Rehabilitation and Therapy Commons^™

“Your Legs Don’T Look All That Good” An Analysis Of Impoliteness And Politeness In Individuals With Traumatic Brain Injuries In The Workplace, Grace Kozal

Theses and Dissertations--Communication Sciences and Disorders

Background: Social communication disorders are a common outcome from traumatic brain injury (TBI). This social communication disorder can be seen through impolite speech acts during conversation. While politeness is a social norm for workplace discourse, instances of impoliteness may have poor consequences. This research explores the use of impoliteness in persons with TBI within computer generated work-based conditions.

Methods: Language samples from the Voicemail Elicitation Task (VET) and Feedback/Advice Spoken Task (FAST) were transcribed word-for-word. Transcripts from all 62 participants were coded for impoliteness using a developed Impoliteness Codebook and were analyzed to identify significant differences in the number of …

The Experience Of Meditation, And Its Effects On Attention, For Adults With Stroke Or Attention Deficit Hyperactivity Disorder: A Three-Part Dissertation With Qualitative And Quantitative Evidence, Cheryl Carrico

Theses and Dissertations--Rehabilitation Sciences

Impairment of attention is common after stroke; is a defining characteristic of attention deficit hyperactivity disorder (ADHD); and has been shown to correlate significantly with difficulties in daily life for individuals with these conditions. More research is needed to establish effective interventions addressing impaired attention in such cases. Meditation is not a standard-of-care intervention for this purpose but may have therapeutic potential. Meditation has been broadly defined as an activity which has self-regulation of attention as its main aim. In other words, it can be considered a training of attention. To shed light on the therapeutic potential of meditation, including …

Evaluating The Microbiome To Boost Recovery From Stroke: The Embrs Study, Tyler Hammond

Theses and Dissertations--Neuroscience

Accumulating evidence suggests that gut microbes modulate brain plasticity via the bidirectional gut-brain axis and may play a role in stroke rehabilitation. A severely imbalanced microbial community has been shown to occur following stroke, causing a systemic flood of neuro- and immunomodulatory substances due to increased gut permeability and decreased gut motility. Here we measure post-stroke increased gut dysbiosis and how it correlates with gut permeability and subsequent cognitive impairment.

We recruited 12 participants with acute stroke, 12 healthy control participants, and 18 participants who had risk factors for stroke, but had not had a stroke. We measured the gut …

Neurophysiological And Psychological Characteristics Of Individuals With History Of Lateral Ankle Sprain, Katherine Bain

Theses and Dissertations--Rehabilitation Sciences

Lateral ankle sprain (LAS) is among the most common lower limb musculoskeletal injuries impacting both the general and sport populations. Even more problematic is that approximately 70% of individuals who sustain an LAS develop residual deficits. Of that subgroup, roughly 40% develop chronic ankle instability (CAI). Chronic ankle instability is a clinical diagnosis defined by the presence of ongoing impairments following the initial LAS which may include perceived instability, pain, mechanical instability, and episodes of giving way during physical activity. Not all who sustain multiple ankle sprains or experience residual deficits fit the clinical diagnosis criteria for CAI; yet may …

Increasing Social Inclusion For Children With Disabilities In Faith-Based Settings: A Four-Part Dissertation, Valerie Miller

Theses and Dissertations--Rehabilitation Sciences

The aim of this dissertation is to increase the body of research in occupational therapy about how to increase the social inclusion of children with disabilities in faith-based settings. Even since the advent of important legislation like the Americans with Disabilities Act, which paved the way for community participation for individuals with disabilities, individuals with disabilities continue to face barriers to participating in society. Decreased inclusion for individuals with disabilities is seen throughout all sectors of society. One area of regular societal participation for many Americans is in faith-based settings such as churches, synagogues and temples. It has been reported …

Content Validation Of A Patient-Reported Outcome Measure For Pediatric Clients With Hand And Upper Extremity Impairment, Jenny M. Dorich

Theses and Dissertations--Rehabilitation Sciences

Occupational therapists and physical therapists practicing in hand therapy have adopted routine use of patient reported outcome measures (PROMs) for evaluating treatment outcomes. However, the PROMs currently used in pediatric hand care are limited in clinical utility for the pediatric population. Thus, a need exists for developing a PROM that is tailored to the pediatric hand therapy population. The overarching purpose of this dissertation is to establish the content validity of a novel PROM for children with hand and upper extremity impairment – the Upper Extremity Life Impact Measure-Youth (UE LIM-Y).

