Medicine and Health Sciences Commons^™

Optimal Interventions To Address Drop Foot And Increase Gait Speed In Stroke Populations, Christopher Tran, Tommy Ngo, Dana Hazlett, Ethan Jung, Faris Alshammari

San Marcos, Summer 2020

Background: The mechanism of stroke or cerebral vascular accident (CVA) is an interruption of blood flow to the brain, which can result in many different neuromuscular impairments including drop foot. There is limited research focusing on comparative interventions for gait improvement in early stroke.

Purpose: The purpose of this study was to review the various physical thereapy interventions to benefit patients with drop foot following a single stroke.

Methods: A comprehensive systematic search was conducted within the PubMed and ProQuest databases. This study examined papers assessing conventional physical therapy for stroke patients with drop foot who had their 1st stroke …

Remedying Healthcare Disparities Affecting The Black Community, Savonna Reed

San Marcos, Summer 2020

The purpose of this literature review is to determine how black communities are being impacted by racial/social determinants of cardiovascular health, and to investigate potential healthcare solutions to eliminate these disparities.

As physical therapists, we commonly treat patients following lumbar spinal fusion surgery. Post-op outcomes have been found to be impacted by racial disparities in decision making in whether care providers offer surgical care, differences in access to care due to socioeconomic barriers, and differences in attitudes towards surgical care among ethnic groups.

Review of current literature has revealed that more research should be done to establish ways of remedying …

The Effectiveness Of Home Health Physical Therapy Following Diagnosis Of Acute Respiratory Failure Secondary To Covid-19: A Case Report, Desiree Lyall, Maura Owens

San Marcos, Summer 2020

The purpose of this case study is to describe the effects of home health physical therapy involving gait training, respiratory exercises, disease process education and rehabilitation exercises for strength, endurance and balance in the treatment of a 73 year-old, male patient with a diagnosis of acute respirtory failure secondary to Covid-19.

For a patient with a diagnosis of acute respiratory failure secondary to Covid-19 diagnosis home health physical therapy was an effective treatment option to facilitate return to prior level of function. This case study supports previous research and recommended treatment guidelines for the effectiveness of gait training, respiratory exercises, …

The Effectiveness Of Heart Rate Variability Biofeedback In Conjunction With Traditional Treatment For Thoracic Outlet Syndrome In A 25-Year-Old Female: A Case Report, Sepehr Rezaei

San Marcos, Summer 2020

Introduction: Thoracic outlet syndrome (TOS) is a complex condition that causes pain, tingling sensation, hypesthesia, muscle atrophy, weakness, and edematous changes in the upper quadrant (UQ) and down upper extremity (UE). ^3,7,8,16,17 TOS is due to compression of neurovascular bundles in the interscalene triangle, costoclavicular space, and under pectoralis minor and caused by trauma, congenital malformations such as a cervical rib, and abnormal/poor postures from muscle imbalances.^3,7,8,16,17 Interventions for TOS can consist of correcting posture by addressing muscle imbalance, decreasing tone and muscle tightness and rib mobilization, and in rare cases, rib resection. ^{3,7,8,13,16,17} However, there is limited research …

Occupational Therapy’S Role In Addressing Sex And Intimacy For Individuals With Progressive Neuromuscular Disorders, Lindsay N. Richards, Becki Cohill, Katrhyn Ellis, Susan Macdermott

San Marcos, Summer 2020

Individuals with progressive neuromuscular disorders (PND); specifically, Parkinson’s disease (PD), Multiple Sclerosis (MS), Huntington’s Disease (HD), and Amyotrophic Lateral Sclerosis (ALS) often face physical, psychological, and social challenges related to sex and intimacy. Occupational therapy (OT) practitioners are experts in activity analysis and are equipped with unique knowledge of performance skills and client factors to address deficits in occupational performance.

Though there is literature presenting the effects of PND on sexual occupations, a gap exists as it relates to qualitative data from the perspective of the individual and their partners. A mixed-methods survey was conducted examining the lived experience of …

Analysis Of Physical Therapy Interventions Vs. Kinesio Taping For Relieving Low Back Pain, Amanda Orr

San Marcos, Summer 2020

Introduction/Background: This topic focuses on the utilization of kinesio taping (KT) to assist with decreasing pain in the low back. According to Shipton, low back pain has gone up by more than 50% since 1990. These factors are attributed to smoking, obesity, sedentary occupations, and to low socioeconomic status.Globally, in 2016, it is said that low back pain contributed 57.6 years to disability and the prevalence peaks around the ages of 35-55 years according to the World Health Organization.

