Rehabilitation and Therapy Commons^™

Aging After Stroke: How To Define Post-Stroke Sarcopenia And What Are Its Risk Factors?, Sheng Li, Javier Gonzalez-Buonomo, Jaskiran Ghuman, Xinran Huang, Aila Malik, Nuray Yozbatiran, Elaine Magat, Gerard E Francisco, Hulin Wu, Walter R Frontera

Faculty, Staff and Student Publications

BACKGROUND: Sarcopenia, generally described as "aging-related loss of skeletal muscle mass and function", can occur secondary to a systemic disease.

AIM: This project aimed to study the prevalence of sarcopenia in chronic ambulatory stroke survivors and its associated risk factors using the two most recent diagnostic criteria.

DESIGN: A cross-sectional observational study.

SETTING: A scientific laboratory.

POPULATION: Chronic stroke.

METHODS: Twenty-eight ambulatory chronic stroke survivors (12 females; mean age=57.8±11.8 years; time after stroke=76±45 months), hand-grip strength, gait speed, and appendicular skeletal muscle mass (ASM) were measured to define sarcopenia. Risk factors, including motor impairment and spasticity, were identified using regression …

Fighting For Recovery On Multiple Fronts: The Past, Present, And Future Of Clinical Trials For Spinal Cord Injury, Valerie A Dietz, Nolan Roberts, Katelyn Knox, Sherilynne Moore, Michael Pitonak, Chris Barr, Jesus Centeno, Scott Leininger, Kent C New, Peter Nowell, Matthew Rodreick, Cedric G Geoffroy, Argyrios Stampas, Jennifer N Dulin

Faculty, Staff and Student Publications

Through many decades of preclinical research, great progress has been achieved in understanding the complex nature of spinal cord injury (SCI). Preclinical research efforts have guided and shaped clinical trials, which are growing in number by the year. Currently, 1,149 clinical trials focused on improving outcomes after SCI are registered in the U.S. National Library of Medicine at ClinicalTrials.gov. We conducted a systematic analysis of these SCI clinical trials, using publicly accessible data downloaded from ClinicalTrials.gov. After extracting all available data for these trials, we categorized each trial according to the types of interventions being tested and the types of …

Treating Phantom Limb Pain: Cryoablation Of The Posterior Tibial Nerve, Matthew Fiala, Abana Azariah, Jean Woo, Ahmed Kamel Abdel Aal, Alexa Levey

Faculty, Staff and Student Publications

Phantom limb pain (PLP) is a complex pathophysiologic process involving both the central and peripheral nervous system for which there is no definitive treatment. The number of individuals living with amputated limbs is predicted to increase to 3.5 million by 2050, and up to 80% of these patients will have PLP. In this case report, we will demonstrate successful reduction of PLP in a patient with bilateral phantom toe pain utilizing nerve blockade and subsequent cryoablation of the posterior tibial nerves.

Energy Drink Usage By Students Attending An Online University, Jodi Lynn Hutak, Ali Boolani, Lauri O. Byerley

School of Medicine Faculty Publications

Objective: This study determined the frequency, reasons for, and side effects of energy drinks (ED) consumption among online students. Participants: Students attending an online university. Methods: Participants were recruited by email and completed a 59-question survey about their prior months ED practices using a combination of validated surveys previously published examining similar constructs in on-campus students. Results: 307 students (age = 32.4 ± 6.5yrs) completed the survey, and 88% reported consuming EDs. Students’ reasons for consuming ED included school (p < .001), work (p < .001), an event/competition (p < .001), pick me up (p < .001), lack of rest (p < .001), more energy (p < .001), and staying awake while driving (p < .001). Only individuals who consumed > 10 ED/month reported side effects of headaches (p = .01) and speeding (p=.01). Conclusions: In our sample, a majority of …

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

Department of Occupational Therapy Faculty Papers

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

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

Advancing The Assessment And Treatment Of Signs And Symptoms Of Parkinson Disease, David Scott May

