Rehabilitation and Therapy Commons^™

Psychosocial Impacts And Employment Preparedness Of Participating In An Hiv Peer Program: Implications For Tailoring A Vocational Counseling Model For Plwh, Erin R. Mckinney-Prupis

Dissertations and Theses

Background:

Medical advancements in HIV care should have reduced barriers to employment for PLWH, yet in 2017 only 47.7% of PLWH reported being employed, as compared to 62.9% in the general population. Employment is a significant social determinant of health, it impacts a variety of factors related to health, including earned income, access to healthcare, and social connectedness. Quantitative and qualitative studies have identified several concerns PLWH have about entering the workforce; the most pressing being fear of losing benefits. Targeted work readiness programs for PLWH is an important approach to help PLWH overcome their unique barriers to work, such …

Low-Intensity Continuous Ultrasound For The Symptomatic Treatment Of Upper Shoulder And Neck Pain: A Randomized, Double-Blind Placebo-Controlled Clinical Trial, Stephanie Petterson, Kevin Plancher, Dominic Klyve, David Draper, Ralph Ortiz

All Faculty Scholarship for the College of the Sciences

Purpose: Low-intensity continuous ultrasound (LICUS) is an emerging high-dosimetry ultrasound-based therapy for accelerated tissue healing and the treatment of myofascial pain. In this study, LICUS treatment is clinically evaluated for chronic upper neck and shoulder pain in a randomized, multi-site, double-blind, placebo-controlled study. Patients and Methods: CONSORT guidelines were followed in conducting and reporting the clinical trial. Thirty-three participants with upper trapezius myofascial pain were randomized for treatment with active (n=25) or placebo (n=8) devices. Investigators and subjects were blinded to treatment groups. Participants self-reported pain daily, rating from 0– 10 on the numeric rating scale. If pain rating was …

Older Adults’ Perspectives On Occupational Supports In Alternative Housing Communities, A'Via Coleman, Lisa Goolsby, Kara Lurvey, Elizabeth Von Achen, Heather Veverica

Older Adult

The Problem: Many older adults in the United States wish to age in place but may find their current living environment is not suitable as they age. Alternative housing supports may improve the ability of older adults to live in their own home and community safely while performing necessary occupations.

The Resolution: Alternative housing communities offer a variety of supports that older adults value having access to, even if they are not always utilized including transportation, social interaction, volunteer opportunities, home maintenance, an accessible location, and the togetherness of community.

Occupational Therapy As Part Of A Team-Based Approach In Primary Care Settings, Lydia Royeen

Dissertations

The purpose of this project was to study issues related to occupational therapists integrating into primary care settings, as part of a team-based approach and to best meet the needs of the clients.

This is a mixed methods study that examined quantitative and qualitative data for members of the primary care team and occupational therapists working in primary care clinics. The Team Climate Inventory-14 (Kivimaki & Elovainio, 1999) was selected as the quantitative measure because it examines themes related to team functioning, which include vision, participative safety, task orientation, and mutual support. Participants completed a semi-structured interview that examined themes …

Access To Eye Care Before And After Vision Loss: A Qualitative Study Investigating Eye Care Among Persons Who Have Become Blind, Tosha Zaback, Stephanie Lam, Joan Randall, Teresa Field, Mitchell V. Brinks

The Qualitative Report

Navigating access to eye care requires that patients recognize the need for screening and care, employ limited financial and social resources, manage complex health insurance policies, and access specialty clinical care. We investigated the experience of patients through the progression of vision loss to blindness, utilizing qualitative methods. We conducted structured telephone interviews with 28 persons with blindness throughout Oregon. Utilizing closed and open-ended questions, we explored patient experience on the events preceding avoidable blindness. Coding for emergent themes was conducted independently by two researchers using a constant comparative method. Participants described important barriers to accessing eye care: at the …

Use Of Mobility And Exercise Videos During Covid-19 To Minimize Deconditioning, Nethra Ankam, Md, Tulasi Gude, Md, Courtney Back, Pt, Monina Florendo, Pt, Elizabeth Hearn, Pt, Morgan Miller, Pt, Kristen Stout, Pt

Health Equity and Quality Improvement (HEQI) Summit

COVID19 patients are at risk for becoming quickly deconditioned, especially in the hospital setting given the nature of the virus and those that get admitted. The concern for deconditioning stems from patients being confined to their room, the need to minimize exposure amongst healthcare providers and the need to conserve PPE.

We wanted to find ways to optimize opportunities for patient mobility, maintain patient and provider safety, all while conserving PPE. We reviewed the Chinese Association of Rehabilitation Medicine guidelines to help develop the exercise program.

