Rehabilitation and Therapy Commons^™

The Impact Of Anterior Cruciate Ligament Reconstructive Surgery On Neuromotor Function, Cortney Noel Armitano

Rehabilitation Sciences Theses & Dissertations

The purpose of this dissertation was to examine the systemic neuromechanical implications in individuals who have had an ACL reconstruction (ACLR) compared to healthy controls. The specific aims addressed were to: 1) examine differences in inter-limb coordination during walking at different speeds, 2) examine differences in trunk, neck and head acceleration during gait, and 3) investigate whether the reaction time responses assessed during stepping are negatively affected by ACLR.

The findings of study 1 revealed that maximal coordination stability was achieved when walking at the person’s preferred gait speed. However, individuals with a previous ACLR exhibited reduced coordination stability between …

Fracture Of A Heterotopic Ossification Of The Syndesmosis In A Collegiate Football Player: A Case Report., Stephen A. Cage, Brandon J. Warner, Diana M. Gallegos

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

Objective: Present a clinical case detailing the assessment and management of a collegiate football player suffering from the fracturing of a heterotopic ossification of the syndesmosis. Background: Heterotopic ossifications are not uncommon following surgical fixation of the tibiofibular syndesmosis. Typically, properly healed fibular fractures do not result in further complications associated with heterotopic ossification. Treatment: A 21-year-old collegiate football player (1.8 m, 77.1 kg) reported to the athletic training staff complaining of acute lateral ankle pain following a plant and twist mechanism while running receiving routes. Initial evaluation led to a diagnosis of a syndesmotic ankle sprain, with a …

Efficacy Of High-Performance Vision Training On Improving The Reaction Time Of Collegiate Softball Athletes: A Randomized Trial, Diana R. Feldhacker, Whitney Lucas Molitor, Ashley Athmann, Molly Boell, Angela Kaiser, Ashley Musch, Logan Willhite

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

Purpose. A well-developed visual system is integral to the dynamic nature of sport performance among collegiate athletes. Occupational therapists play an important role in addressing an athlete’s visual skills through incorporating meaningful occupation, in this case sport, into interventions while addressing specific client factors. The aim of the study was to examine the efficacy of occupational therapist led high-performance visual training in improving the reaction time of collegiate softball athletes. Method. A mixed method approach was used to collect both qualitative and quantitative data. Qualitative data were collected to assess athlete perceptions of sport, and quantitative data were collected using …

Current Athletic Training Educational Preparation For Dry Needling, Brian V. Hortz, Sue Falsone, Duncan Tulimieri

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

Purpose: Dry needling is an advanced practice skill that many athletic trainers are being trained to perform. The purpose of this study is to determine the degree to which the current athletic training educational competencies and standards prepare practitioners for the performance of dry needling tasks. Methods: An expert panel review was used to verify which of the dry needling tasks are currently taught through entry-level athletic education as defined by the 5^th edition competencies and 2020 standards. Results: Results demonstrated that 11% of the tasks were dry needling specific and these were regarded as not provided through entry-level …

Commentary: The Use Of Case-Based Learning And Concept Mapping To Teach Students Clinical Reasoning, Jeremy R. Hawkins, Michael Reeder, Michael Olson, Amy Bronson

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

Introduction: Teaching students as inexperienced clinicians the process of evaluating athletic injuries and medical conditions is often challenging. Utilizing case-based learning and concept mapping as educational tools can facilitate growth in the clinical and diagnostic decision making process. Discussion: Experienced clinicians regularly employ case pattern recognition and hypothetico-deductive reasoning in clinical settings. Each type of reasoning is prone to anchoring and confirmation bias, devaluing relevant information, and framing effect if not utilized correctly. Classroom instructors and preceptors can use case-based learning and concept mapping to help students as inexperienced clinicians organize their thinking and more effectively apply their …

The Effects Of Deep Oscillation Therapy For Individuals With Lower-Leg Pain, Mccall E. Christian, Riley C. Koenig, Zachary K. Winkelmann, Kenneth E. Games