This three-part dissertation applies published standards for PROM development …

Patient And Therapist Perceptions Of Respiratory Functioning Due To Spinal Cord Injury: Implications For Music Therapists, A'Marie Dotson

Theses and Dissertations--Music

Decreased respiratory functioning is a common symptom of spinal cord injury (SCI) and can impact individuals’ personal, professional, and social lives. In spite of this, researchers have not explored the use of music in the lives of individuals with SCIs or music’s role in their healthcare professionals’ treatment plans to improve respiratory functioning. The purpose of this qualitative study was to better understand how decreased respiratory functioning affects individuals with SCIs and healthcare professionals through a multiple case study design. Participants were two individuals with SCIs and three healthcare professionals (physical therapist, recreational therapist, and music therapist) who worked with …

Etiology Of Firefighter Injuries: A Health Care Practitioner Perspective, Alyssa Quinn Eastman

Theses and Dissertations--Kinesiology and Health Promotion

BACKGROUND: Structural firefighting involves the performance of rigorous occupational tasks in unpredictable, dynamic, and hot environments which increases firefighters’ risk of injury. Specifically, the National Fire Protection Association reported that musculoskeletal injuries account for 56% of non-fireground and 41% of fireground injuries. Furthermore, physical training is the most common cause of injury, accounting for one-third of all injuries and resulting in 41% of post-injury absences from work. There is limited research identifying occupational and exercise injury risk factors among firefighters. However, experienced health care practitioners working with fire departments may provide critical insight into potential mechanisms of these common injuries. …

Cognitive-Motor Interactions In Gait And Postural Control And Cortical Network Neurocorrelates, Nathan Morelli

Theses and Dissertations--Rehabilitation Sciences

The ability to mitigate performance decrements during the concurrent completion of cognitive and motor tasks (i.e., dual task (DT)) deteriorates in patients with mild Traumatic Brain Injury (mTBI). It is theorized that the long-term sequelae of mTBI are due to the return to full activity prior to neurophysiologic healing. To mitigate the negative outcomes associated with mTBIs, translational clinical research of neurophysiologic recovery is of paramount importance for both athletic and non-athletic populations. Despite the well-known health consequences, clinical decisions regarding neurophysiologic recovery and return to activity remain problematic for clinicians. Return to activity decisions are currently based on normalization …

Evaluation Of The Effectiveness Of A Pain Neuroscience Education Curriculum For Patients Who Experience Chronic Musculoskeletal Pain With Concurrent Opioid Dependence, Nicole D. Windsor

Theses and Dissertations--Rehabilitation Sciences

Background: Chronic musculoskeletal pain (CMP) is estimated to affect over 100 million adults annually and is targeted as an instigator of opioid dependence (OpD). Opioid medications are often the first response for patients suffering from CMP, but over 10 million people annually admit to misusing opioids. With the opioid epidemic, the healthcare system now has a population of patients who experience CMP with concurrent OpD. This persistent problem creates a perfect storm of fear of movement, low self-efficacy, and physical dysfunction. A critical component to chronic pain management is understanding how patients view their pain experience. Education may be one …

Changing The Perspective In Management Of A Progressive Neurological Disorder: Developing Interventions To Target Multifactorial Components Of Parkinson’S Disease With Emphasis On Improving Clinical Meaningful Outcomes, Jordana Christine Lockwich

Theses and Dissertations--Rehabilitation Sciences

Neurological disorders are currently the leading source of disability in the United States with Parkinson’s disease (PD) having the fastest growing incidence rate (Abate et al., 2017). PD is the second most common degenerative disease in older adults above 60 years old (Tysnes & Storstein, 2017) and epidemiology reports predict that the number of PD cases has doubled to 6 million since 1990 (Dorsey, Sherer, et al., 2018) It is estimated that PD prevalence will continue to rise with a projected 60,000 new cases in the United States by 2030 (Dorsey, Elbaz, et al., 2018) and has the potential to …

Relationship Between Preoperative Frailty And Postoperative Outcomes After Lvad Implantation, Katherine L. Wilhelm

DNP Projects

Abstract

Background: Frailty is common in many patients with advanced heart failure, including those who undergo left ventricular assist device (LVAD) implantation. Frailty has been associated with worse outcomes after other cardiac surgeries; however, little is known about the effect of frailty on postoperative outcomes after LVAD implant.