WUSM Theses and Dissertations – All Programs

People with PD often report signs and symptoms that negatively impact quality of life. Among these are balance difficulties, impaired gait, and FOG. New treatment and assessment strategies for these signs and symptoms are needed, as current techniques are limited. While new treatment and assessment strategies continue to emerge, gaps in knowledge persist. Deep brain stimulation (DBS) has been utilized in many people with PD throughout the 21st century, but it is unknown specifically how subthalamic nucleus deep brain stimulation (STN-DBS) affects balance. Alternative treatment strategies, such as a dental mouthpiece, have also been proposed. While dental mouthpieces have shown …

Advancing Academic Capacity In Physical And Rehabilitation Medicine To Strengthen Rehabilitation In Health Systems Worldwide: A Joint Effort By The European Academy Of Rehabilitation Medicine, The Association Of Academic Physiatrists, And The International Society Of Physical And Rehabilitation Medicine, Walter R Frontera, Gerold Stucki, Julia P Engkasan, Gerard E Francisco, Christoph Gutenbrunner, Nazirah Hasnan, Jorge Lains, Yusniza Mohd Yusof, Stefano Negrini, Zaliha Omar, Linamara Rizzo Battistella, Gwen Sowa, Henk Stam, Jerome Bickenbach, European Academy Of Rehabilitation Medicine, Association Of Academic Physiatrists, International Society Of Physical And Rehabilitation Medicine

Faculty, Staff and Student Publications

No abstract provided.

Contributions Of Semantic And Phonological Working Memory To Narrative Language Independent Of Single Word Production: Evidence From Acute Stroke, Rachel Zahn, Tatiana T Schnur, Randi C Martin

Faculty, Staff and Student Publications

Neuropsychological case studies have provided evidence that individuals with semantic, but not phonological, working memory (WM) deficits have difficulty producing phrases containing several content words. These findings supported the claim of a phrasal scope of planning at the grammatical formulation stage of production, where semantic WM supports the maintenance of lexical-semantic representations as they are inserted into slots in phrasal constituents. Recent narrative production results for individuals at the acute stage of stroke supported the role for semantic WM in phrasal elaboration while suggesting a role for phonological WM at a subsequent phonological encoding stage in supporting fluent, rapid speech. …

Using Noise For The Better: The Effects Of Transcranial Random Noise Stimulation On The Brain And Behavior, Onno Van Der Groen, Weronika Potok, Nicole Wenderoth, Grace Edwards, Jason B. Mattingley, Dylan Edwards

Research outputs 2022 to 2026

NEUROSCI BIOBEHAV REV X (X) XXX-XXX 2021.- Transcranial random noise stimulation (tRNS) is a non-invasive electrical brain stimulation method that is increasingly employed in studies of human brain function and behavior, in health and disease. tRNS is effective in modulating perception acutely and can improve learning. By contrast, its effectiveness for modulating higher cognitive processes is variable. Prolonged stimulation with tRNS, either as one longer application, or multiple shorter applications, may engage plasticity mechanisms that can result in long-term benefits. Here we provide an overview of the current understanding of the effects of tRNS on the brain and behavior and …

Walking Improvement In Chronic Incomplete Spinal Cord Injury With Exoskeleton Robotic Training (Wise): A Randomized Controlled Trial, Dylan J Edwards, Gail Forrest, Mar Cortes, Margaret M Weightman, Cristina Sadowsky, Shuo-Hsiu Chang, Kimberly Furman, Amy Bialek, Sara Prokup, John Carlow, Leslie Vanhiel, Laura Kemp, Darrell Musick, Marc Campo, Arun Jayaraman

Faculty, Staff and Student Publications

Study design: Clinical trial.

Objective: To demonstrate that a 12-week exoskeleton-based robotic gait training regimen can lead to a clinically meaningful improvement in independent gait speed, in community-dwelling participants with chronic incomplete spinal cord injury (iSCI).

Setting: Outpatient rehabilitation or research institute.

