Rehabilitation and Therapy Commons^™

Feasibility And Preliminary Efficacy Of A Lymphedema And Fibrosis Self-Management Program For Head And Neck Cancer Survivors: A Pilot Randomized Controlled Trial, Jie Deng, Barbara Murphy, Lucy Andersen, Erin Mcmenamin, John Lukens, Joy Cohn, Karthik Rajasekaran, Ryan Quinn, Bryan Spinelli, Alexander Lin

Department of Physical Therapy Faculty Papers

OBJECTIVES: Survivors of head and neck cancer (HNC) are at high risk for developing lymphedema and fibrosis (LEF). Once diagnosed with LEF, survivors must engage in a lifelong program of self-care to minimize long-term adverse effects. However, evidence-based LEF self-management (SM) programs are lacking. To fill this void, we developed and pilot-tested a LEF-SM program for HNC survivors.

MATERIALS AND METHODS: The LEF-SM Program was developed using the Information-Motivation-Behavioral Skills model of health behavior change as a framework. The program was pilot tested in a three-group randomized controlled trial evaluating feasibility and preliminary efficacy. Fifty-nine participants were randomized to: Usual …

Evaluating Virtual Group Coaching’S Impact On Self-Determination In Spinal Cord Injury, Alana Scalzo, Ms, Otr/L

Post-Professional Occupational Therapy Doctorate Culminating Presentations

Introduction: Spinal cord injury (SCI) is a lifelong condition that requires effort and adjustment for managing physical, psychological, and social well-being to have the ability to engage in meaningful activities. As people living with SCI have higher rates of isolation and social disconnect, it is important to study group level approaches for addressing mental health.

Objectives: To determine the impact of virtual group coaching to enhance occupational performance, satisfaction, self-efficacy and relationship closeness in people living with SCI.

Methods: A quasi-experimental single-group pre/post-test design was used. Adults with SCI were recruited through online flyers, social media, newsletters, support groups, clinics, …

The Efficacy Of Virtual Group Coaching On The Self-Determination Of People With Ehlers-Danlos Syndrome, Janine E. Rajauski, Ms, Otr/L

Post-Professional Occupational Therapy Doctorate Culminating Presentations

INTRODUCTION
The Ehlers-Danlos Syndromes (EDS) are a family of 13 genetic connective tissue disorders that affect negatively physical and psychosocial health which in turns have been found to decrease their quality of life and self-determination (Baeza-Velasco et al., 2019; Bennet et al., 2021; Estrella & Fraizer, 2024; Tinkle et al., 2017; Palomo-Toucedo et al., 2020). Limited supports and services, including occupational therapy, are available for those with EDS (Estrella & Frazier, 2024; McDonald et al., 2023; Reychler et al., 2021). Those with EDS have requested better services to support their self-determination (Estrella & Frazier, 2024). Coaching has shown positive impacts …

Caregiver Attitudes Of Risky Outdoor Play For Toddlers With Developmental Delays And Disabilities In St. Louis, Missouri: A Socio-Ecological Perspective, Emily Korte-Stroff, Ot/L

Post-Professional Occupational Therapy Doctorate Culminating Presentations

Abstract: Risky outdoor play fosters autonomy, emotional regulation, and resilience in early childhood, yet caregivers of toddlers with developmental delays and disabilities often face unique barriers to supporting such play. Limited research has examined how caregivers perceive the factors shaping these decisions, particularly in the United States context. This mixed-methods cross-sectional study explored how caregivers in the St. Louis, Missouri metropolitan area perceive the socio-ecological factors shaping their attitudes toward risky outdoor play for children aged 13 to 47 months with developmental delays or disabilities. The project sought to first explore caregivers' perceptions of how interpersonal and individual factors, shape …

Resident Case Series: The Utility Of The Athletic Shoulder Test Using Wireless Portable Force Plates For Measuring Peak Force In Ncaa Division One Collegiate Quarterbacks, Carmen Sclafani, Patrick Smith, Terry Mchugh, Patricia Crane

Department of Rehabilitation Medicine Faculty Papers

BACKGROUND: Given the high incidence of shoulder injuries among quarterbacks due to the repetitive stress of the overhead throwing motion, there is a need for targeted, sport-specific assessments that reflect the functional demands of throwing. The Athletic Shoulder (ASH) test, previously validated in rugby and baseball populations, offers a potential solution for upper extremity strength assessment in football quarterbacks. The primary purpose of this case series was to explore the feasibility of conducting the ASH test as a method for evaluating upper extremity strength in overhead athletes, specifically collegiate quarterbacks.

