Rehabilitation and Therapy Commons^™

Can't Hold Me Back! Constraint-Induced Movement Therapy For Children With Cp: Evidence Based Review, Rebecca Coale, Danni Eisner, Alissa Herman, Sarah Merhaut

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

Children with cerebral palsy (CP) have various functional impairments impacting participation in meaningful occupations. While Constraint-Induced Movement Therapy (CIMT) is a widely used intervention for adult populations, a modified version of this technique is a relatively new practice in pediatrics (Charles et al., 2006). Occupational therapy intervention, such as CIMT, can support functional goal attainment to enhance participation and quality of life (Boyd et al., 2010). The purpose of this presentation is to synthesize results of a comprehensive evidence-based review and identify treatment characteristics that impact efficacious use of mCIMT on children with hemiplegic CP. Practitioners will learn about best …

Clinical Effectiveness Of Motor Imagery Post-Stroke: An Evidence Based Review, Azadeh Narimanian, Amanda Reese, Karina Ryabo, Rachel Shepp, Annalisa Synnestvedt

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

Following a stroke, many individuals experience participation limitations secondary to upper extremity hemiparesis (Shenn & Leishear, 2011). Motor imagery, the mental representation of movement without any body movement, is an evidenced-based intervention to optimize upper extremity function for patients following stroke (Dickstein & Deutsch, 2007). Motor imagery is a readily applicable, safe, and cost-effective intervention that can help clients achieve a variety of occupational goals within diverse environments (Guttman, Burstin, Brown, Bril, & Dickstein, 2012). The purpose of this presentation is to present the results of an evidence-based review examining the use of motor imagery to increase functional outcomes for …

Paws With A Purpose: Evidence Supporting The Use Of Animal Assisted Therapy To Improve Quality Of Life In Adults With Psychiatric Diagnoses, Julia Andraka, Lacey Brinser, Kelly D'Ambrosio, Jordan Justice, Elizabeth Rugen

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

Approximately 62.7 million Americans have a psychiatric diagnosis, including Alzheimer’s disease and mental disorders^1,6. Adults who are diagnosed with these conditions experience a variety of limitations, including decreased quality of life⁴. Occupational Therapy (OT) has been shown to be an effective treatment to increase quality of life in adults with psychiatric diagnoses³. Occupational therapists working within the mental health field often need to use creative and innovative approaches to motivate their clients, including Animal-assisted therapy (AAT). AAT is a unique intervention approach that has the potential to improve a person’s emotional, physical, cognitive and …

Transitions For Tomorrow: An Evidence-Based Review Of Post-Secondary Transition Planning For Individuals With Autism, Julie Bardenwerper, James Gillette, Elizabeth Luk, Hilary Moser, Alanna Raffel

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

Autism spectrum disorder (ASD) is the fastest growing neurodevelopmental disability in the US other than ADHD (IACC, 2012). Currently, the prevalence of individuals with ASD is estimated to be 1 in 88 in the US (CDC, 2012). Therefore, increasing numbers of children with ASD will age out of high school and transition to postsecondary settings. Individuals with ASD have demonstrated less successful postsecondary outcomes than individuals with other disabilities (Shattuck et al., 2011). Currently, there is limited research supporting the methods of successful transition planning for students with ASD (IACC, 2012). The purpose of this presentation is to introduce the …

Introduction To Ipe: A School-Wide Orientation Initiative, Audrey Zapletal, Ms, Otr/L, Susan Toth-Cohen, Phd, Otr/L, Susan Wainwright, Phd, Pt, Frances Gilman, Dhsc, Rt, R, Ct, Cv, Mr

Department of Occupational Therapy Posters and Presentations

Session Objectives:

Present an innovative approach to orienting new students from various healthcare disciplines on Interprofessional Educa(on (IPE).

Discuss strategies to shape incoming students’ attitudes toward working in teams.

Discuss challenges and opportunities in coordinating a large-­‐scale IPE event.

Synopsis

Interprofessional experiences are a vital part of healthcare education, and early introduction can positively impact students’ attitudes and knowledge about their team members’ roles. While students at academic health centers (AHC’s) have opportunites to engage in IPE, such opportunites can be overwhelming given significant challenges to coordination and implementation. Addressing these challenges, an interprofessional team at Jefferson School of Health …

Promoting Health Literacy Through Leading Edge Occupational Therapy Education, Susan Toth-Cohen, Phd, Otr/L, Annalisa Synnestvedt, Ba, Ots, Alyssa Frey Peachey, Ots

Department of Occupational Therapy Posters and Presentations

Synopsis:

Health literacy has become a vital focus of U.S. healthcare. By incorporating health literacy knowledge, attitudes, and skills into entry-­‐level education, occupational therapy professionals can enact a leading role in health and human services teams to address our national healthcare goals.

