Medicine and Health Sciences Commons^™

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

Theses and Dissertations--Rehabilitation Sciences

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

Telehealth Readiness In Older Adults In Kentucky, Kristen Weidner

Theses and Dissertations--Rehabilitation Sciences

During the COVID-19 pandemic, telehealth became an increasingly widespread service delivery model. Not all populations, however, accessed telehealth services equally. Older adults were less likely to use telehealth during the pandemic, continuing a historical trend. These usage patterns persist despite evidence that telehealth could be a helpful service delivery option for this population. Researchers have explored how theoretical frameworks explain older adults’ decisions to use technology, but there is yet to be a measure of older adults’ readiness for telehealth technology. A validated, theory-backed tool of older adults’ perceptions about telehealth, prior to the health care encounter, could help clinicians …

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

Theses and Dissertations--Rehabilitation Sciences

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

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

Theses and Dissertations--Rehabilitation Sciences

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

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

Theses and Dissertations--Rehabilitation Sciences

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

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

The Utilization Of Physical Literacy To Understand Physical Activity In Individuals With A History Of Anterior Cruciate Ligament Reconstruction, Rachel Renee Kleis

Theses and Dissertations--Rehabilitation Sciences

Injury to the anterior cruciate ligament (ACL) is common in physically active populations. Anterior cruciate ligament reconstruction (ACLR) is commonly performed after injury in order to restore joint stability and knee function and return patients to desired levels of physical activity. However, not everyone will return to their pre-injury levels of sport after surgery and recent evidence reveals that individuals with a history of ACLR are less likely to meet the recommended physical activity guidelines. Specifically, previous literature has reported that individuals with a history of ACLR take fewer daily steps and participate in less moderate-to-vigorous physical activity compared to …

Cognitive-Motor Interactions In Gait And Postural Control And Cortical Network Neurocorrelates, Nathan Morelli

Theses and Dissertations--Rehabilitation Sciences

The ability to mitigate performance decrements during the concurrent completion of cognitive and motor tasks (i.e., dual task (DT)) deteriorates in patients with mild Traumatic Brain Injury (mTBI). It is theorized that the long-term sequelae of mTBI are due to the return to full activity prior to neurophysiologic healing. To mitigate the negative outcomes associated with mTBIs, translational clinical research of neurophysiologic recovery is of paramount importance for both athletic and non-athletic populations. Despite the well-known health consequences, clinical decisions regarding neurophysiologic recovery and return to activity remain problematic for clinicians. Return to activity decisions are currently based on normalization …

Evaluation Of The Effectiveness Of A Pain Neuroscience Education Curriculum For Patients Who Experience Chronic Musculoskeletal Pain With Concurrent Opioid Dependence, Nicole D. Windsor

Theses and Dissertations--Rehabilitation Sciences

Background: Chronic musculoskeletal pain (CMP) is estimated to affect over 100 million adults annually and is targeted as an instigator of opioid dependence (OpD). Opioid medications are often the first response for patients suffering from CMP, but over 10 million people annually admit to misusing opioids. With the opioid epidemic, the healthcare system now has a population of patients who experience CMP with concurrent OpD. This persistent problem creates a perfect storm of fear of movement, low self-efficacy, and physical dysfunction. A critical component to chronic pain management is understanding how patients view their pain experience. Education may be one …

The Use Of Mechanotherapy To Promote The Recovery From Disuse Atrophy In Aging Rat Skeletal Muscle, Zachary Hettinger

Theses and Dissertations--Rehabilitation Sciences

The combination of age and disuse-related skeletal muscle atrophy predisposes older adults to reduced mobility, loss of independence, and poor quality of life. Poor health outcomes resulting from periods of disuse in older adults are exacerbated by an inability to fully recover, ultimately accelerating geriatric populations towards further functional decline. Aged-related changes to skeletal muscle viscoelastic properties, specifically of muscle extracellular matrix (ECM) stiffness, may not only impact how muscle responds during recovery, but also to interventions intended to augment recovery. Remodeling of muscle ECM in the aged may therefore benefit muscle mass recovery, yet therapies focused on ECM remodeling …

