Medicine and Health Sciences Commons^™

Promoting Participation In Individuals With Parkinson’S Disease Through The Development Of Accessible Occupation-Based Resources, Kelly Struthers

OTD Capstone Projects

This doctoral capstone project was completed through partnership with Rock Steady Boxing Music City, a non-profit organization that provides boxing classes for individuals diagnosed with Parkinson’s disease and other motor-related disorders. The purpose of this project was to understand the participatory barriers that are common within the Parkinson’s disease community and develop solution-oriented resources in response to these barriers. All developed resources were intentionally created to maximize accessibility and explored areas such as driving, fatigue, caregiving, and memory. These resources were compiled and distributed to the “fighters” of Rock Steady Boxing via an in-person “OT Corner” bulletin board, the weekly …

Movement As Medicine: Dance/Movement Therapy For Individuals With Autism, Parkinson’S Disease, And Cancer, Alessia Zanobini

CMC Senior Theses

Dance/movement therapy (D/MT) is the psychotherapeutic use of expressive, creative movement to support holistic well-being. D/MT views the human being as a single body-mind unit and movement as a manifestation of life experiences. While typically practiced as a mental health intervention, D/MT can be adapted for a variety of populations. This thesis evaluates scientific data for the non-traditional use of D/MT for three conditions: autism, Parkinson’s disease, and cancer. For individuals on the autism spectrum, D/MT can strengthen attunement skills, provide creative communication outlets, and relieve harmful physical manifestations of autism. For individuals with Parkinson’s disease, D/MT can simultaneously ease …

A Systematic Literature Review On The Capability Of Sio₂-Np’S Exposure To Exacerbate Parkinson’S (Pd) Pathology And The Risk Factors For Biomedical Applications In Pd, Seth Abdallah

Capstone Experience

Silica Dioxide nanoparticles (SiO₂-NP) have become increasingly ubiquitous in industry, which has stimulated research into the potential toxicity of these compounds. Recent studies have explored the association between amorphous silica nanoparticle exposure and the potential for neurotoxicity. Additionally, research has been conducted in the application of SiO₂-NP’s in theranostics and as drug directing agents , which based on current literature may be contraindicated for individuals with conditions such as Parkinson's Disease (PD) which is characterized by neuroinflammation. The following literature review will discuss evidence for silica dioxide nanoparticle exposure to induce neurotoxicity which may exacerbate neurodegenerative diseases such as PD. …

Self-Feeding Interventions For Adults With Tremors, Kd Bradley, Kristine Miller, Samantha Patterson, Madelyn Siemer

Occupational Therapy Evidence Projects

This research analysis was completed in collaboration with Carol Schramek, OTR/L, who works at a skilled nursing facility (SNF) in Iowa run by ABCM corporations. A systematic review of literature was conducted to explore the research question: "What evidence-based interventions have been shown to be effective for reducing tremors, improving occupational performance, and/or increasing client satisfaction during self-feeding in adults with resting and/or action tremors?" After initial review of 73 articles based on title, 33 articles met our inclusion criteria and were included in our critical appraisal of our topic (CAT). We found there to be a lack of research …

Factors Predicting Fear Of Falling Avoidance Behavior In Parkinsonisms, Kameron Eckard, Franjo Vukojevic, Ryan Hammar

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Fear of falling avoidance behavior (FFAB) is common in parkinsonisms and results in potentially mitigable downstream consequences.

Objective: Determine the characteristics of individuals with parkinsonisms most associated with FFAB.

Methods: A retrospective, cross-sectional study was conducted from medical records data of 142 patients with parkinsonisms. These data included: demographics (age, sex), disease characteristics (Movement Disorders Society – Unified Parkinson’s Disease Rating Scale Part III (MDS-UPDRS III), years since diagnosis), fall history (number of fall injuries in previous year), and gait and balance function (five times sit to stand, MiniBESTest, Timed Up and Go (TUG), dual-task TUG, ten-meter walk test …

The Impact Of Volume Of Tissue Activation On Cortical-Striatal Networks And Verbal Fluency Declines In Post-Deep Brain Stimulation Parkinson's Disease Patients., Alexander Luke Alley

Electronic Theses and Dissertations

This study investigated the cortical-striatal networks of verbal fluency declines in 6-month, post-operative, deep brain stimulation Parkinson’s Disease patients. Nine Parkinson’s disease participants with implanted STN or GPi DBS systems were recruited for this study. Verbal fluency data was obtained from each patient preoperatively and 6- months post implantation. The stimulation-based volume of tissue activated area (VTA) of each target site (STN or GPi) was analyzed using Lead-DBS and Lead-Group. The white matter tracks intersecting each patient’s VTA, terminating in the pre-SMA, SMA, caudate nucleus, and anterior cingulate were investigated and correlated with verbal fluency declines. We found statistically significant …

