Rehabilitation and Therapy Commons^™

Social Participation Program For Older Adults With Dementia Residing In Long Term Care Facilities, Keri Mcclelland

Student Capstone Papers

Social participation is characterized by activities that involve social interaction with others and supports social interdependence; individuals engage in this occupation through a variety of contexts including with their community, family, friends, and peers (American Occupational Therapy Association, 2020). Social participation has been discovered to influence general health and well-being, cognitive health, risk of dementia, and stress (Sommerlad et al., 2023). Dementia is a prevalent disease affecting approximately 50 million individuals worldwide (Sommerlad et al., 2023) causing increased dependence and disability among the older adult population and is shown to be growing as the aging population increases in number (Wang …

Effect Of Acute Care Discharge Delays On Inpatient Rehabilitation Facility (Irf) Utilization, Eric Garrard

Student Dissertations

Discharge delays present hospitals with challenges in managing costs for Medicare admissions. Meanwhile, Inpatient Rehabilitation Facilities (IRF) are subject to strict pre-admission requirements that can complicate efficient transitions of care for patients with intensive rehabilitation needs. The purpose of this retrospective quantitative correlational study was to examine any relationship between acute care discharge delays and IRF utilization. This study investigated whether length of stay (LOS) and Medicare Advantage prior authorization requirements impact IRF referrals by reviewing 3,747 medical records of acute stroke patients aged 65 years and older at a regionally integrated healthcare system over a 3-year period (2020- 2022). …

Addressing Psychosocial Client Factors In People With Cancer: An Occupational Therapy Guidebook, Hannah Marlette

Student Capstone Papers

People with cancer experience a variety of physical, cognitive, and psychosocial impacts that affect their quality of life, occupational performance, and occupational engagement. Occupational therapy (OT) practitioners are well-equipped to address these impacts, however, OT is an underused service in the cancer population, resulting in a limited amount of literature addressing OT interventions in cancer care. OT interventions in the literature are focused on addressing an individual’s physical client factors. The focus on physical client factors is causing people with cancer to report that their psychosocial client factors are not being addressed. The literature demonstrates that OT practitioners do not …

Occupational Therapists’ Role In Educating Caregivers On Pediatric Sensory Interventions Guided By Neurodiversity Principles, Deanna Bourgeois

Student Capstone Papers

Background: Neurodivergent children often experience differences in sensory processing and self-regulation. Traditional sensory-based interventions are frequently used by occupational therapy practitioners (OTP) and caregivers to address dysregulation. However, sensory-based interventions, while often strengths-based, are not always neurodiversity-affirming.

Problem: There are minimal educational resources available to both OTP and caregivers that promote neurodiversity-affirming sensory interventions to support neurodivergent children.

Methods: The purpose of this project was to create self-paced educational modules to teach neurodiversity-affirming sensory interventions that promote children's self-regulation. To achieve this goal, the student investigator developed virtual educational modules and piloted them with OTP, occupational therapy …

Database Of Video Games And Their Therapeutic Properties, Tyler Brinkman

Student Capstone Papers

There are reported to be 2.96 billion video game players in the world as of 2021 and this number is expected to grow to 3.32 billion by the year 2024. Of that total, 215.5 million video game players live in the United States with a reported average age of 33 years old. Thousands of commercial video games are released every year. There is evidence to support video game technology use as therapeutic media however it predominately utilizes outdated technology or technology designed for a specific purpose also called “serious games.” The problem is that OT practitioners are unaware of the …

Analysis Of Firefighters’ Psychological Trauma And Interrupted Domains, Alyssa Garcia, Pam Kasyan-Howe, Kristin Domville, Kristian Llaca

Student Capstone Papers

Firefighters are at a high risk of experiencing posttraumatic stress, anxiety, depression (Teoh et al., 2019), suicidality, substance abuse (Bing-Canar et al., 2019), and burnout (Teoh et al., 2019). Firefighters are regularly exposed to traumatic events on calls which results in their decreased mental health; and associated decreased participation in meaningful occupations, routines, and roles (Edgelow & Cramm, 2020; Edgelow et al., 2021; Wittwer et al., 2021). This project contains both research and a program. The purpose of this research was to understand how firefighter demographics interact with interrupted occupations, routines, and roles and at what frequency when faced with …