Ensure Follow-Up For Functional Issues Post Covid-19, Nethra Ankam, Md, Tulasi Gude, Md, Kristofer Feeko, Do, Shannon Ames, Pt, Catherine Piersol, Ot, Tiffany Prince-Kandrakota, Pt, Erica Rao, Pt, Kristen Stout, Pt, Monina Florendo, Pt

Health Equity and Quality Improvement (HEQI) Summit

What's the Problem?

Patients post COVID-19 infection have functional limitations at home related to the multi-system effects of the infection, in addition to elevated risk for post-intensive care syndrome.

Our goals were to ensure patients had the resources they needed to safely mobilize at home, ensure referral to appropriate agencies for home care and therapies, and provide guidance on return to life activities in the setting of the stay-at-home order, need to self-quarantine, and limited outpatient therapy options.

Screening Tool To Ensure Optimal Patient Care And Function Post Covid Diagnosis, Nethra Ankam, Md, Shannon Ames, Pt, Dpt, Mba, Tiffany Prince-Kandrakota, Pt, Dpt, Ocs, Erica Rao, Pt, Dpt, Namrata Grampurohit, Phd, Otr/L, Catherine Piersol, Phd, Otr/L

Health Equity and Quality Improvement (HEQI) Summit

We developed a screening tool of questions to determine which patients would benefit from outpatient PM&R visits after discharge from the hospital/ED that included: four questions looking at function, shortness of breath and cognition. Screening questions were created so a YES response triggers a referral to PM&R to assess functional and cognitive needs for the patient.

Sars-Cov-2 Testing Guidelines For Patients Admitted To Mrh For Inpatient Rehabilitation, Deborah Cassidy, Do, Roger Liu, Do, Malav Shah, Md, Kyle Hummerston, Do, Jeanne Doherty, Md

Health Equity and Quality Improvement (HEQI) Summit

We implemented a clinical algorithmic approach with an emphasis on symptoms and risk to stratify patients into 3 groups:

• Acutely Ill COVID Rule Out/PUI
• Stable COVID Rule Out/PUI
• COVID OBS

Longitudinal Evaluation Of The Effects Of Illness Perceptions And Beliefs About Cardiac Rehabilitation On Quality Of Life Of Patients With Coronary Artery Disease And Their Caregivers, Patricia Thomson, Neil J. Angus, Federico Andreis, Gordon F. Rushworth, Andrea R. Mohan, Misook L. Chung, Stephen J. Leslie

Nursing Faculty Publications

Background

Patients’ negative illness perceptions and beliefs about cardiac rehabilitation (CR) can influence uptake and adherence to CR. Little is known about the interpartner influence of these antecedent variables on quality of life of patients with coronary artery disease (CAD) and their family caregivers. The aims of the study were: 1) to assess differences in illness perceptions, beliefs about CR and quality of life between patients with CAD and their family caregivers upon entry to a CR programme and at 6 months follow-up; and 2) to examine whether patients’ and caregivers’ perceptions of the patient’s illness and beliefs about CR …

Effects Of Occupational Therapy Intervention In Low Vision, Zach Harrington, Juliana Crossett, Carlie Carter, Baleigh Gooch, Liberty Harris

Master of Occupational Therapy Student Critically Appraised Topics

The purpose of this CAT is to investigate therapeutic intervention and its effects for improving independence in occupational performance, overall health, quality of life, and mental health in adults over 40 with acquired low vision. This CAT contains nine peer-reviewed research articles from national journals. Study designs include one randomized controlled trial, seven systematic reviews, and one non-randomized controlled trial. All studies relate directly to the components of our evidence-based practice question and will be used to support further research on the optometry and occupational therapy collaboration. All of the articles specifically describe various interventions used in the low vision …

Correlations Of Calf Muscle Macrophage Content With Muscle Properties And Walking Performance In Peripheral Artery Disease, Kate Kosmac, Marta Gonzalez-Freire, Mary M. Mcdermott, Sarah H. White, R. Grace Walton, Robert L. Sufit, Lu Tian, Lingyu Li, Melina R. Kibbe, Michael H Criqui, Jack M. Guralnik, Tamar S. Polonsky, Christiaan Leeuwenburgh, Luigi Ferrucci, Charlotte A. Peterson

Physical Therapy Faculty Publications

Background

Peripheral artery disease (PAD) is a manifestation of atherosclerosis characterized by reduced blood flow to the lower extremities and mobility loss. Preliminary evidence suggests PAD damages skeletal muscle, resulting in muscle impairments that contribute to functional decline. We sought to determine whether PAD is associated with an altered macrophage profile in gastrocnemius muscles and whether muscle macrophage populations are associated with impaired muscle phenotype and walking performance in patients with PAD.