Purpose: The purpose of this project was to evaluate whether preoperative frailty [as determined by either short physical performance battery (SPPB) score ≤ 7/12 or 6-minute walk test (6-MWT) <200 >meters] is associated with poorer postoperative outcomes after LVAD implantation than non-frailty in adults with advanced heart failure.

Setting and Sample: This project …

Beyond The Treatment Protocol: Active Ingredients For Precision Voice Rehabilitation, Maria H. Bane

Theses and Dissertations--Rehabilitation Sciences

Despite the growing body of research demonstrating voice therapy efficacy, only 12 of 100 people referred to a speech-language pathologist (SLP) for a voice evaluation will successfully complete therapy. One possible reason for this discrepancy is that clinical laboratory and clinical outcomes studies have focused on if voice therapy works while failing to explain how voice therapy works. While the if question is important, the yes or no response this question generates is of limited utility when those referred for voice therapy fail to complete. Consequently, the how question, which concentrates on the mechanisms and processes underlying effective voice therapy, …

Effect Of Blood Flow Restriction Training On Functional And Self-Reported Outcomes In Female Runners With Patellofemoral Pain, Lauren Nicole Erickson

Theses and Dissertations--Rehabilitation Sciences

Background: Patellofemoral pain (PFP) is the leading cause of lower extremity injury in female runners, significantly limiting running ability and becoming chronic in nearly 50% of the cases. This condition, which presents as pain around (peripatellar) or behind (retropatellar) the patella, is associated with significant weakness of the quadriceps and gluteal musculature, as well as altered movements mechanics. The challenge for clinicians is designing an effective treatment program to reduce pain and improve function without causing symptoms to flare. Blood flow restriction training (BFRT) is a relatively new training method within rehabilitation that involves placing a pressurized cuff to the …

The Influence Of Physical Health, Emotional Health, And Socioeconomic Factors On The Musculoskeletal Pain Experience In Patients Attending A Pro Bono Physical Therapy Clinic, Garrett Naze

Theses and Dissertations--Rehabilitation Sciences

Non-communicable, chronic diseases are highly prevalent in the United States, reducing the quality of life for those affected and contributing to the majority of the nation’s healthcare expenditure. These conditions include, among others, cardiovascular disease, diabetes, and musculoskeletal disease. Musculoskeletal disease is particularly of interest for the field of physical therapy as the vast majority of patients seeking care in the outpatient setting present with musculoskeletal pain complaints, resulting in limitations in function, participation, and quality of life for the patient.

The factors influencing health outcomes are diverse and include a person’s physical environment, social and economic factors, access to …

Development Of A Field Expedient Screening Tool For The Coach To Identify Musculoskeletal Risk Factors In Baseball Players, Kyle Andrew Matsel

Theses and Dissertations--Rehabilitation Sciences

Identification of musculoskeletal (MSK) injury risk factors in baseball players can be challenging particularly for youth and high school coaches. Many baseball coaches lack a sports medicine and/or strength and conditioning staff to assist with injury prevention initiatives. Given the extensive responsibilities in managing the team and preparing the players for athletic competition, little time remains to focus on injury prevention and arm care programs. Furthermore, assessment, diagnosis, and management of MSK impairments is outside the scope of practice and expertise of baseball coaches. However, educating and empowering the coach to efficiently screen their players for potentially injury producing MSK …

Clinical And Neurophysiological Effects Of Dry Needling On Individuals With Chronic Ankle Instability, Jennifer Mullins

Theses and Dissertations--Rehabilitation Sciences

Ankle sprains are generally considered innocuous injuries; however, as many as 74% of patients will develop chronic symptoms. 1-3 Chronic ankle instability (CAI) is defined by a history of ankle sprain accompanied by ongoing bouts of giving way, residual ankle sprain symptoms, and a decrease in patient-perceived function. As understanding of sensorimotor deficits in individuals with CAI have advanced, treatment strategies have evolved to include a robust focus on balance training to mitigate dynamic and static postural control impairments exhibited in individuals with CAI. A problem arises as these improvements have not been conclusively linked to a decrease in CAI. …

Psychosocial Predictors Of Chronic Pain And Pain-Related Disability 12 Months After Lower Extremity Fracture, Joshua Judson Van Wyngaarden

Theses and Dissertations--Rehabilitation Sciences

Over 700,000 lower extremity fractures occur each year with a large portion of these patients developing adverse long-term pain and disability outcomes. Current literature indicates that 39% to 62.7% of all patients report continued pain long after traumatic lower extremity fracture. Concurrent physical limitations and reduced quality of life are common, with nearly one-third of all patients reporting pain-related disability seven years after limb threatening trauma, and approximately 50% of these patients having limitations in functional mobility and activities of daily living at long-term follow-up. These poor long-term injury-related pain and disability outcomes are alarming and require further action to …