Methods: Multi-site (United States), randomized, controlled trial, comparing exoskeleton gait training (12 weeks, 36 sessions) with standard gait training or no gait training (2:2:1 randomization) in chronic iSCI (>1 year post injury, AIS-C, and D), with residual stepping ability. The primary outcome measure was change in robot-independent gait speed (10-meter walk test, 10MWT) post 12-week intervention. Secondary …

A Novel Approach Toward Concussion Testing, Jorge K. Mercado, Ari Schacter, Danielle Euzent

Student Theses

A concussion is a violent jarring or shaking of the head caused by whiplash or direct impact that results in a disturbance of brain function. Concussions can be mild and brief, as a person may be dazed momentarily or can be more serious, resulting in a loss of consciousness. Underreporting of concussions is prevalent because they are a symptom-based diagnosis, lacking a clinical test. In this study, we investigated the use of VNG testing as a clinical diagnosis of concussions. Looking at the VNG test battery, the previous research cohort found that saccades, gaze, and positional testing are the most …

Duchenne’S Muscular Dystrophy & Occupational Therapy, Vanessa Sagredo, Meagan C. Romero

Client Educational Handouts

No abstract provided.

Effective Therapies And Nursing Approaches: Improving Cognition In Older Adult Stroke Patients, Selyna Baltazar

Nursing | Senior Theses

Background

Ischemic stroke occurs in thousands of older adults throughout the year. Due to the lack of oxygen entering the brain, many patients experience a decline in cognitive function due to ischemic stroke. Cognition is the ability to understand, learn, and remember information which is needed for completing daily tasks. Modern technology has allowed for patients to survive ischemic strokes but has yet to provide proper screening tools and methods for stroke-related cognitive impairment.

Objective

To investigate the best practices for identifying, treating, and caring for patients with a cognitive injury related to a stroke. A review of the research …

Effects Of Exercise On Parkinson's Symptom Relief, Brooke Burnett

The Eleanor Mann School of Nursing Undergraduate Honors Theses

In this review of twenty research articles, the effects of moderate exercise therapy on the symptoms of Parkinson’s Disease will be explored. Appropriate literature was located using the research question, “In older adults with a Parkinson’s Disease Diagnosis, how does moderate exercise influence the symptoms of this disease?” Twenty peer-reviewed research articles were examined for the impact of different forms of exercise on various symptoms associated with Parkinson’s. Nineteen of the articles reviewed provide substantial evidence in support of exercise therapy as a treatment option for people with Parkinson’s, and one of the articles found inconclusive evidence neither in support …

Early Detection Of Atypical Motor And Neurobehavior Of Infants At Risk Secondary To Opioid Exposure: A Prospective Study, Kara Boynewicz

Electronic Theses and Dissertations

Prenatal opioid exposure has been studied in relation to infants' medical outcomes. However, large gaps exist in the literature supporting early identification of atypical neurobehavior and motor development of infants with prenatal opioid exposure. The purpose of the study was to investigate whether prenatal opioid exposure has a negative influence on a newborn infant’s neurobehavior and motor development to aid in the early identification of potential delays. Using a prospective quasi experimental design, infants motor development using the Test of Infant Motor Performance (TIMP) and neurobehavior using the NICU Neonatal Network Scale (NNNS) was assessed on 58 infants in a …

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

Department of Pharmacology and Experimental Therapeutics Faculty Papers

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

Blood Flow Restriction And Various Intensity Exercise In The Upper Extremity, Noelle Ashlyn Kaminski, Andrew Lowe

Masters Theses

Purpose: To determine if using Blood Flow Restriction (BFR) combined with low-load exercise can elicit an increase in strength and tendon size of the distal biceps tendon when compared to high-load exercise protocol. Methods: Twenty-one participants (11 M, 10 F; 2 Left-handed: 19 Right-handed; Age range 18-25yoa) were randomized to either the treatment group (BFR + low load exercise) or the control group (high load exercise). Participants were enrolled in a 7-week exercise protocol, with exercise sessions held twice weekly. The first week included measurements of each participant's 1 repetition maximum (1RM) and ultrasound measurements of the dominant distal bicep’s …

