Medicine and Health Sciences Commons^™

Neuromotor Changes In Participants With A Concussion History Can Be Detected With A Custom Smartphone App, Christopher K. Rhea, Masahiro Yamada, Nikita A. Kuznetsov, Jason T. Jakiela, Chanel T. Lojacono, Scott E. Ross, F. J. Haran, Jason M. Bailie, W. Geoffrey Wright

Moss-Magee Rehabilitation Papers

Neuromotor dysfunction after a concussion is common, but balance tests used to assess neuromotor dysfunction are typically subjective. Current objective balance tests are either cost- or space-prohibitive, or utilize a static balance protocol, which may mask neuromotor dysfunction due to the simplicity of the task. To address this gap, our team developed an Android-based smartphone app (portable and cost-effective) that uses the sensors in the device (objective) to record movement profiles during a stepping-in-place task (dynamic movement). The purpose of this study was to examine the extent to which our custom smartphone app and protocol could discriminate neuromotor behavior between …

Effectiveness Of 3d-Printed Upper Extremity Device For Chronic Neurological Impairment, Joe Kardine, Mba, Ms, Otr/L, Cbis, Mikael Avery, Ms, Otr/L, Alessandro Naopli, Phd, Namrata Grampurohit, Phd, Otr/L, Maryjane Mulcahey, Phd, Otr/L, Mijail Serruya, Md, Phd

Farber Institute for Neuroscience Staff Papers and Presentations

Report on the results of the five adults with UE mobility impairment due to stroke experiences with a lightweight, customized, powered hand orthosis. Study measures utilized were Canadian Occupational Performance Measure, Box and Blocks, and Action Research Arm Test.

Anna Magee’S Vision 100 Years Past 1923-2023!, Christopher Formal, John F. Ditunno Jr.

Department of Rehabilitation Medicine Faculty Papers

Anna Magee's vision of Magee Rehabilitation Hospital has been realized in three phases. The first spanned the writing of her will until groundbreaking of the new hospital. This was followed by the early years as an entirely independent institution. The third phase began with its association with Thomas Jefferson University, and continues to this day with integration into a complete system of patient care, education, and research. Magee owes its existence to the philanthropy of Anna Magee and it continues to fortify her legacy and fulfill her vision of an institution where patients whose acute illness has passed can receive …

Developing Guiding Principles For Technology-Based Rehabilitation Program By Engaging People With Motor Incomplete Tetraplegia, Alison Bell, Namrata Grampurohit, Gabrielle Kains, Ralph J. Marino

Department of Rehabilitation Medicine Faculty Papers

Background: Technology-aided rehabilitation is well established in the field of neurologic rehabilitation. Despite the widespread availability, the development of technology-based interventions that incorporate perspectives of the people who will use them is lacking.

Objectives: This qualitative study aims to understand how people with chronic motor incomplete cervical spinal cord injury view rehabilitation technology to improve upper extremity function and neuromuscular recovery to inform future intervention development.

Methods: Seven participants with chronic upper extremity impairment due to spinal cord injury/dysfunction trialed five rehabilitation technology devices. After a 30-45 min trial for each device, participants engaged in a semi-structured interview. Interviews were …

Sensory Adaptive Environment To Enhance Participation In Healthcare For Children With Autism Spectrum Disorder: An Interdisciplinary Design Thinking Approach, Lady Rios-Vega, Otd, Otr/L, Amy Carroll, Otd, Otr/L, Rachel L. Dumont, Otr/L, Dianne Treadwell-Deering, Md, Matthew Fields, Md, Roseann C. Schaaf, Phd, Otr/L, Faota

Department of Occupational Therapy Posters and Presentations

Introduction/Background

• Participation in healthcare for children diagnosed with Autism Spectrum Disorder (ASD) can be overwhelming resulting in stressful responses safety concerns.¹
• Sensory features impact healthcare participation.
• Up to 84% of individuals with ASD experience atypical sensory features of : - Hyper or hypo reactivity to sensation.²
  - Unusual sensory interests in the environment.²
  - Poor sensory integration.²
• Families may refrain from participation in medical care to prevent negative experiences, contributing to occupational deprivation.¹
• Sensory Adaptive Environments (SAE) may improve participation for autistic persons.^1,3,4