Changing The Perspective In Management Of A Progressive Neurological Disorder: Developing Interventions To Target Multifactorial Components Of Parkinson’S Disease With Emphasis On Improving Clinical Meaningful Outcomes, Jordana Christine Lockwich

Theses and Dissertations--Rehabilitation Sciences

Neurological disorders are currently the leading source of disability in the United States with Parkinson’s disease (PD) having the fastest growing incidence rate (Abate et al., 2017). PD is the second most common degenerative disease in older adults above 60 years old (Tysnes & Storstein, 2017) and epidemiology reports predict that the number of PD cases has doubled to 6 million since 1990 (Dorsey, Sherer, et al., 2018) It is estimated that PD prevalence will continue to rise with a projected 60,000 new cases in the United States by 2030 (Dorsey, Elbaz, et al., 2018) and has the potential to …

Beyond The Treatment Protocol: Active Ingredients For Precision Voice Rehabilitation, Maria H. Bane

Theses and Dissertations--Rehabilitation Sciences

Despite the growing body of research demonstrating voice therapy efficacy, only 12 of 100 people referred to a speech-language pathologist (SLP) for a voice evaluation will successfully complete therapy. One possible reason for this discrepancy is that clinical laboratory and clinical outcomes studies have focused on if voice therapy works while failing to explain how voice therapy works. While the if question is important, the yes or no response this question generates is of limited utility when those referred for voice therapy fail to complete. Consequently, the how question, which concentrates on the mechanisms and processes underlying effective voice therapy, …

Effect Of Blood Flow Restriction Training On Functional And Self-Reported Outcomes In Female Runners With Patellofemoral Pain, Lauren Nicole Erickson

Theses and Dissertations--Rehabilitation Sciences

Background: Patellofemoral pain (PFP) is the leading cause of lower extremity injury in female runners, significantly limiting running ability and becoming chronic in nearly 50% of the cases. This condition, which presents as pain around (peripatellar) or behind (retropatellar) the patella, is associated with significant weakness of the quadriceps and gluteal musculature, as well as altered movements mechanics. The challenge for clinicians is designing an effective treatment program to reduce pain and improve function without causing symptoms to flare. Blood flow restriction training (BFRT) is a relatively new training method within rehabilitation that involves placing a pressurized cuff to the …

Epidemiology Of Upper Extremity Injuries In High School Sports, Autumn Ruthe Whitson

Theses and Dissertations--Rehabilitation Sciences

Participation in high school sports has seen a steady increase over the past four decades. With nearly eight million student-athletes participating, careful monitoring of injuries related to their participation is imperative. Injury surveillance efforts through national databases have produced a multitude of studies detailing injuries that occur in specific sports, specific body parts, or particular diagnoses. The lower extremity tends to be injured more frequently than the upper extremity resulting in various comprehensive analyses on that particular body area. Currently, there are no comprehensive reports on the epidemiology of injury to the upper extremity in student-athletes participating in high school …

The Influence Of Physical Health, Emotional Health, And Socioeconomic Factors On The Musculoskeletal Pain Experience In Patients Attending A Pro Bono Physical Therapy Clinic, Garrett Naze

Theses and Dissertations--Rehabilitation Sciences

Non-communicable, chronic diseases are highly prevalent in the United States, reducing the quality of life for those affected and contributing to the majority of the nation’s healthcare expenditure. These conditions include, among others, cardiovascular disease, diabetes, and musculoskeletal disease. Musculoskeletal disease is particularly of interest for the field of physical therapy as the vast majority of patients seeking care in the outpatient setting present with musculoskeletal pain complaints, resulting in limitations in function, participation, and quality of life for the patient.