Occupational Therapy In End-Of-Life Care, Shannon Sudrla

Student Capstone Papers

Patients at the end-of-life (EoL) experience functional decline in response to terminal illness and the active dying process, inhibiting participation and engagement in meaningful daily activities. Occupational therapy practitioners (OTP) are equipped to address patients’ occupational needs and desires despite their declining capacities; however, the absence of occupational therapy (OT) services in EoL care leaves patients’ occupational needs unmet, directly affecting their quality of life. The literature demonstrates the need for enhanced education and training among occupational therapy students (OTS) and practitioners to better prepare them to work with terminally ill patients who face progressive functional decline and imminent death. …

An Occupational Therapy Guidebook For Individuals With Substance Use Disorder, Cassidy B. Ardoin

Student Capstone Papers

Individuals with substance use disorder (SUD) experience barriers and challenges that impact their daily occupational performance, engagement, well-being, and quality of life. In addition to disrupting and distorting an individual’s unique occupational outcomes, SUDs can limit, replace, and dictate an individual’s daily meaningful activities, habits, routines, and skills that support healthy occupational engagement. Occupational therapy (OT) practitioners have a unique and valuable role in SUDs treatment as they are equipped to identify these barriers and implement strategies for supportive skill development or restoration. Based on the literature review conducted, OT practitioners do not have an OT practice guideline, protocol, or …

Establishing A Sustainable Occupational Therapy Student-Led Pro Bono Clinic At The University Of Saint Augustine In Austin, Texas, Daija Chumley

Student Capstone Papers

Under-resourced and underserved communities across the United States experience significant health disparities. These communities lack access to valuable services resulting in health inequities that impinge on their health, quality of life, and engagement in meaningful occupations. There is a need for occupational therapy to provide valuable services to the under-resourced and underserved community to address the historical inequity that impacts their overall quality of life. Universities have the potential to fulfill the gaps within these communities by establishing a pro bono clinic. The purpose of this capstone project is to establish a sustainable occupational therapy pro bono clinic at the …

A Manualized Occupational Therapy Mindfulness Module For Clients With Ptsd, Michael Ramirez

Student Capstone Papers

Posttraumatic stress disorder (PTSD) adversely impacts an individual’s functioning across areas of daily occupation. There is a paucity of literature addressing occupational therapy (OT) for people with PTSD. The literature has advocated for the development of a manualized OT intervention with the inclusion of mindfulness as one of its components. To date, a mindfulness-based OT treatment guide or manualized program specifically for clients with PTSD has not yet been developed. The aim of this paper is to bridge a gap in the literature and to develop a resource for occupational therapists to employ mindfulness as a clinical intervention with clients …

The Role Of Ot In Adapted Crossfit, Emily Adams

Student Capstone Papers

Background: A quarter of adults are diagnosed with a disability in the United States, with almost half considered being inactive (CDC, 2020). The population of persons with disabilities (PWD) are at higher risk for secondary health concerns due to a sedentary lifestyle (Diaz et al., 2019). CrossFit recently implemented their first adaptive division in 2021 (CrossFit, LLC, 2022), however there continue to be barriers preventing PWD from participating in CrossFit.

Problem/Purpose: PWD may experience limited access to CrossFit due to structural and social barriers to access equipment and participating in movements. The purpose of this project was to …

Icu Liberation Bundle: A Multidisciplinary Approach, Julie Anne Snyder Amoroso

Student Scholarly Projects

Practice Problem: Patients with increased ventilator days see dramatic increases in their chances of developing healthcare-related conditions (HAC). Extended ICU stays increase the potential for problematic issues in patients' physical, mental and spiritual health with short-and-long-term consequences.