STUDY DESIGN: Case series.

METHODS: Three NCAA Division I quarterbacks …

Trends In Lumbar Epidural Injection Selection: A Survey Of Practitioner Preferences And Practice Patterns, Ryan Triglia, Andrew Walrond, Jesse Wagner, Paul Kitei, Jeffrey Boyd, Jeremy Simon

Department of Medicine Faculty Papers

BACKGROUND: Lumbar radiculopathy is estimated to affect approximately 3-5 % of the population. Among the leading causes of radiculopathy are degenerative or congenital spinal stenosis and lumbar disc herniations, which can contribute to compression and narrowing in various regions of the spine including the neural foramen, subarticular recess, or central canal. When patients do not respond to typical conservative treatment such as medications and physical therapy, epidural steroid injections can be considered as a next step in management. There are three approaches available for accessing the lumbar epidural space: caudal, interlaminar, and transforaminal. There is no clear consensus regarding the …

Brivaracetam For Spinal Cord Injury-Related Neuropathic Pain: Results Of A Pilot Double-Blinded, Randomized, Placebo-Controlled Clinical Trial, Leslie R. Morse, Ricardo A. Battaglino, Nguyen Nguyen, Brian Devries, Abigail Welch, Ana Lucia Battaglino, Clas Linnman, Michael Stillman, Robert Wudlick, Joda Glossner, Grant Anderton, Richard Goldstein, Scott P. Falci

Department of Medicine Faculty Papers

OBJECTIVE: Assess feasibility, safety, and tolerability of 3 months of oral brivaracetam for severe (9-10/10) spinal cord injury-related neuropathic pain.

METHODS: We conducted a multisite pilot study where adults were randomized to 3 months of brivaracetam (100 mg BID) or placebo. Pain was assessed via the Brief Pain Inventory, the International Spinal Cord Injury Pain Basic Dataset (version 2.0), and a daily pain diary.

RESULTS: We enrolled 24 participants across 2 sites and 14 participants were included in the final analysis (n = 8 placebo, n = 6 brivaracetam). The drug was tolerated with expected, nonserious side effects (nausea if …

A Cascading Effects Model Of Early Sensory Development In Autism, Natalie Russo, Carissa J. Cascio, Grace T. Baranek, Tiffany G. Woynaroski, Zachary J. Williams, Shulamite A. Green, Roseann Schaaf

Department of Occupational Therapy Faculty Papers

Autism has historically been defined by the presence of differences in social communication and restricted, repetitive patterns of behavior, interests, or activities (RRBs). Since 2013 when the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders was published, sensory features were added as one of the polythetic restricted and repetitive behavior diagnostic criteria of autism, though it has remained understudied. Here, we summarize theory and research to provide support for the perspective that early sensory functions and experiences play a primary role in autism and have downstream effects on social communication and repetitive behavioral features of autism. The …

Visiting Medical Student Stipends In The Us | An Analysis Of Equity Within Physiatry, Ashley Otto, Do, Mbs, Jeffrey Gray, Md, Summer Nestorowicz, Md, Adrian Oppong, Md, Ms, Oluseye Raymond, Md, Andrew Walrond, Md, Alexis Tingan, Md, Marisa Moreta, Do

Health Equity and Quality Improvement (HEQI) Summit

Introduction & Aims

Health inequities are ubiquitous throughout medicine especially pertaining to accessibility, affordability, and availability. These challenges disproportionately affect minorities- both patients and providers alike [3,4]. Patient outcomes have been shown to improve when treated by physicians of similar backgrounds [3,4,7]. The journey to improve outcomes begins with pre-residency rotations; medical students who can complete audition rotations have an increased opportunity to matriculate into said residency program. Physical Medicine & Rehabilitation (PM&R), like many specialties, is disproportionately represented by men and Caucasians [1,5, 8] with the greatest drop in URM representation occurring between applicants and residents [Escalon]. This project …

Bridging The Gap: A Structured Curriculum For Occupational Therapy Students On Level Ii Fieldwork In Acute Care, Caroline Cameron, Otr/L

Post-Professional Occupational Therapy Doctorate Culminating Presentations

Introduction: Students achieve entry-level competence through didactic education and fieldwork (Accreditation Council for Occupational Therapy Education [ACOTE], 2023). However, transitioning from student to practitioner can be challenging (Mason et al., 2020). Research has identified challenging areas globally across fieldwork settings environment (Knecht-Sabres et al., 2013; Mason et al., 2020) and specifically in the acute care. These challenges indicate a compelling need to cultivate lacking skills and close the gap between students' didactic curriculum and clinical placement in acute care, where supervisors have the highest expectations for students (Kemp & Crabtree, 2018).