The Simulated Café: A Virtually Delivered Pre-Employment Transition Program For Students With Autism, Leah Haller, Otd, Otr/L, Amy Carroll, Otd, Otr/L

Department of Occupational Therapy Posters and Presentations

Introduction

• Fewer than half the young adults diagnosed with autism are employed (Gotham et al., 2015; Chiang, et al, 2013).
• Individuals diagnosed with autism have a higher rate of unemployment compared to those with other disabilities (Buescher et al., 2014).
• Educators of individuals diagnosed with autism stress employment as a desired and measured outcome (Schall et al. 2012).
• Parents of individuals diagnosed with autism rated employment support as the greatest service priority (Neary et al.,2015).
• Individuals diagnosed with autism are 7.36 times more likely to be in paid employment if they receive vocational services (Park & Bouk, 2018).
• In the …

Exploring Community Recreation And Leisure Of Young Adults With Autism, Alexandria Taylor, Otd, Otr/L, Eis, Amy Carroll, Otd, Otr/L

Department of Occupational Therapy Posters and Presentations

Introduction

• Adults with autism participate less in the community compared to adults with other diagnoses (e.g., intellectual disability, emo tional disturbance, and learning disabilities) (Myers et al., 2015; Orsmond et al., 2013).
• Quantitative studies have shown the benefits of participating in recreation and leisure activities for young adults with auti sm (Bishop Fitzpatrick et al., 2017; Garcia Villamisar & Dattilo, 2010; Stacey et al., 2019).
• The use of qualitative research has been recommended to offer a deeper understanding (Stacey et al., 2019).
• The lack of opportunity for young adults with autism to share their experiences and opinions can lead to …

Ipads For Autism A Web Based Professional Learning Community For Teachers To Support Tablet Usage In Autism Classrooms, Emily E. Smith, Otd, Otr/L, Amy Carroll, Otd, Otr/L

Department of Occupational Therapy Posters and Presentations

Background and Significance

Since its emergence in 2010 the mobile technology of the iPad has excited both parents and teachers for its potential in the classroom. The portability of networked mobile technologies has helped students of all abilities to discover, influence, and examine knowledge as well as interact with educators and other students across the world.¹ While many school students have access to iPads, simply having technology in the school environment does not ensure teachers are ready to use it to their full potential.² Teachers need sufficient professional development to align knowledge of technology, pedagogy, and learning content. …

An Interprofessional And International Collaboration To Establish The Content Validity Of The Checklist Of Nicu Caregiver Behaviors, Amy Carroll, Otd, Otr/L, Cecilia Roan, Otd, Otr/L, Michele K. Savin, Dnp, Aprn, Nnp-Bc, Amitava Sengupta, Md, Fnnf, Dch, Micp, Mbbs, Catherine V. Piersol, Phd, Otr/L, Faota

Department of Occupational Therapy Posters and Presentations

Introduction

The World Health Organization estimates that 15 million babies are born pre term every year.¹ “Preterm infants have a high risk of cognitive, neuromotor, and neurosensory problems after discharge from the Neonatal Intensive Care Unit (NICU).² The outcomes associated with pre term birth are influenced by early adverse experiences during critical care in a stressful NICU environment.³

Developmental care (DC) encompasses a broad array of interventions for developing infants which focus on minimizing the stress of the NICU.⁴ There are a number of approaches associated with DC The Universe of Developmental Care model describes five …

Using Knowledge Translation Strategies To Promote Integration Of Evidence Into Practice: Faculty, Fieldwork Educator And Fieldwork Student Partnerships, Amy Carroll, Otd, Otr/L, E. Adel Herge, Otd, Otr/L, Faota

Department of Occupational Therapy Posters and Presentations

The Research to Practice Gap

The gap between what is known from research and what happens at the point of care continues to be a concern across health care.^1,2 Occupational therapists have a positive attitude toward evidence based practice yet actual use of evidence to guide occupational therapy practice is low.^3,4

Neurodiversity Inclusive Practices In Higher Education: Using A Needs Assessment To Spur Change Throughout University Systems, Caitlin Rosica, Otd, Amy Carroll, Otd, Otr/L, Lady Rios-Vega, Otd, Roseann C. Schaaf, Phd