PICOT: The PICOT question that guided this project was looking at adult ventilated patients in a medical ICU (P) and what is the effect of initiating interdisciplinary ABCDEF-ICU liberation bundle rounding as (I) compared to no ICU liberation bundle rounding (C) has on the length of ventilator days (O) over eight weeks (T).

Evidence: Evidence from quality studies and backing from the …

Nurse-Led Intervention: Implementing Early Mobilization Of Patients In The Intensive Care Unit, Lou A. Hill

Student Scholarly Projects

Practice Problem: Immobility of patients in the hospital intensive care unit can cause longer stays in the intensive care unit and the hospital. Evidence-based early mobilization of patients helps to reduce length of stay (LOS) and avoid many detrimental sequelae, leading to short and long-term debilitation.

PICOT: The PICOT question that guided this project was: In the adult medical and surgical intensive care units (P), how does implementation of a nurse-driven protocol for early mobility (I), affect the LOS in the intensive care units and the LOS in the hospital (O), as opposed to not using a protocol for early …

Development And Implementation Of An Evidence-Based Guideline For Spinal Cord Injury/Disorder Patients Requiring Colonoscopy, Tanya D. Young

Student Scholarly Projects

Practice Problem: Colorectal cancer is one of the leading causes of preventable cancer death in the United States. Spinal cord injury/disorder (SCI/D) patients present with unique challenges for maximizing bowel prep and successful attainment of screening and therapeutic colonoscopy procedures. Current practice for bowel prep regimens does not take into consideration the specific needs of the SCI/D population resulting in significant patient dissatisfaction.

PICOT: The PICOT question that guided this project was in adult patients with spinal cord injuries/disorders requiring colonoscopy (P), how does the development and implementation of evidence-based guidelines for the care of the spinal cord injury/disorder patient …

Cephalocaudal-Remote Approach, David Ledesma

Student Capstone Papers

This opinion paper introduces a global, top-down, bottom-up, and lateral perspective on occupation, known as the Ledesma Cephalocaudal-Remote Approach, which can be used to build an integrated, holistic occupational therapy practice. This approach combines the Ayres (1960, 1966, 1972, 1979) cephalocaudal and vestibular sensory-motor development (confirmed by Lane et al., 2019); the Wilke et al. (2017) remote interoceptive, proprioceptive, and nociceptive stretching, based on Myers (2017) myofascial chain approach; the Serino (2019) peripersonal and multisensory-motor approach; the Leisman et al. (2016) bidirectional dynamic influence of motor activity and cognition approaches, and the Sadil (2019) evidence for rapidly learned low-level associations …

Exploring Occupational Dysfunction And Occupational Performance For Youth In Homeless Shelters, Akio Ross

Student Capstone Papers

The capstone project aims to explore and identify the role of occupational therapist in homeless youth shelters, to improve life skills necessary for independent living, and transition into the community of youths that occupy youth shelters. The proposed research project will fill the gap between occupational therapist, and youth shelters, by revealing barriers, while simultaneously developing and identifying a role for occupational therapist in homeless youth shelters.

An Investigation Of Occupational Therapy Utilizing Sensory Modulation To Manage Co-Morbid Chronic Pain And Substance Use In Order To Promote Occupational Performance And Recovery, Claire Ruth

Student Capstone Papers

Background: Those with chronic pain have worse drug and alcohol treatment outcomes and higher rates of relapse compared to those without pain or with reduced pain (Ilgen et al., 2020).

Methods: A descriptive study was employed with the aim of determining what are the sensory processing pattens of those with co-morbid chronic pain and in recovery for substance use. All participants completed the Adolescent and Adult Sensory Profile, the Brief Pain Inventory, and the Personal Recovery Outcome Measure (PROM).