An Evaluation Of Postural Control And Balance After Anterior Cruciate Ligament Reconstruction, Kathryn Lucas

Theses and Dissertations--Rehabilitation Sciences

Over 100,000 anterior cruciate ligament reconstructions (ACLR) occur annually in the United States, with one in four individuals sustaining a second injury within the first two years after reconstruction. Due to the proprioceptive nature of the anterior cruciate ligament, the lack of regaining postural control and balance are likely large contributors to the rate of secondary injuries after ACLR. Recent literature has identified cerebral changes after anterior cruciate ligament injury and surgery, likely due to altered sensation and feedback loops. However, no study thus far has investigated the neurological feedback loops that may place this group at higher risk of …

Evaluation Of A Concussion Management And Discharge Education Training Module For Emergency Department Nurses, Carmen Frede

DNP Projects

Purpose: The purpose of this project was to improve the Emergency Department (ED) nurses’ knowledge on identifying patients at risk for concussions and delivering effective concussion discharge education using an educational training intervention.

Methods: This project used a descriptive, non-randomized pre-post survey design. Participation involved three stages: a pre-education survey to assess baseline concussion education knowledge, an educational intervention consisting of a narrated PowerPoint presentation, and a post-education survey to evaluate knowledge on concussion discharge education. The intervention was delivered online via the UK Canvas educational platform.

Results: The majority of nursing staff participants were female (97%) and had a …

Physical And Occupational Therapy For Young Children With Delayed Motor Development: Exploring Current Practices, Challenges, And Families’ Implementation Of Home Activities In Early Intervention, Afnan Gmmash

Theses and Dissertations--Rehabilitation Sciences

The literature supports the use of family-centered early intervention(EI) for young children with or at risk for cerebral palsy (CP) to promote the children’s motor development. Young children with or at risk for delayed motor development in their first three years of life are entitled to EI under Part C of The Individuals with Disabilities Education Improvement Act. Identifying current EI provided for young children with delayed motor development is essential to detect possible gaps and factors that could prevent therapists from providing the best EI. Understanding the parent’s perspective on the implementation of activities outside therapy to maximize the …

Effects Of Load Carriage On Shoulder Neuromuscular Functions And Recovery, Muataz R. Almaddah

Theses and Dissertations--Rehabilitation Sciences

Load carriage is a primary source for injury occurrence among military personnel and recreational hikers affecting all body areas. The shoulder ranks as the second or third most common site of injuries among military personnel. Many studies report that elevations in self-reported fatigue, soreness, and discomfort in the shoulders accompany the load carriage. Almost 50% of military personnel experienced a load carriage injury during the first episode of training, and 75% of those injured suffered a second injury during their career. The goal of this research project is to investigate the components associated with load carriage shoulder symptoms to determine …

Influences Of Functional And Psychological Factors On Biomechanics Following An Anterior Cruciate Ligament (Acl) Reconstruction, Chelsey Roe

Theses and Dissertations--Rehabilitation Sciences

Objective: The aims of this research were to identify gaps in the literature related to return to sport (RTS) test batteries following primary anterior cruciate ligament reconstruction (ACLR) (Aim 1) and define recovery in athletes from 4-9 months after ACLR across three domains: 1) psychological recovery and biomechanics (Aim 2), 2) rehabilitation quantity and biomechanics (Aim 3), and 3) functional performance and biomechanics (Aim 4). Ultimately, the results of this research would quantify recovery following ACLR in athletes with a desire to RTS and identify objective criteria throughout rehabilitation prior to RTS.

Participants: Twenty-two post-ACLR athletes 17 females, 8 males, …

Clinical Measurements Of The Posterior Shoulder Endurance Test (Pset), Neil A. Evans

Theses and Dissertations--Rehabilitation Sciences

Of the intrinsic factors responsible for non-traumatic shoulder pain, muscular endurance is often not measured by rehabilitation professionals due to the lack of available shoulder endurance measures. Measurement properties of the PSET have not been adequately assessed in previous studies. The purpose of this dissertation was to develop the clinical measurement properties of the Posterior Shoulder Endurance Test (PSET) so that it might be used as a clinical measure of shoulder muscular endurance.

