Rehabilitation and Therapy Commons^™

Discordance Between Balance Ability And Perception Is Associated With Falls In Parkinson’S Disease: A Coordinated Analysis, Jason K. Longhurst, Andrew Hooyman, Merrill R. Landers, Martina Mancini, Erika Franzén, Breiffni Leavy, Hanna Johansson, Daniel Peterson

Physical Therapy Faculty Articles and Research

Background: The congruence or discordance between actual and perceived balance ability has been proposed to be linked to functional outcomes such as falls. However, gaps remain in our ability to quantify discordance, and its relationship to relevant outcomes.

Objective: To investigate a novel quantification of concordance/discordance between balance performance and perception and determine the relationship to falls among people with Parkinson’s disease (PwPD).

Methods: Data from 244 PwPD were aggregated from 5 previously conducted studies. Variables extracted included age, sex, Activities-Specific Balance Confidence scale (ABC; perceived balance), Timed Up and Go (TUG; balance performance), Movement Disorder Society Unified Parkinson Disease …

Providing End-Of-Life Counseling: A Narrative Inquiry, Carol Hecht, Sibyl West

Adultspan Journal

This qualitative study aimed to address the gap in the research related to end-of-life counseling by exploring the experiences of counselors working with clients at end of life. While counseling literature and education are lacking regarding end of life, many counselors will work alongside clients approaching death. The purpose of this study was twofold: (a) to better understand the nuanced experiences of counselors providing end-of-life counseling and (b) to explore the supports and preparations helpful for counselors to provide end-of-life counseling. A narrative approach, using the Listening Guide (Gilligan, 2015), was employed to analyze and present the stories of three …

Considerations Of Medicare Telehealth Services With Older Adults, Sonah Kho, Amanda Dediego

Adultspan Journal

The onset of the COVID-19 pandemic set in motion a rapid expansion of mental health services offered via telehealth. With this rapid expansion came the need to examine how policy and practice should be shaped in a future where telehealth is considered common in counseling practice. For counselors to understand how to support older adult clients in using telehealth services, they must understand telehealth policy. Following the eligibility of licensed counselors to participate in Medicare, counselors need to stay abreast of regulatory changes regarding restrictions and regulations on use of telehealth for mental and behavioral health services, including video and …

A Single-Center, Assessor-Blinded, Randomized Controlled Clinical Trial To Test The Safety And Efficacy Of A Novel Brain-Computer Interface Controlled Functional Electrical Stimulation (Bci-Fes) Intervention For Gait Rehabilitation In The Chronic Stroke Population, Piyashi Biswas, Lucy Dodakian, Po T. Wang, Christopher A. Johnson, Jill See, Vicky Chan, Cathy Chou, Wendy Lazouras, Alison L. Mckenzie, David J. Reinkensmeyer, Danh V. Nguyen, Steven C. Cramer, An H. Do, Zoran Nenadic

Physical Therapy Faculty Articles and Research

Background

In the United States, there are over seven million stroke survivors, with many facing gait impairments due to foot drop. This restricts their community ambulation and hinders functional independence, leading to several long-term health complications. Despite the best available physical therapy, gait function is incompletely recovered, and this occurs mainly during the acute phase post-stroke. Therapeutic options are limited currently. Novel therapies based on neurobiological principles have the potential to lead to long-term functional improvements. The Brain-Computer Interface (BCI) controlled Functional Electrical Stimulation (FES) system is one such strategy. It is based on Hebbian principles and has shown promise …

Systematic Review And Dosage Analysis: Hyperbaric Oxygen Therapy Efficacy In The Treatment Of Posttraumatic Stress Disorder, Susan R. Andrews, Paul G. Harch

School of Medicine Faculty Publications

Background: Studies of hyperbaric oxygen therapy (HBOT) treatment of mild traumatic brain injury persistent postconcussion syndrome in military and civilian subjects have shown simultaneous improvement in posttraumatic stress disorder (PTSD) or PTSD symptoms, suggesting that HBOT may be an effective treatment for PTSD. This is a systematic review and dosage analysis of HBOT treatment of patients with PTSD symptoms. Methods: PubMed, CINAHL, and the Cochrane Systematic Review Database were searched from September 18 to November 23, 2023, for all adult clinical studies published in English on HBOT and PTSD. Randomized trials and studies with symptomatic outcomes were selected for final …