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

Purpose: Lower extremity (LE) pain accounts for 13-20% of injuries in the active population. LE pain has been contributed to inflexibility and fascial restrictions. Deep oscillation therapy (DOT) has been proposed to improve range of motion and reduce pain following musculoskeletal injuries. Therefore, our objective was to determine the effectiveness of DOT on ankle dorsiflexion range of motion (ROM) and pain in individuals with and without lower-leg pain. Methods: We used a single blind, pre-post experimental study in a research laboratory. Thirty-two active participants completed this study. Sixteen individuals reporting lower-leg pain and sixteen non-painful individuals completed the study. Participants …

Perceptual And Contextual Sources Of Athletic Training Confidence: The Transition To Professional Entry Level Master’S Programs, Craig E. Pfeifer, Erin Moore, Brian Seiler, Caroline Thomason, Eva V. Monsma

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

Introduction: The shift of athletic training education from undergraduate degrees to professional master’s degrees and the prominence of computer-based credentialing may impact the hands-on experiences beneficial for developing confidence in athletic training competency domains. Health care provider confidence is critical for clinical skill development, performance and enhancing patient care. Purpose: To examine domain specific efficacy, its sources, learning contexts (i.e., classroom, laboratory, clinical settings) and clinical characteristics by program types. Method: Descriptive, cross-sectional design where 178 Athletic Trainers (AT; age 24.25 + 3.76, n = 72 male, n = 106 female) participated in the study (Master’s Program (MP) = 38; …

Physicians’ Knowledge And Beliefs Regarding Athletic Trainers, Joseph H. Vogler, Lindsey E. Eberman, Zachary K. Winkelmann, M. Seth Smith, James L. Turner, Kenneth E. Games

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

Purpose: The relationship between athletic trainers (ATs) and physicians is a legal obligation and collaboration to improve patient outcomes. The objective of this study was to examine the knowledge of physicians regarding the educational preparation, legal obligations, and scope of practice for ATs and how it relates to previous experiences with ATs. Additionally physicians’ perceptions of Interprofessional Collaboration (IPC) were studied. Methods: 169 physicians medical doctors (MD)=133/169, 78.7%, doctor of osteopathy (DO)=36/169, 21%) completed a 36-question web-based survey, which included a validated IPC scale. Results: Respondents with experience working with an AT scored significantly higher (P < 0.01) on the knowledge assessment, where physicians currently working with an AT scored higher (5.4/8) than those who previously worked with an AT (4.2/8) and those who had never worked with an AT (3.3/8). Additionally, physicians with previous exposure to an AT as an athlete had significantly higher knowledge scores than those without exposure (P < 0.01). Two areas of weakness in IPC from the physician’s perspective included sharing of important information (2.48/4) and importance of work as compared to others on the team (2.38/4). Conclusions: Physicians who have a current working relationship with an AT and those that had access to an AT as an athlete demonstrated significantly higher knowledge about an AT’s academic preparation, legal obligations, and scope of practice. Moreover, physicians currently working with an AT report positive interprofessional collaborations.

Examining The Benefits Of Educating Caregivers About Tummy Time In The Acute Care Setting, Alexandra L. Turner

Occupational Therapy Doctorate Capstone Projects

Background: This project addressed providing parents with education on tummy time in the acute care setting. This is based on a gap in the literature on occupational therapy (OT) services in the acute care setting.

Purpose: The purpose of this research project was to conduct a pilot study to examine the benefit of educating parents of infants in the acute care setting on providing tummy time as a developmental education measure.

