Rehabilitation and Therapy Commons^™

Parents' Perceptions Of Eye-Gaze Technology Use By Children With Complex Communication Needs, Sandra Masayko, Joy Mcgowan, Namrata Grampurohit

Department of Occupational Therapy Faculty Papers

PURPOSE: Some preschool students with complex communication needs explore eye-gaze computer technology (EGCT) and adopt computer-based augmentative and alternative communication (AAC). The objective of this study was to follow preschool explorers of EGCT who are now school aged to describe the children's use of technology and parents' perceptions of its utility for communication, participation, or leisure.

METHOD: Ten parents completed survey questions by Internet and phone and reported their perceptions of nine children's effectiveness in the use and acceptance of AAC and the support they received in implementing technology. The results are reported as a descriptive study.

RESULTS: All children …

Blood Flow Restriction Therapy: A Review Of Physiology, Clinical Application, And Guidelines For Implementation, Nathan Schuliger

Senior Honors Theses

Blood flow restriction (BFR) therapy is an emerging clinical modality utilizing the metabolic stress of a hypoxic state to induce hypertrophic and strength adaptations in a manner allowing for reduced external loading. BFR has a variety of applications in rehabilitation settings, showing great potential for patients seeking the benefits of high intensity training without the associated degrees of mechanical stress. This literature review details the proposed mechanisms of BFR, along with various clinical applications of BFR including active and aerobic BFR. Concerns and contraindications for BFR usage are discussed regarding certain clinical populations, with risk stratification recommendations provided. Current BFR …

Correlation Enhanced Distribution Adaptation For Prediction Of Fall Risk, Ziqi Guo, Teresa Wu, Thurmon Lockhart, Rahul Soangra, Hyunsoo Yoon

Physical Therapy Faculty Articles and Research

With technological advancements in diagnostic imaging, smart sensing, and wearables, a multitude of heterogeneous sources or modalities are available to proactively monitor the health of the elderly. Due to the increasing risks of falls among older adults, an early diagnosis tool is crucial to prevent future falls. However, during the early stage of diagnosis, there is often limited or no labeled data (expert-confirmed diagnostic information) available in the target domain (new cohort) to determine the proper treatment for older adults. Instead, there are multiple related but non-identical domain data with labels from the existing cohort or different institutions. Integrating different …

Is Sway-Referenced Haptic Assistance Sensitive To Perceptual Context, Andrew Meszaros, Robin Dorociack, Peter Jang, Tanner Lehr, Bayli Mohl

Student-Faculty Research - College of Physical Therapy

Falls account for >$50 billion of medical spending in 2015 (CDC). Real-time haptic feedback shows promise at reducing static standing COM sway (Meszaros, 2019). Pilot data variability suggests that some haptic-wearers ‘over-correct’ (unnecessarily reducing available degrees of freedom), when haptic correction is perceived as ‘a mistake. Does over-correction reduce multi-segment control and impair sway stability (Hsu, Scholz, et al. 2007)?

Imu And Markerless Technology In Gait Analysis: Clinical Lessons, Jessa Barendse, Trevor Nannini, Joanna Zuckerman, Tess Swake, Robin Dorociak, Peter Jang, Andrew Meszaros

Student-Faculty Research - College of Physical Therapy

- Haptic feedback refers to the external vibratory cue that is activated by data picked up by the haptic device, Inertial Measurement Unit (IMU) (Figure 1), which senses joint position.

- Position-driven haptic touch input can modify movement in real-time (Meszaros, 2019)

- Original goal: to reduce knee hyperextension during gait using a popliteal fossa tactor driven by an IMU-based angle sensor (Sagemotion)

-Concerns arose on the validity of IMU/tactor and markerless motion analysis ❏ Are these algorithm-based data technologies clinic-ready?

- Does Sagemotion IMU fire the tactor at the actual knee angle selected in its software?

