Rehabilitation and Therapy Commons^™

Concomitant Epidural And Longitudinal Anterior Spinal Artery Contrast Spread In A Lumbar Transforaminal Epidural Steroid Injection (Tfesi), Philip J. Koehler Iii, Paul M. Kitei, David S. Stolzenberg, Elaine H. Hatch

Rothman Institute Papers

A 78-year-old female with a remote history of L3-4 decompression and fusion presented with several months of low back and radicular leg pain. MRI revealed moderate L2-L3 spinal canal stenosis, ligamentum flavum infolding, moderate bilateral foraminal stenosis, and a grade I retrolisthesis. A right sided L2-L3 TFESI was performed using multiplanar fluoroscopic imaging with a subpedicular supraneural approach. During live iodinated contrast injection, imaging revealed concomitant epidural and central arterial contrast spread. The needle was retracted and repeat live fluoroscopic imaging demonstrated no vascular uptake. Desired epidural and nerve root contrast spread remained in place with repeat still imaging. Dexamethasone …

A Comparison Of Vestibular Function In Young Adult Musicians And Non-Musician Peers, Alexandria W. Greene, Ashley G. Flagge, Nicholas S. Stanley

Ashley Flagge Publications

Purpose: The majority of college-level musicians exceed the daily recommended noise dose level during instrumental practices and performances, although less than one-third report wearing hearing protection while playing their instruments. Although the hazardous effects of music on the auditory system have been established, even in young adult musicians still early in their musical careers, the effects of music on the vestibular system are still unclear. The purpose of the present study was to examine vestibular/balance differences between young adult musicians and non-musicians to determine the effects of music exposure on the vestibular system.

Method: Young adult participants aged 18-27 years …

Perceived Patient-Centered Care In Marching Band Artists, A L. Merrill, Z K. Winkelmann, N A. Uriegas

Bakerman Student Research Awards

Objective: Approximately 27,000 college marching band (MB) artists in the United States could benefit from access to healthcare services and patient-centered clinicians. The purpose of this study was to explore HCPs MB artists have access to and their perceptions of patient-centered care (PCC). Methods: We used a cross-sectional web-based survey of MB artists (n=751, age=20±8 years). MB directors from 242 colleges were emailed a survey link to forward to MB artists. Participants indicated which HCPs they could access. Those who reported no access or unsure were prompted to describe what they would do if an injury or illness occurred. Participants …

How An Athlete’S Injuries Affect Their Caregiver, John-Luke Taylor, Susan Macdermott

Fall 2024 OTD Capstone Symposium

The purpose of this proposal was to explore the experiences that caregivers face when their child recovers from a sports injury and needs physical rehab.

Parent Perceptions Of Modified Toy Cars Influence On Play For Children With Disabilities: A Case Study, Taylor Brown, Angela Labrie Blackwell, Erik Pérez, Karen Aranha

Fall 2024 OTD Capstone Symposium

Play is a crucial childhood occupation because it facilitates the growth of various developmental skills. Children with disabilities (CWD) often exhibit intrinsic factors that can prevent them from participating in meaningful childhood occupations, such as play. Mobility play is a specific type of play that refers to any means for the child to explore and move around their environment, which can be accessed through the use of commercially available toys, including motorized toy cars. However, these commercially available toys are not always accessible to this population due to their unique presentation that hinders performance and participation in the desired and …

Understanding The Perceptions Of Technology In Homes For Aging In Place, Jinelle Abugan, Amy Lyons-Brown Ms, Otd, Otr/L, Molly Wuebker Otd, Otr/L, Actcp

Fall 2024 OTD Capstone Symposium

The purpose of this study is to understand the thoughts and experiences of technology in homes and the use of technology-based home modifications to help individuals with participation and performance in daily activities. The education of perceptions of culture in homes will be supported by faculty, OTs, professional designers, about the need to explore culture in technology for home modifications aging in place.