Objectives: This project aimed to develop an educational program …

Empowering Occupational Therapists: Integrating 3d Printing Into Rehabilitation For Spinal Cord Injury Patients, Juliana Sullivan, Ms, Otr/L, Cbis

Post-Professional Occupational Therapy Doctorate Culminating Presentations

Introduction: Individuals with spinal cord injury (SCI) encounter significant challenges in performing activities of daily living (ADLs). Adaptive equipment (AE) is widely recognized as essential for enhancing ADL participation, which in turn improves quality of life, autonomy, and long-term functional outcomes (Sturm et al., 2021). However, access to AE is hindered by barriers such as lack of personalization, lesion level, financial limitations, and limited rehabilitation access (Hertig-Godeschalk et al., 2017). 3D printing to create custom AE can increase patient satisfaction, adherence, and participation (Schwartz et al., 2019). Occupational therapists (OTs) working in inpatient rehabilitation focus on maximizing patient independence before …

An Integrative, Holistic Treatment Approach For Veterans With Chronic Traumatic Brain Injury And Associated Comorbidities: Case Report, Rebekka Dieterich-Hartwell, Janine Brodovsky, Kathryne Dealba, Allison Rubin, Emily Mcguigan, Bindal M. Mehmel, Yevgeniya Sergeyenko

Moss-Magee Rehabilitation Papers

This case report of a veteran with a history of multiple traumatic brain injuries, posttraumatic stress, and chronic pain highlights the MossRehab Institute for Brain Health (MRIBH) model of care: a collaborative, interdisciplinary, intensive outpatient treatment program. Unique to this case was the severity of symptomatology and the concerted engagement by the clinicians, who fully tailored and adjusted their approaches based on team rounds and daily exchanges. The client's main concerns of headaches, difficulty sleeping, difficulty with memory and cognition, depression, anxiety, posttraumatic stress, anger, and chronic musculoskeletal pain were addressed and significantly improved within three weeks. The outcome of …

Virtual Reality-Enhanced Rehabilitation For Improving Musculoskeletal Function And Recovery After Trauma, Phani Paladugu, Rahul Kumar, Joshua Ong, Ethan Waisberg, Kyle Sporn

SKMC Student Presentations and Publications

Orthopedic trauma remains a critical challenge in modern healthcare, often resulting in severe mobility limitations, acute pain, and delayed recovery. Conventional rehabilitation techniques, though effective, fail to address the individualized, high-precision interventions needed for musculoskeletal injuries like fractures, joint instability, ligament tears, and muscular atrophy. Virtual reality (VR) technologies, such as Apple Vision Pro and HTC Vive Pro, offer a transformative approach by enhancing diagnostic precision, rehabilitation effectiveness, and patient engagement through interactive, immersive environments that improve clinical outcomes. These VR technologies provide real-time biomechanical data, such as joint mechanics, muscle coordination, and movement patterns, allowing clinicians to design personalized …

Optimizing Transcutaneous Spinal Cord Stimulation: An Exploratory Study On The Role Of Electrode Montages And Stimulation Intensity On Reflex Pathway Modulation, Shirin Madarshahian, Michael Trakhtorchuck, Tatiana Guerrero, Kristin Gustafson, James Harrop, Caio Matias, M. J. Mulcahey, Alessandro Naopli, Alex Vaccaro, Mijail Serruya

Farber Institute for Neuroscience Faculty Papers

Transcutaneous spinal cord stimulation (tSCS) is a promising non-invasive method to improve motor function in individuals with spinal cord injury (SCI) by enhancing spinal reflex pathways. This study aimed to investigate the effects of different tSCS electrode placement montages and targeted spinal levels on neurophysiological responses such as spinally evoked motor responses (sEMRs), dorsal root reflex activation, and muscle recruitment in individuals with SCI and healthy controls to optimize stimulation strategies for motor recovery. Five participants (three individuals with SCI and two controls) underwent transcutaneous spinal cord stimulation using various electrode montages, target spinal level stimulation, and single- and paired-pulse …