- Can markerless …

Factors Affecting Peak Effort In Max Effort Tests, Amanda Pardue, Michael Forster, Taylor Kopecky, Zoralei Dayley, Jeff Houck, Rebecca Dobler

Student-Faculty Research - College of Physical Therapy

Challenging older adults to execute peak effort functional tests is not common. A peak effort test pushes patients to the point of not sustaining the task. The Wingate test is a peak effort test that measures the amount of revolutions per second a participant can perform over 30s. Older adults with knee osteoarthritis (OA) may regulate their effort during the Wingate. Alternatively, high exertion during the Wingate test may yield high value in influencing attitudes related to pain and aging. The purpose of this study was to develop themes of what influences peak effort during the Wingate test in participants …

Instrumental Assessment Of Aero-Resistive Expiratory Muscle Strength Rehabilitation Devices, Angela M. Dietsch, Rahul Krishnamurthy, Kelsey Young, Steven M. Barlow

Department of Special Education and Communication Disorders: Faculty Publications

Purpose

Expiratory muscle strength training (EMST) is increasingly being used to treat voice, cough, and swallowing deficits in a wide range of conditions. However, a multitude of aero-resistive EMST models are commercially available, and the ab-sence of side-by-side comparative data interferes with clinicians’ ability to assess which model is best suited to a particular client’s needs. The primary aim of this research was to test and compare the pressure and flow parameters of six currently available EMST models to help inform clinical decision making.

Method

We identified and tested five devices of each of six different EMST models to generate …

Covid‑19‑Related Risk, Resilience, And Mental Health Among Mexican American Mothers Across The First Year Of The Pandemic, Amy L. Non, Elizabeth S. Clausing, Sandraluz Lara‑Cinisomo, Kimberly L. D’Anna Hernandez

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

Background Latina mothers have been especially affected by the pandemic and historically exhibit high rates of depression and anxiety. However, few longitudinal studies have assessed the effect of the pandemic on this vulnerable population. We hypothesized that COVID-19-related stressors would associate with psychological distress among Latina mothers across the first year of the pandemic.

Methods We investigated COVID-19-related impact, stigma, and fears across two critical time points and changes in these measures in relation to changes in maternal anxiety and depression among mothers of Mexican descent living in Southern California (n=152). Surveys were administered within 5–16 weeks of …

Reduced Grey Matter Volume In Adolescents With Conduct Disorder: A Region‑Of‑Interest Analysis Using Multivariate Generalized Linear Modeling, Ru Zhang, R. James R. Blair, Karina S. Blair, Matthew Dobbertin, Jordan E. Pierce, Johannah Bashford‑Largo, Ahria J. Dominguez, Melissa Hatch, Sahil Bajaj

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

Background Conduct disorder (CD) involves a group of behavioral and emotional problems that usually begins during childhood or adolescence. Structural brain alterations have been observed in CD, including the amygdala, insula, ventrolateral and medial prefrontal cortex, anterior cingulate cortex, and fusiform gyrus. The current study developed a multivariate generalized linear model (GLM) to differentiate adolescents with CD from typically developing (TD) adolescents in terms of grey matter volume (GMV).

Methods The whole‐brain structural MRI data were collected from 96 adolescents with CD (mean age = 16.188 ± 1.259 years; mean IQ = 104.292 ± 8.107 ; 63 males) and 90 …

Specialized Late Cingulo-Opercular Network Activation Elucidates The Mechanisms Underlying Decisions About Ambiguity, Jordan E. Pierce, Nathan M. Petro, Elizabeth Clancy, Caterina Gratton, Steven E. Petersen, Maital Neta

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

Cortical task control networks, including the cingulo-opercular (CO) network play a key role in decision-making across a variety of functional domains. In particular, the CO network functions in a performance reporting capacity that supports successful task performance, especially in response to errors and ambiguity. In two studies testing the contribution of the CO network to ambiguity processing, we presented a valence bias task in which masked clearly and ambiguously valenced emotional expressions were slowly revealed over several seconds. This slow reveal task design provides a window into the decision-making mechanisms as they unfold over the course of a trial. In …

Assessing Blood Oxygen Level–Dependent Signal Variability As A Biomarker Of Brain Injury In Sport-Related Concussion, Evan D. Anderson, Tanveer Talukdar, Grace Goodwin, Valentina Di Pietro, Kamal M. Yakoub, Christopher E. Zwilling, David Davies, Antonio Belli, Aron K. Barbey