The factors influencing health outcomes are diverse and include a person’s physical environment, social and economic factors, access to …

Development Of A Field Expedient Screening Tool For The Coach To Identify Musculoskeletal Risk Factors In Baseball Players, Kyle Andrew Matsel

Theses and Dissertations--Rehabilitation Sciences

Identification of musculoskeletal (MSK) injury risk factors in baseball players can be challenging particularly for youth and high school coaches. Many baseball coaches lack a sports medicine and/or strength and conditioning staff to assist with injury prevention initiatives. Given the extensive responsibilities in managing the team and preparing the players for athletic competition, little time remains to focus on injury prevention and arm care programs. Furthermore, assessment, diagnosis, and management of MSK impairments is outside the scope of practice and expertise of baseball coaches. However, educating and empowering the coach to efficiently screen their players for potentially injury producing MSK …

Anterior Cruciate Ligament Injury-Induced Alterations In Inflammation And Muscle Physiology, Emily R. Hunt

Theses and Dissertations--Rehabilitation Sciences

Long term weakness and atrophy of the quadriceps muscle are a direct result of anterior cruciate ligament (ACL) injuries and persist for up to 10 years post injury. Muscle atrophy ensues regardless of ligamentous reconstruction surgery, indicating that muscle atrophy following injury is a function of the ligament rupture and not reconstruction surgery. Elucidating the mechanisms underlying quadriceps atrophy following ACL rupture is crucial for developing interventions to restore proper quadriceps size and mitigate weakness thereby allowing for improved patient function. In addition to understanding the specific mechanisms that contribute to quadriceps atrophy following ACL rupture, the timing of atrophic …

Determining The Role Of Satellite Cells During Skeletal Muscle Adaptation, Davis A. Englund

Theses and Dissertations--Rehabilitation Sciences

Physical inactivity, advancing age, limb immobilization, degenerative diseases and various systemic diseases (many cancers, sepsis, HIV, COPD, kidney disease) all lead to skeletal muscle wasting. The loss of muscle mass is of major clinical importance because it leads to an increased risk for morbidity, disability, and the loss of independence; collectively contributing to a substantive increase in healthcare utilization and cost. The prevalence of cachexia (disease-induced muscle wasting) can reach as high as 80% in certain patient populations and the average cost per hospital stay is $4,641 more than in non-cachectic patients. Direct healthcare costs attributable to sarcopenia were estimated …

Clinical And Neurophysiological Effects Of Dry Needling On Individuals With Chronic Ankle Instability, Jennifer Mullins

Theses and Dissertations--Rehabilitation Sciences

Ankle sprains are generally considered innocuous injuries; however, as many as 74% of patients will develop chronic symptoms. 1-3 Chronic ankle instability (CAI) is defined by a history of ankle sprain accompanied by ongoing bouts of giving way, residual ankle sprain symptoms, and a decrease in patient-perceived function. As understanding of sensorimotor deficits in individuals with CAI have advanced, treatment strategies have evolved to include a robust focus on balance training to mitigate dynamic and static postural control impairments exhibited in individuals with CAI. A problem arises as these improvements have not been conclusively linked to a decrease in CAI. …

The Effects Of Three Service Delivery Models On Vocabulary Learning By Second-Grade Children, Laura Stone

Theses and Dissertations--Rehabilitation Sciences

Speech-Language Pathologists (SLPs) provide services to children in schools across the United States primarily in a direct small group service delivery model outside of the regular education classroom. To date little research exists to indicate that direct pull-out service delivery is an effective model in elementary schools for students requiring speech and language therapy. One area that has been studied is the effectiveness of vocabulary intervention among service delivery models. Preliminary findings suggest that students with language and literacy deficits learn vocabulary well within a regular education environment with SLP support. However, there is little consensus on how service delivery …

Psychosocial Predictors Of Chronic Pain And Pain-Related Disability 12 Months After Lower Extremity Fracture, Joshua Judson Van Wyngaarden

