Rehabilitation and Therapy Commons^™

Evidence Synthesis Methodology: Promoting Reproducible Methodology Through Modified Assignments, Laura Lipke, Neyda Gilman

Library Created Resources

Initially, systematic reviews in healthcare served to synthesize findings from clinical studies, aiding comprehensive access to the most effective treatments within evidence-based practice. Over time, their scope has broadened beyond treatment effectiveness, leading to a surge in publication. Consequently, many health science faculty now assign systematic reviews in classrooms without a full grasp of the standardized process, leaving students ill-equipped due to insufficient guidance and resources.

While mastering systematic review techniques is crucial for evidence-based practice, faculty can opt for modified assignments to foster a deeper understanding of the review process. These modified tasks, can be completed within a semester, …

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 …

Physical Activity For Anxiety For Autistic People: A Systematic Review, Kathryn Riis, Brittany Samulski, Kristina A. Neely, Patricia Laverdure

Rehabilitation Sciences Faculty Publications

Clinical anxiety is a common comorbidity in autistic people. Due to the prevalence of anxiety in the autism population and the adverse effects it causes, there is a critical need to develop effective interventions which address anxiety symptoms for autistic people. Therefore, the purpose of this systematic review was to examine the effectiveness of the use of physical activity as an intervention to reduce anxiety in autistic people. Three databases PubMed, PsychInfo, and Cochrane RCTs, were searched utilizing key terms. PRISMA systematic search procedures identified 44 studies meeting predetermined inclusion criteria. Participant characteristics, the type of physical activity performed, the …

Services Provided To Aging Individuals With Intellectual Disabilities: Survey Of Speech Language Pathologists, Claire H. Gatewood

College of Education and Human Sciences: Dissertations, Theses, and Student Research

Purpose: The present study explored current speech-language pathology service provision for aging individuals with intellectual disabilities in the United States, including areas and domains of services, factors restricting service provision, and reported knowledge and confidence of individuals within the field of speech-language pathology in providing services, to identify possible gaps of service and needed improvement.

Methods: Participants (n = 272) from across the United States completed an online survey to gather descriptive information about current speech-language pathology service provision for aging individuals with intellectual disabilities. Participants were recruited through state speech-language hearing associations and universities with speech-language pathology clinics …

Incog 2.0 Guidelines For Cognitive Rehabilitation Following Traumatic Brain Injury, Part Iii: Executive Functions, Eliyas Jeffay, Jennie Ponsford, Amber Harnett, Shannon Janzen, Eleni Patsakos, Jacinta Douglas, Mary Kennedy, Ailene Kua, Robert Teasell, Penny Welch-West, Mark Theodore Bayley, Robin Green

Communication Sciences and Disorders Faculty Articles and Research

Introduction:

Moderate-to-severe traumatic brain injury (MS-TBI) causes debilitating and enduring impairments of executive functioning and self-awareness, which clinicians often find challenging to address. Here, we provide an update to the INCOG 2014 guidelines for the clinical management of these impairments.

Methods:

An expert panel of clinicians/researchers (known as INCOG) reviewed evidence published from 2014 and developed updated recommendations for the management of executive functioning and self-awareness post-MS-TBI, as well as a decision-making algorithm, and an audit tool for review of clinical practice.

Results:

A total of 8 recommendations are provided regarding executive functioning and self-awareness. Since INCOG 2014, 4 …

Incog 2.0 Guidelines For Cognitive Rehabilitation Following Traumatic Brain Injury: What’S Changed From 2014 To Now?, Mark Theodore Bayley, Shannon Janzen, Amber Harnett, Peter Bragge, Leanne Togher, Ailene Kua, Eleni Patsakos, Lyn S. Turkstra, Robert Teasell, Mary Kennedy, Shawn Marshall, Jennie Ponsford

Communication Sciences and Disorders Faculty Articles and Research

IT IS CRITICAL TO KEEP clinical practice guidelines (CPGs) up to date through integration of the latest evidence. Therefore, it is with great excitement that the INCOG team presents the INCOG 2.0 Guidelines for Cognitive Rehabilitation Following Traumatic Brain Injury (TBI). In this brief introduction, we provide an overview of changes in the evidence from 2014; share insights into the current state and challenges implementing cognitive rehabilitation; and provide an overview of INCOG 2022.