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

Mild traumatic brain injury is a complex neurological disorder of significant concern among athletes who play contact sports. Athletes who sustain sport-related concussion typically undergo physical examination and neurocognitive evaluation to determine injury severity and return-to-play status. However, traumatic disruption to neurometabolic processes can occur with minimal detectable anatomic pathology or neurocognitive alteration, increasing the risk that athletes may be cleared for return-to-play during a vulnerable period and receive a repetitive injury. This underscores the need for sensitive functional neuroimaging methods to detect altered cerebral physiology in concussed athletes. The present study compared the efficacy of Immediate Post-concussion Assessment and …

Preventing Deep Vein Thrombosis In Surgical Patients, Ariel D. Roberson

MSN Capstone Projects

Deep vein thrombosis (DVT) is a significant medical issue that incurs thrombi formation in the venous system which can result in major medical problems. DVT’s often occur because of complications after orthopedic surgery. Common risks factors for DVT are vein injury, slow blood movement, increase estrogen, and chronic medical illness (Centers for Disease Control and Prevention [CDC], 2018). As many as 900,000 individuals are impacted by DVT each year (CDC, 2020). Consequently, recent estimates show that 60,000 to 100,000 Americans die each year because of DVT. Even more alarming, 10 to 30% of individuals will die of DVT within a …

Evaluating Non-Pharmacological Approaches To Nursing Home Dementia Care: A Protocol, Natalie E Leland, Victoria Shier, Catherine V. Piersol, Cara Lekovitch, Jenny Martínez, Yuna H Bae-Shaaw, Neeraj Sood, Claire Day, Paul Cass, Dominique Como, Carin Wong, Felicia Chew

Department of Occupational Therapy Faculty Papers

BACKGROUND: The COVID-19 pandemic has underscored the daily challenges nursing home (NH) staff face caring for the residents living with Alzheimer's Disease and Related Dementias (

METHODS: This clustered randomized trial will compare

CONCLUSION: This trial will be the first-ever evaluation of team- and problem-based approaches to ADRD care across multiple NHs and geographic regions. Results can provide health system leaders and policymakers with evidence on how to optimize ADRD training for staff in an effort to enhance ADRD care delivery.

Identification Of Structural Brain Alterations In Adolescents With Depressive Symptomatology, J. Bashford‑Largo, R. James R. Blair, Karina S. Blair, Matthew Dobbertin, Ahria Dominguez, Melissa Hatch, Sahil Bajaj

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

Introduction: Depressive symptoms can emerge as early as childhood and may lead to adverse situations in adulthood. Studies have examined structural brain alternations in individuals with depressive symptoms, but findings remain inconclusive. Furthermore, previous studies have focused on adults or used a categorical approach to assess depression. The current study looks to identify grey matter volumes (GMV) that predict depressive symptomatology across a clinically concerning sample of adolescents.

Methods: Structural MRI data were collected from 338 clinically concerning adolescents (mean age = 15.30 SD=2.07; mean IQ = 101.01 SD=12.43; 132 F). Depression symptoms were indexed via the Mood …

Specialized Late Cingulo-Opercular Network Activation Elucidates The Mechanisms Underlying Decisions About Ambiguity, Jordan E. Pierce, Nathan M. Petro, Elizabeth Clancy, Caterina Gratton, Steven E. Petersen, Maital Neta

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

Cortical task control networks, including the cingulo-opercular (CO) network play a key role in decision-making across a variety of functional domains. In particular, the CO network functions in a performance reporting capacity that supports successful task performance, especially in response to errors and ambiguity. In two studies testing the contribution of the CO network to ambiguity processing, we presented a valence bias task in which masked clearly and ambiguously valenced emotional expressions were slowly revealed over several seconds. This slow reveal task design provides a window into the decision-making mechanisms as they unfold over the course of a trial. In …

Effectiveness Of Nintendo Ring Fit In Improving Balance Deficits After Recovery From Acl Reconstruction, Emma Lord