Theses and Dissertations--Rehabilitation Sciences

Over 700,000 lower extremity fractures occur each year with a large portion of these patients developing adverse long-term pain and disability outcomes. Current literature indicates that 39% to 62.7% of all patients report continued pain long after traumatic lower extremity fracture. Concurrent physical limitations and reduced quality of life are common, with nearly one-third of all patients reporting pain-related disability seven years after limb threatening trauma, and approximately 50% of these patients having limitations in functional mobility and activities of daily living at long-term follow-up. These poor long-term injury-related pain and disability outcomes are alarming and require further action to …

An Evaluation Of Postural Control And Balance After Anterior Cruciate Ligament Reconstruction, Kathryn Lucas

Theses and Dissertations--Rehabilitation Sciences

Over 100,000 anterior cruciate ligament reconstructions (ACLR) occur annually in the United States, with one in four individuals sustaining a second injury within the first two years after reconstruction. Due to the proprioceptive nature of the anterior cruciate ligament, the lack of regaining postural control and balance are likely large contributors to the rate of secondary injuries after ACLR. Recent literature has identified cerebral changes after anterior cruciate ligament injury and surgery, likely due to altered sensation and feedback loops. However, no study thus far has investigated the neurological feedback loops that may place this group at higher risk of …

Physical And Occupational Therapy For Young Children With Delayed Motor Development: Exploring Current Practices, Challenges, And Families’ Implementation Of Home Activities In Early Intervention, Afnan Gmmash

Theses and Dissertations--Rehabilitation Sciences

The literature supports the use of family-centered early intervention(EI) for young children with or at risk for cerebral palsy (CP) to promote the children’s motor development. Young children with or at risk for delayed motor development in their first three years of life are entitled to EI under Part C of The Individuals with Disabilities Education Improvement Act. Identifying current EI provided for young children with delayed motor development is essential to detect possible gaps and factors that could prevent therapists from providing the best EI. Understanding the parent’s perspective on the implementation of activities outside therapy to maximize the …

Effects Of Load Carriage On Shoulder Neuromuscular Functions And Recovery, Muataz R. Almaddah

Theses and Dissertations--Rehabilitation Sciences

Load carriage is a primary source for injury occurrence among military personnel and recreational hikers affecting all body areas. The shoulder ranks as the second or third most common site of injuries among military personnel. Many studies report that elevations in self-reported fatigue, soreness, and discomfort in the shoulders accompany the load carriage. Almost 50% of military personnel experienced a load carriage injury during the first episode of training, and 75% of those injured suffered a second injury during their career. The goal of this research project is to investigate the components associated with load carriage shoulder symptoms to determine …

Influences Of Functional And Psychological Factors On Biomechanics Following An Anterior Cruciate Ligament (Acl) Reconstruction, Chelsey Roe

Theses and Dissertations--Rehabilitation Sciences

Objective: The aims of this research were to identify gaps in the literature related to return to sport (RTS) test batteries following primary anterior cruciate ligament reconstruction (ACLR) (Aim 1) and define recovery in athletes from 4-9 months after ACLR across three domains: 1) psychological recovery and biomechanics (Aim 2), 2) rehabilitation quantity and biomechanics (Aim 3), and 3) functional performance and biomechanics (Aim 4). Ultimately, the results of this research would quantify recovery following ACLR in athletes with a desire to RTS and identify objective criteria throughout rehabilitation prior to RTS.

Participants: Twenty-two post-ACLR athletes 17 females, 8 males, …

Clinical Measurements Of The Posterior Shoulder Endurance Test (Pset), Neil A. Evans

Theses and Dissertations--Rehabilitation Sciences

Of the intrinsic factors responsible for non-traumatic shoulder pain, muscular endurance is often not measured by rehabilitation professionals due to the lack of available shoulder endurance measures. Measurement properties of the PSET have not been adequately assessed in previous studies. The purpose of this dissertation was to develop the clinical measurement properties of the Posterior Shoulder Endurance Test (PSET) so that it might be used as a clinical measure of shoulder muscular endurance.

