Rehabilitation and Therapy Commons^™

Clinical Case Study: The Effects Of Task Dynamics And Saltatory Pneumotactile Stimulation On Cerebral Oxygenation, Cognitive Performance, And Sensorimotor Function In An Adult Following Left Ischemic Mca Stroke, Bridget Slagle

College of Education and Human Sciences: Dissertations, Theses, and Student Research

In the chronic stage of stroke recovery, neuroplasticity is thought to require external influence, and is often considered to be experience-dependent, or “Hebbian,” plasticity. Current studies have been investigating multiple ways to induce plasticity to enhance recovery, including investigating the role of sensory stimulation in cortical priming to enhance the effects of rehabilitation interventions.

This case study of an 80-year-old female with aphasia after L-MCA ischemic stroke included 18 neurotherapeutic sessions over 10 weeks. Each session included pneumotactile somatosensory stimulation to the glabrous hand and perioral face, delivered to both the left and right side via the GALILEO, as well …

Patient Facing Physical Therapy Clinicians’ Experience Of Leader Development Across Their Professional Span: A Phenomenological Inquiry, Judith R. Gelber

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

While healthcare professions call for leadership among its practitioners as a key function of practice, hospital systems typically employ a top town leadership structure. In physical therapy, leadership is centered around managers and educators. This leaves a gap in understanding about leadership at the level of the patient facing clinician. This study explored the experience of leader development across the career span of experienced patient facing physical therapists in the United States. The study used a hermeneutic phenomenological approach undergirded with leader development, experiential learning, and distributed leadership theories. Participant recruitment focused on patient facing physical therapists with ten or …

The Effect Of Cerebral Somatosensory Network Priming On Language Function In Chronic L-Mca Ischemic Stroke: A Companion Case Study, Mandelin E. Wollesen

College of Education and Human Sciences: Dissertations, Theses, and Student Research

Chronic aphasia following a left middle cerebral artery (L-MCA) stroke is often associated with limited recovery beyond the acute phase, necessitating interventions that target neuroplastic mechanisms. This study examined the effects of somatosensory pneumotactile stimulation paired with cognitive-linguistic tasks on functional language performance in an individual with chronic aphasia. Using a single-subject pre-post design, the participant completed a 10-week intervention protocol involving repeated pneumotactile stimulation via the GALILEO system combined with language and motor tasks. Outcomes were assessed using standardized measures, discourse-based language samples, oral reading, repetition, and phonemic verbal fluency. Discourse was analyzed using Correct Information Units (CIUs), words …

Effects Of Ndbi With Just-In-Time Programming Of Vsds On Communication Of Children With Asd, Jenna M. Rogers

College of Education and Human Sciences: Dissertations, Theses, and Student Research

Autism Spectrum Disorder (ASD) is a prominent neurological and developmental disability that often requires communication support, such as Augmentative and Alternative Communication (AAC). Visual Scene Displays (VSDs) are an AAC support that directly immerses in the user’s life, using images from real environments the user has or may experience. Naturalistic Developmental Behavioral Intervention (NDBI) is an evidence-based approach to early intervention that targets social communication during naturalistic routines, including those who rely on AAC support to communicate. Despite recent research indicating that combining NDBI and AAC is a promising approach (Pope et al., 2024), no studies to date have examined …

Chronic Pain After Traumatic Brain Injury: Treatment Experiences And Effects On Cognition And Functioning, Rachael L. Snyder

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

Traumatic brain injury (TBI) can contribute to changes in cognitive and emotional functioning, quality of life, and psychosocial reintegration. Chronic pain is a common consequence of TBI which can uniquely impact such outcomes. Still, the exact nature of the contribution of pain on post-TBI outcomes remains unclear, and there are few existing studies exploring the treatment journey for chronic pain and injury rehabilitation through qualitative methods, specifically individual interviews with TBI survivors. This study aimed to document these narratives and to identify precisely how the experiences of TBI survivors seeking treatments, rather than the treatments themselves, impact outcomes. It also …

Applications Of Preclinical Magnetic Resonance Imaging In The Treatment Of Traumatic Brain Injury And Understanding Carotid Artery Atherosclerosis, Evan Timothy Curtis

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

Advances in magnetic resonance imaging (MRI) provide the opportunity to investigate research questions that have been left unanswered. In the cases of traumatic brain injury (TBI) and carotid artery atherosclerosis, MRI is a resource for non-invasively viewing the phenomena taking place. Additionally, potential interventions and treatments can be observed without harm to the subject. This dissertation expands the understanding of two preclinical applications of MRI: traumatic brain injury and carotid artery atherosclerosis in mouse models.