Theoretical Framework: The occupational therapy practice theory, of the Model of Human Occupation (MOHO) supports the holistic supporting of families, in their role as a parent, to meet the …

Obstacles Et Facilitateurs Du Retour Et Du Maintien Durable En Emploi Après Une Arthroplastie Totale Du Genou, Marie-France Coutu, Nathaly Gaudreault, Marie-Eve Major, Iuliana Nastasia, Réjean Dumais, Annie Deshaies, Marie-Elise Labrecque, Sara Pettigrew, Pascale Maillette

Rapports de recherche scientifique

Le nombre total d’arthroplasties du genou réalisées entre 2008 et 2009 a connu une augmentation significative par rapport à la décennie précédente, représentant une augmentation de 139 %. Cette augmentation est en partie attribuable au fait que la chirurgie procure une meilleure qualité de vie aux travailleurs vieillissants qui désirent demeurer actifs sur le marché du travail. De plus, l’innovation a amélioré la longévité des types de prothèses, de sorte que la chirurgie peut être proposée plus tôt dans la vie. Cet accroissement étant relativement récent, il existe peu de données dans la littérature permettant de situer la trajectoire de …

Connecting The Pieces: How Low Back Pain Alters Lower Extremity Biomechanics And Shock Attenuation In Active Individuals, Alexa Johnson

Theses and Dissertations--Rehabilitation Sciences

Low back pain in collegiate athletes has been reported at a rate of 37% from a wide array of sports including soccer, volleyball, football, swimming, and baseball. Whereas, in a military population the prevalence of low back pain is 70% higher than the general population. Compensatory movement strategies are often used as an attempt to reduce pain. Though compensatory movement strategies may effectively reduce pain, they are often associated with altered lower extremity loading patterns. Those who suffer from chronic low back pain tend to walk and run slower and with less trunk and pelvis coordination and variability. Individuals with …

Prior History Of Anterior Cruciate Ligament (Acl) Reconstruction Is Associated With A Greater Risk Of Subsequent Acl Injury In Female Collegiate Athletes, Jason Brumitt, Alma Mattocks, Amy Engilis, Dale Isaak, Jeremy Loew

Faculty Publications - College of Physical Therapy

Objectives: The risk of a subsequent anterior cruciate ligament (ACL) sprain is greater in high school aged female athletes with prior history of ACL reconstruction (ACLR) than in age-matched controls. The risk of a subsequent ACL injury in female collegiate athletes with prior ACLR is unknown. The primary purpose of this study was to determine the relative risk of a subsequent ACL injury in female collegiate athletes with prior ACLR when compared to age-matched controls. The secondary purpose of this study was to evaluate the ability of jump and hop tests to discriminate ACL injury risk.

Design: Prospective cohort.

Methods: …

Changes In Muscle Size, Quality And Power Are Related To Physical Function In Patients With Critical Illness, Kirby Mayer

Theses and Dissertations--Rehabilitation Sciences

Patients admitted to intensive care unit (ICU) are known to develop significant impairments in physical function. Patients with critical illness suffer up to 30% reductions in muscle size within the first ten days of admission to the ICU. Muscle strength testing, Medical Research Council-sum score, is current gold-standard to diagnosis ICU-acquired weakness and predicts risk of mortality and long-term physical function. Muscle power different from muscle strength in that it accounts for velocity of movement, is potentially a better independent predictor of function that has not been studied in this population. In addition, we hypothesize that muscle size and quality …

Evaluation Of A Cognitive Training Program And Its Effects On Healthy Older Adults, Nathan Jensen

All Graduate Theses, Dissertations, and Other Capstone Projects

As one ages, some degree of cognitive decline is expected. Despite this, declines in cognitive abilities and the possibility of dementia is a common concern among older adults. In response to these concerns, a variety of cognitive training programs have been developed that aim to improve or maintain cognitive functioning. Prior literature has shown mixed or limited findings on cognitive changes after implementation of cognitive training. This study evaluated the effectiveness of a cognitive training program designed for older adults with no to minimal cognitive decline. The current study included 18 participants who engaged in two one-hour cognitive training sessions …

Quickcough: An Instrumentational Proximal Airway Clearance Technique (Act) For Select Patients With Neuromuscular Disease (Nmd), Sean X. Sullivan, Russell K. Catania, Madison K. Plaster, Sydney E. Kandray, Mariah Costa