Addressing Frailty In Heart Failure: Essential Tools & Strategies For Occupational Therapists, Malachy Clancy, Phd, Otr/L, Bcpr

Department of Occupational Therapy Posters and Presentations

Learning Objectives

• Understand and describe the concept of frailty and its impact on occupational performance for patients with heart failure (HF).
• Identify comprehensive assessments that encompass physical, cognitive, and psychosocial domains to provide a holistic assessment of frailty.

Implementation & Evaluation Of A Neonatal Intensive Care Unit Transition To Early Intervention Program For High-Risk Infants: A Pilot Study, Erin Price, Otd, Otr/L, Cnt, Ntmtc, Amy Carroll Otd, Otr/L

Department of Occupational Therapy Posters and Presentations

Background

Advances in medicine have increased the survival rate of preterm infants. It is well documented that preterm infants have increased risk for developmental delays (Heiny et al., 2020; Pineda et al., 2020) . Additionally, after long stays in the NICU, families report anxiety and feeling unprepared to care for their fragile child at home (Cheong at al., 2020; Garfield et al., 2014; Aloysius et al., 2018; Lakshmanan et al., 2019) . Preterm infants have fewer developmental delays when enrolled in a program that fosters development of skills and provides caregiver education; however, there is often a 4-5 month gap …

Training To Move An Evidence-Based Dementia Caregiver Support Program Into Practice: A Pragmatic, Randomized, Non-Inferiority Trial Protocol, Nancy A. Hodgson, Miranda V. Mcphillips, Karen B. Hirschman, Emily Summerhayes, Catherine Verrier Piersol, Laura N. Gitlin

Department of Occupational Therapy Faculty Papers

Background

Objective

Workplace Isolation And Loneliness In School-Based Occupational Therapy Practitioners: A Cross-Sectional Study, Megan Ziff Otd, Otr/L, Amy Carroll Otd, Otr/L, Catherine V. Piersol Phd, Otr/L

Department of Occupational Therapy Posters and Presentations

Introduction

• Increasing “epidemic” of social isolation and loneliness in the United States
• The workplace is one locale that can provide social connection¹
• School-based occupational therapy practitioners (SBOTPs) report feeling isolated in the workplace²
• Lack of time can constrain development of collaborative relationships³
• Contractors in particular report feeling on the outskirts of school team communication⁴
• No prior study specific to SBOTP’s workplace isolation and loneliness

Purpose: Describe workplace isolation and workplace loneliness in SBOTPs; investigate their relationship to employment type, and indirect time.

Hypothesis 1: A weak-to-moderate positive relationship between workplace isolation and workplace loneliness in SBOTPs …

Ergonomic Consulting As Fieldwork: A Pandemic Need & Beyond, Sarah Klunk, Mba, Otr/L, Sara Loesche, Ms, Otr/L, Cht, Ceas

Department of Occupational Therapy Posters and Presentations

Background

In March of 2020, the COVID-19 pandemic impacted clinical and educational environments accessed by occupational therapy students. Educators had to reimagine learning in virtual spaces—including fieldwork education. At the same time, workers in many industries quickly pivoted from office spaces to a work from home (WFH) environment. Most workers had to navigate this transition without employer support—especially in larger companies (Voss et al., 2021).

This project was a collaboration between the academic fieldwork coordinator (AFWC) and a faculty member (fieldwork educator) who worked to identify a need for services as a result of the shift in work environments. Then, …

Backpacks & Beyond: Applying Ergonomic Principles To Promote Wellness For School Students And Staff, Sara Loesche, Ms, Otr/L, Cht, Ceas

Department of Occupational Therapy Posters and Presentations

Overview

Students in elementary and secondary educational settings encounter ergonomic risk factors due to sedentary activity, poor postural habits, backpacks, and lack of knowledge related to health and wellness. Additionally, students are still physically developing during childhood and adolescent years.

An Occupational Therapy Intervention To Enhance Social And Physical Well-Being In Young Adults With First Episode Psychosis, Sarah Zagorac, Caitlin Taylor, Nuriya Neumann, Ilyse Kramer, Tina Deangelis

Department of Occupational Therapy Posters and Presentations

Background

Can Occupational Therapy (OT) increase social participation, physical well-being, and functional recovery in young adults with psychosis?