Poster presentation at the American Occupational Therapy Association Annual Conference, San Diego, CA, April 2013.

The Walking Index For Spinal Cord Injury (Wisci/Wisci Ii): Nature, Metric Properties, Use And Misuse., J. F. Ditunno, Jr, P. L. Ditunno, G. Scivoletto, M. Patrick, M. Dijkers, H. Barbeau, A. S. Burns, R. J. Marino, M. Schmidt-Read

Department of Rehabilitation Medicine Faculty Papers

STUDY DESIGN: Literature review.

OBJECTIVE: To critically review all publications/internet sites that have described/used the Walking Index for Spinal Cord Injury (WISCI II), as a measure of impairment of walking function after spinal cord injury (SCI), in order to identify its psychometric properties, clarify its nature, specify misuse and incorporate the findings in an updated guide.

METHOD: A systematic literature search was done of Ovid MEDLINE, CINAHL, PsychINFO, Cochrane Central Register of Controlled Trials, Scopus and electronic sites using key words: WISCI or WISCI II, SCI, paraplegia/ tetraplegia/ quadriplegia and ambulation/gait/walking. Among 1235 citations retrieved, 154 relevant articles/sites were identified, …

Meeting The Challenge: Technological Advances In Stroke Rehabilitation, Peggy Seminara Rn, Ne-Bc, Mha, Bernadette R. Anderson Bsn, Rn, Alberto Esquenazi Md

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Dr. Robert L. Bennett: Pioneer And Definer Of Modern Physiatry., John F. Ditunno, Jr, Richard E. Verville

Department of Rehabilitation Medicine Faculty Papers

Few physiatrists today would appreciate Dr. Robert L. Bennett’s contributions to our specialty, since he most commonly was associated with poliomyelitis, a cured disease for over a half century. Less are aware of the pioneering fusion of physical medicine in 1941 by Krusen’s first resident with the independent living environment of the Georgia Warm Spring Foundation (GWSF) created by a USA president. Bennett recognized polio/GWSF as the workshop and laboratory for showcasing the new specialty of Physical Medicine and Rehabilitation (PMR). He taught us that accurate muscle testing determined the plan of muscle reeducation, which led to functional training with …

Contemporary Therapeutic Aquatics: Interprofessional Course, Marcia Levinson, Pt, Phd, Mft, Martha Langley Ankeny, M.Ed. M.Ed., E. Adel Herge, Otd, Otr/L

Academic Commons and Scott Memorial Library Staff Papers and Presentations

Aquatic therapy can meet the needs of individuals from childhood to older adulthood with a variety of health conditions, and, in certain situations, is preferable to land-based therapy. Information on this specialized area of practice is minimally covered in entry-level occupational and physical therapy curricula, yet aquatic therapy is a rapidly expanding area of practice.

Increased Serum And Musculotendinous Fibrogenic Proteins Following Persistent Low-Grade Inflammation In A Rat Model Of Long-Term Upper Extremity Overuse., Helen G L Gao, Paul W Fisher, Alex G Lambi, Christine K Wade, Ann E Barr-Gillespie, Steven N Popoff, Mary F Barbe

Department of Physical Therapy Faculty Papers

We examined the relationship between grip strength declines and muscle-tendon responses induced by long-term performance of a high-repetition, low-force (HRLF) reaching task in rats. We hypothesized that grip strength declines would correlate with inflammation, fibrosis and degradation in flexor digitorum muscles and tendons. Grip strength declined after training, and further in weeks 18 and 24, in reach limbs of HRLF rats. Flexor digitorum tissues of reach limbs showed low-grade increases in inflammatory cytokines: IL-1β after training and in week 18, IL-1α in week 18, TNF-α and IL-6 after training and in week 24, and IL-10 in week 24, with greater …

Exploring The Depths Of Health Literacy Are We Teaching This And Why Does It Matter?, Susan Toth-Cohen, Phd, Otr/L, Tracey Vause-Earland, Ms, Otr/L

Department of Occupational Therapy Posters and Presentations

Background: Why does Health Literacy Matter?

