Rehabilitation and Therapy Commons^™

Facilitators And Barriers To Neonatal Intensive Care Unit Follow-Up Program Attendance: A Critically Appraised Topic, Ciara Clark, Mariko Rudy, Lauren Maher

School of Occupational Therapy Master's Capstone Projects (2016-2021)

Kari Tanta, PhD, OTR/L, FAOTA is the rehabilitation manager of the neonatal intensive care unit (NICU) and the NICU follow-up (NFU) program at Valley Medical Center (VMC). To address the problem of decreased NFU attendance, the following clinical question was asked: “For families with an infant who has been discharged from a NICU, which factors promote or discourage utilization of follow-up services?” Numerous facilitators and barriers affecting attendance were identified relating to severity of infant illness, parent socioeconomic status and education levels, and pragmatic factors including timing of scheduling.

Knowledge translation activities undertaken included collaboration with University of Washington (UW) …

Gender Dysphoria And The Role Of Occupational Therapy, Melanie Murphy, Julie Tinsley Schaefer, Enjoli Washington

School of Occupational Therapy Master's Capstone Projects (2016-2021)

Prompted by Kristin Brubaker, a licensed pediatric occupational therapist who works at the Center for Therapeutic Intervention (CTI) in Gig Harbor, WA, the researchers set out to answer the following question: “What evidence supports the use of occupational therapy (OT) interventions in improving the psychosocial health of children and youth between the ages of 0 to 25 experiencing gender dysphoria (GD)?” After reading and evaluating 29 articles from qualitative and quantitative research, systematic reviews, and additional evidence, the researchers concluded that occupational therapists can assist this population by affirming the experience of GD, encouraging exploration of gender identity, providing a …

Using Sensation In Pediatric Occupational Therapy, Kaitlin Gaspich, Sydney Anderson, Catherine Terhune, Emiline Gonzalez

School of Occupational Therapy Master's Capstone Projects (2016-2021)

Molly McBroom, OTR/L, of Mary Bridge Children’s Therapy Unit (CTU) requested University of Puget Sound occupational therapy (OT) graduate students research the following question: “What is the effectiveness of using sensory based intervention (SBI) or Ayres’ sensory integration^® (ASI)and neurodevelopmental treatment (NDT) approach with children with sensory processing disorder (SPD), autism spectrum disorder (ASD), and/or attention-deficit/hyperactivity disorder (ADHD) on behavior?” A systematic review of the literature resulted in eight out of 12 studies reporting positive findings. Four of the studies examined ASI and four examined SBI. The other four studies showed inconclusive or negative results. Overall, no clear conclusions …

Interventions For Sleep Problems In Pediatrics, Chelsea Rogers, Marie Trevisan, Maureen Traxler

School of Occupational Therapy Master's Capstone Projects (2016-2021)

Julie Anderson, DrOT, OTR/L, will be conducting screenings and providing treatment for children with sleep problems in the Puyallup School District of Washington. To assist her in this emerging practice area, a systematic search and critical appraisal of research published between 2000 and January, 2017 was completed to address the question, “What is the current evidence regarding sleep intervention effectiveness in school-aged children?” The majority of research has investigated the use of behavioral interventions for improving child sleep. These studies included children with developmental disabilities (DD), attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), oppositional defiant disorder (ODD), sensory …

Cognitive And Occupationally-Based Assessments In Acute Care: For Individuals With Acquired Brain Injury, Jillian Harrison, Stephanie Lenk, Brooke Logan

School of Occupational Therapy Master's Capstone Projects (2016-2021)

The student researchers collaborated with Marcy Boschee, OTR/L, an occupational therapist practicing in the acute care unit at St. Joseph's Medical Center in Tacoma, WA to investigate two clinical questions: [1] “What evidence is there for the effectiveness of the Montreal Cognitive Assessment (MoCA) in predicting functional cognitive impairment of patients 18-years-old and older in acute care who have sustained an ABI?” and [2] “Which occupationally-based cognitive assessments, feasible to use in the acute care setting, are most effective at predicting functional impairment in patients 18-years-old and older with mild to severe ABI?” A systematic review was conducted and 29 …

Rate And Duration Of Adaptive Equipment Use Post-Discharge And Factors Affecting Use Post-Discharge, Elizabeth Goodwin, Elizabeth Siska, Jamie Theuer

School of Occupational Therapy Master's Capstone Projects (2016-2021)

Patients in in-patient rehabilitation are often discharged with adaptive equipment in order to be safe and independent in their homes, as is the case for patients at ManorCare, a skilled nursing facility in Tacoma, Washington. However, if adaptive equipment that is functionally necessary is not being used by the patient, it can lead to reduced independence and safety, potentially resulting in incidents that result in injury and re-admittance. Therefore, Rehabilitation Director Joette Jindra, OTR/L requested research to understand the factors that contribute to continued use or non-use after discharge to assist therapists in their clinical decision-making when making equipment provisions …

Impact Of Trauma On Brain Morphology & Maladaptive School Behaviors, Brandon Escobar, Sharlene Lavaris, Teresa Le

School of Occupational Therapy Master's Capstone Projects (2016-2021)

Wendi Trummert, DrOT, OTR/L, the collaborating clinician for this project, works with students in a self-contained program. Wendi wanted to know how childhood trauma affects brain structure and morphology and how it is linked to behaviors seen in children affected by trauma. A synthesis of all articles looking at the brain reveals differences in both structure and function in the brains of individuals exposed to childhood trauma versus those not exposed (e.g. Daniels, Lamke, Gaebler, Walter, & Scheel, 2013; McGowan et al., 2009; Saleh et al., 2017). A synthesis of articles looking at maladaptive behaviors finds that those often seen …