Department of Occupational Therapy Posters and Presentations

Introduction

• Approximately 50% of autistic people have average or above average intelligence, and growing numbers of autistic young adults attend college.¹
• Autistic students experience poor outcomes in college despite being academically well qualified. 34.9% of autistic young adults attempt college within 6 years of high school.² Of those, approximately 39% will graduate.³
• In higher education, there may be a mismatch in supports needed by autistic students versus supports provided.
• Autistic students report difficulty with sensory overload, mental health concerns, and daily living tasks.⁴
• The majority of supports for autistic students focus on academics, which is a …

Efficacy Of Early Inpatient Rehabilitation Of Post-Covid-19 Survivors: Single-Center Retrospective Analysis, Ning Cao, Jaclyn Barcikowski, Franklin Womble, Bianca Martinez, Yevgeniya Sergeyenko, Jacob H. Koffer, Michael Kwasniewski, Thomas Watanabe, Rui Xiao, Alberto Esquenazi

Moss-Magee Rehabilitation Papers

OBJECTIVE: The aim of this study was to understand the demographic, clinical characteristics, and effectiveness of early inpatient rehabilitation of post-COVID survivors.

DESIGN: A single-center retrospective chart review analysis of 100 patients admitted to a newly created acute COVID rehabilitation unit (CORE+) from April to December 2020 was conducted.

RESULTS: The demographic and clinical characteristics and complications of 100 post-COVID patients were reviewed. Functional outcomes of GG Self-care and Mobility Activities Items (Section GG0130 and GG0170) of the Centers for Medicare & Medicaid Services of the Inpatient Rehabilitation Facility Patient Assessment Instrument (Version 3.0) at admission and discharge, prevalence of …

Cost-Benefit Analysis Of The Cope Program For Persons Living With Dementia: Toward A Payment Model, Laura T Pizzi, Eric Jutkowitz, Katherine M Prioli, Ember Yiwei Lu, Zachary Babcock, Heather Mcabee-Sevick, Dorothy B Wakefield, Julie Robison, Sheila Molony, Catherine V. Piersol, Laura N Gitlin, Richard H Fortinsky

Department of Occupational Therapy Faculty Papers

Background and objectives: There is a critical need for effective interventions to support quality of life for persons living with dementia and their caregivers. Growing evidence supports nonpharmacologic programs that provide care management, disease education, skills training, and support. This cost-benefit analysis examined whether the Care of Persons with Dementia in their Environments (COPE) program achieves cost savings when incorporated into Connecticut's home- and community-based services (HCBS), which are state- and Medicaid-funded.

Research design and methods: Findings are based on a pragmatic trial where persons living with dementia and their caregiver dyads were randomly assigned to COPE with HCBS, or …

Student Satisfaction And Quality Improvement For An Alzheimer’S Virtual Interprofessional Training (Avit) Program, Susan Toth-Cohen, Phd, Otr/L, Jeannette Kates, Phd, Aprn, Agpcnp-Bc, Gnp-Bc, Richard W. Hass, Phd

Department of Occupational Therapy Posters and Presentations

Learning Objectives

• Identify key areas of focus for addressing student satisfaction in 3-DVW IPE simulations
• Discuss specific quality improvement strategies targeting student satisfaction and engagement based on the Flexible Learning Model
• Apply findings of the continuous quality improvement (CQI) strategies used in the AVIT 3-D virtual world simulation to their own approaches to CQI for virtual simulations

Sickle Cell Disease Chronic Joint Pain: Clinical Assessment Based On Maladaptive Central Nervous System Plasticity, Tiago Da Silva Lopes, Samir K. Ballas, Jamille Evelyn Rodrigues Souza Santana, Pedro De Melo-Carneiro, Lilian Becerra De Oliveira, Katia Nunes Sá, Larissa Conceição Dias Lopes, Wellington Dos Santos Silva, Rita Lucena, Abrahão Fontes Baptista

Department of Medicine Faculty Papers

Chronic joint pain (CJP) is among the significant musculoskeletal comorbidities in sickle cell disease (SCD) individuals. However, many healthcare professionals have difficulties in understanding and evaluating it. In addition, most musculoskeletal evaluation procedures do not consider central nervous system (CNS) plasticity associated with CJP, which is frequently maladaptive. This review study highlights the potential mechanisms of CNS maladaptive plasticity related to CJP in SCD and proposes reliable instruments and methods for musculoskeletal assessment adapted to those patients. A review was carried out in the PubMed and SciELO databases, searching for information that could help in the understanding of the mechanisms …