TBI is a leading cause of death and disability for individuals between 15–45 years of age and effective pharmaceutical interventions for treating the secondary damage …

The Tree That Would Not Fall: An Educator’S Autoethnographic Journey Of Healing Through Words, Raeanna Marie Carlson

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

To say the world has changed since the 2020 COVID-19 shut down is to minimize the micro and macro social changes that infiltrated the school system. In the wake of it all, we find a landscape marred by a both rising teacher attrition and struggling student motivation. This autoethnographic dissertation explores the deeply personal experience tethered to a deeply problematic system that contributes to not only teacher burnout but what I came to know as teacher demoralization. Personal traumas of teachers profoundly impact their experience in the classroom, and as I examined my own near departure from the classroom, I …

Enhancing The Eden Alternative Model With Well Standards: A Case Study Analysis, Mariah Stoner

Architecture Masters of Science Program: Theses

This thesis investigates the potential for improving the Eden Alternative Model, a person-centered approach to elder care that emphasizes creating a homelike environment and meaningful relationships, using WELL Standards, a building certification system focused on enhancing human health and well-being through improvements in environmental quality. Through a mixed-methods approach involving quantitative data analysis and qualitative case studies, this research examines how WELL Standards, which cover aspects such as air quality, water quality, lighting, and thermal comfort, can improve environmental quality and resident satisfaction within the Eden Alternative Model. This research introduces a tailored approach to elder care by combining these …

Addressing The Lack Of Patient Adherence To Exercise Within The Physical Therapy Clinic And Creating Infographics To Improve Patient Adherence, Gretchen Panovich

Honors Program: Senior Projects (Public)

The primary objective of this applied knowledge project is to develop educational materials to enhance patient adherence. The World Health Organization defines adherence as “the extent to which a person’s behavior…corresponds with agreed recommendations from a healthcare provider.” Within the physical therapy field, non-adherence to exercise is a significant problem linked with increased duration of treatment, more patient complaints, reduced positive clinical outcomes, and even surgical intervention.

Multiple factors affect patient adherence, making it hard to pinpoint a singular cause. Clinical observations and research suggest that belief in the rehabilitation process may suffer due to a prolonged recovery period, lack …

Clinical Case Study: The Effects Of Saltatory Pneumotactile Stimulation Of Glabrous Hand And Perioral Face On Cerebral Oxygenation, Cognitive Performance, And Sensorimotor Function In An Adult Following Left Hemorrhagic Stroke, Tara L. Hull

College of Education and Human Sciences: Dissertations, Theses, and Student Research

Stroke remains a leading cause of adult disability and a significant global health concern. Effective rehabilitation strategies for cognitive and communicative impairments following stroke are limited (Kuhn & Sharman, 2023). One emerging approach involves repetitive somatosensory stimulation to drive cerebral hemodynamic changes, potentially offering a novel rehabilitative method. Functional Near-Infrared Spectroscopy (fNIRS) is a non-invasive, accessible tool for monitoring these changes during stroke recovery. Prior studies suggest tactile stimulation rapidly affects brain hemodynamics (Custead et al., 2015; Oh et al., 2017). This clinical single-case study explored the use of GALILEO saltatory pneumotactile stimulation applied to the face and hand in …

The Effects Of Anchor Scheme On The Central And Peripheral Contributions To Performance Fatigability, Perceived Responses And Sensations, And Psychological Factors Following Sustained, Isometric Forearm Flexion Tasks To Failure, Robert Walker Smith