Examining The Diagnostic Accuracy Of A Novel Performance-Based Test For Alzheimer's Disease Screening, A. M. Reed, K. Duff, L. E. Dibble, S. S. Paul, Andrew Hooyman, S. Y. Schaefer

Physical Therapy Faculty Articles and Research

Affordable, rapid methods for identifying mild Alzheimer’s disease (AD) are needed. A simple, brief performance-based test involving the learning of functional upper-extremity movements has been developed and is associated with AD pathology and functional decline. However, its specificity to AD relative to other neurodegenerative diseases that present with motor impairment is unknown. This study examined whether this novel test could distinguish between 34 participants diagnosed with mild AD (Clinical Dementia Rating Scale = 0.5-1) from 23 participants with mild-to-moderate Parkinson’s disease (PD) (Hoehn & Yahr = 2-3) using Receiver Operating Characteristic analysis of secondary data from two separate clinical trials. …

Emotion Regulation Strategies And Perceived Emotional Intelligence: The Effect Of Age., Iwanna Sepiadou

Adultspan Journal

The aim of this study was to investigate the relationship between perceived emotional intelligence and the reported use of cognitive reappraisal and expressive suppression. We also investigated the possible effects of age on the aforementioned variables. The total sample consisted of 379 people (158 men, 220 women, 1 unreported). Across participants, 273 were young (20-39 years old) and 106 were middle-aged (40-65 years old). We found statistically significant positive correlations between the dimensions of perceived emotional intelligence and the reported use of cognitive reappraisal and negative primarily correlations between the dimensions of perceived emotional intelligence and the reported use of …

Prevalence Of Cardiovascular Conditions After Traumatic Brain Injury: A Comparison Between The Traumatic Brain Injury Model Systems And The National Health And Nutrition Examination Survey, Shanti Pinto, Bhaskar Thakur, Raj Kumar, Amanda Rabinowitz, Ross Zafonte, William C Walker, Kan Ding, Simon Driver, Umesh Venkatesan, Gilbert Moralez, Kathleen Bell

Department of Rehabilitation Medicine Faculty Papers

BACKGROUND: The purpose of this study is to compare the prevalence of self-reported cardiovascular conditions among individuals with moderate to severe traumatic brain injury (TBI) to a propensity-matched control cohort.

METHODS AND RESULTS: A cross-sectional study described self-reported cardiovascular conditions (hypertension, congestive heart failure [CHF], myocardial infarction [MI], and stroke) from participants who completed interviews between January 2015 and March 2020 in 2 harmonized large cohort studies, the TBI Model Systems and the National Health and Nutrition Examination Survey. Mixed-effect logistic regression models were used to compare the prevalence of cardiovascular conditions after 1:1 propensity-score matching based on age, sex, …

Healing Horses: An Occupational Therapy Approach In An Equine Environment, Ashlyn Renee Yoder

Occupational Therapy Capstone Presentations

Aim: This project focused on the development of advanced clinical skills of OT-based hippotherapy in a pediatric setting and program development of the Genesis Therapeutic Riding Center. Information was gathered from primary and secondary sources to promote student skill acquisition, client goal progress, and parent-caregiver education of at-home interventions.

Objective: Goals focused on gaining knowledge and competencies of OT-based hippotherapy, key clinical information, and interdisciplinary roles. The purpose of this project was to highlight the impact of staff responsibilities and OT-based hippotherapy on physical and cognitive deficits.

Method: OT hippotherapy session observation and facilitation, extensive literature review, and multidisciplinary interviews …

A Literature Review Of Pain Control In Osteoarthritis Patients Using Blood Flow Restriction Training, John Gericke, Dakota Pastore, Tyler Pigott

Rowan-Virtua Research Day

Background: Osteoarthritis (OA) is a degenerative disease that mainly affects articular cartilage of joints. OA most commonly affects the knees and causes pain and reduces quality of life in older adults. Blood flow restriction (BFR) occludes arterial and venous flow during exercise using a blood pressure cuff placed on the proximal lower limb. This creates an intramuscular hypoxic environment which promotes muscle hypertrophy. High load training can cause pain and inflammation in knee OA patients due to increased stress. BFR can allow patients with knee OA to use lower loads to achieve beneficial effects of rehabilitation.