A Comparison Of Voice Amplifiers And Personal Communication Systems In Individuals With Hypophonia: An Exploration Of Communicative Participation, Jessi-Rae A. Schroeder

Electronic Thesis and Dissertation Repository

Hypophonia is one of the most prevalent speech impairments in hypokinetic dysarthria. Unfortunately, behavioral interventions for hypophonia often fail to generalize beyond the clinic. An alternative approach to management is the use of speech amplification devices. This study evaluated how 17 individuals with hypophonia (HP) and their primary communication partners (PCPs) rated communicative participation across three, one-week device trial periods at home. Amplification devices included: a wired belt pack amplifier, wireless stationary amplifier, and personal FM system. Patient-reported outcome measures included the CES, VAPP and PIADS. Results indicated HPs rated participation higher following device use in comparison no device. Further, …

Exploring The Effects Of Spinal Cord Stimulation For Freezing Of Gait In Parkinsonian Patients, Olivia Samotus

Electronic Thesis and Dissertation Repository

Dopaminergic replacement therapies (e.g. levodopa) provide limited to no response for axial motor symptoms including gait dysfunction and freezing of gait (FOG) in Parkinson’s disease (PD) and Richardson’s syndrome progressive supranuclear palsy (PSP-RS) patients. Dopaminergic-resistant FOG may be a sensorimotor processing issue that does not involve basal ganglia (nigrostriatal) impairment. Recent studies suggest that spinal cord stimulation (SCS) has positive yet variable effects for dopaminergic-resistant gait and FOG in parkinsonian patients. Further studies investigating the mechanism of SCS, optimal stimulation parameters, and longevity of effects for alleviating FOG are warranted. The hypothesis of the research described in this thesis is …

Current And Novel Neuroregenerative Therapies, Arrin Brooks

Theses, Dissertations and Capstones

Underlying the physical and cognitive deficits consequent of many neuropathologies is one common factor, the loss of neurons. While neurodegenerative diseases, stroke, and traumatic brain injury arise from a variety of etiologies, they all ultimately result in injury and/or death of neuronal cells and concomitant functional deficits. In the present work we primarily focus on current and potential treatments for localized lesions, particularly those in the striatum of Parkinson’s disease (PD) or the cortex as in stroke. First, we discuss a new surgical technique for deep brain stimulator (DBS) placement, as DBS is a mainstay treatment for movement disorders including …

Is Extended-Release Amantadine Effective At Treating Levodopa- Induced Dyskinesia In Parkinson’S Disease Patients?, Maegan M. Mendoza

PCOM Physician Assistant Studies Student Scholarship

Objective: "The objective of this selective EBM review is to determine "Is extended-release amantadine efficacious in treating levodopa-induced dyskinesia in Parkinson's disease patients?”

Study Design: A systematic review of three randomized controlled trials (RCT's) that were peer-reviewed and published in English after 2010.

Data Sources: All data sources were discovered in PubMed, NLM Catalog, EMBASE, and CINAHL. All articles were published in English in peer-reviewed journals and selected based on applicability to the clinical question and whether the outcomes were patient-oriented.

Outcome Measured: The primary outcome measure was a change from baseline in the Unified Dyskinesia Rating Scale total scores …

Effect Of Levodopa On Eeg Connectivity In Parkinson's Patients, Sepehr Torab Parhiz

Electronic Thesis and Dissertation Repository

Levodopa is a dopamine replacement medication administered to patients with Parkinson’s disease (PD) to alleviate their motor symptoms. However, its long-term use can cause adverse side effects, including involuntary motor movements. We studied 16 PD patients before and after taking Levodopa based on resting-state electroencephalography (EEG) recordings to determine how Levodopa affects the functional connectivity of their brain networks. We used several metrics from graph theory, in particular the minimum spanning tree (MST) metric, and analyzed how they change after subjects take Levodopa. We observed significant changes in the lower alpha band toward a more path-like and less globally efficient …

Real Time Neurochemical Analysis Of The Brain For Pharmacological Treatments In Mood Disorders And Neurodegeneration, Anna Marie Buchanan