Mahurin Honors College Capstone Experience/Thesis Projects

PURPOSE: This study aimed to assess the effectiveness of a gaming system in improving balance and strength after recovery from an anterior cruciate ligament reconstruction (ACLR). Existing bilateral deficits in strength and balance were also assessed among patients. METHODS: Four participants between the ages of 18-24 were recruited for this case-control study. Participants must have had ACL reconstruction surgery in the last 2 years, been discharged from formal physical therapy, and have a continued history of participating in physical activity at least three times a week. Participants were assigned to either the experimental or control groups using counterbalancing. The two …

Higher Sexual Excitation Is Associated With An Increase In Sex-Linked Substance Use In Women With A History Of Unwanted Sexual Contact, Harper R. Jones, Tierney K. Lorenz

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

Survivors of unwanted sexual contact have an increased likelihood of using substances in sexual situations, which puts them at heightened risk for intoxication-related harms. Separately, research has indicated that women may intentionally use substances in sexual situations to either enhance pleasure (i.e., increase sexual excitation) and/or reduce sexual anxiety or shame (i.e., reduce sexual inhibition), a phenomenon termed sex-linked substance use (SLSU). A predominant assumption in the literature is that women with unwanted sex histories are more likely to disengage during sex, suggesting greater inhibition-related SLSU; however, there is little prior research directly examining if women who have unwanted sex …

Manydogs Project: A Big Team Science Approach To Investigating Canine Behavior And Cognition, Daniela Alberghina, Emily E. Bray, Daphna Buchsbaum, Sarah- Elizabeth Byosiere, Julia Espinosa, Gitanjali E. Gnanadesikan, C.-N. Alexandrina Guran, Elizabeth Hare, Daniel J. Horschler, Ludwig Huber, Valerie A. Kuhlmeier, Evan L. Maclean, Madeline H. Pelgrim, Bryan Perez, Dana Ravid-Schurr, Liza Rothkoff, Courtney L. Sexton, Zachary A. Silver, Jeffrey R. Stevens

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

Dogs have a special place in human history as the first domesticated species and play important roles in many cultures around the world. However, their role in scientific studies has been relatively recent. With a few notable exceptions (e.g., Darwin, Pavlov, Scott, and Fuller), domestic dogs were not commonly the subject of rigorous scientific investigation of behavior until the late 1990s. Although the number of canine science studies has increased dramatically over the last 20 years, most research groups are limited in the inferences they can draw because of the relatively small sample sizes used, along with the exceptional diversity …

Concussion-Related Disruptions To Hub Connectivity In The Default Mode Network Are Related To Symptoms And Cognition, Heather C. Bouchard, Kate L. Higgins, Grace Amadon, Julia M. Laing-Young, Arthur C. Maerlender, Seima Al-Momani, Maital Neta, Cary R. Savage, Douglas H. Schultz

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

Concussions present with a myriad of symptomatic and cognitive concerns; however, the relationship between these functional disruptions and the underlying changes in the brain are not yet well understood. Hubs, or brain regions that are connected to many different functional networks, may be specifically disrupted after concussion. Given the implications in concussion research, we quantified hub disruption within the default mode network (DMN) and between the DMN and other brain networks. We collected resting-state functional magnetic resonance imaging data from collegiate student-athletes (n = 44) at three timepoints: baseline (prior to beginning their athletic season), acute post-injury (approximately 48 hours …

Pre–Post Intervention Exploring Cognitive Function And Relationships With Weight Loss, Intervention Adherence And Dropout, Amanda N. Szabo-Reed, Laura E. Martin, Cary R. Savage, Richard A. Washburn, Joseph E. Donnelley

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

Objective: To evaluate the association between baseline cognitive function, intervention dropout, adherence and 3-month weight loss (WL) when controlling for confounding demographic variables.

