Rehabilitation and Therapy Commons^™

Technology Improving Spinal Cord Injured Outlook: Our Experience With The Diaphragmatic Pacing System, Amanda Morina, Pt, Dpt, Ncs, Catharine Farnan-Kennedy, Ms, Crrn, Onc, Cbis

Department of Rehabilitation Medicine Faculty Papers

Introduction

Technology is always changing and that is a certainty. Integrating it into a population in a cost effective manner is always a challenge. One of the benefits of technology is the power to improve quality of life for those who are spinal cord injured. Five years ago in 2009, our rehabilitation team had the opportunity to partner with a young spinal cord injured patient with a newly implanted diaphragmatic pacer device (DPS). Since then we have had several patients with chronic spinal cord injury with this technology. The following poster will review the literature related to this device in …

Access To Therapy For Children With Autism: A Population-Based Analysis, Teal W. Benevides, Phd, Otr/L, Henry J. Carretta, Mph, Phd, Shelly J. Lane, Otr/L, Faota

Department of Occupational Therapy Posters and Presentations

1. Objective: Examine population-based trends in access to needed therapy services for children with ASD under the age of 18 years
2. Compare differences in access to needed therapy services between children with ASD and children with other special health care needs (CSHCN)
3. Identify individual, family enabling, and child need characteristics that contribute to reduced access to therapy services

Psychometric Evaluation Of The Functional Capacity Card Sort: Measuring Caregiver Appraisal Of Functional Capacity In Persons With Dementia, Catherine V. Piersol, Phd, Otr/L

Department of Occupational Therapy Posters and Presentations

Background

Caregivers play a vital role in the safety and well-being of people with dementia

• Majority of people with dementia live at home, are cared for by families or close friends/neighbors, and require supervision or assistance with daily activities

• 80% of care provided in the home is delivered by unpaid caregivers (Alzheimer’s Association, 2013, Family Caregiver Alliance, 2006)

  Functional capacity in the person with dementia is usually assessed by caregiver interview

• Caregiver report is an important proxy measure in dementia care as the person with the cognitive impairment tends to overestimate function (Karagiozis et al., 1998; Kiyak, et al., 1994) …

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Systematic Review: Occupational Therapy And Chronic Conditions In Primary Care, John Flood, Jillian Petty, Noreen Reidy, Shannon Whyte

Collaborative Research and Evidence shared Among Therapists and Educators (CREATE Day)

Learning Objectives:

• Define occupational therapy’s role in the primary care setting with a focus on those with chronic conditions using Occupational Therapy Practice Framework terminology.
• Describe the current evidence on occupational performance related to occupational therapy services in primary care.
• Discuss the future implications for occupational therapists working in primary care.

Integrating The Classroom, Clinic, And Use Of Simulation To Prepare Students For Working With Individuals With Sci, Audrey Zapletal, Ms, Otr/L, Rob Hargraves, Ba, Gina Cooke, Ms, Otr/L

Department of Occupational Therapy Posters and Presentations

Background Information

• Students learn best through active engagement. Although experiences vary, practicing skills in clinical situations have proven to be an effective method.
• Practicing skills in a simulated controlled environment provides opportunities for students to receive feedback on their skills.
• Standardized patient experiences provide students a safe environment to practice clinical skills in challenging situations. These experiences have been shown to have a positive impact on learning.

Revisiting Our Roots: Innovative Community-Based Psychosocial Fieldwork Programs: Classroom To Clinic, Susan Santalucia, Ms, Otr/L, Kimberly S. Mollo, Ms, Otr/L, Tina Angelis, Edd, Otr/L

Department of Occupational Therapy Posters and Presentations

Objectives:

1. Understand the core components of a community-based level 1 psychosocial experience that bridge and enhance student classroom learning.

2. Examine strategies to identify, create, and maintain partnerships with community based sites.

3. Explore 2-3 learning activities and/or strategies that facilitate student learning during the Level 1 experience in a community based psychosocial setting.