Theses and Dissertations

The monoamine, serotonin, is an important modulator in the central nervous system. It is believed to participate in a variety of functions ranging from moderating stress, promoting brain plasticity, and regulating sleep and appetite. Dysfunction of the serotonergic system has also been implicated in mood disorders and neurodegenerative diseases. While serotonin is of great interest to the research community, real-time in vivo serotonin dynamics remain understudied. This is because direct measurement of fast serotonergic transmission is analytically challenging. In 2009, the Hashemi lab pioneered the direct measurement of endogenously evoked serotonin using a method called fast scan cyclic voltammetry (FSCV). …

Autophagy Regulation By Lipid Factors With Implications For Parkinson's Disease, Alejandro Soto-Avellaneda

Boise State University Theses and Dissertations

Parkinson’s disease is the second most common neurodegenerative disorder. It is characterized by the death of dopaminergic neurons in the substantia nigra and a series of debilitating motor symptoms. Macroautophagy (hereafter referred to as autophagy) is a cellular process by which cells degrade proteins, lipids, organelles or dysfunctional components. Autophagy is thought to play an important role in Parkinson’s disease, because it is the only cellular process known to remove large protein aggregates, such as those seen in Parkinson’s disease pathology. Historically, a large body of work has focused on reporting on protein effectors of autophagy, and regulation of autophagy …

Development Of A Novel Cognitive-Motor Dual Task Assessment Battery In Neurodegenerative Disease, Jason Longhurst

UNLV Theses, Dissertations, Professional Papers, and Capstones

Automaticity --- the ability to perform a task with directing attentional resources to its completion --- is commonly reduced among individuals with neurodegenerative diseases. These automaticity deficits result in impaired functional and daily activities and are sensitive to subtle, subclinical impairments. However, current measurement of automaticity by dual task paradigms is methodologically limited. In order to gain insight into the current state of the literature regarding cognitive-motor interference in symptomatic and prodromal neurodegenerative disease, the author of this dissertation conducted a scoping review (Chapter 1). To address the methodological limitations of current measurement of automaticity, a new measurement tool was …

Doctoral Capstone Experience With A Neurological Population, Courtney E. Groce

Department of Occupational Therapy Entry-Level Capstone Projects

Through the completion of a doctoral capstone experience, an entry-level occupational therapy doctoral student is able to further develop advanced skills. The doctoral capstone experience is during the student’s last semester in the program and is 16 weeks long. The doctoral capstone experience consists of both a culminating project and the experience itself. The capstone project is “comprised of a literature review, needs assessment, goals/objectives, and an evaluation plan based on specific focus areas” (ACOTE, 2020). The Nova Southeastern University Entry-Level Doctor of Occupational Therapy Doctoral Capstone Manual states that “the goal of the doctoral capstone project and experience is …

Cooper Neurological Institute, Kayla Cupano

Department of Occupational Therapy Entry-Level Capstone Projects

No abstract provided.

Perceptions Of Caregivers Of Parkinson's Patients Regarding Using Advance Directives, Meghan Morgan

Walden Dissertations and Doctoral Studies

The increasing focus on end-of-life (EOL) care is influencing the role of advance directive (AD) documents. Difficult conversations among family caregivers and their loved ones are becoming more and more critical. Considering the value of communicating EOL wishes, family caregivers’ perceptions about ADs for their loved ones with Parkinson’s disease (PD) must be examined. Using the theory of planned behavior (TPB) as a foundation, the purpose of this generic qualitative study was to understand family caregivers of PD patients and their perceptions and experiences relating to AD documents. This study involved using purposeful sampling and semi-structured interviews with 11 family …

Sleep And Health-Related Quality Of Life Among Persons With Parkinson’S Disease And Their Caregiverssleep And Health-Related Quality Of Life Among Persons With Parkinson’S Disease And Their Caregivers, Sushmitha Inguva

Electronic Theses and Dissertations

This dissertation aimed at filling gaps in the body of Parkinson’s disease (PD) and sleep literature by synthesizing and appraising current knowledge on the influence of sleep on health-related quality of life (HRQoL) in persons with Parkinson’s (PWP) and their caregivers, conducting a psychometric evaluation of a HRQoL instrument among PWP, and applying a novel method to assess the dyadic relationship between sleep and HRQoL in PWP and their caregivers. First, the systematic literature review results showed that nocturnal and diurnal sleep problems among PWP are strong predictors of their HRQoL. Additionally, studies that focused on caregiver outcomes showed that …

Plasma Proteins That May Cause Parkinson’S Disease And Multiple Sclerosis: A Mendelian Randomization Study, Brigid A. Staley