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

The Effects of Anchor Scheme on the Central and Peripheral Contributions to Performance Fatigability, Perceived Responses and Sensations, and Psychological Factors Following Sustained, Isometric Forearm Flexion Tasks to Failure Robert W. Smith, Ph.D. University of Nebraska, 2024 Advisor: Terry J. Housh This study assessed time to task failure (TTF), performance fatigability (PF), neuromuscular responses, central and peripheral measures of fatigue, and perceived responses including sensations and psychological factors that contributed to task termination during sustained, isometric forearm flexion tasks anchored to ratings of perceived exertion (RPE) and the torque corresponding to RPE. Fifteen men (age = 21.5 ± 2.3 yrs; …

Using Machine Learning To Determine A Functional Classifier Of Reward Responsiveness And Its Association With Adolescent Psychiatric Symptomatology, Robert James Richard Blair, Johannah Bashford-Largo, Ahria Dominguez, Matthew Dobbertin, Karina S. Blair, Sahil Bajaj

Center for Brain, Biology, and Behavior: Faculty Publications

Background. Machine learning (ML) has developed classifiers differentiating patient groups despite concerns regarding diagnostic reliability. An alternative strategy, used here, is to develop a functional classifier (hyperplane) (e.g. distinguishing the neural responses to received reward v. received punishment in typically developing (TD) adolescents) and then determine the functional integrity of the response (reward response distance from the hyperplane) in adolescents with externalizing and internalizing conditions and its associations with symptom clusters.

Methods. Two hundred and ninety nine adolescents (mean age = 15.07 ± 2.30 years, 117 females) were divided into three groups: a training sample of TD adolescents …

Second Language Learning In Older Adults Modulates Stroop Task Performance And Brain Activation, Douglas H. Schultz, Alison Gansemer, Kiley Allgood, Mariah Gentz, Lauren Secilmis, Zoha Deldar, Cary R. Savage, Ladan Ghazi Saidi

Center for Brain, Biology, and Behavior: Faculty Publications

Introduction: Numerous studies have highlighted cognitive benefits in lifelong bilinguals during aging, manifesting as superior performance on cognitive tasks compared to monolingual counterparts. Yet, the cognitive impacts of acquiring a new language in older adulthood remain unexplored. In this study, we assessed both behavioral and fMRI responses during a Stroop task in older adults, pre- and post language-learning intervention.

Methods: A group of 41 participants (age: 60–80) from a predominantly monolingual environment underwent a four-month online language course, selecting a new language of their preference. This intervention mandated engagement for 90 minutes a day, five days a week. …

Performance Fatigability And Neuromuscular Responses During And After One Set Of Forearm Flexion Muscle Actions To Failure At 30% Versus 70% One-Repetition Maximum In Men And Women, Tyler Joseph Neltner

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

Previous studies have examined sex differences in performance fatigability during isometric, isokinetic and controlled dynamic constant external resistance (DCER) fatiguing tasks (FT), however, whether those sex differences remain during maximal intended velocity (MIV) DCER muscle actions remains unclear. The purpose of this study was to examine the sex-related differences in the time course of fatigue, neuromuscular responses, and coactivation from the ipsilateral and contralateral limbs during MIV DCER muscle actions to failure at low versus high relative loads, as well as performance fatigability from pre- to post-testing. Twenty-seven college-aged men (n = 14) and women (n = 13) …

Less Activity Means Improved Welfare? How Pair Housing Influences Pinyon Jay (Gymnorhinus Cyanocephalus) Behaviour, London M. Wolff, Jeffrey R. Stevens

Center for Brain, Biology, and Behavior: Faculty Publications

The activity level and specific behaviours exhibited by captive animals are crucial indicators of welfare. Stereotypies, or repetitive behaviours that have no apparent function or goal, are performed by animals experiencing poor conditions in their environment and indicate welfare concerns. Changes in the housing environment in particular may have critical influences on behaviour and welfare. Here, we measured behavioural changes in a captive pinyon jay (Gymnorhinus cyanocephalus) population (n = 10) associated with a shift from single to pair housing. Using automated video processing, we show that pair housing greatly reduced overall activity levels in these birds. The …