Biostimulation With Low-Level Laser Therapy And Its Effects On Soft And Hard Tissue Regeneration. Literature Review, Anida Maria Babtan, Aranka Ilea, Claudia Nicoleta Feurdean, Sabino Ceci, Berate Pula, Sebastian Candrea, Daniela Azzollini, Fabio Piras, Luigi Curatoli, Alberto Corriero, Assunta Patano, Francesco Valente, Maria Elena Maggiore, Antonio Mancini, Delia Giovanniello, Ludovica Nucci, Rossella Elia, Adina Sirbu, Nausica Bianca Petrescu, Codruta Mirica, Andrea Galderisi, Filippo Cardarelli

Journal of Mind and Medical Sciences

Objective. Low-Level Laser Therapy encourages the healing process, reduces inflammation and pain. The aim of this study is to identify the impact of Low-Level Laser Therapy on tissue regeneration with special attention to hard tissues and to compare the effect of several wave lengths in the proliferation and differentiation of cells. Methods. The keywords used were “bone regeneration”, “laser therapy”, “photobiomodulation” OR “bio-stimulation”, “Low-Level Laser therapy” OR “LLLT”, “osteoblast proliferation” AND “differentiation”. Results. The bio-stimulation with Low-Level Laser Therapy also seems to interfere with the osseous integration of implants, by increasing its adherence on the bone-implant surfaces. Evidence has shown …

The Parkinson's Wellness Project: An 8-Part Educational Video Series, Samantha L. Stevenson

OTD Capstone Projects

The Parkinson’s Wellness Project is an 8-part educational video series created by Samantha Stevenson, a student in Belmont University’s Doctorate Program in Occupational Therapy. Purpose: This project was created to benefit all persons with Parkinson’s disease (PD) and their care partners who attend Rocksteady Boxing (RSB) in Franklin/Nashville, TN. Methodology: The student conducted research to identify the salient issues experienced by people living with PD. The issues were then synthesized into 8 separate categories including the following: facial expression, mental health, sexual health, self-care, sleep, diet and nutrition, meditation, and postural alignment. Experts in the healthcare field produced specialized content …

Psycho-Emotional Education For Occupational Therapists Supporting Individuals Assuming The Role Of Family-Caregiver For People With A Traumatic Brain Injury (Tbi), Laura Dawn Lippman, Caitlyn E. Baird, Natalie L. Billharz

2022 Celebration of Scholarly Works

The purpose of this research was to identify the psycho-emotional needs of family-caregivers of individuals who sustained a traumatic brain injury (TBI), and measure if there was a change in knowledge among occupational therapists, and occupational therapy students following a two-hour seminar covering topics identified in the literature. The topics covered in the seminar included the concept of ambiguous loss, the importance of validating emotions, the caregiver grieving process, and the importance of providing caregiver resources. To measure the change in knowledge, researchers utilized primarily a quantitative research design using pre- and post-test questionnaires with Likert- scale questions. The questionnaire …

Long-Lasting Impairments In Quadriceps Mitochondrial Health, Muscle Size, And Phenotypic Composition Are Present After Non-Invasive Anterior Cruciate Ligament Injury, Steven M. Davi, Ahram Ahn, Mckenzie S. White, Timothy A. Butterfield, Kate Kosmac, Oh Sung Kwon, Lindsey K. Lepley

Center for Muscle Biology Faculty Publications

Introduction: Despite rigorous rehabilitation aimed at restoring muscle health, anterior cruciate ligament (ACL) injury is often hallmarked by significant long-term quadriceps muscle weakness. Derangements in mitochondrial function are a common feature of various atrophying conditions, yet it is unclear to what extent mitochondria are involved in the detrimental sequela of quadriceps dysfunction after ACL injury. Using a preclinical, non-invasive ACL injury rodent model, our objective was to explore the direct effect of an isolated ACL injury on mitochondrial function, muscle atrophy, and muscle phenotypic transitions.