Methods: Data was ascertained …

Preventing Postoperative Cognitive Dysfunction Through Preoperative Exercise, John Andre Socci

Rowan-Virtua Research Day

Introduction: Postoperative cognitive dysfunction (POCD) is a common problem in the elderly population after undergoing anesthesia that results in sometimes irreversible cognitive and physical impairment that can increase mortality and decrease quality of life.

Methods: To see the relationship between preoperative fitness capacity and how this relates to postoperative cognitive ability a literature review was performed. Studies that were included involved populations older than sixty years old that had undergone anesthesia. Additionally, animal studies were included to show inflammatory marker levels and how they increased in relation to physical activity.

Results: Various fitness scales were used such as the Timed …

Does Strength Training Decrease The Risk Of Sports Related Knee Injury?, Zachary J. Noll, Quin W. Buob

Rowan-Virtua Research Day

The knee is the most common joint affected by sports-related injuries, with approximately 2.5 million cases treated annually in the US alone, alongside 2 million worldwide ACL repairs. Among athletes engaged in contact sports like football, soccer, basketball, and volleyball, ACL tears are the primary injury concern. In non-contact sports, particularly running, meniscus tears are commonly experienced. A notable 23% of college athletes encounter knee injuries to varying degrees. Many risk factors have been identified including patient sex, activity type, and body composition, justifying the need for individualized preventive measures.

Various strength training protocols have demonstrated efficacy in reducing the …

Physical Medicine & Rehabilitation Referrals In Cancer Patients, Bhumik Patel, Venkateswar Venkataraman, Deanna Janora, Jack Goldberg

Rowan-Virtua Research Day

Physical Medicine and Rehabilitation (PM&R) can address functional limitations in various conditions, including cancer. Cancer rehabilitation aims to address functional impairments resulting from both the disease itself and its treatments, striving to optimize physical, social, psychological, and vocational functioning. Existing literature indicates that PM&R services significantly benefit cancer patients by improving their overall quality of life. Studies have found that optimal utilization of PM&R services can increase the Functional Independence Measure (FIM) in cancer patients. Current National Comprehensive Cancer Network and American Cancer Society guidelines emphasize the importance of incorporating PM&R services into oncology care to enhance the function and …

Examining The Differences In Functional Outcomes For Patients With Traumatic Brain Injury After Acute Rehabilitation And Subacute Rehabilitation: A Review Of The Literature, Michael Rangel, Ashley Kakkanatt

Rowan-Virtua Research Day

BACKGROUND/PURPOSE

Traumatic brain injury (TBI) is one of the major causes of morbidity in the US [1-4]. Studies suggest TBI patients’ enrollment in a rehabilitation program strongly predicts social reintegration. The structure and outcomes of inpatient rehabilitation programs, including acute and subacute rehabilitation, are not well-delineated [5-7].

DESIGN

A structured review of current literature was conducted. Articles were screened using the search string: (post-traumatic brain injury OR post-TBI OR traumatic brain injury OR TBI) AND (acute rehabilitation OR subacute rehabilitation) AND (outcomes OR functional outcomes) NOT (outpatient OR outpatient populations) NOT (pediatric OR pediatric populations). Articles were limited to 1990 …

A Literature Review Of Current Treatments For The Hypermobility Subtype Of Ehlers-Danlos Syndrome, John Gericke, Mary Zsolway, Chelsea Reyes, Pooja Patel, Saad Ahmed, Julia Hwang, Venkateswar Venkataraman

Rowan-Virtua Research Day

Purpose: The purpose of this study is to compare pharmacologic intervention, neurocognitive therapy, physical therapy, and orthotics in treating the hypermobility subtype of Ehlers-Danlos Syndrome (hEDS) and determine which has the most positive effect on symptoms.

Introduction: Ehlers-Danlos Syndrome is an inheritable connective tissue disorder which results from a genetic mutation that alters the body’s ability to produce collagen. The most common subtype of Ehlers-Danlos Syndrome is hEDS, which leads to hypermobility and hyperextensibility and can cause frequent joint dislocations.