Playful Progress: A Parent's Guide To Growth And Development, Gabriella N. Lawrey

Honors Program: Senior Projects (Public)

This thesis presents a creative project aimed at empowering parents to recognize developmental achievements, as well as address potential developmental delays in their children. Grounded in the principles of child development, this project focuses on creating age-appropriate activities that facilitate the identification of developmental milestones. By utilizing foundational resources in the field of child development, this toolkit of engaging activities has been curated to support parental understanding and observation. The primary objective of this applied knowledge project is to better equip parents with the vocabulary and tools to facilitate their child’s development. Throughout these activities, parents are encouraged to engage …

Associations Of Sex And Sport Contact‑Level With Recovery Timelines Among Collegiate Athletes With Sport‑Related Concussion, Bernadette A. D'Alonzo, Andrea L. C. Schneider, Ian J. Barnett, Christina L. Master, Abigail C. Bretzin, Douglas J. Wiebe, Ivy League-Big Ten Epidemiology Of Concussion Study Investigators

Center for Brain, Biology, and Behavior: Faculty Publications

Background

Growing interest has motivated recent studies to examine differences in recovery after sportrelated concussion (SRC) by sex. However, heterogeneity in study design, participants, and recovery outcomes has led to mixed findings. Further work is needed to evaluate potential differences by sex and to investigate the role of related characteristics, such as sport contact-level, in recovery timelines. This study aimed to investigate whether concussion recovery trajectories differ by sex, considering a priori clinical and demographic covariates, and accounting for the sequence of recovery outcomes. Our secondary question was whether sport contact-level modifies the relationship between sex and time to outcomes. …

Instrumental Assessment Of Aero-Resistive Expiratory Muscle Strength Rehabilitation Devices, Angela M. Dietsch, Rahul Krishnamurthy, Kelsey Young, Steven M. Barlow

Department of Special Education and Communication Disorders: Faculty Publications

Purpose

Expiratory muscle strength training (EMST) is increasingly being used to treat voice, cough, and swallowing deficits in a wide range of conditions. However, a multitude of aero-resistive EMST models are commercially available, and the absence of side-by-side comparative data interferes with clinicians’ ability to assess which model is best suited to a particular client’s needs. The primary aim of this research was to test and compare the pressure and flow parameters of six currently available EMST models to help inform clinical decision making.

Method

We identified and tested five devices of each of six different EMST models to generate …

Providing Optimal Resident Sleep Hygiene In Assisted Living Communities; Opportunities For Design And Operation Teams To Collaborate And Share Their Unique Knowledge, Beverly B. J. Miller

Architecture Masters of Science Program: Theses

Research is emerging relating sleep hygiene to disease pathogenesis including Parkinson's, dementia, Alzheimer’s disease and increased cardiovascular risk. The application of circadian science as it relates to human wellness has intensified as a result. The quality of sleep significantly impacts the wellness of residents living in long term care, however sleep hygiene research is lacking in assisted living (AL) communities.

The thesis question inquires; How can operation and design teams collaborate to optimize sleep health for residents in assisted living communities? The research methodology utilized a two-phase process. Phase I identified three AL communities as test sites, providing case studies …

Covid‑19‑Related Risk, Resilience, And Mental Health Among Mexican American Mothers Across The First Year Of The Pandemic, Amy L. Non, Elizabeth S. Clausing, Sandraluz Lara‑Cinisomo, Kimberly L. D’Anna Hernandez

Center for Brain, Biology, and Behavior: Faculty Publications

Background Latina mothers have been especially affected by the pandemic and historically exhibit high rates of depression and anxiety. However, few longitudinal studies have assessed the effect of the pandemic on this vulnerable population. We hypothesized that COVID-19-related stressors would associate with psychological distress among Latina mothers across the first year of the pandemic.