Avoid, Accommodate, Confront Or Collaborate: Using Simulation To Teach Conflict Resolution Skills, E. Adel Herge, Otd, Otr/L, Deborah A. Hopkins, Ms, Otr/L

Department of Occupational Therapy Posters and Presentations

Objective:

• Interprofessional education competencies include understanding roles & responsibilities of team members, and demonstrating effective communication and team building skills (Pardue, 2013).
• Team conflict impacts patient safety and outcomes (Knickle & McNaughton, 2009; Wagner, Liston & Miller, 2011) so effective team communication and conflict resolution in an important skill for students to develop (Greer et al., 2012; Levi, 2014).
• Simulation is effective in teaching interprofessional communication skills to health profession students (Velde, 2009).

Implementation Of A Four Year Rehabilitation Curriculum For Medical Students, Nethra S. Ankam, Md

Department of Rehabilitation Medicine Faculty Papers

In 2009 the Vice-Dean of Undergraduate Medical Education modified the 4th year curriculum by eliminating the required clerkship in Rehabilitation Medicine, and the Department was tasked with the creation of a four year curricular thread. While disappointing, this was a blessing in disguise. For years, we attempted to fit a great deal of content into an ever decreasing timespan, to increasingly disinterested students. Our teachers were also burned out with the sheer volume of students.

Through collaboration with other course directors, we inserted content where it fit the developmental needs of the students. We were also able to introduce students …

Bridging The Evidence Gap: The Role Of Fieldwork Students, Tracey Vause-Earland, Ms, Otr/L, E. Adel Herge, Otd, Otr/L, Faota

Department of Occupational Therapy Posters and Presentations

Introduction

Understanding and using evidence in practice improves health care delivery (Lugtenberg, Burgers, & Westert, 2009), reduces errors, and increases professional identity. Despite the call for increased use of evidence in occupational therapy decision making and positive attitudes of therapists toward use of evidence in practice), evidence based practice (EBP) is perceived by clinicians as time consuming and difficult due to lack of knowledge and/or resources (Humphries, et al, 2000; Bennett et al, 2003).

Evaluating The Effects Of Grasp Patterns And Grip Strength On Handwriting Skills, Jennifer Bebey, Ots, Kelsey Engelstad, Ots, Audrey Zapletal, Ms, Otr/L

Department of Occupational Therapy Posters and Presentations

Background Information

• Handwriting is a critical and complex skill that school aged children acquire over time.
• When a child demonstrates handwriting difficulties, he or she may have challenges with:

Completing written school assignments in a timely fashion,

Taking notes,

Finishing homework,

Completing exams, especially short answer.

• 80% to 85% of occupational therapy referrals in schools are due to atypical grasp pattern, fine motor and handwriting concerns that affect a child’s educational performance.

The International Society Of Physical And Rehabilitation Medicine: The Way Forward - Ii., Marta Imamura, Christoph Gutenbrunner, Gerold Stucki, Jianan Li, Jorge Lains, Walter Frontera, John Olver, Levent Özçakar, Joel Delisa, Linamara Rizzo Battistella, John L. Melvin

Department of Rehabilitation Medicine Faculty Papers

This paper reports on recent changes and future plans concerning the International Society of Physical and Rehabilitation Medicine. Issues discussed are its structural organization, collaboration and recognition, liaison with the World Health Organization , work in strengthening science, and its future agenda.

The Teaching Self-Reflection Tool And Skills Checklist, Arlene Lorch, Otd, Otr/L, Ches

Department of Occupational Therapy Faculty Papers

OBJECTIVE.

To provide occupational therapy faculty with a collaborative system to review and improve teaching skills within the educational program.

METHOD.

Six faculty members completed a self-assessment using self-reflection tools and feedback from an interview with a fellow faculty member serving as consultant. Surveys evaluated perceptions of the experience.

RESULTS.

Survey responses indicated strong approval of the peer review process as a valuable method for faculty development. Results identified aspects of the process that needed revision, specifically, the burden of time required to complete the process.

CONCLUSION.