Exercise As A Therapeutic Intervention And Its Effects On The Quality Of Life Of Those Diagnosed With Amyotrophic Lateral Sclerosis, Theresa Stettner, Helen Carey, Cynthia Haynes

Fall 2024 OTD Capstone Symposium

The standard of care for those with ALS includes range of motion, limb relaxation, trunk balance, and gait training (Braga et al., 2018). This study examines perceived quality of life in ALS clients before and after an in-person exercise program and home exercise program to evaluate the benefits of exercise as exercise does not exacerbate symptoms of ALS (Meng et al., 2020). Daily occupation performance requires functional ability which may be preserved through exercise (Kalron et al., 2021).

Fournier's Gangrene Severity Index And Charlson Comorbidity Index Predict Mortality, Intensive Care Unit Admission, And Length Of Hospital Stay In Patients With Fournier's Gangrene: An Analysis Of 264 Consecutive Patients, Nicholas Hauser, Chenlin Huang, Girija Vaidya, Timothy Chrusciel, Krithika Narayana Kumarasan, John Culhane, Sameer Siddiqui

Faculty, Staff and Students Publications

Introduction

Fournier’s gangrene (FG) is a rapidly progressing necrotizing fasciitis. The Fournier's Gangrene Severity Index (FGSI), in conjunction with the Charlson Comorbidity Index (CCI), has been used as a mortality predictor during hospitalization. Patients with diabetes have also been shown to be at an increased risk for the development of FG. This study explores the potential of using FGSI, CCI, and patient diabetes status in predicting more extensive patient outcomes, including intensive care unit (ICU) admission and length of hospital stay.

Methods

From 2013 to 2023, inpatient admissions with the diagnosis of FG were selected from the EPIC Clarity database …

Examining Anxiety And Coping Strategies With Persons With Parkinson's Disease (Pwpd) Who Routinely Exercise, Ashlynn Milburn, Angela Labrie Blackwell, Karen Aranha, Maggie Abbott

Fall 2024 OTD Capstone Symposium

Forty to 50% of the PwPD are reported to experience anxiety (Kwok et al., 2019). Anxiety is psychological distress characterized by excessive worry, and apprehension about future events (Khatri et al., 2020). Psychological distress with this population is secondary to care dependency, poor work and social function, increased physical and cognitive decline, increased dementia risk, and high mortality rate (Kwok et al., 2019).Exercise and meditation have been found to be useful coping strategies to manage one’s physical condition as well as psychosocial factors such as anxiety, with PD (Mantri et al., 2021).Although these coping strategies have the potential to reduce …

Benefits Of Occupational Therapy In Concussion Treatment For Professional Athletes, Alexandria Brown, Zeida Gutierrez Ph.D., Mhs, Otr/L, James Wersal Otd, Msot, Otr/L, Cbis, Drs, Dcs

Fall 2024 OTD Capstone Symposium

Concussions are a significant concern in sports, with an estimated 1.6 to 3.8 million cases in the U.S. annually, many of which go unreported. These traumatic brain injuries result from various impacts, causing symptoms like headaches, dizziness, and memory loss, which can disrupt an athlete's daily life. Recovery typically follows a staged protocol, with professional organizations implementing concussion management guidelines. Despite these measures, athletes often hesitate to report symptoms due to concerns about playing time or team expectations. There is a gap in treatment for concussions as activities of daily living and occupations are not addressed. Occupational therapy can help …

Adapting Classroom Activities To Increase Social Engagement, Ivie Hacker, Mary Jan Greer Ph.D., Otr

Fall 2024 OTD Capstone Symposium

This capstone program focuses on enhancing the development of children with disabilities through adaptive play strategies. It aims to create a supportive, engaging environment that accommodates the unique needs of children on the autism spectrum. By incorporating individualized play techniques, the program promotes social, emotional, and cognitive skills, fostering greater communication, creativity, and physical coordination. The project explores the role of adaptive play in improving social interactions, reducing sensory sensitivities, and building self-confidence, ultimately contributing to the overall well-being and development of children with autism.

Sex Education Program For Individuals With Disabilities, Kalynne Coates, Keisa Boykin

Fall 2024 OTD Capstone Symposium

The purpose of this project is to develop and implement a program to discuss the ADL of sex education with individuals with intellectual and developmental disabilities (IDD).