Methods We investigated COVID-19-related impact, stigma, and fears across two critical time points and changes in these measures in relation to changes in maternal anxiety and depression among mothers of Mexican descent living in Southern California (n=152). Surveys were administered within 5–16 weeks of …

Reduced Grey Matter Volume In Adolescents With Conduct Disorder: A Region‑Of‑Interest Analysis Using Multivariate Generalized Linear Modeling, Ru Zhang, Robert James R. Blair, Karina S. Blair, Matthew Dobbertin, Jaimie Elowsky, Johannah Bashford‑Largo, Ahria J. Dominguez, Melissa Hatch, Sahil Bajaj

Center for Brain, Biology, and Behavior: Faculty Publications

Background

Conduct disorder (CD) involves a group of behavioral and emotional problems that usually begins during childhood or adolescence. Structural brain alterations have been observed in CD, including the amygdala, insula, ventrolateral and medial prefrontal cortex, anterior cingulate cortex, and fusiform gyrus. The current study developed a multivariate generalized linear model (GLM) to differentiate adolescents with CD from typically developing (TD) adolescents in terms of grey matter volume (GMV).

Methods

The whole‐brain structural MRI data were collected from 96 adolescents with CD (mean age = 16.188 ± 1.259 years; mean IQ = 104.292 ± 8.107 ; 63 males) and 90 …

Specialized Late Cingulo-Opercular Network Activation Elucidates The Mechanisms Underlying Decisions About Ambiguity, Jordan E. Pierce, Nathan M. Petro, Elizabeth Clancy, Caterina Gratton, Steven E. Petersen, Maital Neta

Center for Brain, Biology, and Behavior: Faculty Publications

Cortical task control networks, including the cingulo-opercular (CO) network play a key role in decision-making across a variety of functional domains. In particular, the CO network functions in a performance reporting capacity that supports successful task performance, especially in response to errors and ambiguity. In two studies testing the contribution of the CO network to ambiguity processing, we presented a valence bias task in which masked clearly and ambiguously valenced emotional expressions were slowly revealed over several seconds. This slow reveal task design provides a window into the decision-making mechanisms as they unfold over the course of a trial. In …

Assessing Blood Oxygen Level–Dependent Signal Variability As A Biomarker Of Brain Injury In Sport-Related Concussion, Evan D. Anderson, Tanveer Talukdar, Grace Goodwin, Valentina Di Pietro, Kamal M. Yakoub, Christopher E. Zwilling, David Davies, Antonio Belli, Aron K. Barbey

Center for Brain, Biology, and Behavior: Faculty Publications

Mild traumatic brain injury is a complex neurological disorder of significant concern among athletes who play contact sports. Athletes who sustain sport-related concussion typically undergo physical examination and neurocognitive evaluation to determine injury severity and return-to-play status. However, traumatic disruption to neurometabolic processes can occur with minimal detectable anatomic pathology or neurocognitive alteration, increasing the risk that athletes may be cleared for return-to-play during a vulnerable period and receive a repetitive injury. This underscores the need for sensitive functional neuroimaging methods to detect altered cerebral physiology in concussed athletes. The present study compared the efficacy of Immediate Post-concussion Assessment and …

Identification Of Structural Brain Alterations In Adolescents With Depressive Symptomatology, J. Bashford‑Largo, R. James R. Blair, Karina S. Blair, Matthew Dobbertin, Ahria Dominguez, Melissa Hatch, Sahil Bajaj

Center for Brain, Biology, and Behavior: Faculty Publications

Introduction: Depressive symptoms can emerge as early as childhood and may lead to adverse situations in adulthood. Studies have examined structural brain alternations in individuals with depressive symptoms, but findings remain inconclusive. Furthermore, previous studies have focused on adults or used a categorical approach to assess depression. The current study looks to identify grey matter volumes (GMV) that predict depressive symptomatology across a clinically concerning sample of adolescents.