Methods: 107 (Mage = 40.9 yrs.), BMI in the overweight and obese range (BMI = 35.6 kg/m2), men (N = 17) and women (N = 90) completed a 3-month WL intervention. Participants attended weekly behavioral sessions, comply with a reduced calorie diet, and complete 100 min of physical activity (PA)/wk. Cognitive function tasks at baseline included Flanker (attention), Stroop (executive control) and working memory, demographics, body weight and cardiovascular fitness were assessed at baseline. Session attendance, adherence …

Reliability Of Accelerometer-Based Reaction Time Tests, Jacob Hepp, Warner Rhodes, Jordan Walton, Rahul Soangra, Brent Harper

Student Scholar Symposium Abstracts and Posters

Concussions are traumatic brain injuries that affect the function of the brain. One of the primary symptoms of a concussion is a lack of reaction time. The people that are most susceptible to concussions are athletes; Laker’s (2011) study found that 135,000 patients that suffer concussions from playing sports are expected to be hospitalized each year, with football making up 75% of concussions at high school and college levels. Honda et al. (2018) suggested reaction time as an important biomarker of concussion. Laboratory camera-based motion capture data, while reliable, is not a realistic tool to use outside of a laboratory …

Explicit And Implicit Emotion Processing In The Cerebellum: A Meta‑Analysis And Systematic Review, Jordan E. Pierce, Marine Thomasson, Philippe Voruz, Garance Selosse, Julie Péron

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

The cerebellum’s role in affective processing is increasingly recognized in the literature, but remains poorly understood, despite abundant clinical evidence for affective disruptions following cerebellar damage. To improve the characterization of emotion processing and investigate how attention allocation impacts this processing, we conducted a meta-analysis on task activation foci using GingerALE software. Eighty human neuroimaging studies of emotion including 2761 participants identified through Web of Science and ProQuest databases were analyzed collectively and then divided into two categories based on the focus of attention during the task: explicit or implicit emotion processing. The results examining the explicit emotion tasks identified …

Age-Dependent White Matter Disruptions After Military Traumatic Brain Injury: Multivariate Analysis Results From Enigma Brain Injury, Heather C. Bouchard, Delin Sun, Emily L. Dennis, Mary R. Newsome, Seth G. Disner, Jeremy Elman, Annelise Silva, Carmen Velez, Andrei Irimia, Nicholas D. Davenport, Scott R. Sponheim, Carol E. Franz, William S. Kremen, Michael J. Coleman, M. Wright Williams, Elbert Geuze, Inga K. Koerte, Martha E. Shenton, Maheen M. Adamson, Raul Coimbra, Gerald Grant, Lori Shutter, Mark S. George, Ross D. Zafonte, Thomas W. Mcallister, Murray B. Stein, Paul M. Thompson, Elisabeth A. Wilde, David F. Tate, Aristeidis Sotiras, Rajendra A. Morey

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

Mild Traumatic brain injury (mTBI) is a signature wound in military personnel, and repetitive mTBI has been linked to age-related neurogenerative disorders that affect white matter (WM) in the brain. However, findings of injury to specific WM tracts have been variable and inconsistent. This may be due to the heterogeneity of mechanisms, etiology, and comorbid disorders related to mTBI. Non-negative matrix factorization (NMF) is a data-driven approach that detects covarying patterns (components) within high-dimensional data. We applied NMF to diffusion imaging data from military Veterans with and without a self-reported TBI history. NMF identified 12 independent components derived from fractional …

The Role Of Reported Affective Symptoms And Anxiety In Recovery Trajectories After Sport-Related Concussion, Bernadette A. D'Alonzo, Abigail C. Bretzin, Douglas J. Wiebe, Ivy League–Big Ten Epidemiology Of Concussion Study Investigators, Arthur C. Maerlender, Cary R. Savage

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

Background: There is growing awareness and clinical interest in athletes with affective symptoms after sport-related concussion (SRC), as these symptoms may contribute to overall symptoms and represent a modifiable risk factor of longer recovery. However, evidence of their effects on the entire return-to-play (RTP) trajectory, particularly among women and men, is limited.

Purpose/Hypothesis: To examine the relationship between affective symptom reporting and RTP progression after SRC among a cohort of Division 1 student-athletes. We hypothesized that those endorsing affective symptoms, specifically nervous-anxious symptoms, spend more time in RTP progression and recovery.

Study Design: Cohort study; Level of evidence, 3.

