lower Extremity Injury Risk In College Athletes: A Systematic Review And Meta Analysis, Vanessa Ramirez, Ryan Mccann, Eric Schussler, Jessica Martinez

Rehabilitation Sciences Faculty Publications

INTRODUCTION: Collegiate athletes who suffer a concussion may possess prolonged impairments even after clearance for return-to-participation, which may place them at an increased risk of lower extremity injury.

OBJECTIVE: To conduct a systematic review and meta-analysis of studies examining risk of lower extremity musculoskeletal injury following a concussion in collegiate athletes.

METHODS: A literature search was performed using the following databases: PubMed, CINAHL, SPORTDiscus. The following search terms were used to identify relevant articles, ["concussion" OR "brain injury" OR "mild traumatic brain injury" OR "mTBI"] AND ["lower extremity injury" OR "musculoskeletal injury"]. Articles were included if they were published between …

Characteristics Of Athletic Training Students' Patient Encounters During Immersive And Nonimmersive Clinical Experiences: A Report From The Association For Athletic Training Education Research Network, Bailey C. Jones, Julie M. Cavallario, Cailee E. Welch Bacon, Stacy E. Walker, R. Curtis Bay, Bonnie L. Van Lunen

Rehabilitation Sciences Faculty Publications

Context: The 2020 Standards for the Accreditation of Professional Athletic Training Programs from the Commission on Accreditation of Athletic Training Education require programs to include at least one immersive clinical experience (ICE) in their clinical education curricula. Yet, it is unknown whether ICEs provide more opportunities and benefits than nonimmersive clinical experiences (N-ICEs). The purpose of this study was to compare characteristics of patient encounters (PEs) that occurred during ICEs and N-ICEs.

Design: Multisite panel design.

Setting: Twelve professional programs (5 undergraduate, 7 graduate).

Patients or Other Participants: Three hundred thirty-eight athletic training students logged PEs in the E*Value system. …

Barring Methadone Behind Bars: How Prisons Err When Denying Methadone Treatment To Inmates With Opioid Use Disorder, Julia Durst

Mitchell Hamline Law Review

No abstract provided.

Etiology Of Firefighter Injuries: A Health Care Practitioner Perspective, Alyssa Quinn Eastman

Theses and Dissertations--Kinesiology and Health Promotion

BACKGROUND: Structural firefighting involves the performance of rigorous occupational tasks in unpredictable, dynamic, and hot environments which increases firefighters’ risk of injury. Specifically, the National Fire Protection Association reported that musculoskeletal injuries account for 56% of non-fireground and 41% of fireground injuries. Furthermore, physical training is the most common cause of injury, accounting for one-third of all injuries and resulting in 41% of post-injury absences from work. There is limited research identifying occupational and exercise injury risk factors among firefighters. However, experienced health care practitioners working with fire departments may provide critical insight into potential mechanisms of these common injuries. …

Evaluating The Microbiome To Boost Recovery From Stroke: The Embrs Study, Tyler Hammond

Theses and Dissertations--Neuroscience

Accumulating evidence suggests that gut microbes modulate brain plasticity via the bidirectional gut-brain axis and may play a role in stroke rehabilitation. A severely imbalanced microbial community has been shown to occur following stroke, causing a systemic flood of neuro- and immunomodulatory substances due to increased gut permeability and decreased gut motility. Here we measure post-stroke increased gut dysbiosis and how it correlates with gut permeability and subsequent cognitive impairment.

We recruited 12 participants with acute stroke, 12 healthy control participants, and 18 participants who had risk factors for stroke, but had not had a stroke. We measured the gut …

Development Of A National Pain Management Competency Profile To Guide Entry-Level Physiotherapy Education In Canada, Nathan Augeard, Geoff Bostick, Jordan Miller, David Walton, Yannick Tousignant-Laflamme, Anne Hudon, André Bussières, Lynn Cooper, Nicol Mcniven, Aliki Thomas, Lesley Singer, Scott M. Fishman, Marie K. Hoeger Bement, Julia M. Hush, Kathleen A. Sluka, Judy Watt-Watson, Lisa C. Carlesso, Sinead Dufour, Roland Fletcher, Katherine Harman, Judith Hunter, Suzy Ngomo, Neil Pearson, Kadija Perreault, Barbara Shay, Peter Stilwell, Susan Tupper, Timothy H. Wideman

Physical Therapy Faculty Research and Publications

Background

National strategies from North America call for substantive improvements in entry-level pain management education to help reduce the burden of chronic pain. Past work has generated a valuable set of interprofessional pain management competencies to guide the education of future health professionals. However, there has been very limited work that has explored the development of such competencies for individual professions in different regions. Developing profession-specific competencies tailored to the local context is a necessary first step to integrate them within local regulatory systems. Our group is working toward this goal within the context of entry-level physiotherapy (PT) programs across …

Occupation, Dissociation, And Queer Identity, Katie Christopherson

Occupational Therapy Capstones

Queer youth and young adults are more likely to experience trauma and are at a higher risk of developing mental health conditions and experiencing dissociation that negatively impacts occupational engagement (Keating & Muller, 2020; Tankersley et al., 2021). This disparity is attributed to environmental factors, such as discrimination (Keating & Muller, 2020). The goal of this project is to advocate for queer youth and young adults through educational resources. The resources were designed for an audience of healthcare professionals who work with queer youth in mental health settings in order to have a broader impact on the target population. The …

Protecting Against Pain And Stress In The Nicu: An Evidence-Based Eye Examination Guideline, Heather Jo Bowman

Occupational Therapy Capstones

Purpose: The purpose of this project was to create an evidence-based Neonatal Intensive Care Unit (NICU) eye examination guideline and associated resources that supported use of non-pharmacological interventions and emphasized the importance of parent education and involvement from both an interdisciplinary and occupational therapy perspective.

Literature Review: Although medically necessary, researchers and practitioners in the NICU interdisciplinary field have discussed pain and stress associated with preterm infant eye examinations (American Academy of Pediatrics [AAP], 2016; Fierson, 2018; Francis, 2016; Pollaci et al., 2020; Samra & McGrath, 2009). Pain and stress likely impact sensory and overall brain development (AAP, 2016; Brummelte …