An Integrative Review Of Clinical Outcome Assessments Used To Measure Carryover Effects Of Exoskeletons And Functional Electrical Stimulation In Spinal Cord Injury, Martha K. Childress, Olivia M. Biller, Nicole Gerhardt, Ms, Otr/L, Cbis, Namrata Grampurohit, Phd, Otr/L, Rachel Y. Kim, Otd, Otr/L, Mj Mulcahey, Phd, Otr/L

Department of Occupational Therapy Posters and Presentations

Introduction

• Functional electrical stimulation (FES) and exoskeletons are rehabilitation technologies that provide direct functional ability and potential carryover effects
• Carryover effects may be due to neuromuscular recovery, behavioral compensation, or a combination of both (Figure 1)
• Clinical outcome assessments (COAs) are used to measure recovery of function with and without the device on

Engaging Stakeholders As Advisors On The Design Of A Large-Scale Calibration Study Of The Spinal Cord Injury Movement Index (Sci-Mi) Item Pools, Olivia M. Biller, Otdc, Jason Biundo, Bs, Edward S.-L. Mitchell, Mba, Ernest Ofori, Mb Chb, Lmcc, Bonnie Richardson, Rachel Y. Kim, Otd, Otrl/L, Nicole Gerhardt, Ms, Otr/L, Cbis, M.J. Mulcahey, Phd, Otr/L, Fasia

Department of Occupational Therapy Posters and Presentations

Introduction

• People living with spinal cord injury (SCI) in North America are involved in the following as stake holders in research: identifying priorities for research; planning interventions; and implementing rehabilitation or peer-support interventions.
• The best practice is for partnerships to span the continuum of research.
• Project purpose: to collaborate with an advisory board of individuals living with SCI, to make recommendations for the methods of a large-scale calibration study of the Spinal Cord Injury Movement Index )SCI-MI).
• The SCI-MI is being developed as a SCI clinical trial outcome assessment to evaluate the construct of movement in the context of function …

Refinement & Preliminary Examination Of A Fidelity Assessment For The Spinal Cord Injury -- Movement Index (Sci-Mi), Nicole Gerhardt, Otd(C), Otr/L

Department of Occupational Therapy Posters and Presentations

Introduction: Assessment fidelity refers to the adherence to intended procedures and guidelines when administering an assessment (Mowbray et al., 2003; Walton et al., 2020). Clinical outcome assessments (COAs) play a crucial role in the assessment of treatment effects in clinical trials. However, there is a scarcity of fidelity assessments for COAs, which has the potential to impact the accurate evaluation of treatment effects (Richardson et al., 2016). The Spinal Cord Injury Movement Index (SCI-MI) is a performance-based COA being developed with the intent to be used in spinal cord injury (SCI) clinical trials. As the stakes in SCI clinical trials …

Notes From An Epicenter: Navigating Behavioral Clinical Trials On Autism Spectrum Disorder Amid The Covid-19 Pandemic In The Bronx, Alaina S Berruti, Roseann C Schaaf, Emily A Jones, Elizabeth Ridgway, Rachel L. Dumont, Benjamin E Leiby, Catherine Sancimino, Misung Yi, Sophie Molholm

Department of Occupational Therapy Faculty Papers

Background: The COVID-19 pandemic impacted nearly all facets of our daily lives, and clinical research was no exception. Here, we discuss the impact of the pandemic on our ongoing, three-arm randomized controlled trial (RCT) Sensory Integration Therapy (SIT) in Autism: Mechanisms and Effectiveness (NCT02536365), which investigates the immediate and sustained utility of SIT to strengthen functional daily-living skills and minimize the presence of maladaptive sensory behaviors in autistic children.