Methods: …

Feasibility And Effectiveness Of A Prehabilitation Program Prior To Breast Cancer Surgery: A Critically Appraised Topic, Emma Choi, Alissa Lee, Kayla Woods, Morgan Mills, Carol Houston

Master of Occupational Therapy Student Critically Appraised Topics

The purpose of our project is to determine the feasibility and effectiveness of a prehabilitation (prehab) program for patients undergoing breast cancer surgery as compared to only receiving post-surgical rehabilitation. Our clinical mentor has recently obtained certification as a lymphedema specialist and is assisting with the opening of an outpatient mastectomy clinic through the Methodist University systems. Through our research process, we critically appraised two Level II articles, two Level III articles, and one Level IV article. Positive outcomes related to the feasibility were identified, however there is limited significant evidence supporting the effectiveness of the intervention. We recommend using …

Effect Of Botox And Therapy On Spasticity In Cerebral Palsy: A Critically Appraised Topic, Rachel Bray Mot/S, Tatum Cabot Mot/S, Peyton Clark Mot/S, Cameron Goodman Mot/S, Tarason Moore Mot/S, Claire Napier Mot/S

Master of Occupational Therapy Student Critically Appraised Topics

Children diagnosed with Cerebral Palsy often experience upper limb spasticity. Research has shown Botox injections in combination with occupational therapy can reduce the effects of spasticity in the upper limb. This literature review aims to determine how long is the appropriate duration of occupational therapy to administer after Botox injections to see decreased spasticity in the upper limbs.

Effects Of Sensory Intervention On Neurological Development In The Neonatal Intensive Care Unit: A Critically Appraised Topic, Paulina Bullard Mot/S, Emma Gadberry Mot/S, Siham Sherif Mot/S, Virginia Strawn Mot/S, Courtney Travis Mot/S, Delaney Weller Mot/S

Master of Occupational Therapy Student Critically Appraised Topics

The final portfolio contains four research articles from both national and international journals. Study designs include a randomized clinical trial, a randomized control trial, a systematic review and meta-analysis, and an integrative review. All studies relate directly to components of the evidence-based practice question and will be used to recommend sensory intervention for neurological development of premature infants in the neonatal intensive care unit (NICU). One of the articles describes statistically significant effects. One of the articles describes both statistically significant and non-statistically significant effects of sensory intervention on neurological development of premature infants in the NICU. The other two …

The Effects Of Air-Cell Based Cushions On Pressure Relief For Adults With Spinal Cord Injury: A Critically Appraised Topic, Audrey Carr Mot/S, Olivia Hamby Mot/S, Hailey Hanson Mot/S, Olivia Kincaid Mot/S, Molly Mcwilliams Mot/S, Anna Pollan Mot/S

Master of Occupational Therapy Student Critically Appraised Topics

Most acute care level patients with a SCI are dependent in performing pressure relief. Research was appraised and synthesized to answer the question: Are air-filled cushions effective for reducing pressure and development of pressure ulcers among adults with a spinal cord injury who are unable to independently perform pressure relief?

Group Therapy For Adults With Hip Replacements, Riley Burford Mot/S, Hillary Talley Mot/S, Elizabeth Seals Mot/S, Alishah Pirwani Mot/S, Tylan Wakefield Mot/S

Master of Occupational Therapy Student Critically Appraised Topics

The purpose of our critically appraised topic is to synthesize the best current evidence regarding the feasibility of group occupational therapy and outcomes related to ADL performance. The final portfolio contains a total of four research articles. Study designs include two randomized control trials, one cohort design, and one systematic review. All studies related directly to the PICO question and were used to determine best evidence for the feasibility of group therapy of the older adult population who have hip replacements in a rehabilitation setting.

Effect Of Early Mobilization On Length Of Hospital Stay In Covid-19 Patients: A Critically Appraised Topic, Ashlee Hodges, Anna Claire Briscoe, Anna Beth Willoughby, Carlton Hubbard, Nathan Smith

Master of Occupational Therapy Student Critically Appraised Topics

For this project, we created a critically appraised topic to study the effects of early mobilization on length of hospital stay in COVID-19 patients in the ICU.