Incog 2.0 Guidelines For Cognitive Rehabilitation Following Traumatic Brain Injury, Part Iv: Cognitive-Communication And Social Cognition Disorders, Leanne Togher, Jacinta Douglas, Lyn S. Turkstra, Penny Welch-West, Shannon Janzen, Amber Harnett, Mary Kennedy, Ailene Kua, Eleni Patsakos, Jennie Ponsford, Robert Teasell, Mark Theodore Bayley, Catherine Wiseman-Hakes

Communication Sciences and Disorders Faculty Articles and Research

Introduction:

Moderate to severe traumatic brain injury causes significant cognitive impairments, including impairments in social cognition, the ability to recognize others' emotions, and infer others' thoughts. These cognitive impairments can have profound negative effects on communication functions, resulting in a cognitive-communication disorder. Cognitive-communication disorders can significantly limit a person's ability to socialize, work, and study, and thus are critical targets for intervention. This article presents the updated INCOG 2.0 recommendations for management of cognitive-communication disorders. As social cognition is central to cognitive-communication disorders, this update includes interventions for social cognition.

Methods:

An expert panel of clinicians/researchers reviewed evidence published since …

The Future Of Incog (Is Now), Peter Bragge, Mark Theodore Bayley, Diana Velikonja, Leanne Togher, Jennie Ponsford, Shannon Janzen, Amber Harnett, Ailene Kua, Eleni Patsakos, Amanda Mcintyre, Robert Teasell, Mary Kennedy, Shawn Marshall

Communication Sciences and Disorders Faculty Articles and Research

IT HAS BEEN 8 years since the first iteration of the INCOG clinical practice guidelines (CPGs) were published. Much has happened since 2014, and a considerable body of evidence has been published in the various domains of cognitive rehabilitation research represented in this special issue. Over this time, significant developments in the science of identifying, appraising, and distilling research evidence into practically applicable CPGs have emerged, as well as implementation efforts to ensure meaningful change in care delivery.

Incog 2.0 Guidelines For Cognitive Rehabilitation Following Traumatic Brain Injury, Part V: Memory, Diana Velikonja, Jennie Ponsford, Shannon Janzen, Amber Harnett, Eleni Patsakos, Mary Kennedy, Leanne Togher, Robert Teasell, Amanda Mcintyre, Penny Welch-West, Ailene Kua, Mark Theodore Bayley

Communication Sciences and Disorders Faculty Articles and Research

Introduction:

Memory impairments affecting encoding, acquisition, and retrieval of information after moderate-to-severe traumatic brain injury (TBI) have debilitating and enduring functional consequences. The interventional research reviewed primarily focused on mild to severe memory impairments in episodic and prospective memory. As memory is a common focus of cognitive rehabilitation, clinicians should understand and use the latest evidence. Therefore, the INCOG (“International Cognitive”) 2014 clinical practice guidelines were updated.

Methods:

An expert panel of clinicians/researchers reviewed evidence published since 2014 and developed updated recommendations for intervention for memory impairments post-TBI, a decision-making algorithm, and an audit tool for review of clinical practice. …

Identifying Voice-Based Digital Biomarkers Of Parkinson's Disease, Rachelle Beshay, Madison Gill, Michael Shiraishi, Rahul Soangra