Lymphedema Assessments, Jessica Enyeart, Cullyn Foxlee, Divina Ramolete, Connie Colleen Wyatt

School of Occupational Therapy Master's Capstone Projects (2016-2021)

Heidi Shaffer, a MultiCare occupational therapist specializing in lymphedema (LE) management, proposed the research question of whether bioimpedance spectroscopy (BIS) via the L-Dex (U400 Impedimed) is the most reliable, valid, cost-effective and time-efficient assessment tool on the market for measuring LE in comparison to circumferential measurements (CM). Shaffer currently uses the L-Dex in practice and hoped to substantiate its psychometrics from the literature to promote its clinical usage and potentially obtain consistent insurance coverage. A critical appraisal of the literature revealed a strong correlation between BIS and CM, suggesting that both can be used reliably and validly in clinical practice. …

School-Based Tier Ii And Iii Rti Interventions For Children Affected By Trauma, Sarah Ladderud, Maria Randall, April Crabtree

School of Occupational Therapy Master's Capstone Projects (2016-2021)

We partnered with Wendi Trummert, DrOT, OTR/L, an occupational therapist in a school district in Puyallup, Washington. We collaborated to examine what school-based Tier II & Tier III Response to Intervention (RTI) interventions can be used by occupational therapists, teachers, and paraeducators to improve school participation in children aged 3-13 who have experienced trauma. It was found that various forms of Cognitive Behavioral Therapy (CBT) interventions may reduce post-traumatic stress disorder (PTSD) symptoms, depression, and anxiety in children age birth - 13 who have experienced trauma. CBT was the most effective intervention based on the current literature. Additionally, there is …

Strategies For Effective Collaboration Among Multidisciplinary Teams: Integration Of An Aba Professional, Elizabeth Schroeder, Kalene Lynch, Allison Turgeon

School of Occupational Therapy Master's Capstone Projects (2016-2021)

Our collaborating practitioner (CP), Kari Tanta, PhD, OTR/L, FAOTA, manages Valley Medical Center which is a multidisciplinary pediatric outpatient therapy clinic. Dr. Tanta was seeking research to support incorporating an applied behavior analysis (ABA) professional into VMC’s practice. The focused question became, “What are strategies to promote successful collaboration when integrating a Board Certified Behavior Analyst (BCBA) into an established multidisciplinary pediatric clinic to promote best practice for clients?” From September 2016 - January 2017, 26 articles were analyzed using a critically appraised topic (CAT) table. The literature indicated effective health care team collaboration yields positive patient outcomes, provided strategies …

Determining The Efficacy Of The Use Of Instrument Assisted Soft Tissue Mobilization In Hand Therapy, Kaitlin Chaput, Sarah Clue, Yoseph Kim, Evan Kimpton

School of Occupational Therapy Master's Capstone Projects (2016-2021)

In collaboration with Brian Chase, CHT, OTR/L of NW Sports Physical Therapy in

Tacoma, WA, our research group addressed his question of whether instrument assisted soft tissue mobilization (IASTM) is effective for clients and if so, are certain brands such as Graston Technique (GT) or Astym more effective. Through our careful review of the literature, summarized in a critically appraised topic format, we found that the majority of studies (case reports and experimental studies) found that IASTM treatments improved scores on outcome measures including return to occupation, range of motion, pain, and grip and pinch strength over baseline measurements. However, …

A Review Of Health Related Quality Of Life Assessments For Patients With Lymphedema, Bonnie C. Blair, Gina M. Dellino, Jennifer E. Thomas

School of Occupational Therapy Master's Capstone Projects (2016-2021)

In collaboration with Heidi Shaffer, one of the occupational therapists on staff at the MultiCare lymphedema clinic in Gig Harbor, Washington, we sought to answer the question “Which patient-reported outcome assessments are most valid and reliable in measuring health-related quality of life (HRQoL) in patients with lymphedema?” We conducted a systematic literature review to answer this question. In reviewing selected databases, 19 articles were chosen to appraise the evidence supporting psychometric properties and clinical utility of 10 HRQoL assessments used for patients with lymphedema. The Disability of the Arm, Shoulder and Hand (DASH) and Lymphedema Life Impact Scale (LLIS) assessments …

Social Skills Interventions For Adolescents With Asd, Adhd, And Other Comorbidities, Margaret Batson, Sarah Elliott, Gary Lam, Nora Seimears

School of Occupational Therapy Master's Capstone Projects (2016-2021)

This project was part of a research initiative to collaborate with Kristin Brubaker, MSOT, OTR/L, practicing pediatric occupational therapist at the Center for Therapeutic Intervention (CTI). CTI is an outpatient, private pediatric occupational therapy clinic in Gig Harbor, WA. The purpose of our project was to determine existing and effective interventions to improve social skills in adolescents, ages 11 to 18 years, with autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), sensory processing disorder (SPD) and other sensory processing issues. Our search of the literature yielded a total of 22 research studies, with the majority representing group-based interventions. Limited …

Utilization Of The Progressive Return To Activity Following Acute Concussion Clinical Recommendations, Elena Liroff, Erika Schultz, Holly Roberts

Physical Therapy Research Symposium

Purpose:

Since 2000, almost 300,000 concussions have been reported in the military population. Concussions were labeled the signature injury of the wars in Iraq and Afghanistan. Prevalence of concussions and implications for service members prompted the Defense Centers of Excellence (DCoE) for Psychological Health and Traumatic Brain Injury to introduce the Progressive Return to Activity Progression Following Acute Concussion/Mild Traumatic Brain Injury clinical recommendations in 2014 to guide cognitive and physical rehabilitation of concussion. The purpose of this study was to identify utilization rates of the DCoE clinical practice recommendations and to identify barriers to implementation that affect clinician adherence. …