Purpose: The purpose of this literature review is to compare research articles between KT with physical therapy interventions as compared …

The Occupation Of Training Service Dogs: A Therapeutic Intervention For Combat Veterans With Ptsd, Denae A. Padilla, Jessica De Brun

San Marcos, Summer 2020

There are few interventions that present opportunities to engage in meaningful occupation (Kashiwa et al., 2017) to help Veterans reintegrate into the civilian lifestyle that create a desire to participate and attend therapy (Goetteret al., 2015).

The purpose of this study is to explore the effectiveness of training service dogs as an occupation and means of social support for combat Veterans living with PTSD with the following objectives:

• explore an occupation basedintervention that addresses low retention rates in occupational therapy.
• teach coping mechanisms and provide social support as a by-product to training service dogs in order to assist in reintegration …

Dressing Skills For Children With Cerebral Palsy [Research Plan], Diane Mellin, Jenna Oberg, Amber Torgerson, Charlene Yuson

San Marcos, Summer 2020

Cerebral palsy (CP) is the most common physical dysfunction in children. Because there is damage to their cortex and corticospinal tracts, children who have cerebral palsy have difficulty in precise grasping and fine motor control, affecting their activities of daily living and quality of life (Ouyang et al., 2020).

The purpose of this study will be to develop an OT intervention using threading techniques that will help children with cerebral palsy dress independently without using adaptive clothing. This study will utilize a quasi-experimental design with the subjects as their own control. Pre- and post-tests will be administered for each child …

Week Of August 17, 2020, New York Medical College

InTouch

• NYMC Students Distribute Masks and Good Will with the Mask Transit Project
• NYMC Receives $594K NIH Shared Instrumentation Grant
• Chancellor Hosts Town Hall Meeting

Understanding The Impact Of Social Distancing On Older Adults And Senior Organizations To Better Adapt Towards A New Normal, Salina Jivan, Christine Mary Childers, Susan Macdermott, Becki Cohill

Summer 2020 Virtual OTD Capstone Symposium

COVID-19 brought about social distancing mandates that posed as a new barrier to meaningful social participation in the community. The purpose of this project was to understand the impact of social distancing on older adults and senior organizations to better inform the role of OT in helping seniors adapt to towards a new normal within the community. A qualitative study and needs assessment were performed through phone interviews with seniors and organizations that support them from around the United States. Themes highlighted seniors desire for social contact and cautious return to the community once mandates are lifted. Both seniors and …

Occupational Therapist’S Role In Addressing Transition Support Through Life Skills, Rupa Parikh, Becki Cohill, Susan Macdermott

Summer 2020 Virtual OTD Capstone Symposium

The transition period from high school to postsecondary education has been shown to be a difficult time for youth, especially those with disabilities. The use of occupational therapists in transition services can positively affect a student's ability to attend postsecondary education. Guidance and support are necessary to teach these individuals life skills needed for future success in the transition to postsecondary education. This capstone project aims to assess the needs of students at the Winston school to identify occupational limitations in the area of life skills. Through identification of problem areas, a detailed program was created and implemented to meet …

The Role Of Occupational Therapy For Homeless Women And Women At-Risk Of Homelessness, Kelcey Storkersen, Susan Macdermott, Becki Cohill

Summer 2020 Virtual OTD Capstone Symposium

This capstone project is focused on assessing the occupational needs and barriers of women at-risk of homelessness at a resource center. A needs assessment, facility observations, and research study were conducted to identify population needs and create a client-centered program for offering occupational enrichment to these women at CMOH.

Occupational Therapy And Accessibility In The Outdoors And Summer Camps, David M. Lewis, Susan Macdermott, Becki Cohill

Summer 2020 Virtual OTD Capstone Symposium

Opportunities for positive youth development (PYD) are promoted through both outdoor and camp experiences. The experiences provided by the outdoors and camps are ideal for developing physically, cognitively, socially, emotionally, and spiritually. These areas of PYD are further generalizable to several aspects of occupational performance and participation, while continuing to have benefits throughout the lifespan. While the outdoors and camps provide these valuable opportunities for development, the environments and contexts of these opportunities are often limiting factors for individuals with disabilities.