Student Scholar Symposium Abstracts and Posters

Introduction: Parkinson's disease is a disorder in the central nervous system that causes tremors, abnormal gait and balance, and muscle rigidity due to loss of function in parts of the brain. Traditionally, Parkinson's is identified by the physical symptoms seen in a patient's gait and motor skills, but irregular speech patterns (hypokinetic dysarthria) is one of the first symptoms to be derived from the disease. Objective: The goal of this ongoing study is to use Mel Frequency Centrum Coefficients (MFCC), to diagnose Parkinson's in the early stages by identifying hypokinetic dysarthria. MFCC's process speech recognition patterns and produce …

Evaluation Of Swallowing Related Measures In Different Head And Neck Postures In Healthy Young And Older Adults, Mabell Vargas

FIU Electronic Theses and Dissertations

This study evaluated swallowing related measures (oral transit time and number of swallows, tongue force and lip force) and different head and neck postures in a group of healthy young adults and older adults. Participants consisted of 19 healthy young and 17 healthy old. They were asked to ingest 2 different liquid consistency to measure the time they take to swallow and the number of swallows. The maximum tongue and lip force was measured with the IOPI device for 3 seconds and repeated 3 times.

The results of the study showed that the number of swallows is not significant regardless …

Differential Effects Of Speech And Language Therapy And Rtms In Chronic Versus Subacute Post-Stroke Aphasia: Results Of The Northstar-Ca Trial, Anna Zumbansen, Heike Kneifel, Latifa Lazzouni, Anja Ophey, Sandra E. Black, Joyce L. Chen, Dylan Edwards, Thomas Funck, Alexander Erich Hartmann, Wolf Dieter Heiss, Franziska Hildesheim, Sylvain Lanthier, Paul Lespérance, George Mochizuki, Caroline Paquette, Elizabet Rochon, Ilona Rubi-Fessen, Jennie Valles, Susan Wortman-Jutt, Alexander Thiel

Research outputs 2022 to 2026

Background & objective: Contralesional 1-Hz repetitive transcranial magnetic stimulation (rTMS) over the right pars triangularis combined with speech-language therapy (SLT) has shown positive results on the recovery of naming in subacute (5–45 days) post-stroke aphasia. NORTHSTAR-CA is an extension of the previously reported NORTHSTAR trial to chronic aphasia (>6 months post-stroke) designed to compare the effectiveness of the same rTMS protocol in both phases. Methods: Sixty-seven patients with left middle cerebral artery infarcts (28 chronic, 39 subacute) were recruited (01-2014 to 07-2019) and randomized to receive rTMS (N = 34) or sham stimulation (N = 33) with SLT for …

Perceived Exercise Habits Of Individuals With Parkinson’S Disease Living In The Community, Jordana Lockwich, Kate Schwartzkopf-Phifer, Camille L. Skubik-Peplaski, Richard D. Andreatta, Patrick H. Kitzman

Communication Sciences and Disorders Faculty Publications

Context

Exercise has been shown to improve gait in individuals with Parkinson’s disease (PD). Stepping practice at higher intensity levels has been suggested as a beneficial treatment option to improve gait in the neurological population. Unfortunately, this mode is poorly understood and underutilized within the PD population. Information on what individuals with PD are doing for exercise would be beneficial to help tailor exercise programs to improve gait and provide exercise options in the community for intensity-based exercise.

Objective

To investigate the current exercise habits of individuals living with PD in the community aimed at improving walking and to understand …

Evaluating The Effects Of Physical Activity On The Cognitive Functions And Motor Skills Of The Special Needs Population And Testing A Different Teaching Style To Maximize The Efficiency Of Special Needs Programs, Oren Nedjar

BIO4960: Practicum in Biology I

This study aimed to analyze the effects of physical activities on the motor and cognitive functions of participants with special needs and compare these results with a similar program but organized online because of the health precautions that have been applied due to the COVID-19 pandemic. An intervention consisting of sending an educational brochure aiming to increase high school volunteers' health literacy was then tested and results showed that it improved participants' health outcomes and also could increase the program's effectiveness in the long term.