Findings support the need for a peer review process because it benefits faculty, …

Two Phase 3, Multicenter, Randomized, Placebo-Controlled Clinical Trials Of Fampridine-Sr For Treatment Of Spasticity In Chronic Spinal Cord Injury., D. D. Cardenas, J. F. Ditunno, V. Graziani, A. B. Mclain, D. P. Lammertse, P. J. Potter, M. S. Alexander, R. Cohen, A. R. Blight

Department of Rehabilitation Medicine Faculty Papers

STUDY DESIGN: Two randomized, double-blind, placebo-controlled trials.

OBJECTIVE: To evaluate the efficacy and safety of fampridine sustained-release tablets (fampridine-SR) 25 mg twice daily for moderate-to-severe spasticity in patients with chronic spinal cord injury (SCI).

SETTING: United States and Canada.

METHODS: Patients with incomplete chronic SCI were randomized to twice daily fampridine-SR 25 mg or placebo, with a 2-week single-blind placebo run-in, a 2-week titration, 12 weeks of stable dosing, 2 weeks of downward titration and 2 weeks of untreated follow-up. Co-primary end points were the change from baseline, averaged over the double-blind treatment period, for Ashworth score (bilateral knee flexors …

An Intervention For Sensory Difficulties In Children With Autism: A Randomized Trial., Roseann C Schaaf, Teal W. Benevides, Zoe Mailloux, Patricia Faller, Joanne Hunt, Elke Van Hooydonk, Regina Freeman, Benjamin E Leiby, Jocelyn Sendecki, Donna Kelly

Department of Occupational Therapy Faculty Papers

This study evaluated a manualized intervention for sensory difficulties for children with autism, ages 4-8 years, using a randomized trial design. Diagnosis of autism was confirmed using gold standard measures. Results show that the children in the treatment group (n = 17) who received 30 sessions of the occupational therapy intervention scored significantly higher (p = 0.003, d = 1.2) on Goal Attainment Scales (primary outcome), and also scored significantly better on measures of caregiver assistance in self-care (p = 0.008 d = 0.9) and socialization (p = 0.04, d = 0.7) than the Usual Care control group (n = …

Giving Back: Physiatry, Program & Patients, Seyed Amir Tahaei, Md, John F. Ditunno, Jr, Md, Frank Naso, Md, John L. Melvin, Md

Department of Rehabilitation Medicine Faculty Papers

“Giving Back” is a Jefferson tradition beginning with Dr. William Schmidt (JMCF1917-1959), who together with Dr. Frank Krusen (JMC 1921) served as Presidents of the American Academy of Physical Medicine and Rehabilitation (AAPM&R) in 1943 and 1941 respectively. Other Jefferson graduates and faculty have also served as President of the Academy including Drs. Bender (1973), Ditunno (1981), Reinstein (1993), Melvin (1998) and recent presidents in 2009-2013, Betsy Sandel (JRR 1984), Mike Lupinacci (Jefferson Resident teaching faculty) and Alberto Esquenazi (JMCF 2000). Both Krusen and Schmidt were founding members of the American Board of PM&R in 1947. Over the years many …

The Fieldwork Planning Matrix – Maximizing The Learning Environment In Non-Traditional Community Based Settings, Arlene Lorch, Otd, Otr/L, Ches, Tina Angelis, Edd, Otr/L

Department of Occupational Therapy Posters and Presentations

OBJECTIVES

•Learn about a matrix guided tool utilized to plan and structure unique fieldwork experiences.

•Identify key elements associated with “matrix” implementation.

•Understand multi-faceted uses of the manual.

BACKGROUND - NONTRADITIONAL FW

•More community-based sites are needed to meet FW placement demand

•Typically, these FW sites rely upon non-traditional, distant supervision.

•These learning environments require high degree of structure to support experiential self-directed learning

•High structure requires detailed planning

•A planning matrix method to maximize the learning environment is proposed.