• Early Intervention Services (EIS), including Coordinated Specialty Care programs (CSC), for young adults who experience a first episode of psychosis (FEP) have been shown to reduce hospitalizations, increase quality of life, and increase global functioning.^1,2,3
• Young adults who experience FEP report a need to further address physical well-being and social participation, areas of life linked with long-term functional recovery.^4,5,6
• Early evidence related to the COVID-19 pandemic demonstrates the disproportionate impact on underserved youth’s psychological well-being, including decreased social participation and …

Women’S Health Considerations In Traumatic Brain Injury, Sindhoori Nalla

Department of Rehabilitation Medicine Faculty Papers

Purpose of Review: Biological sex differences are an important factor to consider when treating TBI, as there can be a disproportionate manifestation of symptoms and recovery process when comparing females to males. Historically, these differences have not been well studied, and there is still much to be understood as to why these differences exist. Recent Findings: A number of factors are thought to contribute to disparities with women who have a TBI, including lack of well-designed research studies focused on women, hormonal fluctuations at the time of and as a result of a TBI, psychosocial comorbidities, and societal norms/expectations. While …

Using The 5ms Framework To Advance Aging-Responsive Care For Heart Failure With Reduced Ejection Fraction, Abigail Latimer, Debra K. Moser, Jia-Rong Wu, Kim K. Birtcher, Malachy J. Clancy, Jennifer D. Portz, Joanna Paladino, Daniel D. Matlock, Christopher E. Knoepke

Department of Occupational Therapy Faculty Papers

Complexity of care is the inevitable consequence of an aging population and is particularly true in instances where patients are managing chronic conditions such as heart failure with reduced ejection fraction (HFrEF). HFrEF itself is complex, with an undulating course of illness, increased risk of sudden cardiac death, and myriad accompanying treatment considerations. Generalist management of HFrEF among older patients is further complicated by competing comorbidities, potential for financial toxicity, potential for mental health symptoms, and risk of care with does not align with goals and preferences. The 5Ms (multicomplexity, mind, mobility, medications, and matters most) is a holistic conceptualization …

Generative Artificial Intelligence In Education: Insights From Rehabilitation Sciences Students, Robert Dekerlegand, Alison Bell, Malachy Clancy, Erin Pletcher, Travis Pollen

Department of Occupational Therapy Faculty Papers

Little is known about how students in rehabilitation sciences accept and use generative artificial intelligence (GenAI) in their educational endeavors. We explored student perceptions, acceptance, and utilization of GenAI in school and their beliefs about its usefulness and ease of use. A cross-sectional online survey was conducted of adult students enrolled in rehabilitation sciences programs within a private urban academic university. The survey was based on the Technology Acceptance Model with questions specific to the use of GenAI in school. A total of 196 responses were included in the analysis (32.9% response rate), with responses received across all rehabilitation sciences …

Respiratory Muscle Training Reduces Painful Swallowing And Opioid Use During Radiation Therapy For Head And Neck Cancer: A Matched Pair Analysis, Andrew D. Ray, Chi-Chen Hong, Nicolas F. Schlecht, Han Yu, Kristopher Attwood, Kent L. Nastiuk, Bryan A. Spinelli, Ann Marie Flores, Hillary Jacobson, Julia Fulfaro, M. Jeffrey Mador, Austin J. Iovoli, Mark K. Farrugia, Anurag K. Singh

Department of Physical Therapy Faculty Papers

BACKGROUND: Patients with head and neck cancer (HNC) receiving radiation therapy (RT) are at increased risk for symptoms of oral mucositis (OM), opioid use, and declines in physical function, outcomes that contribute to increased morbidity and mortality. The study objective was to determine the effects of respiratory muscle training (RMT) on OM and opioid use, as well as functional performance in patients with HNC receiving RT with or without concurrent chemotherapy (CCRT).