Main text: In this text, we detail how we navigated the unique challenges that the pandemic brought forth between the years 2020 and 2021, including the need to rapidly …

Bilateral Upper Extremity Motor Priming (Bump) Plus Task-Specific Training For Severe, Chronic Upper Limb Hemiparesis: Study Protocol For A Randomized Clinical Trial, Mary Ellen Stoykov, Olivia M Biller, Alexandra Wax, Erin King, Jacob M Schauer, Louis F Fogg, Daniel M Corcos

Department of Occupational Therapy Faculty Papers

BACKGROUND: Various priming techniques to enhance neuroplasticity have been examined in stroke rehabilitation research. Most priming techniques are costly and approved only for research. Here, we describe a priming technique that is cost-effective and has potential to significantly change clinical practice. Bilateral motor priming uses the Exsurgo priming device (Exsurgo Rehabilitation, Auckland, NZ) so that the less affected limb drives the more affected limb in bilateral symmetrical wrist flexion and extension. The aim of this study is to determine the effects of a 5-week protocol of bilateral motor priming in combination with task-specific training on motor impairment of the affected …

Response: Commentary: Evaluating Sensory Integration/Sensory Processing Treatment: Issues And Analysis, Sarah A Schoen, Roseann C. Schaaf, Zoe Mailloux, Anita Bundy, Shelly Lane, Teresa A May-Benson, L Diane Parham, Susanne Smith Roley

Department of Occupational Therapy Faculty Papers

No abstract provided.

Faculty Perspectives On Interprofessional Collaborations Between Occupational Therapy And Industrial Design: A Qualitative Ethnographic Inquiry, Kimberly S. Mollo, Madalyn Peterson, Rebecca Brown

Department of Occupational Therapy Faculty Papers

Incorporating a user-centred approach to universal design solutions improves functionality and access for a more diverse group of individuals to engage with end products within everyday environments successfully. Interprofessional collaborations between industrial design and occupational therapy are one approach that integrates a user-centred universal design perspective throughout the design process, as occupational therapists have unique expertise in understanding how individuals participate in activities and engage with everyday products and environments. This qualitative ethnographic inquiry explored faculty perspectives (n=5) involved in interprofessional academic collaborations between design and occupational therapy at the university level in the Northeastern United States. Five themes emerged: …

Survey Of Confidence And Knowledge To Manage Patellofemoral Pain In Readers Versus Nonreaders Of The Physical Therapy Clinical Practice Guideline, Richard W. Willy, Lisa T. Hoglund, Neal R. Glaviano, Lori A. Bolgla, David M. Bazett-Jones

Department of Physical Therapy Faculty Papers

Objectives: To compare beliefs of physical therapists (PTs) who read the clinical practice guideline (CPG) for the management of individuals with patellofemoral pain (PFP) to those who have not read the CPG.

Design: Cross-sectional study.

Setting: Online survey.

Participants: 494 currently licensed/registered PTs or physiotherapists.

Main Outcome Measures: Respondents answered Likert-based or open-ended questions regarding the diagnosis, prognosis, risk factors, and management of individuals with PFP, as well as confidence for managing individuals with PFP, especially the ability to identify beneficial and non-beneficial interventions. We dichotomized responses into participants who read (READERS) and did not read (NonREADERS) the CPG.

Results: …

Age Moderates The Effect Of Injury Severity On Functional Trajectories In Traumatic Brain Injury: A Study Using The Nidilrr Traumatic Brain Injury Model Systems National Dataset., Laraine Winter, Janell L Mensinger, Helene J Moriarty, Keith M Robinson, Michelle Mckay, Benjamin E Leiby

Department of Pharmacology and Experimental Therapeutics Faculty Papers

Age is a risk factor for a host of poor outcomes following traumatic brain injury (TBI), with some evidence suggesting that age is also a source of excess disability. We tested the extent to which age moderates the effect of injury severity on functional trajectories over 15 years post injury. Data from 11,442 participants from the 2020 National Institute of Disability and Independent Living Rehabiitation Research (NIDILRR) Traumatic Brain Injury Model Systems (TBIMS) National Dataset were analyzed using linear mixed effects models. Injury severity was operationally defined using a composite of Glasgow Coma Scale scores, structural imaging findings, and the …

Robotic Table And Serious Games For Integrative Rehabilitation In The Early Poststroke Phase: Two Case Reports, Grigore Burdea, Nam Kim, Kevin Polistico, Ashwin Kadaru, Namrata Grampurohit, Jasdeep Hundal, Simcha Pollack

Department of Occupational Therapy Faculty Papers

Background: BrightArm Compact is a new rehabilitation system for the upper extremities. It provides bimanual training with gradated gravity loading and mediates interactions with cognitively challenging serious games.