Creating An Infrastructure To Support Faculty Outcomes Research On Teaching And Learning, Susan Toth-Cohen, Phd, Otr/L, Susan Wainwright, Phd, Pt

Department of Occupational Therapy Posters and Presentations

This presentation discusses the Teaching and Learning Initiative (TLI), a comprehensive program for building faculty capacity to design and implement educational research in a school of health professions. The TLI is a staged program based on Eade's (1997) approach to capacity building, which the authors apply to the academic environment. The TLI consisted of 4 stages:

1. Initial planning and data gathering.

2. Training faculty in educational outcomes research.

3. Faculty submission of educational outcomes research for intramural funding.

4. Participatory action research approach to further develop faculty capacity for the scholarship of teaching and learning, including educational outcomes …

New Phenotype Of Parsonage-Turner Syndrome Involving Radial And Proximal Median Nerve: A Case Report, Matthew Mcauliffe, Md, Nancy Vuong, Md, Adam L. Schreiber, Do

Department of Rehabilitation Medicine Faculty Papers

History

A 74-year-old woman developed sudden severe left shoulder, arm, and forearm pain that suddenly developed. This pain lasted approximately 2 months. Approximately 1-2 months after the resolution of the first pain she developed a different type of pain which she described as a tingling, burning, pins and needle sensation that radiated from her shoulder past her elbow into the dorsal and palmar aspect of her hand in the thumb, index, and long fingers. Additionally, she developed numbness in her hand along the palmar thumb, index, and long fingers. Two months following the onset of the initial type of pain, …

An Organization-Wide Service Improvement Approach, Jennifer Jasmine Arfaa, Phd, Mhsa, Cynthia Line, Phd, Nora Kramer, Msn, Rn, Karen Montoro, Rn, Richard D. Blob,, Maria Francesco, Jaime Stazi, Rn, Elisabeth Kunkel, Md, Susan Krekun, Md, Lizanne Mason, Rn, Kathy Evans, Rn, Lorraine Weikel, Rn, Ann D. Clark, Ms, Otr/L, Ray Wisniewski, Teresa Heavens

Department of Nursing papers and presentations

APPROACH TO PROBLEM SOLVING

High priority index questions from HCAHPS and Press Ganey surveys, including overall ratings, communication with RNs and MDs, hospital environment and response to concerns and complaints, were targeted for improvement. These high priority indices served as the basis for redesigning Patient Services using a multi-faceted approach to improve patients’ experiences.

At Thomas Jefferson University Hospital (TJUH), high performance on the Patient Experiences of Care Survey has been driven by a successful multi-tiered approach to patient services:

·Hospital leadership guided and implemented new approaches to ensure excellence in patient services is an ever-present and obtainable goal

·Physician …

Trans-Sacrococcygeal Joint Ganglion Impar Injection For Treatment Of Pudendal Neuralgia (3 Cases Report), Matthew Mcauliffe, Md, Linqiu Zhou, Md

Department of Rehabilitation Medicine Faculty Papers

History

Three patients, 2 male and 1 female were diagnosed with pudendal neuralgia. The female patient developed pudendal neuralgia secondary to post-herpetic neuralgia. The two male patients were caused from likely repetitive sitting injury. One patient was a truck driver causing him to sit for long periods of time and the other patient was a professional writer. The three patient initially all attempted conservative therapies, however their pain persisted. They elected to undergo Trans-sacrococcygeal joint ganglion impar injection for treatment of pudendal neuralgia.

Evidence-Based Practice In Occupational Therapy Curricula., Tina Angelis, Edd, Otr/L, Thomas G Dimarco, Susan Toth-Cohen, Edd, Otr/L

Department of Occupational Therapy Faculty Papers

The purpose of this study is to describe currently used educational strategies for teaching evidence-based practice (EBP) in entry-level master's degree occupational therapy programs in the United States. Fifty-eight entry-level occupational therapy program directors completed a survey. Results showed that occupational therapy programs consistently use a wide variety of EBP resources for teaching EBP including database searches, literature reviews, and the development of a research proposal. Less commonly used strategies include the use of case stories and journal clubs. The current study provides a baseline of existing strategies taught in entry level programs that may be built upon to gather …