METHODS: Patients aged ≥ 18 years of age with stage I to IV HNC being treated with RT or CCRT receiving a home-based respiratory muscle training (RMT) (n …

Impact Of Educational Models On Student Confidence In Acute Care Physical Therapy: A Comparative Analysis, Robert Dekerlegand, Pt, Mpt, Phd, Ccs

Department of Physical Therapy Posters

Background and Purpose

• Hybrid and blended education have evolved as innovative models to deliver physical therapy (PT) education.¹
• PT faculty rapidly integrated these models into their pedagogy during the COVID pandemic in 2020 and many have retained these methods.¹
• Assessment of these models most frequently use cognitive indicators of learning outcomes (e.g. National Physical Therapy Examination).²
• Noncognitive indicators (e.g. confidence and self-efficacy), should be considered when assessing new educational models in PT given their relationship with competency and career direction.^3-5
• The impact of “distance models” on noncognitive learning indicators is of particular value to acute care …

Adoption And Awareness Of Long-Covid Clinical Practice Guidelines Among Physical Therapists: A Nationwide Survey, Robert Dekerlegand, Pt, Mpt, Phd, Ccs, Malachy Clancy, Phd, Otr/L, Bcpr

Department of Physical Therapy Posters

Background and Purpose

• Approximately 15% of individuals infected with SARS-CoV-2 develop “Long-COVID” with persistent physical, cognitive, and/or mental symptoms potentially amendable to physical therapy.
• Variability exists in the rehabilitation approach for individuals receiving physical therapy for this novel condition.
• Clinical practice guidelines (CPGs) and other evidence-based resources exist to help standardized rehabilitation; however, it is unknown if physical therapists (PTs) are applying them in the management of individuals with Long-COVID.
• We surveyed PTs in the contiguous United States (U.S.) to explore their awareness and application of Long-COVID CPGs along with their general awareness of this condition.

The Efficacy Of Inspiratory Muscle Training Post Covid: A Systematic Review, Robert Dekerlegand, Sydney Brannen, Olivia Bunch, Amrit Deo, Erin Dopke, Kayleigh Moreland

Department of Physical Therapy Posters

Introduction

• Fatigue and dyspnea can persist post COVID infection and negatively impact both functional capacity and quality of life (QOL).^1,2
• Residual pulmonary impairments and/or inspiratory muscle dysfunction associated with COVID infection contribute to these symptoms.^2,3
• Ventilatory demands exceeding the capacity of the inspiratory muscles can exacerbate these symptoms accentuating activity limitations that restrict participation in life roles.
• As symptom-limited exercise and QOL are related to inspiratory muscle function post COVID,^4,5 inspiratory muscle training (IMT) may improve rehabilitation outcomes.³
• The purpose of this systematic review was to determine the potential efficacy of IMT in individuals post-COVID.

Optimizing Long Covid Outcomes: Insights From A Survey Of U.S. Occupational Therapists, Malachy J. Clancy, Phd, Otr/L, Bcpr, Robert Dekerlegand, Pt, Mpt, Phd, Ccs

Department of Occupational Therapy Posters and Presentations

Background & Purpose

• Upwards of 15% of individuals infected with SARS-CoV-2 may develop “Long COVID” with persistent physical, cognitive, and/or mental symptoms potentially amendable to occupational therapy.
• Variability exists in the rehabilitation approach for individuals receiving occupational therapy for this novel condition.
• Clinical practice guidelines (CPGs) and other evidence-based resources exist to help standardized rehabilitation; however, it is unknown if occupational therapists (OTs) are aware of these resources and applying them in the management of individuals with Long COVID.
• We surveyed OTs in the contiguous United States (U.S.) to explore their awareness and application of Long COVID CPGs along with …

A Case Report Of Long-Latency Evoked Diaphragm Potentials After Exposure To Acute Intermittent Hypoxia In Post-West Nile Virus Meningoencephalitis, Joseph F. Welch, Erica A. Dale, Jayakrishnan Nair, Paul W. Davenport, Emily J. Fox, Gordon S. Mitchell

Department of Physical Therapy Faculty Papers

We present a case report of a 42-year-old female with post-West Nile virus meningoencephalitis who exhibited unique, long-latency diaphragm potentials evoked by transcranial and cervical magnetic stimulation after exposure to acute intermittent hypoxia (AIH). The subject was recruited for a study investigating AIH effects on respiratory motor function in healthy individuals. She had contracted West Nile virus infection 5 years before assessment that resulted in hospitalization and persistent allodynia but was not reported to the research team. During the study, transcranial (TMS) and cervical (CMS) magnetic stimulation were performed before and 30-60 min after a single presentation of AIH [15, …