Medicine and Health Sciences Commons^™

Rain Rhythms: Fall 2014 - Summer 2015, College Of Nursing & Professional Disciplines

RAIN Rhythms

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Adherence To Home Programs In Patients With Acute Orthopedic Injuries Of The Upper Extremity, Brien J. Buckentine, Justin L. Fredrickson

Occupational Therapy Capstones

The purpose of this project was to explore the relationship between occupational therapy home program of clients with acute upper extremity injuries, client factors, and performance patterns that are influential in clients’ adherence to their prescribed home programs. A secondary purpose was to develop an instrument intended to measure adherence in patients with an orthopedic injury of the upper extremity.

Using the Occupational Adaptation Model and Occupational Therapy Practice Framework Domain and Practice as guiding foundations, a thorough literature review of client home program adherence was completed. This led to the development of a prospective, online survey designed to capture …

Promoting Social Participation, Leisure And Community Integration For Adults With Developmental Disabilities: An Intervention Guide, Joelle Evenson, Rebekah Miesbauer

Occupational Therapy Capstones

Upon an initial review of literature, it was found that life expectancy of individuals with developmental disabilities has been increasing which is leading to a greater number of adults with developmental disabilities living in the community. Because these individuals are living longer, it puts an extended burden on caregivers and the adults with developmental disabilities are being placed in group homes. Adults with developmental disabilities have limited access to activities outside of group homes (Mansell, Elliott, Beadle-Brown, Ashman, & Macdonald, 2002; Abbott & McConkey, 2006). They are spending most of their time engaged in more passive activities and have little …

The Incidence And Influence Of Musculoskeletal And Nerve Injuries Among Occupational Therapists: An Exploratory Study, Alyssa A. Jenkins, Renae H. Witta

Occupational Therapy Capstones

Purpose: The purpose of this research study was to explore the incidence and influence of musculoskeletal and nerve injuries among occupational therapists. Specifically, we examined the influence of musculoskeletal and nerve injuries on work satisfaction, work performance and overall quality of life in occupational therapists practicing in physical rehabilitation settings.

Methodology: An exploratory survey research design was implemented following study approval from the University of North Dakota (UND) Institutional Review Board. Occupational therapists who were affiliated with the UND Occupational Therapy Program contract sites were invited, via email, to participate in this exploratory study. In addition, the survey was posted …

Interventions Used By Occupational Therapists And Allied Health Providers In Regards To Chronic Musculoskeletal Pain, Kara L. Maatz, Jared Q. Zimmerman

Occupational Therapy Capstones

Problem: Chronic musculoskeletal pain is the most widely known disability in the American health care system (National Institute of Health [NIH], 2010). Chronic pain affects how individuals are able to engage in meaningful activities of daily life. Unrelieved pain can potentially result in longer hospital visits, emotional distress, and increased re-admission rates to hospitals (The American Academy of Pain Medicine, 2012). A review of research in the American Occupational Therapy Association (AOTA) database revealed that few clinically useful references were available for practitioners regarding interventions used with chronic musculoskeletal pain (AOTA, 2014). As a result, it was determined that effective …

A Community Grant Application To Support People With Dementia And Their Caregivers, Jessica Montomery

Occupational Therapy Capstones

In upcoming years, the population of older adults with dementia is expected to rise exponentially, with the expectation that the majority of these individuals will choose to age in place with increased caregiver support (AARP, 2011; National Alliance for Caregiving, 2009; Vincent & Velkoff, 2010). Without adequate education to prepare for the caregiving role, education, instruction, and support, informal caregivers are at an increased risk for caregiving burden, stress, and mortality rates (Morimoto, Schreiner, & Asano, 2003; Schulz & Beach, 1999; Thinnes & Padilla, 2011). The goal for this scholarly project was to create a home and community-based program for …

Fostering Self-Identity In Adolescents Who Experience Spinal Cord Injuries, Lauren Schneibel, Terese Boeder