Methods and Results

Macrophages, satellite cells, and extracellular matrix in gastrocnemius muscles from 25 patients with PAD and 7 patients without PAD were quantified using immunohistochemistry. Among patients …

Medical Student Understanding Of The Pm&R Specialty, Disability, And Post-Acute Care, Stephanie Tow

Research Days

No abstract provided.

The Β3-Adrenergic Receptor Agonist Mirabegron Improves Glucose Homeostasis In Obese Humans, Brian S. Finlin, Hasiyet Memetimin, Beibei Zhu, Amy L. Confides, Hemendra J. Vekaria, Riham H. El Khouli, Zachary R. Johnson, Philip M. Westgate, Jianzhong Chen, Andrew J. Morris, Patrick G. Sullivan, Esther E. Dupont-Versteegden, Philip A. Kern

Internal Medicine Faculty Publications

BACKGROUND. Beige adipose tissue is associated with improved glucose homeostasis in mice. Adipose tissue contains β3-adrenergic receptors (β3-ARs), and this study was intended to determine whether the treatment of obese, insulin-resistant humans with the β3-AR agonist mirabegron, which stimulates beige adipose formation in subcutaneous white adipose tissue (SC WAT), would induce other beneficial changes in fat and muscle and improve metabolic homeostasis.

METHODS. Before and after β3-AR agonist treatment, oral glucose tolerance tests and euglycemic clamps were performed, and histochemical analysis and gene expression profiling were performed on fat and muscle biopsies. PET-CT scans quantified brown adipose tissue volume and …

Relative Contribution Of Arms And Legs Through Repetitive Assisted Sit-To-Stand Motion In Individuals With Incomplete Spinal Cord Injury, Abd Aziz Musfirah

Student Works (2020-2029)

Sit-To-Stand (SitTS) exercise is one of important prerequisites to achieve some functional independence goals in everyday life especially for individuals undergoing rehabilitation In general, the execution of SitTS in spinal cord injury (SCI) patients involves motor function in both upper and lower extremities. The use of arm support in particular is a very significant element while executing SitTS movement for SCI population. In addition, application of functional electrical stimulation (FES) onto the quadriceps muscles is one of the prescribed management for incomplete SCI to improve muscle action for simple lower limb movements. However, the relative contribution of upper and lower …

Promoting Resilience In Self-Management (Prism): Adverse Childhood Experiences And Impacts On Emotion Regulation, Kasey Ann Macedo

Honors Scholar Theses

PRISM (Promoting Resilience in Self-Management) is a mindfulness-based intervention that aims to strengthen emotion regulation skills among individuals by employing cognitive behavioral therapy components. The purpose of the current study is to identify the relationship between adverse childhood experiences (ACEs) and depression, as well as to examine the changes in emotion regulation strategies of participants by comparing pre and post test data. The participants were voluntarily recruited from the Cornerstone Foundation, a homeless shelter, food pantry, and community center in Vernon, CT. The 13 participants completed PRISM through four weeks of two-hour workshop sessions in a small-group format. Results indicate …

What Outcomes Matter To Patients After Joint Or Spine Surgery?, Robin R. Whitebird, Leif I. Solberg, Christine K. Norton, Jeanette Y. Ziegenfuss, Stephen E. Asche, Elizabeth S. Grossman

Journal of Patient-Centered Research and Reviews

Purpose: Patient-reported outcome measures (PROMs) are increasingly used in clinical care, but there have been few studies of what patients identify as the most important outcomes.

Methods: Semi-structured interviews were conducted with 65 patients undergoing hip or knee replacement, spinal discectomy/laminotomy, or a spinal fusion. Interviews focused on outcomes patients identified as important, perceived usefulness of standardized PROMs measures, and contextual situations important to their care. Data were analyzed using a directed content analysis approach.

Results: Patients identified desired outcomes that were unique and important to them. Their preferred outcomes focused in the areas of freedom from pain, getting back …

Giving Credence To The Experience Of X-Linked Hypophosphatemia In Adulthood: An Interprofessional Mixed-Methods Study, Melissa Hughes, Carolyn Macica, Catherine Meriano, Maya Doyle

Journal of Patient-Centered Research and Reviews

Purpose: X-linked hypophosphatemia (XLH) is a rare X-linked dominant metabolic bone disease, often diagnosed in childhood but causing increasing physical debilitation and pain in adulthood. Physical comorbidities of XLH in adulthood include pervasive and early-onset degenerative arthritis, mineralizing enthesophytes and osteophytes, osteomalacia and pseudofracture, dental abscesses, and hearing loss.