A 3-Month Interdisciplinary Process Drama Program To Build Social Skills In Pre-Schoolers With Asd: A Feasibility Study, Lorie G. Richards, Heidi Woolley, Xan S. Johnson, Pamela Mathy, Stacy Manwaring, M. Raby, Penelope Caywood, W. Wilde, L. Thornton

Occupational Therapy Collection

Objectives:

• To test the feasibility and effect of an interdisciplinary process drama program targeting social skill development in 3-5 year-old children with Autism Spectrum Disorder (ASD) characteristics
• To develop a paradigm for testing brain-behavior relationships related to social skills in these children using EEG and testing its ability to detect intervention-related changes.

Background: Social skill deficits are a hallmark cause of disability in ASD. Such disability is of critical concern given the rising prevalence (1 in 54 Utah children) of ASD. [1] As children learn through social experiences, difficulty in social interactions can limit development and ability to succeed …

Effects Of Speech Cues In French-Speaking Children With Dysarthria, Erika S. Levy, Gemma Moya-Galé, Younghwa Michelle Chang, Luca Campanelli, Andrea A. N. Macleod, Sergio Escorial, Christelle Maillart

Publications and Research

Background: Articulatory excursion and vocal intensity are reduced in many children with dysarthria due to cerebral palsy (CP), contributing to the children’s intelligibility deficits and negatively affecting their social participation. However, the effects of speech-treatment strategies for improving intelligibility in this population are understudied, especially for children who speak languages other than English. In a cueing study on English-speaking children with dysarthria, acoustic variables and intelligibility improved when the children were provided with cues aimed to increase articulatory excursion and vocal intensity. While French is among the top 20 most spoken languages in the world, dysarthria and its management in …

Pills And Spills: An Assessment Of Medications And Fall Risk In Older Patients, Kelly L. Covert, Courtney D. Hall

ETSU Faculty Works

No abstract provided.

Comparison Of Upper Extremity Function In Women With And Women Without A History Of Breast Cancer, Mary Insana Fisher, Gilson J. Capilouto, Terry Malone, Heather M. Bush, Timothy L. Uhl

Communication Sciences and Disorders Faculty Publications

Background

Breast cancer treatments often result in upper extremity functional limitations in both the short and long term. Current evidence makes comparisons against a baseline or contralateral limb, but does not consider changes in function associated with aging.

Objective

The objective of this study was to compare upper extremity function between women treated for breast cancer more than 12 months in the past and women without cancer.

Design

This was an observational cross-sectional study.

Methods

Women who were diagnosed with breast cancer and had a mean post-surgical treatment time of 51 months (range = 12–336 months) were compared with women …

Development Of A Non-Invasive Device For Swallow Screening In Patients At Risk Of Oropharyngeal Dysphagia: Results From A Prospective Exploratory Study, Catriona M. Steele, Rajat Mukherjee, Juha M. Kortelainen, Harri Pölönen, Michael Jedwab, Susan L. Brady, Kayla Brinkman Theimer, Susan Langmore, Luis F. Riquelme, Nancy B. Swigert, Philip M. Bath, Larry B. Goldstein, Richard L. Hughes, Dana Leifer, Kennedy R. Lees, Atte Meretoja, Natalia Muehlemann

Neurology Faculty Publications

Oropharyngeal dysphagia is prevalent in several at-risk populations, including post-stroke patients, patients in intensive care and the elderly. Dysphagia contributes to longer hospital stays and poor outcomes, including pneumonia. Early identification of dysphagia is recommended as part of the evaluation of at-risk patients, but available bedside screening tools perform inconsistently. In this study, we developed algorithms to detect swallowing impairment using a novel accelerometer-based dysphagia detection system (DDS). A sample of 344 individuals was enrolled across seven sites in the United States. Dual-axis accelerometry signals were collected prospectively with simultaneous videofluoroscopy (VFSS) during swallows of liquid barium stimuli in thin, …

The Quality Of Transdisciplinary Team Assessment Practices For Mobile Technology As Augmentative And Alternative Communication, Laura Jeanne Mansfield