Electromyography (EMG) offers the ability to identify which muscles in the posterior shoulder girdle are fatiguing during the PSET. Surface EMG of upper trapezius (UT), middle trapezius …

Biopsychological Predictors Of Pain And Function In Patients With Rotator Cuff Conditions, Nicole Cascia

Theses and Dissertations--Rehabilitation Sciences

Predicting worse patient-reported outcomes in those with Rotator Cuff (RC) conditions is dependent on examining both biological and psychological impairments. In order to help determine which biopsychological factors are associated with pain and function in patients with RC related conditions and to determine who may be at an increased risk for worse outcomes after Reverse Shoulder Arthroplasty (RSA), biopsychological associations between patient demographics, scapular motion, humeral motion, RC tear size, pain associated psychological distress, and function were clinically evaluated to investigate prediction models for pain and function. The central hypothesis is that in a group of patients with symptomatic Cuff …

Transcriptomic And Cellular Response To Mechanical Overload And The Underlying Role Of Macrophages In Extracellular Matrix Remodeling, Bailey D. Peck

Theses and Dissertations--Rehabilitation Sciences

The extracellular matrix (ECM) in skeletal muscle plays an integral role in tissue development, structural support, and force transmission. Upon mechanical loading, including resistance exercise, which alter muscle fiber contractile activity, size, orientation and connectivity, remodeling processes must occur that involve both ECM deposition and degradation. ECM remodeling involves many cell types in muscle, but the focus of our research was directed towards macrophages, which participate in the early immune response to damage and loading. We have consistently demonstrated a significant increase in skeletal muscle macrophage abundance using pan macrophage markers (CD11b/CD68) and anti-inflammatory markers (CD206/CD163) following exercise training in …

Vestibular Function And Sports-Related Concussion: An Exploratory Investigation Of The Consequences Of Sports Related Concussion On Vestibular Function And Outcomes, Carolina Quintana

Theses and Dissertations--Rehabilitation Sciences

Sports-related concussions (SRC), or mild traumatic brain injuries that occur as a result of sports or athletic participation, are said to affect approximately 300,000 young adults and 1.4 million youth athletes in the United States on an annual basis. SRC create a significant burden on the health care system by generating an estimated $60 billion dollars in direct and indirect costs in 2000. In addition to the financial burden these injuries create, they additionally impose both short- and long-term effects for those effected and their overall health. Among the many effects of concussions are physical signs as symptoms such as …

Using Transcranial Direct Current Stimulation To Improve Naming Ability In Post-Stroke Aphasia: Evaluating Evidence And Optimizing Outcomes, Mohammed Alharbi

Theses and Dissertations--Rehabilitation Sciences

Introduction. Aphasia is a devastating acquired language disorder that affects about one third of stroke survivors. Aphasia can severely affect quality of life and can be associated with economic burdens due to the need for long-term communication rehabilitation. Traditional aphasia therapies are known to be effective; however, progress is often slow and limited in severe cases – full restoration of communication abilities is rarely achieved. Thus, there is a critical need for therapeutic solutions that can reduce the associated burden of aphasia. Transcranial direct current stimulation (tDCS) is a non-invasive and inexpensive neuromodulation technique that has the potential to boost …

Experiences Of Adolescents In The General Education Setting Interacting With Peers With Intellectual Disability, Katie Goldey

Theses and Dissertations--Rehabilitation Sciences

Social interaction is critical to health, quality of life, and linguistic and cognitive development. However, young people with intellectual disabilities are unlikely to have equitable opportunities for social interaction. This may be particularly true of adolescents. This study used qualitative phenomenological methods to examine the lived experiences of students in the general education setting interacting with their peers with intellectual disability. Twenty participants engaged in one on one interviews with the author. Interviews were recorded, transcribed verbatim, and analyzed for overarching themes. Four main themes emerged from the data including: (1) Teens just don’t have many opportunities to interact with …