Methods: A review of literature was performed to compare each treatment based on reported results. The types of studies reviewed …

How Psychological And Nonpharmacological Treatment Modalities Reduce The Disease Burden Of Amplified Musculoskeletal Pain Syndromes In Pediatrics, Aalia Narvel, Sabrina Gmuca

Rowan-Virtua Research Day

The prevalence of pediatric chronic musculoskeletal pain ranges from 8.5% to 40%.¹ This literature review examined the treatment of amplified musculoskeletal pain syndrome (AMPS), which is a general term that represents a spectrum of pain disorders for patients who may not satisfy specific diagnostic criteria.² Specifically, sources were analyzed to compare the efficacy of individual components in the nonpharmacological, interdisciplinary treatment of AMPS against pain medications. These components included cognitive behavioral psychotherapy (CBT), physical therapy (PT), as well as occupational therapy (OT). There is limited information that assesses these components individually, but there is ample evidence that when …

Effect Of Exercise Intervention On Facioscapulohumeral Muscular Dystrophy (Fshd), John Desrochers

Rowan-Virtua Research Day

Facioscapulohumeral Muscular Dystrophy (FSHD) is a common muscular dystrophy. The facial muscles, shoulder girdles, and upper arms are notably affected.¹ A common presenting symptom is asymmetrical scapular winging and further symptoms may include but are not limited to: loss of pectoral muscles, fatigue, severe pain, pathologic spinal curvatures, and foot drop.² It is a particularly debilitating muscular dystrophy, with 20% of people >50 y.o. requiring a wheelchair.³ With no approved therapeutics, patients are managed symptomatically.³ This review sought to determine the effect of different exercise interventions on patients with FSHD. It is hypothesized that exercise may …

Best Screening: Introducing The Neonatal Assessment Visual European Grid To Nicus In Tennessee, Gabrielle Sledge

OTD Capstone Projects

Blind Early Services Tennessee (BEST) is an early intervention agency that serves children ages 0-5 with visual impairments across Tennessee. BEST serves over 200 children and families across the state offering early intervention (BEST Start), parent empowerment (BEST Advocate), and family support (BEST Together) programming. The purpose of this project was to assist in the implementation of an early identification initiative (BEST Screening) using the Neonatal Assessment Visual European Grid (NAVEG). The NAVEG is a newborn vision screening shown to identify neurological risk for visual impairments. The long-term goal of this program is to promote the screening and early identification …

”To Be Or Not To Be – It’S Good”: Actor And Student Experiences In A Drama Club For People With Aphasia, Jade K. Hannan

Senior Theses

Individuals with aphasia, a disorder caused by damage to the brain’s language network, confront a variety of social and emotional struggles. While leaving their cognition largely intact, aphasia tremendously impacts a person’s ability to communicate confidently, fracturing their social network and contributing to feelings of loneliness and frustration. To address this persistent need in the chronic aphasia population, the Play on Words drama club at the University of South Carolina provides a forum for people with aphasia (PWA) to engage in dramatic exercises focused on non-verbal communication of emotions, ideas, and stories, culminating the production of an original devised play. …

Effects Of Core Stabilization Exercises In Patients With Non-Specific Low Back Pain: Huber Motion Lab Versus Conventional, Ebru Koyuncu, Nur Tunali, Seda Saka, Ertuğrul Ural, Melek Güneş Yavuzer

Baltic Journal of Health and Physical Activity

Introduction: This study aimed to determine the effects of core stabilization exercises with Huber® Motion Lab on pain, depression, and activity levels in patients with non-specific low back pain (LBP).