Doctoral Dissertations and Projects

While research acknowledges the impact the rapid growth in mobile technology is having on the field of augmentative and alternative communication (AAC), little has been done to investigate the impact this development has had on assessment practices for matching an individual with the appropriate technology. The purpose of this descriptive and causal-comparative research study was to gather demographic and descriptive data on mobile technology as AAC and to investigate the quality of transdisciplinary teamwork assessment practices as evaluated by speech-language pathologists (SLPs) for the provision of mobile technologies as AAC devices across SLP practice settings. A random sample of 60 …

Treatment Of Auditory Processing In Noise In Individuals With Mild Aphasia: Pilot Study, Anastasia M. Raymer, Hilary M. Sandberg, Kathryn S. Schwartz, Ginger S. Watson, Stacie I. Ringleb

Communication Disorders & Special Education Faculty Publications

Purpose: Listening in noise challenges listeners with auditory comprehension impairments in aphasia. We examined the effects of Trivia Game, a computerized program with questions spoken in increasing levels of background noise with success in the game.

Methods: We piloted Trivia Game in four individuals with chronic aphasia and mild auditory comprehension impairments. Participants played Trivia Game for 12 twenty-minute sessions. In addition to the Western Aphasia Battery (WAB), we measured outcomes on Quick Speech in Noise (QSIN), a sentence repetition test, administered in auditory (AUD) and auditory+visual (AV) conditions as signal-to-noise ratio varied from 25 to 0 dB.

Results: All …

Assessment Of Interprofessional Team Collaboration Scale (Aitcs): Further Testing And Instrument Revision., Carole Orchard, Linda L Pederson, Emily Read, Cornelia Mahler, Heather Laschinger

Nursing Publications

INTRODUCTION: The need to be able to assess collaborative practice in health care teams has been recognized in response to the direction for team-based care in a number of policy documents. The purpose of this study is to report on further refinement of such a measurement instrument, the Assessment of Interprofessional Team Collaboration Scale (AITCS) first published in 2012. To support this refinement, two objectives were set: Objective 1: to determine whether the items from the data collected in 2016 load on the same factors as found for the 2012 version of the 37-item AITCS. Objective 2: to determine whether …

Immature Auditory Evoked Potentials In Children With Moderate-Severe Developmental Language Disorder., Elaine Yuen Ling Kwok, Marc F Joanisse, Lisa Archibald, Janis Oram Cardy

Health and Rehabilitation Sciences Publications

Purpose: Immature auditory processing has been proposed to underlie language impairments in children with developmental language disorder (DLD; also known as specific language impairment). Using newly available normative auditory evoked potential (AEP) waveforms, we estimated AEP maturity in individual children with DLD and explored whether this maturational index was related to their language abilities.

Method: AEPs were elicited by 225 trials of a 490-Hz pure tone. Using intraclass correlation and our previously established normative AEP waveforms of 7- to 10-year-old children with typical development, we estimated the age equivalent of the AEPs (AEP-age) from 21 children with DLD. The relation …

A Speed-Based Approach To Vestibular Rehabilitation For Peripheral Vestibular Hypofunction: A Retrospective Chart Review, Robert Alen Roller, Courtney D. Hall

ETSU Faculty Works

BACKGROUND: Current vestibular rehabilitation for peripheral vestibular hypofunction is an exercise-based approach that improves symptoms and function in most, but not all patients, and includes gaze stabilization exercises focused on duration of head movement. One factor that may impact rehabilitation outcomes is the speed of head movement during gaze stability exercises.

OBJECTIVE: Examine outcomes of modified VOR X1 exercises that emphasize a speed-based approach for gaze stabilization while omitting substitution and habituation exercises. Balance training focused on postural realignment and hip strategy performance during altered visual and somatosensory inputs.