Occupational Therapy Capstones

The purpose of this scholarly project is to identify a need and to guide occupational therapists during the treatment of adolescents who have acquired a spinal cord injury. During the adolescence stage, an individual begins to develop a sense of self and sense of direction, as well as formulate values which all contribute to personal identity formation (Erickson, 1968). The manual will guide the occupational therapist to address identity formation through use of the chosen assessments and interventions. It is believed that focusing on aspects of identity formation as experienced in the midst of a traumatic spinal cord injury will …

Muscle Fiber Size And Composition Differences Between Ames Dwarf Mice And Wild-Type Mice, Jordan Anderson

Physical Therapy Scholarly Projects

Background: Ames dwarf mice demonstrate delayed aging processes in multiple body systems. We compared muscle composition and area between dwarf and wild-type mice to determine if any significant differences exist.

Methods: We resected soleus, gastrocnemius/plantaris, tibialis anterior, and extensor digitorum longus muscles from both dwarf and wild-type mice, then froze, sliced, set on slides, and stained to isolate fast-twitch and slow-twitch fibers. Microscopy images were taken at 10x magnification and fiber composition and cross-sectional area were measured in soleus muscles.

Results: Wild-type mice had an average composition of 52.3% fast-twitch and 47.7% slow-twitch fibers while dwarf mice had 66.3% slow-twitch …

Effectiveness Of Physical Therapy Intervention Following Partial Medial Meniscectomy: A Case Report, Alexa Risan

Physical Therapy Scholarly Projects

Background and Purpose. Partial meniscectomy is a very commonly performed surgical procedure and many cases are uncomplicated and successfully treated with home-based exercise programs. However, some patients experience more significant problems following surgery and require rehabilitation services. Research is limited regarding physical therapy (PT) effectiveness in the post-operative management of such complicated cases. This case report aims to evaluate the effectiveness of PT treatment of a 34-year-old male with significant impairments and functional limitations following partial medial meniscectomy.

Case Description. Examination and evaluation included ROM/flexibility and strength measurements as well as functional assessment. PT included therapeutic exercise which was aimed …

Sarcopenia And Current Research Using Ames Dwarf Mice: A Research Study, Amanda Sodemann

Physical Therapy Scholarly Projects

This research project focused on the differences observed in muscle fiber composition and surface area between wild type mice and Ames dwarf mice as they aged. A mouse model was utilized because the skeletal muscle framework of mice closely resembles that of human muscle; thus, the observations seen within the mice may also be seen within humans as they age. Comparisons between the wild type and dwarf mice include a smaller cross-sectional muscle area in a dwarf mouse and no drastic change in the percentages of fast and slow twitch muscle fibers as the dwarf mouse ages. Furthermore, differences in …

Reducing Recidivism For Youth Through An Integrated Residential And Community-Based Program, Alexandra Berdal, Megan Meyer, Nicolet Sadlowski

Occupational Therapy Capstones

Purpose: Reportedly, 95% of youth in the juvenile justice system have had prior involvement with the juvenile justice system, suggesting that intervention does not adequately address the needs of these youth (Sedlack & Bruce, 2010; OJJDP, 2003). The purpose of this project was to address the problem of recidivism with an emphasis on preparing for transition from residential placements to community engagement.

Methods: An extensive literature review was conducted in order to understand the occupational performance deficits that youth in the juvenile justice system face in transitioning to their community. The information obtained from the literature review was then analyzed …

Collaboration To Impact Occupation-Based Practice During Level Ii Fieldwork, Krista Coleman, Natalie Senger

Occupational Therapy Capstones

The purpose of the product was to develop a collaborative learning process between the fieldwork educator and the student to promote the use of occupation-based and client-centered practice during level II fieldwork experiences in adult physical rehabilitation settings. The literature review revealed many obstacles that constrain occupation-based and client-centered practice from being utilized by occupational therapists in the medical setting. The product uses the Model of Human Occupation (MOHO) as a catalyst to promote implementation of occupation-based practice throughout the fieldwork experience. A collaborative approach to learning using the social collectivism perspective is used. The product provides opportunity through participation …

A Pilot Study: Examining The Effectiveness Of Managing Fatigue Post-Stroke Via Telehealth, Nicole Gronhovd, Hannah Muehlberg

Occupational Therapy Capstones

There is currently a lack of research on the effectiveness of energy conservation techniques to treat the fatigue experienced by individuals following a stroke. Because of this, the purpose of this research study was to explore the effects of Managing Fatigue: A Six Week Course for Energy Conservation, developed by occupational therapists, Packer, Brink, and Sauriol (1995), on the level of fatigue individuals experience following a stroke. As telehealth is an emerging area in occupational therapy service delivery, the present study also aimed to determine the effectiveness of occupational therapy services delivered via teleconference.