Methods: This mixed-methods analysis included physical findings, diagnostic imaging, occupational and physical therapy assessments, and semi-structured interviews by social work to understand the functional outcomes and lived experience of XLH in adulthood, through connections between qualitative data obtained by social work and occupational therapy with the quantitative findings from other disciplines. …

Myocardial Work Index: A Novel Method For Assessment Of Myocardial Function In South Asian Recreational Athletes, Shantanu Sengupta, Renuka Jain, Nitin Burkule, Susan Olet, Bijoy K. Khandheria

Journal of Patient-Centered Research and Reviews

Purpose: We used a novel noninvasive method based on speckle-tracking echocardiography to evaluate myocardial performance in South Asian recreational athletes who completed a half marathon.

Methods: Transthoracic echocardiography was performed on 24 recreational athletes 48 hours before they took part in a half marathon (premarathon), within 2 hours of half marathon completion (postmarathon), and 72 hours after completion. Clinical, laboratory, and echocardiographic variables were collected. Speckle-tracking echocardiography was performed in all subjects to characterize myocardial mechanics.

Results: Mean age of participants was 41.8 ± 7.4 years, and 23 (95.8%) were male. No subject had a prior history of coronary artery …

Developing Educational Resources To Support The Use Of The Hippotherapy Evaluation And Assessment Tool, Emily Peoples

Student Capstone Papers

The Hippotherapy Evaluation and Assessment Tool (HEAT) was created in 2011 with the goal of creating an assessment specific to this therapeutic intervention and effectively tracking client progress. Based on the current literature of client progress during hippotherapy intervention, four domains of scoring were created: Static Posture, Dynamic Motor Behavior, Sensory Processing, and Psychosocial/Behavioral. Over the years, many thesis studies have been conducted to confirm the reliability and validity of the HEAT. However, further dissemination was required as many therapists had not yet heard of the tool. A doctoral capstone project was completed in 2019-2020 to create a training program …

Perceived Impact Of Non-Contact Boxing On Daily Life And Occupational Participation At Home Among Individuals With Parkinson's Disease, Kristen E. Bignal

Student Capstone Papers

The aim of this project was to determine whether individuals with Parkinson's disease perceive an impact on their daily life and occupational participation at home secondary to participation in non-contact boxing.

Semi-structured open-ended interview questions were conducted with 17 participants (3 female) who have been diagnosed with Parkinson's disease for(i.e., self-care, home and health maintenance, sleep, intimacy, social and leisure interests, etc.) in the home environment. Interviews were transcribed and analyzed utilizing thematic analysis.

Data analysis derived three overarching themes including psychological benefits, sense of community, and framework to develop routines. Subsequent research exploring how non-contact boxing directly impacts specific …

Animal-Assisted Therapy And Quality Of Life In Patients With Dementia, Karissa D. Thomson

Student Capstone Papers

The aim of this quantitative study was to examine the effects animal-assisted therapy (AAT) had on people diagnosed with dementia living in a nursing home. The study aimed to examine the effects AAT had on depression, blood pressure, social interaction, and how these factors impact quality of life (QOL). The study was conducted once a week for one hour on Thursdays for 6 weeks. 7 participants were included in the study and further broken down into two groups based upon their level of cognition as measured by the Mini-Mental Status Examination. Beck’s Depression Inventory (BDI) and the World Health Organization …

Orthopedic Injuries In Athletes, Cameron Adams

Showcase of Undergraduate Research and Creative Endeavors (SOURCE)

When thinking of athletes and orthopedic injuries, we often associate these injuries with more physical sports such as football, basketball, or even soccer. What we don’t realize is that an injury of any degree can occur in any sport, regardless of the level of physicality. An orthopedic injury is any injury to the bones, muscles, or joints of the musculoskeletal system. These injuries include, but are not limited to, ACL tears, meniscus tears, broken bones, muscle tears, sprains, dislocations, or fractures, obtained during a sport. Most injuries of this nature are hard to ignore, but depending on the area and …

Animal-Assisted Therapy And Quality Of Life Of Patients With Dementia, Karissa D. Thomson, Kayla Collins, Mary P. Shotwell