Utilizing an occupational therapy approach allows for further understanding of how to promote inclusion and accessibility practices in these …

Occupation-Based Programming For Survivors Of Human Trafficking, Breann H. Paul, Becki Cohill, Susan Macdermott

Summer 2020 Virtual OTD Capstone Symposium

Occupational therapists have an essential role in overcoming the gaps in maternal health care by providing the necessary support to both mothers and children. There is currently limited research on the unique needs of survivors of human trafficking who are mothers, especially their psychosocial needs. Survivors of human trafficking may experience severe trauma, physical violence, long-term emotional distress, and health problems. Therefore, it is essential that survivors of human trafficking are provided the appropriate resources, education, support, and guidance throughout the transition to motherhood and this life changing role. The program created for this population focuses on the occupational needs …

Occupational Therapy’S Role In Addressing Sensory Deficits In Children With Behavioral Health Challenges Through Teacher Training, Devon A. Ayres, Becki Cohill, Susan Macdermott, Mark Wilson

Summer 2020 Virtual OTD Capstone Symposium

Sensory processing difficulties have been well-documented in children who have behavioral health challenges. Addressing a child’s sensory processing needs may decrease behaviors that disrupt occupational participation and thus leading to improved learning and better information retention. A review of current literature revealed that teachers who work with children with behavioral health challenges are not required to receive education in addressing sensory deficits in the classroom. This capstone project performed a needs assessment, exploring current teacher understanding of sensory processing and what role occupational therapy could play in providing training for teachers. The project also generated pertinent online teacher training modules …

Turning Everyday Activities Into Play: Building Relationships And Fostering Connections For Adopted And Foster Children, Marissa E. Siu, Becki Cohill, Susan Macdermott

Summer 2020 Virtual OTD Capstone Symposium

Turning Everyday Activities into Play is a program that was created for foster children, adopted children, and individuals who work with this population in the community. This program uses everyday activities to foster the connection between children and adults. The goal of this program is to use the power of play to support regulation and build stronger bonds and relationships by turning everyday activities into play.

Occupational Therapy’S Role In Assisting With Community Reintegration For Survivors Of Human Trafficking, Jane Huynh, Becki Cohill, Susan Macdermott

Summer 2020 Virtual OTD Capstone Symposium

Victims of human trafficking were exposed to traumatic experiences that affected their physical, psychological, cognitive, and social health. As the survivors entered the healing stage and progressed in their journey to community reintegration, the complex traumatic experiences may affect their independence with occupational tasks. This capstone explored the areas where occupational therapy can assist with community reintegration for survivors of human trafficking. Interviews were conducted through casual conversation using the modified-COPM as guidance, and the QOL was used to gather baseline data. Survivors identified priorities of their everyday living and the barriers to them achieving their goals: education, vocation, transportation, …

The Effect Of A Parental Diagnosis Of Cancer On The Occupational Performance Of Adolescent And Young Adult Offspring, Brianna Wong, Susan Macdermott, Becki Cohill, Pandora Patterson

Summer 2020 Virtual OTD Capstone Symposium

Objective: To gain an understanding on the current knowledge and practice of OTs relating to the occupational impact that a parental diagnosis of cancer can have on AYA offspring. In addition, to determine if there is occupational disruption or imbalance impacting AYAs whose parents have cancer and if OT is a good fit to treat this population.

Methods: A scoping literature review was conducted gathering relevant peer-reviewed articles, analyzing and creating themes with the current literature. In tandem with the scoping review, a qualitative study was conducted. Eight occupational therapists working in either an oncology care setting or pediatric setting …

Assessing The Impact Of Online Occupational Therapy Content On Professional Development For Occupational Therapists, Lisa Nguyen, Susan Macdermott, Becki Cohill

Summer 2020 Virtual OTD Capstone Symposium

Social media has provided a virtual space for occupational therapists around the world to connect and to share practical information and this type of media has great potential as a source of social support and mentorship. This project’s purpose is to assess the qualitative impact of online occupational therapy-based content among occupational therapists. Data was collected and compiled from the currently available blogs and podcasts with OT-based content. Surveys were conducted among 40 occupational therapy students and occupational therapy practitioners and five occupational therapy content creators were interviewed on their experiences producing OT-based content online. The themes that resulted from …