METHODS: A retrospective chart review of 159 patients with vestibular deficits …

Tbi Stac Procedures: Touchscreen Tablet-Based Cognitive Assessment Versus Paper-Based Assessments For Traumatic Brain Injury, Sarah E. Wallace Ccc-Slp, Elena V. Donoso Brown Otr/L, James B. Schreiber Ph.D., Sarah Diehl M.S., Cf-Slp, Joanne Kinney M.S., Ccc-Slp, Lani Zangara M.S., Otr/L

Speech-Language Pathology Faculty Scholarship

No abstract provided.

Delirium Reduction Strategies For The Critically Ill, June Chaves, Sam Canonico, Will Cheney, Tammy Corey, Gil Fraser, Alex Kowalewski, Jen Low, Cardiac Intensive Care Unit, Haley Pelletier, Cathy Palleschi, Stephen Tyzik, Suneela Nayak, Ruth Hanselman

MaineHealth Maine Medical Center

Delirium, an acute and fluctuating disturbance of consciousness and cognition, is a common manifestation of acute brain dysfunction in critically ill patients. Patients with delirium have longer hospital stays and a lower 6-month survival rate than do patients without delirium. Preliminary research suggests that delirium may be associated with cognitive impairment that persists months to years after discharge.

In a large acute care hospital, the cardiac intensive care staff became interested in mitigating their unit’s high delirium rate of ventilated patients. At baseline, many members of the healthcare team did not believe that delirium could be prevented and the predominant …

Strategies To Improve Interdisciplinary Communication In An Acute Care Inpatient Pediatric Unit, Sarah Thompson, Haley Pelletier, Barbara Bush Children's Hospital-Inpatient, Maine Medical Center, Suneela Nayak, Ruth Hanselman, Stephen Tyzik

MaineHealth Maine Medical Center

Interdisciplinary patient rounding has been shown to improve patient and family satisfaction as well as reduce patient length of stay and readmission rates. In an acute care inpatient pediatric unit, baseline metrics demonstrated that 100% of the time, nursing was not included in these rounds thus resulting in sub optimal communication.

The goal of this performance improvement project was to attain increased nursing participation. Data collection demonstrated several reasons for lack of participation and corrective actions were instituted. After undertaking this KPI goal and utilizing operational excellence, 95% of the time, nurses were called to morning rounds with the medical …

An Ableist Society: What Does Disability Look Like?, Maricela Paramo

Nebraska College Preparatory Academy: Senior Capstone Projects

One out of every five adults in the United States has a disability. That is about 63.976 million people, yet, ableism is a common type of discrimination. This paper is an attempt to create awareness of ableism and its negative effects by providing testimonies and methods that will help people with disabilities live a life without prejudice.

The United States is nowhere close to being an ableist free society and it will remain this way until people stop using ableist language as an insult or to mock someone, until mocking the disabled is not a media entertainment, until public figures …

Neural Control Of Tongue Movements Across Effort Levels, Megan Rovang, Angela M. Dietsch

UCARE Research Products

Background

A hallmark of Parkinson’s disease (PD) is a mismatch between the perceived effort and actual forces exerted during functional activities such as speech. Current evidence supports therapy to help reset this perception of effort, but the neurological underpinnings of such treatments are unclear. This study examined brain activity during tongue movements performed at varying levels of effort to determine (1) which brain areas are involved in each task, and (2) which areas, if any, scale in activation according to effort level. These results, considered with the neurological changes associated with PD, can be used to develop and refine treatment …

Internship Impact In Early Intervention, Morgan E. Anderson

Senior Honors Projects

Early childhood intervention programs were introduced in the 1960s, and professionals have recognized the benefits of intensive therapy and education starting when the child is an infant up to the age of three. Working with a child in a comfortable environment, such as their own home, preschool, child care center or even the community has many benefits. Conducting sessions in a more everyday environment encourages family interaction and support. When a family member, caretaker, or even teacher is present to witness the therapy session, they are more likely to be comfortable carrying these techniques over into the everyday routine. Working …