A pilot study using a pretest-posttest …

Integration Of Sexuality Content Into An Occupational Therapy Curriculum, Brittany L. Larson, Sarah R. Stutz

Occupational Therapy Capstones

Sexuality is a broad term that can be used to encompass other terms such as sexual expression and sexual functioning, and can be defined as a holistic concept of the individual that is more than just physical sexual behavior but also relates to thoughts and feelings of everyday life (Couldrick, 1998a). Sexuality and sexual functioning are considered an activity of daily living (ADL) by the Occupational Therapy Practice Framework: Domain and Process (2008); however, it is a topic that is not being routinely addressed with clients by occupational therapists or other healthcare professionals (Hattjar, 2012). Studies show there is a …

A Study Examining The Effectiveness Of A Sensory-Based Feeding Group For Children With Problematic Eating Behaviors, Laura Notch, Brionna Simenson

Occupational Therapy Capstones

KEY WORDS: children, problematic eating behaviors, sensory, intervention

OBJECTIVE: The purpose of this pilot study was to analyze the process and outcomes of a routine sensory-based feeding group on a child’s problematic eating behaviors.

METHODS: An experimental pretest-posttest research design was used to gather and analyze quantitative and qualitative data on 4 children who demonstrated problematic eating behaviors. The children participated in a routine 8-week sensory-based feeding group, which utilized sensory activities to promote change. The Children’s Eating Behavior Inventory (CEBI) and the Feeding Intake Form (FIF) were completed through parental report prior to and upon completion of the intervention. …

Weighing The Risks And Benefits Of Radiation Exposure And Diagnostic X-Rays In Children, Leah Costello

Physician Assistant Scholarly Project Posters

The number of X-rays, specifically CT scans, performed on patients in the United States is increasing exponentially every year. Children are at most risk for long term damage from this increase in radiation exposure. This study explores how much risk children are being exposed to and how we can, as practitioners, make informed decisions about when or when not to order CT scans. The purpose of this paper is to provide practitioners the information needed to help patients decide if the long-term risks of cancer from medical radiation outweigh the potential benefit of diagnostic or therapeutic radiation. The review of …

Continuous Subglottic Suctioning Of Intubated Patients In The Icu, Dan Deutsch

Physician Assistant Scholarly Project Posters

Ventilator associated pneumonia (VAP) is a common complication in mechanically ventilated patients. It causes substantial morbidity and mortality, as well as substantial cost to the patients and healthcare systems. One of the major risk factors identified for risk of VAP is the aspiration of secretions from the oropharynx. One intervention aimed at decreasing the incidence of secretion aspiration is an endotracheal tube (ETT) that can be hooked up to suction, providing continuous subglottic suctioning. The purpose of this paper was to explore the use of continuous subglottic suctioning and its effects on the incidence of ventilator-associated pneumonia. Review of literature …

Comparing Fecal Microbiota Transplant (Fmt) To Vancomycin: In Treatment Of Recurrent Clostridium Difficile Infections (Cdi), Christopher Seil

Physician Assistant Scholarly Project Posters

• Clostridium difficile infection (CDI) is the main cause of antibiotic-associated pseudomembranous colitis.

• CDI has tripled over the last ten years due to the increased use of broad spectrum antibiotics. CDI has become increasingly difficult to manage with traditional therapies such as metronidazole and vancomycin due to mutations in the pathogen, resulting in resistant organisms.

• The purpose of this review was to determine if fecal microbiota transplantation (FMT) is more effective in treating and curing CDIs than traditional vancomycin therapy.

• The hypothesis was that FMT will have better treatment outcomes than traditional vancomycin therapy.