Results: From the preliminary findings, individuals with co-morbid chronic pain and substance use may have atypical sensory processing …

Qualitative Exploration Of Mealtime Routines And Parental Stress Of Children With Pediatric Feeding Disorders: Analysis Of Occupational Performance, Andrea Patino

Student Capstone Papers

Pediatric feeding disorders (PFD) affect approximately 25-35% of children with typical development, 40-80% of children with developmental disabilities, and 90% of children with autism spectrum disorder (ASD). Feeding disorders affect families by disrupting mealtime routines, changing family dynamics, and increasing parental stress. Occupational therapy (OT) focuses on client-centered care that facilitates independence in meaningful occupations, including feeding and eating. OTs also play an essential role in assisting, training, and educating parents on effective mealtime strategies that can be implemented and carried over into the home environment. Few research studies show how parents manage behaviors and stress during mealtime routines, and …

Analysis Of Occupational Therapy’S Role To Promote Healthy Sleep Participation To Support Caregivers Of Children With Autism Spectrum Disorder, Sophia N. Roman

Student Capstone Papers

Children with autism spectrum disorder (ASD) face sleep disturbances. Healthy sleep habits are essential for children with ASD and their caregivers to properly engage in their everyday lives. Occupational therapists are trained to evaluate clients in areas that contribute to sleep dysfunction and to focus on promoting optimal sleep performance. There is limited research on caregivers’ perceptions of their child’s sleep disturbances, these disturbances’ influence on occupational engagement, and whether occupational therapists have collaborated with caregivers of children with ASD to treat this area of occupation. Collecting data from caregivers by using a questionnaire can provide occupational therapy (OT) practitioners …

Reducing Stroke Readmission Through The Implementation Of Telehealth, Leilani Hermosura

Student Scholarly Projects

Practice Problem: Readmission occurs frequently among patients with stroke and because of this, the Centers for Medicare and Medicaid Services (CMS) have imposed programs to reduce 30-day readmissions among hospitals. The health care system must respond with transition of care, especially during the period of recent stroke to improve patient outcomes.

PICOT: The PICOT question that guided this project was among patients with a recent diagnosis of stroke (P), what is the effect of a telehealth appointment with a nurse practitioner (NP) for post discharge follow-up (I), compared to a standard face-to-face clinic appointment (C), on 30-day readmissions rates (O), …

Reducing Fall Among Acute Rehabilitation Patients Through Implementation Of A Video Monitoring System, Priscila Alfonso

Student Scholarly Projects

Practice Problem: Falls are a significant healthcare issue that leads to substantial patient suffering and exorbitant health care expense. The Centers for Medicare and Medicaid Services (CMS) identify falls as preventable and not eligible for reimbursement.

PICOT: The PICOT question that guided this project was: for acute rehabilitation inpatients (P), will the continuous use of video monitoring (VM) (I) compared to using bed alarms (C), decrease the fall rate by 10% (O) within six weeks of implementation (T)?

Evidence: The practice recommendation for using a VM system as a primary intervention or part of a multifactorial comprehensive fall prevention strategy …

Occupational Engagement And Integration Among Egyptian Coptic Orthodox Immigrants, Sherry Manoly

Student Capstone Papers

Background: The Egyptian Coptic Orthodox (Copt) population in America has grown exponentially due to religious intolerance in Egypt. Many Copts experience feelings of helplessness because of the stark difference in American culture compared to their home culture. Occupational therapy (OT) is a profession that can impact the experience of Copts through participation in meaningful occupations. This qualitative study sought to answer the research question, “what is the current state of occupational engagement for recently immigrated Coptic immigrants?”

Methods: Eighteen participants filled out the 9-question open-ended survey concerning overall perceptions about moving to America. Data was analyzed using thematic …

Occupational Therapy’S Role In Addressing Sexuality And Intimacy For Individuals With Progressive Neuromuscular Disorders, Lindsay N. Richards

Student Capstone Papers

Individuals with progressive neuromuscular disorders (PND); specifically, Parkinson’s disease (PD), Multiple Sclerosis (MS), Huntington’s Disease (HD), and Amyotrophic Lateral Sclerosis (ALS) often face physical, psychological, and social challenges related to sex and intimacy. Occupational therapy (OT) practitioners are experts in activity analysis and are equipped with unique knowledge of performance skills and client factors to address deficits in occupational performance.