Early Intervention Provider Use Of Child Caregiver-Teaching Strategies, Philippa Campbell, Phd, Catherine Ehret-Coletti, Ms

Department of Occupational Therapy Faculty Papers

Most current early intervention approaches emphasize the importance of a provider role as teacher or coach, a role in which providers give parents or other caregivers information about how to optimize children’s growth and development (Stremel & Campbell, 2007). However, few studies have examined the information that should be provided for caregivers or how this information is best delivered to caregivers although a number of rating scales are able to distinguish between roles of direct service provider for the child (e.g., traditional) and triadic interaction among provider, caregiver, and child (Campbell & Sawyer, 2007; Salisbury & Cushing, 2013). Related factors …

You've Got A Friend In Me: Effectiveness Of Social Skills Interventions For Children With Adhd, Michelle Carlton, Kelly Davis, Jacquelyn Matlack, Marietta Van Ness

Collaborative Research and Evidence shared Among Therapists and Educators (CREATE Day)

Children diagnosed with ADHD present with the core symptoms of inattention and hyperactivity/impulsivity, which lead to challenges with school based activities, including peer interactions, academics, and extracurricular activities (McClelland, Morrison, & Holmes, 2000; Hoza, 2007). Current research identifies social skills interventions as a potential strategy for occupational therapists (OTs) to address these participation challenges of children with ADHD, however there is a multitude of interventions that fall under this umbrella. The variety of social skills interventions allows for flexibility and diversity in implementation, but poses the challenge of choosing the most effective intervention. This choice should be informed by evidence-based …

Rehabilitative Interventions To Improve Biomechanical Or Functional Outcomes For Children With Obstetric Brachial Plexus Palsy, Loren Massimino, Erin Mulrain, Katherine Scheponik, Rachel Wiley, Houman Ziai

Collaborative Research and Evidence shared Among Therapists and Educators (CREATE Day)

Background: Obstetric brachial plexus palsy (OBPP) affects children worldwide, with incidence rates ranging from 0.5 to 3 per 1000 live births (Foad, Mehlman & Ying, 2008). Injury characteristics vary greatly and therefore, discrepancies exist regarding the most effective rehabilitation interventions. These children receive conservative management (through occupational and physical therapy), Botulinum toxin, surgery, or a combination of treatments (Benjamin, 2005).

Objective: To present the results of a systematic review of the literature to identify rehabilitative interventions that demonstrate statistically significant functional/biomechanical outcomes in children with OBPP.

Methods: A systematic search of the databases PubMed, CINAHL, and MEDLINE …

Doing It Well: Education To Promote Satisfaction With Sexual Intimacy For People With Spinal Cord Injury, Allison Duggan, Erin Maniscalco, Dannielle Miccinello, Lauren Pasciuto, Catherine Scaccia

Collaborative Research and Evidence shared Among Therapists and Educators (CREATE Day)

Physical and psychosocial effects of a spinal cord injury may lead to concerns and difficulty with sexual satisfaction, exploration, and arousal as well as diminished confidence with participation in intimate relationships (Craig Hospital, 2012). Current research indicates a decreased level of satisfaction with participation in sexual intimacy for adults with spinal cord injury (Fisher et al., 2002). Occupational therapists have a key role in the rehabilitation of individuals with spinal cord injury, and sexuality is an area of occupation which falls within our scope of practice (AOTA, 2008). Therefore it is necessary that occupational therapists are assertive in addressing the …

Technology In Practice: Promoting Participation In Patients With High Level Of Spinal Cord Injury, Morgan Gill, Kate Nuschke, Kaitlin O'Sullivan, Casey Puvogel, Alex Sagnor

Collaborative Research and Evidence shared Among Therapists and Educators (CREATE Day)