• Healthcare practitioners often work with older persons with low health literacy without realizing that this issues limiting the success of their interventions. They may also lack awareness of the serious impact that low health literacy can have, since it is associated with lower reported health status, increased hospitalizations, and increased morbidity (Levasseur & Carrier, 2011).
• The current US healthcare system places increase demands on consumers to manage their own health (Smith & Gutman, 2011).
• Educators in the health professions must instill a sense of responsibility in future practitioners to understand the important role they …

Activating Healthcare Advocates: A Collaboration Between Npa And The Ihi Open School, Ashlee Goldsmith, Md, Valerie Pracilio, Mph, Cpps

Department of Rehabilitation Medicine Faculty Papers

Presented at: National Physician's Alliance National Conference in Alexandria Virginia.

AIM

To facilitate opportunities for interdisciplinary learning and aligning the missions of the two organizations, we organized an educational program for current and future healthcare professionals focused on the relationship between quality and cost using the Top 5 lists to promote good stewardship in clinical practice, initially developed by the NPA, as a tool to initiate collaboration.

Engaging Students In Interprofessional Collaboration: A United States-Japan Exchange, Susan Toth-Cohen, Noriyoshi Asai, Susan Wainwright, Miki Sakamoto, Frances Gilman, Kenneth Covelman, Annalisa Synnestvedt

Department of Occupational Therapy Faculty Papers

Overall Purpose of Exchange

Kitasato University and Thomas Jefferson University, Jefferson School of Health Professions To promote mutual understanding and friendship, to promote cooperation and progression in the education and research of health sciences at Kitasato University and Thomas Jefferson University

Started in 1992 by Dr. Shirley Greening Chair, Department of Bioscience Technology, TJU and Dr. Takeda former medical director of cytotechnologist program and former pathologist at TJUH developed a relationship for faculty exchange with Dr. Hiroyuki Kuramoto, PhD former chair of the OB-GYN dept. at Kitasato School of Medicine

1997: official exchange agreement for Jefferson and Kitasato University students …

Emerging As Leaders In Autism Research And Practice: Using The Data-Driven Intervention Process., Roseann C Schaaf, Erna Imperatore Blanche

Department of Occupational Therapy Faculty Papers

No abstract provided.

Cross-Cultural Comparison Of Sensory Behaviors In Children With Autism., Kristina G Caron, Roseann C Schaaf, Teal W. Benevides, Eynat Gal

Department of Occupational Therapy Faculty Papers

Parents of children with autism frequently report that their children exhibit unusual responses to sensory experiences. Little research is available, however, describing how parents' and children's culture and environment might influence parents' reports of their children's behaviors. This study compared the frequency of parent-reported responses to sensory experiences in children from two countries-Israel and the United States. We administered the Short Sensory Profile to primary caregivers of children with autism spectrum disorders (ASD) and typically developing peers. Results indicate that Israeli parents reported unusual responses to sensory experiences less frequently than U.S. parents for both ASD and typically developing children. …

How Do We Change Practice When We Have The Evidence?, Janice P Burke, Laura N. Gitlin

Department of Occupational Therapy Faculty Papers

Translating research findings into practice includes myriad pragmatic realities, including understanding the suitability of the data to a particular patient group, writing new guidelines for occupational therapy practitioners, facilitating adoption of the guidelines, and instituting new patterns of care for patients. The process is more than a matter of disseminating the information to practitioners and expecting immediate change in patient treatment. Indeed, the field of implementation science is devoted to the identification of the numerous barriers and supports that constrain or expedite practice change in response to research. Moving forward and adopting evidence-based findings will require a focused understanding of …

Occupational Therapy And Sensory Integration For Children With Autism: A Feasibility, Safety, Acceptability And Fidelity Study., Roseann C Schaaf, Teal W. Benevides, Donna Kelly, Zoe Mailloux-Maggio

Department of Occupational Therapy Faculty Papers

Objective: To examine the feasibility, safety, and acceptability of a manualized protocol of occupational therapy using sensory integration principles for children with autism. Methods: Ten children diagnosed with autism spectrum disorder ages 4-8 years received intensive occupational therapy intervention using sensory integration principles following a manualized protocol. Measures of feasibility, acceptability and safety were collected from parents and interveners, and fidelity was measured using a valid and reliable fidelity instrument. Results: The intervention is safe and feasible to implement, acceptable to parents and therapist, and therapists were able to implement protocol with adequate fidelity. These data provide support for implementation …

The Appropriateness Of Long-Term Opioids To Treat Chronic Back Pain, Thomas Watanabe, Michael Salino, Adam Schreiber