Evaluating The Superiority Of Multimodal Analgesia Over Opioid-Based Analgesia In Postoperative Pain Management For Total Knee Arthroplasty: A Comprehensive Integrative Review, Janna Smith, Mahdi Mofazali, Nya-Qien Smith

Master's Projects

With total knee arthroplasty (TKA), postoperative pain management is so important for optimal recovery and patient outcomes. This integrative review evaluates the effectiveness of multimodal analgesia (MMA) compared to traditional opioid-based analgesia in reducing pain and opioid consumption post-TKA. Research shows that MMA is very effective at providing adequate pain relief, reducing side effects, and also decreasing opioid use. MMA also addresses both the specific needs of individual patients and the broader public health issue of opioid dependence. However, a significant barrier to widespread adoption is the absence of standardized protocols. This review sets forth the importance of coming up …

Early Mobility And Delirium Prevention For Intensive Care Unit Patients At Kingman Regional Medical Center, Lyndsey R. Lehman Ms, Otr/L

Masters Projects

Over five million patients are admitted to the intensive care unit (ICU) annually in the United States, with 50-70% of those developing debilitating physical, cognitive, and mental health issues. Occupational therapy (OT) is a holistic profession that provides evidence-based interventions to improve ICU patients’ function and participation in daily occupations by addressing early mobility and delirium. A needs assessment performed for the Kingman Regional Medical Center (KRMC) ICU revealed a lack of knowledge about early mobility and delirium prevention among nursing staff, underutilization and limited understanding of OT services, and KRMC-specific barriers impacting patient care. This author designed and implemented …

A Geriatric Interprofessional Education Workshop: A Mixed Method Study, Patricia Watford, Meghan Hall, Colleen Hergott, Wanda Jirau-Rosaly, Shilpa Brown, Elena Wood, Nicole Rockich-Winston

Journal of Applied Disciplines

Interprofessional healthcare teams are essential for meeting the needs of our older population. To prepare for interprofessional collaboration, educational programs should offer opportunities for interprofessional education. We created a four-hour geriatric interprofessional workshop addressing cognition, macular degeneration, dysphagia, home safety, fall risk, and pharmacotherapy to examine student perceptions of working in interprofessional teams and their attitudes toward geriatric patients. Participants included 189 second-year medical (MD) students, 41 first-year occupational therapy (OT) students, and 36 second-year physical therapy (PT) students. We utilized a sequential explanatory mixed-method approach. Data analysis comprised descriptive statistics, paired t-tests for the pre/post surveys, and inductive content …

Observers Have Similar Improvements In Student Learning Outcomes As Participants In Athletic Training Simulation Education: A Pilot Study., Alma R. Mattocks Phd, Atc, Chse, Sara E. Mahoney Phd, Facsm, Rachele E. Vogelpohl Phd, Atc, Kim Hawkins Phd, Aprn, Fnp-C

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

Introduction: The use of standardized patient (SP) encounters in athletic training education programs have become more common; however, due to time and space constraints, it is possible that not all athletic training students will be able to participate and some must be observers. The objective of this study was to determine if observers experience similar improvements in student learning outcomes as participants for SP encounters. Methods: A pretest/posttest, non-randomized controlled trial was utilized. Nine athletic training students volunteered to participate in the research study. All participants completed a pretest survey including a knowledge assessment and confidence rating scale, followed by …

Relationship Between Posterior Tibial Artery Blood Flow And Lower Leg Flexibility Among Collegiate Runners, Jeffrey Williams, Megan Battles, Rachel Bowden, Cameron Greene, Arbin Thapaliya, Justin Stanek

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

Purpose: Understanding relationships between blood flow and muscle inflexibility in the lower leg can support improved healthcare competency. Sports medicine practitioners might use the reference ranges and knowledge of relationships among these variables to support effective health screenings among their competitive runners. These variables have been linked in other areas of the body where inflexibility in the pectoralis minor and scalene muscles have been associated with diminished blood flow to the upper limb. No studies, however, have examined the relationship between vascular and mobility characteristics in the lower legs of runners. Therefore, the purpose of this study was to examine …

Bidirectional Nature Of Work Family Conflict: Family Interfering With Work Conflict Among Athletic Trainers In The Collegiate Setting, Stephanie M. Singe, Milana Adaspour, Alexandrya Cairns, William Pitney

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

Introduction: Work-family conflict is bidirectional, yet research has largely only investigated the extent to which work interferes with family conflict (WIFC) and not whether family interferes with work conflict (FIWC). Objective: Investigate FIWC among collegiate athletic trainers. Specifically, we were focused on relationships between gender, marital status, employment status of the athletic trainer’s spouse, and number of children. Methods: Data were collected via a cross-sectional, online survey (Qualtrics). Descriptive statistics were calculated for demographic information; Mann Whitney U analyses were utilized to discover differences between gender, marital status, employment status of spouse, and number of children.