Occupational Therapy's Role In Addressing Sex And Intimacy For Individuals With Progressive Neuromuscular Disorders, Lindsay N. Richards, Becki Cohill, Kathryn Ellis, Susan Macdermott

Summer 2020 Virtual OTD Capstone Symposium

Individuals with progressive neuromuscular disorders (PND); specifically, Parkinson’s disease (PD), Multiple Sclerosis (MS), Huntington’s Disease (HD), and Amyotrophic Lateral Sclerosis (ALS) often face physical, psychological, and social challenges related to sex and intimacy. Occupational therapy (OT) practitioners are experts in activity analysis and are equipped with unique knowledge of performance skills and client factors to address deficits in occupational performance. Though there is literature presenting the effects of PND on sexual occupations, a gap exists as it relates to qualitative data from the perspective of the individual and their partners.

A mixed-methods survey was conducted examining the lived experience of …

Challenges For Cancer Patients Returning Home During Covid-19 Pandemic After Medical Tourism - A Consensus Report, Humaid 0. Al-Shamsl, Ibrahim Abu-Ghelda

Covid19 Newsletters

The COVID-19 pandemic has caused global health crisis. Numerous cancer patients from non-Western countries, including the United Arab Emirates (UAE), seek cancer care outside their home countries and many are sponsored by their governments for treatment. Many patients interrupted their cancer treatment abruptly and returned to their home countries with unique challenges.

Investigating Virological, Immunological, And Pathological Avenues To Identify Potential Targets For Developing Covid-19 Treatment And Prevention Strategies, Zafar Mahmood, Hani Alrefai Alrefai, Helal F. Hetta, Hidaya A. Kader

Books and Book Chapters

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an emerging coronavirus causing respiratory disease commonly known as COVID-19. This novel coronavirus transmits from human to human and has caused profound morbidity and mortality worldwide leading to the ongoing pandemic. Moreover, disease severity differs considerably from individual to individual. Investigating the virology of COVID-19 and immunological pathways underlying its clinical manifestations will enable the identification and design of effective vaccines and potential therapies. In this review, we explore COVID-19 virology, the contribution of the immune system (innate and adaptive) during infection and control of the virus. Finally, we highlight vaccine development …

Week Of August 3, 2020, New York Medical College

InTouch

• NYMC Welcomes Newest Cohort of Medical Students
• eCampus Offers Affordable Course Materials for NYMC

Intratracheal Lidocaine And Postoperative Sore Throat At Providence Sacred Heart Medical Center And Providence Holy Family Hospital, Jennifer Cowgill, Scot Pettey, Kenn B Daratha

Books, Presentations, Posters, Etc.

Background Postoperative sore throat (POST) is a common side effect from general anesthesia (GA) and has a prevalence of 14.4-50%.1 The experience of POST contributes to patient discomfort during recovery from surgery. The etiology of this is thought to be from tracheal mucosal erosion from the cuff of the endotracheal tube (ETT), trauma from intubation, coughing and bucking, and friction between the ETT and the tracheal mucosa during general anesthesia.2 Risk factors shown to contribute to the development of POST include, but are not limited to, elderly age, smoking history, patient positioning, ETT cuff pressure, and movement of ETT during …

Postoperative Length Of Stay Following Enhanced Recovery After Surgery Protocol Implementation For Scheduled Cesarean Deliveries, Hannah Zimmerman, Emily L. Mcquaid-Hanson, Amanda Affleck, Kenn B Daratha

Books, Presentations, Posters, Etc.

Background Cesarean delivery is the most common major surgery worldwide. 1 In 2018, 1.2 million cesarean deliveries occurred in the United States, accounting for nearly 32% of all deliveries.2 Research has shown ERAS benefits include decreased length of stay, improved pain control, and improved patient satisfaction.2,3 Despite its use in numerous surgical specialties, ERAS implementation within obstetrics has been slow.2 The ERAS Society released a three-part guideline specific to cesarean deliveries in 2018 and 2019,4,5,6 yet few studies have assessed the impact of ERAS on cesarean postoperative outcomes.2 An improved perioperative course would be particularly beneficial for mothers undergoing cesarean …

Opioid Consumption After Scheduled Cesarean Delivery Following Implementation Of Enhanced Recovery After Surgery, Mindy Woodruff, Emily L. Mcquaid-Hanson, Amanda Affleck, Kenn B Daratha

Books, Presentations, Posters, Etc.