Objective: The aim of this study is to design and test a robotic rehabilitation table-based virtual rehabilitation system for functional impact of the integrative training in the early poststroke phase.

Methods: A new robotic rehabilitation table, controllers, and adaptive games were developed. The 2 participants underwent 12 experimental sessions in addition to the standard of care. Standardized measures of upper extremity function (primary outcome), depression, and cognition were administered before and after …

Baroreflex Sensitivity In Facioscapulohumeral Muscular Dystrophy, Miguel Anselmo, Shandon Coffman, Mia Larson, Kathryn Vera, Emma Lee, Mary Mcconville, Michael Kyba, Manda L Keller-Ross

Department of Medicine Faculty Papers

Facioscapulohumeral muscular dystrophy (FSHD), a common form of muscular dystrophy, is caused by a genetic mutation that alters DUX4 gene expression. This mutation contributes to significant skeletal muscle loss. Although it is suggested that cardiac muscle may be spared, people with FSHD have demonstrated autonomic dysregulation. It is unknown if baroreflex function, an important regulator of blood pressure (BP), is impaired in people with FSHD. We examined if baroreflex sensitivity (BRS) is blunted in patients with FSHD. Thirty minutes of resting BP, heart rate, and cardiovagal BRS were measured in 13 patients with FSHD (age: 50 ± 13 years, avg …

Occupational Therapy's Role In Serious Mental Illness, Sam Sutton, Anabelle Scalora, Tina Deangelis

Doctorate of Occupational Therapy Program Capstone Presentations

The intent of this electronic manual is to provide a client-centered and evidence-based resource to inform students, clinicians, and educators of occupational therapy’s unique role in working with adults with serious mental illness (SMI) and those experiencing psychosis. This manual, while not exhaustive, is designed to serve as a user-friendly resource for providing valid, equitable care to those with serious mental illness.

Objectives:

1. Provide an electronic resource that outlines the occupational therapy process when working with individuals with serious mental illness and supports inclusion and reimbursement for occupational therapy practitioners in this setting.
2. Define the multiple roles occupational therapy practitioners …

The Role Of Electrical Stimulation For Rehabilitation And Regeneration After Spinal Cord Injury, Brian A Karamian, Nicholas Siegel, Blake Nourie, Mijail Serruya, Robert F Heary, James Harrop, Alex R. Vaccaro

Rothman Institute Faculty Papers

Electrical stimulation is used to elicit muscle contraction and can be utilized for neurorehabilitation following spinal cord injury when paired with voluntary motor training. This technology is now an important therapeutic intervention that results in improvement in motor function in patients with spinal cord injuries. The purpose of this review is to summarize the various forms of electrical stimulation technology that exist and their applications. Furthermore, this paper addresses the potential future of the technology.

Rehabilitation Care At The Time Of Coronavirus Disease-19 (Covid-19) Pandemic: A Scoping Review Of Health System Recommendations, Ahmed M Negm, Adrian Salopek, Mashal Zaide, Victoria J Meng, Carlos Prada, Yaping Chang, Preeti Zanwar, Flavia H Santos, Elena Philippou, Emily R Rosario, Julie Faieta, Jason R Falvey, Amit Kumar, Timothy A Reistetter, Vanina Dal Bello-Haas, Jonathan F Bean, Mohit Bhandari, Patricia C Heyn

College of Population Health Faculty Papers

Purpose: The coronavirus disease-19 (COVID-19) was declared a pandemic by the World Health Organization in March 2020. COVID-19, caused by SARS-CoV-2 has imposed a significant burden on health care systems, economies, and social systems in many countries around the world. The provision of rehabilitation services for persons with active COVID-19 infection poses challenges to maintaining a safe environment for patients and treating providers. Materials and Methods: Established frameworks were used to guide the scoping review methodology. Medline, Embase, Pubmed, CINAHL databases from inception to August 1, 2020, and prominent rehabilitation organizations' websites were searched. Study Selection: We included articles and …