Williams Honors College, Honors Research Projects

Patients with neuromuscular disease (NMD) requiring tracheostomy and mechanical ventilation secondary to respiratory failure encounter increased difficulty in removing pulmonary secretions from the airways. To combat issues associated with current treatment modalities for insufficient cough efficacy (cost, poor mobility, discomfort, lack of evidence), we have developed an instrumentational proximal airway clearance technique (ACT) which augments a manual proximal ACT developed by a client with NMD. QuickCough is a 3D-printed PLA attachment to the tracheostomy apparatus which has demonstrated its ability to facilitate pressure changes necessary to increase patient’s peak cough flow (PCF) by providing a stronger exsufflation for the patient. …

Data Patterns Discovery Using Unsupervised Learning, Rachel A. Lewis

College of Graduate Studies: Theses & Dissertations

Self-care activities classification poses significant challenges in identifying children’s unique functional abilities and needs within the exceptional children healthcare system. The accuracy of diagnosing a child's self-care problem, such as toileting or dressing, is highly influenced by an occupational therapists’ experience and time constraints. Thus, there is a need for objective means to detect and predict in advance the self-care problems of children with physical and motor disabilities. We use clustering to discover interesting information from self-care problems, perform automatic classification of binary data, and discover outliers. The advantages are twofold: the advancement of knowledge on identifying self-care problems in …

Immersive Virtual Reality For The Management Of Pain In Community-Dwelling Older Adults., Sara Benham, Minhee Kang, Namrata Grampurohit

Department of Occupational Therapy Faculty Papers

Immersive virtual reality (VR) can provide a high level of engagement and distraction analgesia to address pain. However, community-based applications of this technology for older adults have not been studied. The objective of this study was to examine the applicability and effectiveness of an immersive VR intervention for pain, depression, and quality of life (QOL) in older adults. This pretest–posttest, mixed-methods design included senior center members (n = 12) with pain that interfered with daily functioning. The outcomes included the Numeric Pain Rating Scale, Patient-Reported Outcomes Measurement Information System (PROMIS^®) depression scale, World Health Organization Quality of Life …

Breast Injury During Sport Participation, Laura J. Smith, Tamara Eichelberger, Elizabeth Miller, Edward J Kane

Athletic Training Collection

A recent study found that almost half (47.9%), of female college athletes participating in basketball, soccer, volleyball and softball (n = 194) suffered a breast injury during their college career with less than 10% reporting their injury to health personnel with only 2.1% receiving treatment ^[1]. Breast injury in female athletes is under-reported and is lacking a much-needed level of awareness in sport. If there is a void in awareness of breast injuries and in reporting breast injuries, preventive measures as well as any potential sequela from the injury will not be given the necessary attention.

Shoulder-Specific Patient Reported Outcome Measures For Use In Patients With Head And Neck Cancer:An Assessment Of Reliability, Construct Validity, And Overall Appropriateness Of Test Score Interpretation Using Rasch Analysis, Melissa Michelle Eden

Department of Physical Therapy Student Theses, Dissertations and Capstones

Context: Medical management for head and neck cancer (HNC) often includes neck dissection surgery, a side effect of which is shoulder dysfunction. There is no consensus for which patient-reported outcome measure (PRO) is most appropriate to quantify shoulder dysfunction in this population.

Objective: The aims of this research study were to: (1) use Rasch methodologies to assess construct validity and overall appropriateness of test score interpretation of Disability of the Arm, Shoulder and Hand (DASH), QuickDASH, Shoulder Pain and Disability Index (SPADI) and Neck Dissection Impairment Index (NDII) in the HNC population; (2) determine appropriateness of use of University of …

Rapid And Robust Restoration Of Breathing Long After Spinal Cord Injury, Philippa M. Warren, Stephanie C. Steiger, Thomas E. Dick, Peter M. Macfarlane, Warren J. Alilain, Jerry Silver

Spinal Cord and Brain Injury Research Center Faculty Publications

There exists an abundance of barriers that hinder functional recovery following spinal cord injury, especially at chronic stages. Here, we examine the rescue of breathing up to 1.5 years following cervical hemisection in the rat. In spite of complete hemidiaphragm paralysis, a single injection of chondroitinase ABC in the phrenic motor pool restored robust and persistent diaphragm function while improving neuromuscular junction anatomy. This treatment strategy was more effective when applied chronically than when assessed acutely after injury. The addition of intermittent hypoxia conditioning further strengthened the ventilatory response. However, in a sub-population of animals, this combination treatment caused excess …