Materials and methods: In this study, 30 patients with non-specific LBP were allocated either to an experimental or to a control group. Both groups received a conventional physiotherapy program for 15 sessions. In addition, the control group performed 30 minutes of core stabilization exercises on the floor, whereas the experimental group used the Huber® Motion Lab device. The main outcome measures were pain severity (Visual Analogue Scale VAS), depression (Beck …

Pembrolizumab Versus Placebo As Adjuvant Therapy In Resected Stage Iib Or Iic Melanoma: Outcomes In Histopathologic Subgroups From The Randomized, Double-Blind, Phase 3 Keynote-716 Trial, Dirk Schadendorf, Jason J. Luke, Paolo A. Ascierto, Georgina V. Long, Piotr Rutkowski, Adnan Khattak, Michele Del Vecchio, Luis De La Cruz-Merino, Jacek Mackiewicz, Vanna C. Sileni, John M. Kirkwood, Caroline Robert, Jean-Jacques Grob, Reinhard Dummer, Matteo S. Carlino, Yujie Zhao, Mizuho Kalabis, Clemens Krepler, Alexander Eggermont, Richard A. Scolyer

Research outputs 2022 to 2026

Background Adjuvant pembrolizumab significantly improved recurrence-free survival (RFS) and distant metastasis-free survival (DMFS) versus placebo in the phase 3 KEYNOTE-716 study of resected stage IIB or IIC melanoma. At the prespecified third interim analysis (data cut-off, January 4, 2022), the HR for RFS in the overall population was 0.64 (95% CI, 0.50 to 0.84) and the HR for DMFS was 0.64 (95% CI, 0.47 to 0.88). We present a post hoc analysis of efficacy by subtypes defined by histopathologic characteristics.

Methods Patients aged ≥ 12 years with newly diagnosed, resected stage IIB or IIC melanoma were randomly assigned (1:1) to …

Piriformis Syndrome With A Variant Presentation, Roberto Chuapoco, Ryan E. Linford

Annual Research Symposium

Piriformis syndrome has long been a diagnostic quandary due to its tendency to present as other nerve-related conditions. Piriformis syndrome is commonly caused by entrapment of the sciatic nerve as it travels through the greater sciatic foramen due to hypertrophy of the piriformis muscle. However, its constellation of symptoms, including radiating pain down the thigh, can easily be mistaken for lumbosacral radiculopathy. This case report aims to address the misdiagnosis of piriformis syndrome which has prolonged pain for many patients and increased the cost of medical care. It demonstrates a 76-year-old female with a confounding presentation of piriformis syndrome: buttock …

Digital Phobia: An Inquiry For Mapping The Unseen Dimension Of New Digital Anxiety, The ‘Digiphobia’, Amarjit Kumar Singh ,Library Assistant, Md. Arshad Ali , Professional Assistant, Dr. Pankaj Mathur, Deputy Librarian,

Library Philosophy and Practice (e-journal)

Background: As technology continues to advance, individuals' interactions with digital platforms have become integral to daily life. Amidst this technological evolution, a novel concern emerges—Digital Phobia, hereafter referred to as “Digiphobia.” This phenomenon, although not previously explored in scholarly literature, necessitates an in-depth investigation due to its potential impact on individuals' well-being. Our research employs a two-step methodology to investigate its existence, implications, and manifestations.

Introduction: This research paper introduces and proposes the term "Digiphobia" as a comprehensive conceptualization of anxiety arising from interactions with digital spaces, applications, and environments. The proliferation of digital technologies has led to the emergence …

Effect Of Acute Care Discharge Delays On Inpatient Rehabilitation Facility (Irf) Utilization, Eric Garrard

Student Dissertations

Discharge delays present hospitals with challenges in managing costs for Medicare admissions. Meanwhile, Inpatient Rehabilitation Facilities (IRF) are subject to strict pre-admission requirements that can complicate efficient transitions of care for patients with intensive rehabilitation needs. The purpose of this retrospective quantitative correlational study was to examine any relationship between acute care discharge delays and IRF utilization. This study investigated whether length of stay (LOS) and Medicare Advantage prior authorization requirements impact IRF referrals by reviewing 3,747 medical records of acute stroke patients aged 65 years and older at a regionally integrated healthcare system over a 3-year period (2020- 2022). …

Step Squad Bundle In Older Adults With Multiple Myeloma Hospitalized For An Autologous Stem Cell Transplant, Nadya Panjwani

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Multiple Myeloma (MM) is a hematological malignancy with demographic disparities. MM is a debilitating cancer mainly affecting older adults, with 66% over the age of 70. Additionally, 33% of older patients with MM are frail with weakness, fatigue, slow gait, weight loss, and malnutrition.