Methods: A total of 40 male and female, Long Evans rats (16-week-old) were exposed to …

Trait Energy And Fatigue May Be Connected To Gut Bacteria Among Young Physically Active Adults: An Exploratory Study, Ali Boolani, Karyn M. Gallivan, Kristin S. Ondrak, Courtney J. Christopher, Hector F. Castro, Shawn R. Campagna, Christopher M. Taylor, Meng Luo, Scot E. Dowd, Matthew Lee Smith, Lauri O. Byerley

School of Medicine Faculty Publications

Recent scientific evidence suggests that traits energy and fatigue are two unique unipolar moods with distinct mental and physical components. This exploratory study investigated the correlation between mental energy (ME), mental fatigue (MF), physical energy (PE), physical fatigue (PF), and the gut microbiome. The four moods were assessed by survey, and the gut microbiome and metabolome were determined from 16 S rRNA analysis and untargeted metabolomics analysis, respectively. Twenty subjects who were 31 ± 5 y, physically active, and not obese (26.4 ± 4.4 kg/m2) participated. Bacteroidetes (45%), the most prominent phyla, was only negatively correlated with PF. The second …

Analysis Of Zero Balancing Case Studies Through An Occupational Therapy Lens, Deanna Waggy Otr, Msa, Czb, Csla

Journal of Transformative Touch

Does Zero Balancing positively impact occupational performance? This is a question many Occupational Therapists (OTs) ask when discerning if Zero Balancing (ZB) is an evidence-based treatment modality. Case studies from the book Experiencing the Power of Zero Balancing: Case Studies of Journeys to Health and Wholeness (Quarry & King, 2016) were reviewed and compared to the Occupational Therapy domain of practice to show clear evidence that each case study had a positive impact on occupational performance. A comparison chart shows a direct link between the occupational categories and documented evidence of improved occupational performance through practitioner observation and client feedback …

Physical Therapy Interventions And Outcomes In A Patient With Transfemoral Amputation Following Sound Side Total Knee Arthroplasty: A Case Report, Scott Love, Debra Gray, Jenna Yent, Michael Jason Highsmith

Physical Therapy Collection

Background: Following a transfemoral amputation (TFA), osteoarthritis (OA) on the sound limb may occur secondary to overuse. Potential causative factors include gait abnormalities, increased knee load, and performing hopping activities without a prosthesis. Unilateral TFA patients may require a total knee arthroplasty (TKA) to improve function.

Case Description and Methods: A 56-year-old male with a TFA who was diagnosed with left knee OA and was classified as a limited community ambulator underwent a TKA to restore function. The purpose of this case report is to determine the benefits of standard physical therapy (PT) augmented by a high intensity, whole-body …

Comparison Of Landing Biomechanics Between Different Competitive Levels Of Irish Dance, Jade Shields

West Chester University Master’s Theses

Abstract

Objectives: To determine differences in lower limb landing biomechanics and lower extremity function scale scores between champion levels, in young female Irish dancers.

Design: Cross-sectional.

Setting: McDade-Cara School of Irish Dance

Participants: 12 Open Champion (OC) level female Irish dancers (11.9 ± 3.37 years) and 9 Preliminary Champion (PC) Irish dancers (13.5 ± 3.37 years) performed the landing error scoring system test (LESS), and completed the lower extremity functional scale (LEFS) and a descriptive data questionnaire

Main outcome measures: LESS scoring sheet and LEFS PRO

Results: No significant differences found between OC and PC levels on …

Exploring Vestibular/Ocular And Cognitive Dysfunction As Prognostic Factors For Protracted Recovery In Sports-Related Concussion Patients Aged 8 To 12 Years, August Price, Gregory Knell, Todd Caze, John Abt, Dustin Loveland, Scott Burkhart