Department of Rehabilitation Medicine Faculty Papers

Point/Counterpoint Case Scenario: A 55-year old man presents to a pain clinic upon referral from his primary care physician. His symptom is axial low back pain. His pain started approximately 1 year earlier without a specific inciting event. He denies radiation of pain into the lower extremities. There is no bowel or bladder involvement. There is no directional preference. He reports pain "all the time," with minimal specific exacerbating or relieving factors. There is no medical-legal involvement. His medical history is significant for hypertension, hypercholesterolemia, obesity, and sleep apnea. He is a divorced father of 2 adult children. He is …

The Graded Redefined Assessment Of Strength Sensibility And Prehension: Reliability And Validity., Sukhvinder Kalsi-Ryan, Dorcas Beaton, Armin Curt, Susan Duff, Milos R Popovic, Claudia Rudhe, Michael G Fehlings, Mary C Verrier

Department of Physical Therapy Faculty Papers

Abstract With the advent of new interventions targeted at both acute and chronic spinal cord injury (SCI), it is critical that techniques and protocols are developed that reliably evaluate changes in upper limb impairment/function. The Graded Redefined Assessment of Strength Sensibility and Prehension (GRASSP) protocol, which includes five subtests, is a quantitative clinical upper limb impairment measure designed for use in acute and chronic cervical SCI. The objectives of this study were to: (1) establish the inter-rater and test-retest reliability, and (2) establish the construct and concurrent validity with the International Standards of Neurological Classification of Spinal Cord Injury (ISNCSCI), …

Aging Contributes To Inflammation In Upper Extremity Tendons And Declines In Forelimb Agility In A Rat Model Of Upper Extremity Overuse., David M Kietrys, Ann E Barr-Gillespie, Mamta Amin, Christine K Wade, Steve N Popoff, Mary F Barbe

Department of Physical Therapy Faculty Papers

We sought to determine if tendon inflammatory and histopathological responses increase in aged rats compared to young rats performing a voluntary upper extremity repetitive task, and if these changes are associated with motor declines. Ninety-six female Sprague-Dawley rats were used in the rat model of upper extremity overuse: 67 aged and 29 young adult rats. After a training period of 4 weeks, task rats performed a voluntary high repetition low force (HRLF) handle-pulling task for 2 hrs/day, 3 days/wk for up to 12 weeks. Upper extremity motor function was assessed, as were inflammatory and histomorphological changes in flexor digitorum and …

Manifestations Of Rheumatoid Arthritis: Epidural Pannus And Atlantoaxial Subluxation Resulting In Basilar Invagination., Adam L Schreiber, Do, Ma

Department of Rehabilitation Medicine Faculty Papers

Presented in part at the AAPMR 71st Annual Assembly Meeting, Seattle, WA, November 4-7, 2010.

Atlantoaxial instability results from cartilaginous destruction, periarticular erosions, and ligament and tendon attenuation. Instability affects 19%-70% of patients, and basilar invagination from vertical odontoid subluxation through the foramen magnum occurs in 38% of patients. This phenomenon occurs twice as often in women than men, whose age at diagnosis typically ranges from 30-50 years. Along with bony compression, the pannus further decreases the space available for the cord by 3mmor more in approximately 66% of patients (Figures 1-7). The earliest and most common symptom of cervical …

Use Of Robotics In Spinal Cord Injury: A Case Report., Lori Siedziewski, Roseann C. Schaaf, Julie Mount

Department of Occupational Therapy Faculty Papers

OBJECTIVE: We examined the use of robotics to treat upper-extremity (UE) dysfunction in tetraplegic patients with spinal cord injury (SCI).

METHOD: a 51-yr-old man with incomplete SCI participated in an occupational therapy program that combined traditional occupational therapy with Reo Go®, a comprehensive therapy platform that includes a robotic guide featuring a telescopic arm to enable high repetitions of functionally relevant UE exercises.

RESULTS: The participant demonstrated measurable improvements in active range of motion, muscle strength as measured through manual muscle testing, perceived right UE function, and self-care performance as measured by the FIM™.

CONCLUSION: The findings from this case …

Clinical Care Plan: Interdisciplinary Course (Ccpic), Marcia Levinson, Pt, Phd, Mft, Amy M Egras, Pharm.D, Bcps, E. Adel Herge, Otd, Otr/L, Kathryn Shaffer, Rn, Msn

Department of Physical Therapy Faculty Papers

Background/Rationale:

Interprofessional collaborative practice significantly improves patient outcomes, reduces mortality and enhances quality-of-life.

Person-focused care demands collaboration among professions in a team approach to address multiple issues including illness, prevention, and health promotion activities.

Key elements of successful implementation of interprofessional education supported by Clinical Care Plan, Interprofessional Course (CCPIC):

-Increasing knowledge of the roles, responsibilities, and competencies of multiple health professions.