Dissertations and Theses

Multiple sclerosis (MS) and Parkinson’s disease (PD) are progressively disabling neurologic disorders that profoundly affect quality of life and shorten life expectancy. There is no cure for either disease, and current treatments only alleviate symptoms and may cause serious side effects. The causes of MS and PD are not well understood. Previous epidemiologic studies have documented numerous environmental risk factors for both diseases. However, these studies are inherently prone to bias from confounding which may generate spurious results. The lack of unbiased evidence on environmental causes of MS and PD has been a critical barrier to fully understanding their pathophysiology. …

Perceived Impact Of Non-Contact Boxing On Daily Life And Occupational Participation At Home Among Individuals With Parkinson's Disease, Kristen E. Bignal

Student Capstone Papers

The aim of this project was to determine whether individuals with Parkinson's disease perceive an impact on their daily life and occupational participation at home secondary to participation in non-contact boxing.

Semi-structured open-ended interview questions were conducted with 17 participants (3 female) who have been diagnosed with Parkinson's disease for(i.e., self-care, home and health maintenance, sleep, intimacy, social and leisure interests, etc.) in the home environment. Interviews were transcribed and analyzed utilizing thematic analysis.

Data analysis derived three overarching themes including psychological benefits, sense of community, and framework to develop routines. Subsequent research exploring how non-contact boxing directly impacts specific …

Acoustic Changes During Passage Reading In Speakers With Parkinson's Disease, Kimberly C. Grubbs

LSU Master's Theses

Purpose: The purpose of this study was to evaluate speech changes in Parkinson’s disease (PD) while reading a passage, using both local (i.e., segment level) and global (i.e., utterance level) acoustic measures.

Methods: 20 speakers participated in the study (10 PD, 10 neurologically healthy controls). The speakers were asked to read The Caterpillar passage in a conversational mode. A total of five acoustic measures were included (local: vowel duration, Euclidean distance between corner vowels and schwa; global: articulation rate, F0/intensity range). These acoustic measures were compared between two sentences located in the two positions within the paragraph, initial and final. …

T Cells In Synucleinopathies, Gregory Paul Williams

All ETDs from UAB

Synucleinopathies, which include Parkinson disease (PD), dementia with Lewy Bodies (DLB), and multiple system atrophy (MSA), are a collection of neurodegenerative diseases that are in major part defined by the presence of alpha-synuclein (α-syn) rich protein aggregates in the brain. Increasing evidence has highlighted a neuroinflammatory phenotype also associated with these synucleinopathies. This neuroinflammatory phenotype includes the activation of central nervous system (CNS) microglia, increased pro-inflammatory cytokines, and the infiltration of peripheral T cells into the CNS. We sought to further explore the T cell responses associated with PD and MSA. Using two preclinical mouse models of PD and MSA, …

Pharmacodynamic Responses And Efficacies Associated With Lrrk2 Inhibition, Kaela Kelly

All ETDs from UAB

Parkinson’s disease (PD) is an age-related, progressive, movement disorder pathologically characterized by the loss of dopaminergic neurons in the substantia nigra pars compacta (SNpc) and the presence of proteinaceous aggregates, termed Lewy bodies, that are largely comprised of αSynuclein (αSyn). Missense mutations in the leucine-rich repeat kinase (LRRK2) gene are the most common genetic cause of PD and lead to gain-of-function increases in kinase activity. The G2019S-LRRK2 mutation is the most frequent mutation and elevates kinase activity by ~2-3 fold. Genetic and biochemical evidence suggest elevated LRRK2 kinase activity plays a pathogenic role in the development of PD, implicating LRRK2 …

Investigation Of Visual Perceptions In Parkinson's Disease And The Development Of Disease Monitoring Software, Matthew Bernardinis

Electronic Thesis and Dissertation Repository

Non-motor Parkinson’s Disease (PD) symptoms are substantial factors of PD arising throughout disease stages, yet their diagnosis and monitoring remain a challenge. Sensory abnormalities in PD occur across sensory systems and disease stages, contributing to disease-related impairments. However, the extent of symptoms is unknown, with inadequate monitoring and treatment options furthering disease management difficulties. The current work studies movement-independent visual perceptions of time, displacement and velocity in PD patients across disease stages using levodopa, deep brain stimulation (DBS), or no PD therapy. Perceptual tasks were conducted using a computer-generated graphical device designed with a focus on simplicity and flexibility. Perception …

Effects Of A Unilateral Injection Of Botulinum Neurotoxin Subtype-A In The Subthalamic Nucleus Of A Parkinsonian Rat Model, Olga Khazov