Though there is literature presenting the effects of PND on sexual occupations, a gap exists as it relates to qualitative data from the perspective of the individual and their partners. A mixed-methods survey was conducted examining the lived experience of …

Exploring Accessibility And Social Inclusion For Children With Hearing Impairments In Residential Camps Through The Occupational Therapy Lens, Tiffany Coles

Student Capstone Papers

Children are encouraged to engage in various play, leisure, and social participation activities to enhance the development of life skills, independence, and social skills. A common leisure and social participation activity for children aged 6 to 18-years-old is to attend residential camp. Residential camps provide children a structured opportunity to engage in leisure activities while learning to become independent and self-confident when socializing and making new friends. Attending camp can be a fun and engaging environment to help accelerate growth in key developmental outcomes, such as positive identity, social skills, physical skills, positive values, and spirituality.

Within the residential camp …

Reducing Catheter-Associated Urinary Tract Infection Project, Beatriz Agado

Student Scholarly Projects

Practice Problem: Catheter-associated urinary tract infections (CAUTIs) are prevalent and responsible for an estimated 13,000 deaths annually in the United States. Reported cases of CAUTIs remain disproportionately high at a rehabilitation center located in South Texas.

PICOT: This evidence-based project answered the following question: In rehabilitation patients, what is the effect of a nurse-driven protocol (NDP) CAUTI bundle on the number of indwelling urinary catheter-related infections, compared to the current practice, over a 12-week time period?

Evidence: Twenty high-quality studies that met the inclusion and exclusion criteria recommended using an NDP CAUTI bundle, education, and champions to …

Understanding The Impact Of Social Distancing On Older Adults And Senior Centers To Better Adapt Towards A New Normal, Salina Jivan

Student Capstone Papers

COVID-19 brought about social distancing mandates that posed as a new barrier to meaningful social participation in the community. The purpose of this project was to understand the impact of social distancing on older adults and senior organizations to better inform the role of OT in helping seniors adapt towards a new normal within the community. A qualitative study and needs assessment were performed through phone interviews with seniors and organizations that support them from around the United States. Themes highlighted seniors desire for social contact and cautious return to the community once mandates are lifted. Both seniors and organizations …

Occupational Therapy And Accessibility In The Outdoors And Summer Camps, David M. Lewis

Student Capstone Papers

Opportunities for positive youth development (PYD) are promoted through both outdoor and camp experiences. The experiences provided by the outdoors and camps are ideal for developing physically, cognitively, socially, emotionally, and spiritually. These areas of PYD are further generalizable to several aspects of occupational performance and participation, while continuing to have benefits throughout the lifespan. While the outdoors and camps provide these valuable opportunities for development, the environments and contexts of these opportunities are often limiting factors for individuals with disabilities. Utilizing an occupational therapy approach allows for further understanding of how to promote inclusion and accessibility practices in these …

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 …

Occupational Therapy's Role In Pain Management Using Virtual Reality, Johnathan Quach

Student Capstone Papers

Pain is a complex phenomenon that affects millions every day and is frequently associated with activity restriction and decreases in psycho-social health. Studies have shown that opioids alone cannot eliminate all the difficulties that are associated with chronic pain, demonstrating a dire need to consider safer and more effective alternatives. Furthermore, given the impact of chronic pain on an individual’s ability to perform valued activities, and therefore overall well-being and quality of life, occupational therapy must be considered an essential member of any pain management team. Thus, there may be potential benefits to reviewing the use of virtual reality (VR) …

Non-Pharmaceutical Methods For Pain Management: An Occupational Therapist’S Perspective On Chronic Pain, Alison L. Brown

Student Capstone Papers

Typically pharmaceuticals are the first intervention for chronic pain but in a world where there is an opioid crisis, and chronic pain rates rising, is there more to be done? A non-pharmaceutical approach to chronic pain management can be addressed through occupational therapy. Occupational therapists are specialized to handle these types of interventions. This capstone provides evidence to support the use of aquatic therapy, adaptive equipment, adaptive strategies, fitness-based programs, and ergonomics for a non-pharmaceutical approach in occupational therapy.