Trunk Control And Gross Motor Outcomes After Body-Weight Supported Treadmill Training In Young Children With Severe Cerebral Palsy: A Case Series, Megan Flores, Carolyn Da Silva

Physical Therapy Collection

BACKGROUND AND PURPOSE: Children with cerebral palsy (CP) in Gross Motor Function Classification System (GMFCS) levels IV and V present with decreased gross motor function and trunk control that impacts their functional activities and participation in family activities. Research indicates body-weight supported treadmill training (BWSTT) may improve motor control for children with neuromotor disabilities. The toddler years present a window of opportunity for developmental changes. The purpose of this case series was to explore the impact of a 6-week BWSTT intervention on postural control and gross motor function in 3 young children with cerebral palsy in GMFCS levels IV and …

Caregiver Perspectives On Body-Weight Supported Treadmill Training As An Intervention For Young Children With Cerebral Palsy, Megan Flores, Carolyn Da Silva

Physical Therapy Collection

PURPOSE/HYPOTHESIS: Children with cerebral palsy (CP) in Gross Motor Function Classification System (GMFCS) levels IV and V present with challenges that impact their functional activities and participation in family activities. The purpose of this study was to examine caregivers’ perspectives on body-weight supported treadmill training (BWSTT) as an intervention for their young children with CP.

NUMBER OF SUBJECTS: Participants included 4 caregivers of children with CP in GMFCS levels IV (n = 2) and V (n = 2) who previously participated in 6 weeks of BWSTT.

MATERIALS/METHODS: Three children diagnosed with CP in GMFCS levels IV and V between the …

Handwriting And Occupational Therapy In The Schools, Anne H. Zachry, L. Woods

Faculty Presentations

Handwriting is an important life skill, and handwriting tasks take up a significant amount of time during the school day. Research suggests that writing by hand influences reading skills, recall, academics, and motor and composition skills. Pediatric occupational therapists evaluate and treat children who are struggling with handwriting; therefore, it is important for practitioners to be aware of a variety of treatment strategies for addressing handwriting challenges. After participating in this session, the learner will be able to discuss the research on typical and atypical pencil grasps, identify and name 5 common handwriting errors, and explain 3 techniques for increasing …

Trunk Control And Gross Motor Outcomes After Body Weight Supported Treadmill Training In Young Children With Severe Cerebral Palsy: A Non-Experimental Case Series, Megan Flores, Carolyn P Da Silva

Physical Therapy Collection

OBJECTIVE: To explore the impact of a body weight supported treadmill training (BWSTT) intervention on postural control and gross motor function in three young children with cerebral palsy (CP) classified as Gross Motor Function Classification System (GMFCS) levels IV or V.

METHOD: Children (N = 3) between the ages of 2-3 years who were diagnosed with CP classified as GMFCS levels IV and V participated in BWSTT three times per week. The Segmental Assessment of Trunk Control (SATCo) and the gross motor function measure (GMFM-66) were assessed before and after the 6-week intervention.

RESULTS: Final testing revealed …

Integrating Art And Narrative To Enhance Quality Of Life In Palliative Care, Jennifer Fortuna

The Open Journal of Occupational Therapy

Lacie Lee Wallace, a mixed-media artist from Wheeling, West Virginia, is featured on the cover of the Fall 2018 issue of The Open Journal of Occupational Therapy (OJOT). The photograph depicts Lacie holding a self-portrait painted by artist CeCey Rose. Lacie’s physical appearance in the photograph is strikingly different from the physical appearance of the woman featured in the painting. The portrait was created 4 years before Lacie was diagnosed with advanced stage colon cancer. In the year following the diagnosis, Lacie lost nearly 100 lbs. as a result of an aggressive treatment regimen. When the palliative care team at …

Idiopathic Proximal Tibiofibular Joint Laxity In A Collegiate Baseball Player: A Case Report, Stephen A. Cage, Brandon J. Warner, Diana M. Gallegos, Phil Stevenson