Background With 47,600 opioid overdose related deaths in the U.S. in 2017, the opioid crisis is of national concern.1 Cesarean delivery is the most common surgery worldwide, with over 1.2 million in the U.S. in 2018 alone.2,3 As cesarean delivery is a highly prevalent surgery it has a large capacity to influence the opioid epidemic. Literature is showing that Enhanced Recovery after Surgery (ERAS) and multimodal analgesia are effective means of managing postoperative pain while minimizing opioid use.4,5,6,7,8 This project aims to help discover if introduction of ERAS, and more specifically it’s multimodal analgesia aspect, has helped decrease oral morphine …

Neostigmine Versus Sugammadex And The Relationship To Reintubation Rates In The Pacu, Delanie Urrutia, Scot Pettey, Kenn B Daratha

Books, Presentations, Posters, Etc.

Background Findings Discussion Reintubation in the post-anesthesia care unit (PACU) is a complication that may be related to residual neuromuscular blockade. Neostigmine and sugammadex have different pharmacokinetics that effect speed and completeness of reversal of paralysis. According to Tillquist et al. (2016) reintubation following general anesthesia in the PACU is associated with a 50% increased risk of mortality. Few studies have investigated the incidence rate of PACU reintubation and its possible relationship and choice of reversal medication.

Methods • Retrospective Observational Research Study. • This project was approved by the PSHMC Clinical Innovation and Research Council and deemed human subjects …

Rate Of Unscheduled Administration Of An Epidural Bolus Among Pregnant Women Receiving Labor Epidurals, Aleksandr A. Lyakhov, Emily L. Mcquaid-Hanson, Amanda Affleck, Kenn B Daratha

Books, Presentations, Posters, Etc.

Background The labor and delivery process is a painful experience that pregnant women undergo and while various medical options are available for managing labor pain, labor epidurals are the most common.1,3 Breakthrough pain, or inadequate analgesia, is a significant complication of labor epidurals that is typically managed with the administration of an unscheduled epidural bolus. The purpose of this evidence-based practice (EBP) project is to describe the rate of unscheduled epidural bolus administration in pregnant women receiving continuous labor epidurals (CLE) at Providence Sacred Heart Medical Center (PSHMC) and Providence Holy Family Hospital (PHFH).

Methods • Design: Retrospective, observational, EBP …

Correlation Of Ondansetron Timing In Postoperative Nausea And Vomiting: A Retrospective Evaluation Amongst Adult Patients Receiving General Anesthesia, Jeff Tanguay, Braden Hemingway, Kenn B Daratha

Books, Presentations, Posters, Etc.

Background Addressed as a national quality initiative by the Centers for Medicare and Medicaid Services (CMS), postoperative nausea and vomiting (PONV) is a vexing complication requiring further attention by anesthesia providers.3 Medication optimization is an area of focus to address this complication.4 Ondansetron, a selective 5- hydroxytryptophan subtype 3 (5-HT3 ) receptor antagonist, is effective and considered the “gold standard” in the prevention of PONV.4 GlaxoSmithKline™ suggests administering Zofran® (ondansetron) before the induction of anesthesia.5 These directions are in contrast to the synthesis of the research evidence, which supports increased effectiveness of ondansetron when administered 30 minutes before emergence from …

Rates Of Ondansetron Administration Prior To Spinal Anesthesia: Evaluating The Practice Of Prophylactic Attenuation Of Spinal-Induced Hypotension And Bradycardia, Clare Santana, Scot Pettey, Kenn B Daratha

Books, Presentations, Posters, Etc.

Background Hypotension and bradycardia are common complications of spinal anesthesia. Intraoperative hypotension and bradycardia may lead to complications that require additional treatment and increase cost. The literature identifies intervention strategies to attenuate spinalinduced hypotension (SIH) and bradycardia.1 Prophylactic administration of ondansetron, a serotonin 5-hydroxytryptamine receptor antagonist, prior to spinal anesthesia is associated with reduced SIH and bradycardia.1,2,3,4,6 The objective of this scholarly project was to report the practice of ondansetron prophylaxis for SIH and bradycardia and the rate of rescue interventions in patients who received ondansetron prior to spinal anesthesia.

Methods Retrospective, multi-center observational evidence-based practice project conducted at Providence …