Faculty Publications - Doctor of Psychology (PsyD) Program

Objective: To explore the prognostic ability of the vestibular/ocular motor screening (VOMS), King–Devick (K-D) Test, and C3 Logix Trails A and B to identify protracted recovery from sports-related concussion (SRC) in patients aged 8 to 12 years. Design: Retrospective cohort analysis. Setting: Specialty pediatric sports concussion clinic. Participants: A total of 114 youth athletes aged 8 to 12 years who were diagnosed with an SRC within 7 days of injury. Independent Variables: A positive screen on the VOMS, K-D, and C3 Logix Trails A and Trails B. Combined positive screens on multiple tests (ie, 2, 3, or all 4 positive …

Mindfulness And Pain Regulation: The Role Of Acceptance And Commitment Therapy For Individuals With Chronic Pain, Ariana C. White

Honors Theses and Capstones

Chronic pain is a significant and widely prevalent health condition which requires comprehensive care to address the many facets contributing to symptomatology. In 2016, 20% of American adults (about 50 million) reported experiencing chronic pain, of which 7.4% indicated that chronic pain frequently limited their life and participation in activities within the past 3 months (CDC, 2018). As a result, many individuals with chronic pain turn to opioid-based medication for pain relief, but long-term use of opioids actually increases pain sensation (Tobin, 2019). Moreover, opioid medication is unable to target underlying mental health components which emerge as part of chronic …

Evaluating The Microbiome To Boost Recovery From Stroke: The Embrs Study, Tyler Hammond

Theses and Dissertations--Neuroscience

Accumulating evidence suggests that gut microbes modulate brain plasticity via the bidirectional gut-brain axis and may play a role in stroke rehabilitation. A severely imbalanced microbial community has been shown to occur following stroke, causing a systemic flood of neuro- and immunomodulatory substances due to increased gut permeability and decreased gut motility. Here we measure post-stroke increased gut dysbiosis and how it correlates with gut permeability and subsequent cognitive impairment.

We recruited 12 participants with acute stroke, 12 healthy control participants, and 18 participants who had risk factors for stroke, but had not had a stroke. We measured the gut …

Multi-Center, Single-Blind Randomized Controlled Trial Comparing Functional Electrical Stimulation Therapy To Conventional Therapy In Incomplete Tetraplegia, Kim D Anderson, Radha Korupolu, Kristin E Musselman, Jacqueline Pierce, James R Wilson, Nuray Yozbatiran, Naaz Desai, Milos R Popovic, Lehana Thabane

Faculty, Staff and Student Publications

BACKGROUND: Loss of upper extremity function after tetraplegia results in significant disability. Emerging evidence from pilot studies suggests that functional electrical stimulation (FES) therapy may enhance recovery of upper extremity function after tetraplegia. The aim of this trial was to determine the effectiveness of FES therapy delivered by the Myndmove stimulator in people with tetraplegia.

METHODS: A multi-center

RESULTS: Between June 2019 to August 2021, 51 participants were randomized to FES (

CONCLUSION: Forty sessions of FES therapy delivered by the MyndMove stimulator are as effective as conventional therapy in producing meaningful functional improvements that persist after therapy is completed. …

Factors Associated With Ventilator Weaning Success And Failure In People With Spinal Cord Injury In An Acute Inpatient Rehabilitation Setting: A Retrospective Study, Radha Korupolu, Hannah Uhlig-Reche, Emmanuel Chigozie Achilike, Colton Reeh, Claudia Pedroza, Argyrios Stampas

Faculty, Staff and Student Publications

OBJECTIVES: To evaluate baseline characteristics, describe pulmonary outcomes, and identify weaning predictors for people with acute traumatic spinal cord injury (SCI) who are dependent on mechanical ventilation at admission to acute inpatient rehabilitation (AIR).

METHODS: The retrospective study was conducted at an AIR facility in the United States. It included 91 adults with acute traumatic SCI from 2015 to 2019 who were dependent on mechanical ventilation.

RESULTS: People who successfully weaned (85%) had fewer days from time of SCI to AIR admission (22 vs. 30,

CONCLUSION: In this retrospective study, there was an increased risk of pneumonia in people with …