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

Objective: Present a clinical case detailing the assessment and management of a collegiate baseball player suffering from symptomatic laxity of the proximal tibiofibular joint. Background: Injuries to the proximal tibiofibular joint are rare, and generally accompanied by some form of trauma. Typically, dislocations of the proximal tibiofibular joint occur in an anterior direction, and require reduction and possible fixation as a first course of treatment. Treatment: A 20-year-old collegiate baseball player reported to the athletic training clinic complaining of idiopathic lateral right knee pain. The patient could not recall a mechanism, but recalled an insidious onset of pain that …

Effects Of Compex As A Warm Up For Glenohumeral Range Of Motion, Melissa Ericson, Elizabeth R. Neil, Kenneth E. Games

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

Purpose: Research regarding proper upper extremity warm-up protocols remains inconclusive, especially for electrical stimulation methods like the Compex Sport Elite^® unit. The purpose of this study is to evaluate the acute effects of a single treatment of the Compex^® using the pre-warm-up protocol on glenohumeral range of motion compared to a standardized upper body ergometer (UBE) warm-up protocol. Methods: Thirty-five healthy, young adults completed the study (19 men, 16 women; age=22±2y; height=172.1±9.4cm; mass=71.3±16.1kg; right-hand dominant=28; left-hand dominant=7). Participants came to the research laboratory on two occasions, at least 48 hours apart. Participants were randomly assigned the order to …

Effect Of Ankle Taping On Dynamic Balance And Perception Of Stability, William S. Gear, Megan J. Lundstrom

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

Purpose: The purpose of this study was to examine the actual and perceived effect of taping on dynamic stability. Methods: 21 physically active subjects [12 females (age = 20.33 ± 1.44 years, height = 165 ± 0.05 cm, mass = 68.76 ± 12.69 kg), and 9 males (age = 21.33 ± 1.66 years, height = 180 ± 0.10 cm, mass = 86.54 ± 9.46 kg)] participated in this study. Dynamic stability and perception of stability were assessed barefoot and with the ankle taped. The taped ankle condition used a standard preventive tape application including two anchors, three stirrups, close …

Predicting Gains With Visuospatial Training After Stroke Using An Eeg Measure Of Frontoparietal Circuit Function, Robert J. Zhou, Hossein M. Hondori, Maryam Khademi, Jessica M. Cassidy, Katherine M. Wu, Derek Z. Yang, Nikhita Kathuria, Fareshte R. Erani, Lucy Dodakian, Alison Mckenzie, Cristina V. Lopes, Walt Scacchi, Ramesh Srinivasan, Steven C. Cramer

Physical Therapy Faculty Articles and Research

The heterogeneity of stroke prompts the need for predictors of individual treatment response to rehabilitation therapies. We previously studied healthy subjects with EEG and identified a frontoparietal circuit in which activity predicted training-related gains in visuomotor tracking. Here we asked whether activity in this same frontoparietal circuit also predicts training-related gains in visuomotor tracking in patients with chronic hemiparetic stroke. Subjects (n = 12) underwent dense-array EEG recording at rest, then received 8 sessions of visuomotor tracking training delivered via home-based telehealth methods. Subjects showed significant training-related gains in the primary behavioral endpoint, Success Rate score on a standardized test …

Journey Interrupted: A Phenomenological Exploration Of Miscarriage, Marit A. Watson, Vanessa D. Jewell, Sarah L. Smith

The Open Journal of Occupational Therapy

Background: Miscarriage is a significant life event that impacts occupational performance, identity, and competence and that influences perceptions of motherhood. Because of the lack of social rituals often attributed to the death of a loved one, miscarriages may result in disenfranchised grief, which impedes coping.

Methods: This phenomenological study explored the impact of miscarriage on relationships, perceptions of motherhood, and the meaning of occupation in the context of grief. Data was collected through semi-structured interviews (N = 4) and completion of a brief demographic questionnaire. The interviews were digitally recorded, transcribed verbatim, and reviewed to ensure accuracy. Using inductive thematic …