Motor impairment often occurs following a spinal cord injury, limiting participation in functional tasks. Although the primary rehabilitative focus is to cure paralysis, not all patients experience full recovery. For those who may not regain complete motor function, rehabilitative interventions are needed to bridge the gap between disability and optimal participation. During rehabilitation, patients prioritize increasing independence and participation in meaningful activities (Rigby, Ryan, & Campbell, 2010). More specifically, regaining arm and hand function was reported as a top priority during treatment for individuals with complete spinal cord injury (Peckham, et al., 2001). Technology has been utilized to improve participation …

Dementia And Technology: Evidence Supporting Assistive Technology For Individuals With Alzheimer’S Disease And Related Dementias, Diana Skoutelas, Christine Tanner, Gabriella Vulpis, Gittel Zelczer

Collaborative Research and Evidence shared Among Therapists and Educators (CREATE Day)

The prevalence of Alzheimer’s disease in the Unites States is estimated to be 5.2 million (Alzheimer’s Association, 2013). Alzheimer’s disease and related dementias (ADRD) can impact an individual’s ability to independently participate in daily occupations within their environment due to executive dysfunction, memory loss, poor judgment, and decreased problem solving (Desai, Grossberg, & Sheth, 2004; Alzheimer’s Association, 2013). Due to the rising prevalence of dementia, Labelle and Mihailidis (2006) note the importance of occupational therapists finding innovative and evidence-based strategies to enable participation in daily occupations. The purpose of this presentation is to present the results of a literature review …

Thinking Through The Chemo-Fog: Occupational Therapy’S Role In Promoting Participation In Adults With Breast Cancer, Amanda Ally, Lisa Ferguson, Emily Grabow, Katrina Long, Alisha Sharp

Collaborative Research and Evidence shared Among Therapists and Educators (CREATE Day)

Breast cancer is currently the most common type of cancer in women (American Cancer Society, 2012). In 2012, 2,971,610 women in the United States were breast cancer survivors (American Cancer Society, 2012). Chemotherapy is often used to effectively treat breast cancer but can cause chemobrain, or chemotherapy-related cognitive impairments (CRCI), including decreased attention, concentration, memory, and difficulty learning new skills and completing routine tasks (American Cancer Society, 2013). CRCI can persist for years and may impact an individual’s occupational performance in daily activities and occupations. Occupational therapy practitioners currently work with this population in other areas including cancer-related fatigue management, …

Beyond Piecework: Employment For Persons With Intellectual And Developmental Disabilities, Kelly Brandwene, Ilese Coleman, Adva Epstein, Alyssa Peachey, Lauren Rosenthal

Collaborative Research and Evidence shared Among Therapists and Educators (CREATE Day)

All people deserve competitive, fulfilling employment (Lysaght, Cobigo, Hamilton, 2011). Many people with intellectual or developmental disabilities (I/DD) have difficulty obtaining competitive employment despite desiring to work (Lysaght, Ouellett-Kuntz, & Lin, 2010). In past years, people with I/DD have been employed in sheltered workshops; however, they are often paid below minimum wage, do not receive benefits, and are viewed as subordinates. Workers report the desire to work outside of sheltered employment. Competitive employment (integrated/supported employment), can lead to social justice, social inclusion, personal growth, and improved financial situations (Migliore, Mank, Grossi, & Rogan, 2007). Occupational therapists are suited to assist …

Falling Into Home Mods: Occupational Therapy’S Role In Keeping Older Adults Safe At Home, Elizabeth Janeczko, Brendan Kiernan, Mary Susan Paige, Stephanie Reitemeier, Joshua Springer

Collaborative Research and Evidence shared Among Therapists and Educators (CREATE Day)

Falls are the leading cause of injury-related deaths and the most common cause of nonfatal injuries and hospital admissions for older adults aged 65 and older.¹ Other consequences of falls are increased fear of falling, and decreased independence and participation in performance of daily activities. In the past decade, evidence has identified the multifactorial approach, which includes home modification, as the most effective approach in preventing falls in older adults.² Occupational therapists have the education and unique skill set to perform client-centered home modifications. The purpose of this presentation is to describe the results of an evidenced-based literature …