• The findings …

Lyme Disease Outcomes With Immediate, Short Duration Antibiotic Use Versus Delayed, Longer Duration Use, Lori A. Steinley

Physician Assistant Scholarly Project Posters

Lyme disease is the fastest growing vector-borne disease in the United States, according to the Infectious Disease Society of America (IDSA). The guidelines for diagnosis provided by the IDSA include evidence of erythema migrans rash with validation of a positive two-tier serology testing. With no established treatment standards, decreased sensitivity of testing and inconsistency of observing the rash, practitioners following the guidelines may delay treatment of antibiotics. This delay could cause progression of severity of symptoms.

The purpose of this study is to compare implementation and duration time of antibiotics and establish the treatment protocol for best clinical outcomes for …

Acute Myocardial Infarction: Are We Overlooking Nstemi?, Kevin D. Swenson

Physician Assistant Scholarly Project Posters

• Acute myocardial infarction (AMI) is one of the leading causes of death in the United States.

• The purpose of this study was to examine methods of clinical differentiation between ST-segment elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI) and then to compare the various treatment methods and subsequent outcomes in STEMI versus NSTEMI.

• A compilation of systematic reviews, medical journals, practice guidelines, medical texts and meta-analyses were researched for the purpose of this study.

• NSTEMI patients are older, have more comorbidities and present with more atypical symptoms than STEMI patients.

• NSTEMI patients are treated less aggressively …

The Addition Of Tiotropium In Uncontrolled Asthma, Kathryn Gray

Physician Assistant Scholarly Project Posters

• Many patients with asthma have poorly controlled disease despite the use of both an inhaled corticosteroid (ICS) and a long acting beta agonist (LABA).

• The review explored several studies that compared the addition of tiotropium to patients with uncontrolled asthma currently using both a ICA and a LABA to determine if further symptom reduction is obtained along with reduction of exacerbations

• It was found that patients with poorly controlled asthma will benefit from the addition of tiotropium to the current medication regimen of an ICS and a LABA. Tiotropium offers providers an additional disease controlling option in …

Occupational Therapy Based Guide For Caregivers Of Individuals With Muscular Dystrophy, Chelsea Hesby, Macaila Pagel

Occupational Therapy Capstones

The purpose of this scholarly project was to develop a holistic guide that could be provided by occupational therapists (OTs) to caregivers of individuals with muscular dystrophy (MD). A comprehensive literature review was conducted on the impact that caregiving for individuals with MD has on quality of life, stress management and mental health. The review of literature also explored caregivers’ access to resources and common difficulties experienced. The literature revealed that there have been recent advances in medical fields which have led to an increased lifespan for individuals with MD to an average age of 27 years old (Eagle et …

Increased Incidence Of Asthma After Previous Infantile Rsv Bronchiolitis Infection, Ellen Adelia Doebler

Physician Assistant Scholarly Project Posters

• Respiratory Syncytial Virus (RSV) is a very common infection in children less than two years of age.

• Asthma is a common respiratory disease in childhood, which may cause frequent hospitalizations.

• The purpose of this study is to determine if infants previously diagnosed with RSV bronchiolitis have an increased incidence of asthma diagnosis compared to infants not diagnosed with RSV.

• The literature review examines correlation studies of both disease processes and explores incidence of asthma in patients previously diagnosed with Respiratory Syncytial Virus bronchiolitis.

• Individuals previously diagnosed with Respiratory Syncytial Virus bronchiolitis have a higher risk …

Hypertonic Saline Therapy In Cystic Fibrosis, Idil Mohamed

Physician Assistant Scholarly Project Posters

Cystic fibrosis is an autosomal recessive genetic disorder that severely affects the lungs as well as other organs in the body. The pathophysiology of cystic fibrosis lung disease involves the production of thick and sticky mucus that accumulates leading to obstruction and inflammation of the airways. This disease is characterized by abnormal transport of sodium and chloride across an epithelium by defective genes, resulting in thick mucus secretions.