Results: 984 (605 women, …

Athletic Trainer Emergency Management Skill Assessment Via Low Fidelity Simulation, Jaclyn B. Arduini, Jennifer L. Volberding

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

Introduction: Athletic training education requires the inclusion of emergency management (EM) best practices, however the Board of Certification (BOC) does not mandate any continuing education (CE) past Emergency Cardiac Care (ECC). With EM best practices continuing to change there is potential for a large knowledge gap to develop in practicing athletic trainers (ATs) who do not chose to engage in EM CE. The purpose of this study was to identify knowledge gaps in practicing ATs’ EM skills via low fidelity simulation. Methods: A cross-sectional study was conducted in an educational laboratory setting involving twenty-two ATs (age 36.7±10.8 years; 13 males, …

Telehealth Education In Athletic Training, W. David Carr, Mccall E. Christian, Jennifer L. Volberding, Zachary K. Winkelmann

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

Context: Within the broad telehealth education literature, there are numerous case studies and position statements from various associations of model practices. Little is known about how athletic training is addressing telehealth education. Objective: To determine how athletic training education programs teach, assess, and structure telehealth content. Design: Cross-sectional study Setting: Online survey instrument Patients or Other Participants: An institutional athletic training faculty member from 82 athletic training programs in the United States. Data Collection and Analysis: The survey contained the validated Telehealth Evaluative Content in Higher Education (TECHE) instrument, which consisted of descriptive items focused on how education programs teach, …

Athletic Training Students’ Experiences And Perceptions Of Exertional Heat Stroke Simulated Encounters: A Qualitative Analysis, Hannah L. Stedge, Malissa Martin, Beth L. Kinslow, Valerie Herzog, Christine Reyes

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

Introduction: Athletic trainers are trained to recognize exertional heat stroke (EHS), which is critical to implementing lifesaving measures. Rectal thermometry is the best practice for recognizing EHS, and the Commission on Accreditation of Athletic Training Education (CAATE) requires students to learn rectal thermometry. Rooted in transformative learning theory, this study explored the perceptions and experiences of athletic training students following simulated EHS encounters with either high-fidelity (HF) simulators or standardized patients (SPs). Methods: This was a qualitative study using phenomenological theory. Through semi-structured qualitative interviews, we explored participants' personal experiences and perceptions following their simulation interventions. Participants included sixteen first-year …

Barriers To Cardiac Rehabilitation Enrolment And Secondary Prevention Adherence In Patients With Coronary Heart Disease Following Percutaneous Coronary Intervention: A Cross-Sectional Survey, Ahmed Mohammed Almoghairi, Jane O’Brien, Anna Doubrovsky, Jed Duff

Journal of the Saudi Heart Association

Objectives: This study aimed to evaluate adherence to secondary prevention measures and to identify barriers to cardiac rehabilitation enrolment among patients with coronary heart disease after percutaneous coronary intervention.

Methods: An observational cross-sectional survey was conducted through computer-assisted telephone interviews to assess recently treated percutaneous coronary intervention patients at the Prince Sultan Cardiac Center in Saudi Arabia.

Results: Out of 104 surveyed patients with coronary heart disease, 85 (82%) were male, with an average age of 59.5 years. The obesity rate was 28% (n = 29), with a high prevalence of comorbidities: 82 (79%), 63 (61%), and 62 (60%) …

Atrial Fibrillation Status And Physical Rehabilitation In Older Patients With Acute Decompensated Heart Failure: An Analysis From The Rehab-Hf Trial, Douglas Corsi, Sean Dikdan, Naman Upadhyay, Haiying Chen, Dalane W Kitzman, Robert Mentz, David J Whellan, Daniel R Frisch

SKMC Student Presentations and Publications

BACKGROUND: The REHAB-HF (Rehabilitation Therapy in Older Acute Heart Failure Patients) trial demonstrated that a transitional, tailored, progressive rehabilitation intervention improved physical function, 6-minute walk distance, frailty, quality-of-life, and depression in older patients hospitalized for acute decompensated heart failure. This analysis assessed the impact of atrial fibrillation (AF) on intervention benefits.