Spring 2020 Virtual OTD Capstone Symposium

The aim of this quantitative study was to examine the effects animal-assisted therapy (AAT) had on people diagnosed with dementia living in a nursing home. The study examined the effects AAT had on depression, blood pressure, social interaction and how these factors impact quality of life (QOL). The study was conducted once a week for one hour on Thursdays for 6 weeks. 7 participants were included in the study and further broken down into two groups based upon their level of cognition as measured by the Mini Mental State Examination. The Beck’s depression inventory (BDI) and the World Health Organization …

Supporting The Role And Transition To Motherhood Through The Occupation Of Feeding, Bethanne N. Vidmar, Becki Cohill, Susan Macdermott

Spring 2020 Virtual OTD Capstone Symposium

The purpose of this project was to assess and explore the occupational needs of mothers who are feeding their infants in a variety of ways to then identify psychosocial and occupational barriers affecting women's’ choices in feeding options for their infant through survey and interviews and opportunities for occupational therapists to become more involved in the occupation of breastfeeding.

Data analysis for this capstone project consisted of running a needs assessment in Santa Barbara County. The needs assessment consisted of written or online surveys and semi-structured in-depth interviews. Of the 95 women who filled out the hard-copy or online survey, …

Exploring Occupational Disruption In Newly Diagnosed Individuals With Cancer With Minor (Dependent) Children, Riley S. Harrold, Susan Macdermott, Becki Cohill

Spring 2020 Virtual OTD Capstone Symposium

Background: According to the American Cancer Society (2019), there were more than 1.7 million new cases of cancer in 2019 alone. Individuals are being diagnosed at a young age with 22.4% of cases occurring in individuals 22-55 years old and whom are childrearing age (Shah et al., 2017). There are an estimated 2.85 million children under the age of 18 who are living with a parent who has cancer (Shah et al., 2017). Newly diagnosed individuals face changes in daily life, the threat of possible death, and fear of dying (Compas et al., 1994). Changes in shared family roles …

Exploring The Occupation-Based Needs Of Older Adults With Alzheimer’S Disease At A Reminiscence Therapy Adult Day Center, Kendra C. Gillio, Susan Macdermott, Becki Cohill

Spring 2020 Virtual OTD Capstone Symposium

Alzheimer’s disease is the most common form of dementia, affecting approximately 60% to 70% of the older adult population aged 65 and older (Santos da Silva, de Oliveira Alves, Barros Leite Slagueiro & Bezerra Barbosa, 2018). Reminiscence therapy prompts an individual’s memory by stimulating their sense – sight, smell, hearing, taste, and touch, and provides an opportunity for them to revisit and relive their past through their surrounding environment (Swann, 2013). For individuals with Alzheimer’s disease, occupational therapy focuses on adapting the environment in order to promote their ability to engage in meaningful occupations, increase quality of life, and social …

The Health Benefits Of Visual Art Activities In The Geriatric Population, Melody Au-Yeung, Abraham Avila, Jason Bandong, Hy Ia, Naureen Imam, Kayla Wilcox

San Marcos, Spring 2020

Purpose: The purpose of this poster presentation is to assess the efficacy of visual art therapy on the physical and mental health of the geriatric population.

Description: The potential impact of art therapy on cognition and dementia is a growing field of research in the rehabilitative world. Some researchers have found support for certain mediums, such as ceramic painting, while others have explored multimodal treatment programs that integrate art into physical activities. Combining physical activity with an arts and crafts program could posit a significant impact on ADL function and quality of life in older adults. As a …

The Effectiveness Of Lsvt-Big And Pwr! Programs On A Patient With Parkinson’S Disease: A Case Report, Naureen Imam, Jennifer Dannenbring

San Marcos, Spring 2020

Background: The prevalence of Parkinson’s Disease (PD) drives the search for effective interventions. While LSVT-BIG and high-intensity training improve gait speed and balance deficits, only limited research exists on the impact of the Parkinson's Wellness Recovery (PWR!) program on PD symptoms. Thus, LSVT-BIG and PWR! should be explored in tandem as standardized treatment for patients with PD.

Purpose: The primary purpose of this case report is to determine the effects of LSVT-BIG and PWR! programs on gait impairments, balance deficits, and participation restrictions in a patient with PD.

Case Description: A 74-year old male with PD attended PT …

Lymphatouch™ As A Preparatory Method For Chemo-Induced Peripheral Neuropathy And Radiation-Induced Fibrosis: A Case Study, Abigail Harris

OTD Capstone Projects

Quality Improvement: Aims to explore the ability to expand the services offered at the Nashville Breast Center and potentially provide improved health-related quality of life for patients in the survivorship stage of breast cancer. Case Study: To assess the LymphaTouch ™ device for use in treating Chemo-Induced Peripheral Neuropathy and Radiation-Induced Fibrosis.