Nebulized hypertonic saline (3% NaCl) improves mucociliary clearance through rehydration of the airway surface liquid of the lungs. The purpose of this study is to evaluate the effects of nebulized hypertonic saline …

S/P Right Hip Orif, Brian Bartow

Physical Therapy Scholarly Projects

Background and Purpose: Hip fracture is a major medical problem among older adults, leading to impaired balance and gait and loss of functional independence. An open reduction internal fixation (ORIF) is a method of surgically repairing a fractured bone. Generally, this involves either the use of plates and screws or an intramedullary (IM) rod to stabilize the bone.

Case Description: The patient was a 51-year-old female who fractured her right hip while running. She had complained of thigh pain with running for 1 to 2 months prior. She had gamma nail pinning.

Intervention: The focus of treatment was to increase …

Cervical Radiculopathy: A Case Report, Kimberly Dobrovolny

Physical Therapy Scholarly Projects

There is currently little evidence to determine which conservative treatment approach is best for the management of patients with cervical radiculopathy; however, there is evidence these patients benefit from a multi-treatment approach. The purpose of this case is to describe the physical therapy management of a patient with cervical radiculopathy. Physical therapy diagnosis was based on the patient’s physical signs and symptoms as well as meeting three of the four criteria of the clinical prediction rule which is used to identify patients with cervical radiculopathy. Results from the examination and evaluation were consistent with the magnetic resonance imaging findings. Physical …

Pilot Study: Affect Of Power Posing On Ot Student Performance When Implementing Interventions, Aimee Abel, Brittney Barelman

Occupational Therapy Capstones

Objectives. This pilot study used a quasi-experimental repeated measures design to explore the affect of power posing on Occupational Therapy student performance when conducting interventions with clients. The study was conducted in an attempt to determine an effective strategy used to enhance student therapist performance to support occupational adaptation in school and during the transition to entry-level clinician.

Method. Second year occupational therapy students (n = 10) from the University of North Dakota at the Casper, WY site and practicing clinicians (n = 10) from the community of Casper participated in the study. The student therapists conducted two interventions on …

Retained Primitive Reflexes And Adhd: Examining Atypical Symptomology In The School-Aged Population, Quincey Adams, Jamie Craft

Occupational Therapy Capstones

Purpose: Typical development begins in-utero and progresses throughout the lifespan. Jean Piaget authored a theory that encompasses core aspects of the lifespan stages related to typical development of sensory and motor systems. Piaget outlined the developmental stages as: sensorimotor stage, preoperational stage, concrete operational stage, and formal operational stage. Within these stages, the typically developing child learns to adapt and respond effectively to his or her environment (Cole & Tufano, 2008). Dr. Jean Ayres described a similar developmental process, termed Sensory Integration. This process is defined as the coordination of the sensory systems in order for an individual to effectively …

Weight Management For The Elderly Population Who Have Sustained A Lower Limb Amputation: Resource Manuals For Clinicians, Lauren Battles, Maia Sobolik

Occupational Therapy Capstones

It is becoming more common for individuals to sustain a lower limb amputation, thus impacting their ability to participate in functional tasks of daily living such as ambulation, balance, dressing, driving, and toileting. Approximately two million people within the United States are living with an amputation, most commonly in the lower extremity (Amputation Coalition, 2013). According to Resnik and Borgia (2011), by the year 2050, the number of lower limb amputations will increase significantly due to the aging population who encounter a variety of debilitating diseases such as diabetes, peripheral artery disease (PAD), dysvascular, and/or heart diseases. Weight management is …

Increasing Collaborative Communication Regarding Proper Positioning: A Photographic Guide, Kyle Donner, Rachel Newman

Occupational Therapy Capstones

Approximately 98,000 people die annually in the United States due to medical errors (Institute of medicine, 2013). These medical errors are most often due to miscommunication between healthcare providers (Sutcliffe, Lewton, & Rosenthal, 2004). Impaired positioning is one type of medical error, which leads to severe complications such as contractures, pressure ulcers, and occupational deficits (Amidei, 2012; de Jong, Nieuwboer, & Aufdemkampe, 2006; Gordon, Gottschlich, Helvig, Marvin, & Richard, 2004). The purpose of this scholarly project is to provide a communication tool that will increase interprofessional communication and collaboration in regards to client positioning needs in healthcare settings. A literature …