METHODS AND RESULTS: Of 349 enrolled patients hospitalized for acute decompensated heart failure (mean age 72.7±8.1 years), 176 (50.4%) had AF. Participants were randomly assigned to 12-week rehabilitation intervention or attention control. The primary outcome was Short Physical Performance Battery score at 3 months. Participants with AF were older …

Simultaneous Ipsilateral Hip And Knee Dislocation: Management And Outcome – A Case Report, Christian G Falgons, Stephen J Warner

Faculty, Staff and Student Publications

Case: This clinical case report presents a 40-year-old male who sustained an ipsilateral hip and knee dislocation with ipsilateral femoral head fracture and incomplete femoral neck fracture following a motorcycle collision.

Conclusion: This report describes acute and later definitive orthopedic care and management, with focus on urgent interventions and timing of immediate treatments. Given the presented patient's favorable clinical outcomes, return to baseline activities, and absence of significant sequelae following injury, the considerations from the acute management and surgical planning of this patient's injuries can be used as a reference for treating the rare injury of ipsilateral knee and hip …

Correspondence Re Essam El-Sayed Felaya Et Al, Kiyeun Nam, Dongho Lee, Seokjoon Hwang, Minsu Seo, Taeheon Lee, Yonghoon Lee, Michael Y Lee

Faculty, Staff and Students Publications

No abstract provided.

Enhancing Recovery: Surgical Techniques And Rehabilitation Strategies After Direct Anterior Hip Arthroplasty, Alberto Di Martino, Christopher Keating, Micahel J. Butsick, Daniela Platano, Lisa Berti, Louis N. Hunter, Cesare Faldini

Department of Physical Therapy Faculty Papers

Total hip arthroplasty (THA) is a common surgical procedure for hip joint pathologies, with the direct anterior approach (DAA) gaining popularity due to potential benefits in postoperative recovery. This review aims to provide a comprehensive analysis of rehabilitation strategies following DAA THA, focusing on surgical techniques, postoperative care, and outcomes. The evolution of the DAA to THA is discussed, highlighting historical advancements and comparisons with other surgical approaches. Surgical techniques and considerations specific to the DAA are detailed, including outcomes and complications compared to alternative approaches. The role of the surgical technique in influencing postoperative rehabilitation is explored, emphasizing the …

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 …

Anxiety And Depression Amongst Female Athletes, Dp Golden, Re Obmann, Em Moore

Clinical Practice in Athletic Training

Context: Anxiety (categorized by a feeling of fear, dread, and uneasiness) and depression (mood disorder causing feelings of persistent sadness and loss of interest in things an individual once loved) are two major mental health disorders effecting females considerably who participate in sport. Females are more likely to present with anxiety (55-60%)1 and depression (1.844 times)2 compared to males. The purpose of this study was to examine the prevalence between mental health comorbidities (anxiety and depression), across female athletes aged 18-40. Methods: An anonymous survey was distributed via snowball sampling using social media. Demographic data, Generalized Anxiety Disorder-7 (GAD-7), validated …

Effects Of Sex Hormones And The Menstrual Cycle On Knee Joint Laxity In Physically Active Females: A Critically Appraised Topic, Ae Eicher, Rj Gage, K Park-Braswell

Clinical Practice in Athletic Training

Clinical Scenario: In recent years, females have exhibited increased physical activity and sport participation than ever before. Recent studies have identified a rising incidence rate of ACL injuries and indicate that the risk of ACL tears is greater in females than males. Knee laxity and physiological variation in women during the menstrual cycle have demonstrated increased ligament laxity, therefore, varying hormone concentrations may contribute to changes in ligamentous mechanical properties. Despite these findings, it remains unclear whether fluctuating sex hormone concentrations directly correlate to measurable changes in knee laxity. Clinical Question: How do fluctuations in sex hormones throughout the menstruation …