-Collaborating in teams

-Recognizing the patient as the expert

-Communicating effectively

Course Statistics:

-176 students from various disciplines completed course (2008-2011).

Disciplines include:

-Medicine, Nursing, Occupational Therapy, Physical Therapy, Pharmacy

Treatment Of Cerebrospinal Fluid Leak During Spinal Cord Stimulator Implantation With Epidural Blood Patches, Farid Kia, Md, Linqiu Zhou, Md, Jason Berk, Md

Department of Rehabilitation Medicine Faculty Papers

Conclusion:

Our data is consistent with prior studies in demonstrating that the incidence of dural puncture and CSF leak with SCS procedures is rare. Based on our experiences, performing an epidural blood patch intra-operatively on the contra-lateral side under fluoroscopy could prevent PDPH. This treatment should especially be considered in patients undergoing SCS trials in order to accurately assess the level of pain reduction. Patients with prior spine surgeries might pose higher risks for dural puncture and more extensive pre-operative assessment could be beneficial.

Promoting Occupational Therapy In Virtual Environments: Project-Based Learning In Second Life®, Susan Toth-Cohen, Phd, Otr/L, Veronica Souter, Ots, Elizabeth Vanderlaan, Ots, Kaitlin Rodriguez, Ots

Department of Occupational Therapy Posters and Presentations

Description of project

Occupational therapy students from Jefferson School of Health Professions in Philadelphia planned and implemented interactive exhibits within the virtual world of Second Life®. The educational exhibits were provided through an ongoing project designed to promote occupational therapy, provide immersive experiences on health and wellness for persons in Second Life® and promote collaboration between project personnel and others with an interest in health and wellness. Exhibits focused on home and playground adaptations, mental health and productive aging and were based on current research evidence and best practices. Students also participated in events in which they promoted occupational therapy …

Aging Enhances Serum Cytokine Response But Not Task-Induced Grip Strength Declines In A Rat Model Of Work-Related Musculoskeletal Disorders., Dong L Xin, Michelle Y Harris, Christine K Wade, Mamta Amin, Ann E Barr, Mary F Barbe

Department of Physical Therapy Faculty Papers

BACKGROUND: We previously reported early tissue injury, increased serum and tissue inflammatory cytokines and decreased grip in young rats performing a moderate demand repetitive task. The tissue cytokine response was transient, the serum response and decreased grip were still evident by 8 weeks. Thus, here, we examined their levels at 12 weeks in young rats. Since aging is known to enhance serum cytokine levels, we also examined aged rats.

METHODS: Aged and young rats, 14 mo and 2.5 mo of age at onset, respectfully, were trained 15 min/day for 4 weeks, and then performed a high repetition, low force (HRLF) …

Development Of A Fidelity Measure For Research On The Effectiveness Of The Ayres Sensory Integration Intervention., L Diane Parham, Susanne Smith Roley, Teresa A. May-Benson, Jane Koomar, Barbara Brett-Green, Janice P Burke, Ellen S. Cohn, Zoe Mailloux, Lucy J. Miller, Roseann C. Schaaf

Department of Occupational Therapy Faculty Papers

OBJECTIVE: We developed a reliable and valid fidelity measure for use in research on Ayres Sensory Integration (ASI) intervention.

METHOD: We designed a fidelity instrument to measure structural and process aspects of ASI intervention. Because scoring of process involves subjectivity, we conducted a series of reliability and validity studies on the process section. Raters were trained to score therapist strategies observed in video recordings of adult-child dyads. We examined content validity through expert ratings.

RESULTS: Reliability of the process section was strong for total fidelity score (ICC = .99, Cronbach's alpha = .99) and acceptable for most items. Total score …

What's Going On Here? Deconstructing The Interactive Encounter., Janice P Burke

Department of Occupational Therapy Faculty Papers

Eleanor Clarke Sagle Lecture

A Clincial Outcomes Commentary On "A Longitudinal Study Of Outcome Measures For Children Receiving Early Intervention Services", Marcia Levinson, Pt, Phd, Mft, Rosaleen Creedon Gnoffo, Pt, Ms, Dpt, Pcs

Department of Physical Therapy Faculty Papers

Pediatric physical therapy, especially in early intervention (EI), focuses on children’s function in natural environments and within daily routines. Valid and reliable tests measuring the ICF participation component are important to consider if we are to align our treatment focus and goals to our measures of progress. This article demonstrates that the Pediatric Evaluation of Disability Inventory (PEDI) Functional Skill scaled scores are sensitive to change in children receiving EI with and without motor involvement.