PICOTS: The purpose of this Doctor of Nursing (DNP) scholarly project is to implement an evidence-based practice (EBP) change consisting of a Step Squad Bundle that will identify frailty in older patients with MM hospitalized for an Autologous Stem Cell Transplant (ASCT) to reduce morbidity and mortality and increase the chances of a quality of …

Outpatient Fall Prevention In Ambulatory Adults 65 Years Old And Over, Dorothy L. Osborne-White

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: In the United States (U.S.), falls are the leading cause of injury among adults 65 and over, resulting in 36 million falls yearly (Moreland et al., 2020). According to the Centers for Disease Control and Prevention (CDC, 2023), one in four older adults experiences a fall each year. Falls are the world's second most prominent cause of accidental deaths (World Health Organization [WHO], 2021). Falls are the leading cause of both fatal and non-fatal injuries among older adults (Moreland et al., 2020).

Methods: A quality improvement project that included a fall bundle was implemented in a primary clinic. A …

Exploration Of Burn Survivors’ Experiences With Nutrition During The Rehabilitation Phase Of Burn Injury Recovery: A Qualitative Study, Alyaa M. Zagzoog

Theses and Dissertations--Rehabilitation Sciences

Approximately 500,000 people in the United States are affected by a burn injury and seek care every year. With medical innovation, however, the burn injury survival rate has increased to 97% in the United States. Burn survivors undergo two phases of recovery: acute and rehabilitation.With advances in burn treatment and care, the focus has shifted from the expectation of survival to improving outcomes. Nutritional care, including assessment and education, plays a major role in burn survivors’ wellness, facilitating wound healing and promoting recovery, but nutritional guidelines and polices appear limited during the rehabilitation phase,with literature suggesting nutritional assessment has historically …

The Unequal Distribution Of Social Risk For Black Men Across The Life-Span. A Novel Framework., Waleed Y. Sami

Adultspan Journal

This conceptual overview offers a comprehensive overview of systemic pathways that negatively impact the mental health of Black Men throughout their lives. Our argument highlights the importance for counselors and mental health professionals to utilize a thorough social risk assessment that considers these pathways in order to effectively address the mental health needs of Black Men while fostering positive working relationships. This overview strongly advocates for the use of context and structural determinants when evaluating mental health symptoms. Without an appropriate understanding of social risk and determinants, counselors may inadvertently perpetuate disparities by decontextualizing symptomology, and reproducing racist discourse.

A Comparison Of Concurrent Training And Moderate Intensity Continuous Training In Patients With Coronary Artery Disease, Amanda Alfaro-Chaverri, John Quindry, Charles Dumke, Brian Loyd

Graduate Student Theses, Dissertations, & Professional Papers

Moderate intensity continuous training (MICT) is the most studied method in cardiac rehabilitation (CR) for patients with coronary artery disease (CAD). Traditionally, resistance training has been utilized as a secondary role in CR. Recent interest in the topic suggests that MICT and resistance training should be applied collectively, an approach termed concurrent training (CT). The collective understanding of the potential of CT in CR patients is currently lacking.

Purpose: The aim of this professional paper is to analyze scientific evidence regarding the efficacy and safety of CT versus MICT. The analysis will focus on five primary measurements: exercise capacity, cardiovascular …

Current Education Offerings On Occupational Therapy: Addressing Feeding, Eating, And Swallowing Across The Lifespan, Thilini Abeywickrema, Kate G. Barlow, Janelle Hatlevig, Cuyler Romeo, Tatiana Barcelos Pontes

Journal of Occupational Therapy Education

Occupational therapists play a vital role in the care of individuals with feeding, eating, and swallowing (FES) disorders across the lifespan. Although there are certain standards created by the Accreditation Council of Occupational Therapy (ACOTE) for understanding of assessment and management practices specific to FES, there are inconsistencies in how occupational therapy programs in the United States address FES disorders within their curriculum. This cross-sectional exploratory survey study received responses from 54 Master of Occupational Therapy (MSOT) programs and 63 entry-level Occupational Therapy Doctoral (OTD) programs. Survey questions included quantitative and qualitative information on general information regarding FES content taught …