Electronic Thesis and Dissertation Repository

Dopaminergic degeneration in Parkinson’s disease (PD) leads to altered functional activity within the basal ganglia (BG) circuitry, including hyperactivity of the subthalamic nucleus (STN). Treatments restoring the BG functional circuitry often result in improvements in parkinsonian symptoms in patients and animal models. A recent study from our laboratory identified that infusing botulinum toxin (BoNT-A) into the internal globus pallidus provided a transient restoration of motor asymmetry and goal-directed locomotion in a rat model of PD. We hypothesized that infusions of BoNT-A into the STN in a parkinsonian rat model will improve motor asymmetry and locomotor abnormalities. Infusions of BoNT-A into …

Differentiating The Substantia Nigra And Ventral Tegmental Area In Early-Stage Parkinson's Disease Using Iron Imaging, Erind Alushaj

Electronic Thesis and Dissertation Repository

Excessive midbrain iron accumulation in Parkinson’s Disease (PD) contributes to degeneration of the substantia nigra pars compacta (SNc) and ventral tegmental area (VTA). Despite this understanding, there are no validated PD biomarkers. Magnetic resonance imaging (MRI) can localize and quantify brain iron for diagnosis of PD. Seventeen early-stage PD patients and twenty-one controls were scanned at 3T and 7T MRI. Using quantitative susceptibility mapping (QSM) and R2* relaxometry, we analyzed the average iron content in the SNc, substantia nigra pars reticulata (SNr), and VTA. QSM detected significantly higher SNc iron content in PD patients compared to controls at both …

Optimizing Gait Outcomes In Parkinson's Disease With Auditory Cues: The Effects Of Synchronization, Groove, And Beat Perception Ability, Emily A. Ready

Electronic Thesis and Dissertation Repository

This dissertation explores a common, rehabilitative strategy for mitigating gait impairments in Parkinson’s disease (PD) called Rhythmic Auditory Stimulation (RAS). The effects of this intervention on gait in PD are well documented but highly variable, which poses difficulty for appropriate therapeutic application. Part of this variability may be related to individual musical abilities, such as beat perception accuracy, as most RAS interventions involve synchronizing with a beat. However, music is complex and variable. Therefore, factors inherent in the music itself may play a role in these differences, such as how much the music makes you want to move (groove), or …

End Of Life Costs In Medicare Beneficiaries With Parkinson’S Disease, Sasikiran Nunna

Electronic Theses and Dissertations

Parkinson's disease (PD) is a chronic and progressive neurodegenerative disorder which is characterized by motor and non-motor disorders. The prevalence of PD is high among elderly patients. Due to the chronic nature of PD, increasing prevalence and ageing population, it is important to understand the burden of PD at various stages of patient’s life so that value of PD therapies can be assessed. While direct healthcare costs during the life time of PD were assessed in previous studies, there is lack of information about end of life costs in PD patients. This dissertation aimed at filling the gap in literature …

Investigating The Practical And Clinical Effectiveness Of Applying Current Steering To Deep Brain Stimulation For Parkinsonian Gait Therapy, Daphne Hui

Electronic Thesis and Dissertation Repository

Multiple neural network integration, influence of bradykinesia and rigidity, and bias of upper limb symptom improvement during deep brain stimulation implementation may attribute to the variable responsiveness of Parkinsonian gait therapy. Current steering (CS) addresses variability through fractionating current to fine-tune the stimulation field shape. It was hypothesized that CS would exhibit greater gait improvements and lower the total electrical energy delivered (TEED), which reduces power consumption and battery drainage. Divisions of 70/30 and 50/50 and single-contact stimulation modelled CS and conventions, respectively. Overall ambulation improved with TEED reduction; further, bilateral CS improved step time and length but left CS …

The Effect Of Patterned Sensory Enhancement On Balance And Ambulation In Persons Diagnosed With Parkinson’S Disease, Brittany Barko

Masters Theses

One rehabilitation protocol effective in delaying the symptoms of Parkinson’s Disease (PD) is Lee Silverman Voice Training BIG (LSVT BIG), comprising pre-gait exercises and gait training. This study seeks to determine if combining Patterned Sensory Enhancement (PSE), a music therapy intervention, with LSVT BIG will improve quality of movement. During physical therapy sessions with three participants, a music therapist adapted the PSE stimuli to support each patient’s motor needs, which were then recorded on CD and sent with patients to exercise with at home. Results showed improved balance and ambulation comparing pre- and post- measures of the BERG balance scale …