Electromyography (EMG) offers the ability to identify which muscles in the posterior shoulder girdle are fatiguing during the PSET. Surface EMG of upper trapezius (UT), middle trapezius …

Biopsychological Predictors Of Pain And Function In Patients With Rotator Cuff Conditions, Nicole Cascia

Theses and Dissertations--Rehabilitation Sciences

Predicting worse patient-reported outcomes in those with Rotator Cuff (RC) conditions is dependent on examining both biological and psychological impairments. In order to help determine which biopsychological factors are associated with pain and function in patients with RC related conditions and to determine who may be at an increased risk for worse outcomes after Reverse Shoulder Arthroplasty (RSA), biopsychological associations between patient demographics, scapular motion, humeral motion, RC tear size, pain associated psychological distress, and function were clinically evaluated to investigate prediction models for pain and function. The central hypothesis is that in a group of patients with symptomatic Cuff …

Vestibular Function And Sports-Related Concussion: An Exploratory Investigation Of The Consequences Of Sports Related Concussion On Vestibular Function And Outcomes, Carolina Quintana

Theses and Dissertations--Rehabilitation Sciences

Sports-related concussions (SRC), or mild traumatic brain injuries that occur as a result of sports or athletic participation, are said to affect approximately 300,000 young adults and 1.4 million youth athletes in the United States on an annual basis. SRC create a significant burden on the health care system by generating an estimated $60 billion dollars in direct and indirect costs in 2000. In addition to the financial burden these injuries create, they additionally impose both short- and long-term effects for those effected and their overall health. Among the many effects of concussions are physical signs as symptoms such as …

Knee Joint Loading Following Anterior Cruciate Ligament Reconstruction: Link To Patient Reported Outcomes And A Novel Method To Monitor With Wearable Sensors, Alex Spencer

Theses and Dissertations--Kinesiology and Health Promotion

Recovery from anterior cruciate ligament reconstruction (ACLR) commonly results in undesirable physical and patient-reported outcomes (PROs). Identification of modifiable factors such as knee contact force (KCF) early in rehabilitation that can improve these outcomes is important due to the rapid decrease in function, quality of life, and joint health in this population. Additionally, if noninvasive measurement of KCFs outside of a traditional laboratory were possible, clinicians could optimize patient treatment with personalized care. Therefore, there are two primary aims to this thesis: 1) quantify the link between KCF and PROs which measure pain, ability to perform activities of daily living, …

Leadership Development In Physical Therapy: Moving Toward A Community Of Transformative Practitioners, Kerry Cronin Mallini

Theses and Dissertations--Educational Leadership Studies

Physical therapy as an emerging profession is committed to establishing its identity and solidifying its role as a leader in health care. With expertise in human movement, wellness, and disease prevention, physical therapists possess invaluable knowledge and skill to influence public health and enhance patient recovery without increasing cost. Physical therapists have the opportunity to transform the delivery of public health services to meet current and future needs. A major challenge, however, is a dearth of leadership development in preparation programs. Because most physical therapists have not received formal education or explicit training in leadership, a problem of practice exists. …

A Brain-Computer Interface For Closed-Loop Sensory Stimulation During Motor Training In Patients With Tetraplegia, Sarah Helen Thomas

Theses and Dissertations--Biomedical Engineering

Normal movement execution requires proper coupling of motor and sensory activation. An increasing body of literature supports the idea that incorporation of sensory stimulation into motor rehabilitation practices increases its effectiveness. Paired associative stimulation (PAS) studies, in which afferent and efferent pathways are activated in tandem, have brought attention to the importance of well-timed stimulation rather than non-associative (i.e., open-loop) activation. In patients with tetraplegia resulting from spinal cord injury (SCI), varying degrees of upper limb function may remain and could be harnessed for rehabilitation. Incorporating associative sensory stimulation coupled with self-paced motor training would be a means for supplementing …

Injury-Related Fear In Patients After Anterior Cruciate Ligament Reconstruction, Shelby Elyse Baez

Theses and Dissertations--Rehabilitation Sciences

Approximately 200,000 anterior cruciate ligament (ACL) injuries occur each year with about 100,000 of these injuries undergoing reconstruction (ACLR). The impetus of ACLR is to allow previously high functioning, physically active individuals to return to desired levels of sports participation and to engage in recommended levels of physical activity. However, 1 out of 3 patients after ACLR fail to return to competitive levels of sport and meet recommended levels of physical activity. Injury-related fear has been cited as the primary barrier for failure to return to sport. However, the research has been primarily qualitative in nature and limited research has …