Methods: Structural MRI data were collected from 338 clinically concerning adolescents (mean age = 15.30 SD=2.07; mean IQ = 101.01 SD=12.43; 132 F). Depression symptoms were indexed via the Mood …

Services Provided To Aging Individuals With Intellectual Disabilities: Survey Of Speech Language Pathologists, Claire H. Gatewood

College of Education and Human Sciences: Dissertations, Theses, and Student Research

Purpose: The present study explored current speech-language pathology service provision for aging individuals with intellectual disabilities in the United States, including areas and domains of services, factors restricting service provision, and reported knowledge and confidence of individuals within the field of speech-language pathology in providing services, to identify possible gaps of service and needed improvement.

Methods: Participants (n = 272) from across the United States completed an online survey to gather descriptive information about current speech-language pathology service provision for aging individuals with intellectual disabilities. Participants were recruited through state speech-language hearing associations and universities with speech-language pathology clinics …

Specialized Late Cingulo-Opercular Network Activation Elucidates The Mechanisms Underlying Decisions About Ambiguity, Jordan E. Pierce, Nathan M. Petro, Elizabeth Clancy, Caterina Gratton, Steven E. Petersen, Maital Neta

Center for Brain, Biology, and Behavior: Faculty Publications

Cortical task control networks, including the cingulo-opercular (CO) network play a key role in decision-making across a variety of functional domains. In particular, the CO network functions in a performance reporting capacity that supports successful task performance, especially in response to errors and ambiguity. In two studies testing the contribution of the CO network to ambiguity processing, we presented a valence bias task in which masked clearly and ambiguously valenced emotional expressions were slowly revealed over several seconds. This slow reveal task design provides a window into the decision-making mechanisms as they unfold over the course of a trial. In …

The Importance Of Mood And Motivation Of An Individual In The Success Of Physical Therapy, Spencer Wagner

Honors Program: Senior Projects (Public)

Physical therapy is a health profession that helps people improve their movement and range of motion in certain body areas. Since the time it was founded, physical therapists have mainly focused on the physical health of the patient. While that is their job, they may not have been as successful because they neglected the mental health of the patient. The mindset of an individual, particularly their mood and motivation, can influence how they progress through physical therapy and how successful they are in regaining functionality in their affected body area. The purpose of this study is to determine how the …

Emotionally Concussed: The Impact Of Pre-Existing Anxiety On Concussion Recovery, Grace Szucs

Honors Program: Senior Projects (Public)

Recent advances in concussion research have shed light on numerous mental and physiological factors that may complicate concussion recovery. Systematic reviews of the existing literature have found that premorbid mental health conditions such as depression and anxiety may be a predictor of complicated concussion recovery, but studies have not had an appropriate design to isolate anxiety or depression as a predictor of lengthened recovery. This study investigated if athletes with a history of premorbid anxiety and/or depression would have a longer time of recovery than athletes without this history. Male and female athletes from a Division-1 athletic department treated for …

Higher Sexual Excitation Is Associated With An Increase In Sex-Linked Substance Use In Women With A History Of Unwanted Sexual Contact, Harper R. Jones, Tierney K. Lorenz

Center for Brain, Biology, and Behavior: Faculty Publications

Survivors of unwanted sexual contact have an increased likelihood of using substances in sexual situations, which puts them at heightened risk for intoxication-related harms. Separately, research has indicated that women may intentionally use substances in sexual situations to either enhance pleasure (i.e., increase sexual excitation) and/or reduce sexual anxiety or shame (i.e., reduce sexual inhibition), a phenomenon termed sex-linked substance use (SLSU). A predominant assumption in the literature is that women with unwanted sex histories are more likely to disengage during sex, suggesting greater inhibition-related SLSU; however, there is little prior research directly examining if women who have unwanted sex …

Pre–Post Intervention Exploring Cognitive Function And Relationships With Weight Loss, Intervention Adherence And Dropout, Amanda N. Szabo-Reed, Laura E. Martin, Cary R. Savage, Richard A. Washburn, Joseph E. Donnelley

Center for Brain, Biology, and Behavior: Faculty Publications

Objective: To evaluate the association between baseline cognitive function, intervention dropout, adherence and 3-month weight loss (WL) when controlling for confounding demographic variables.

Methods: 107 (Mage = 40.9 yrs.), BMI in the overweight and obese range (BMI = 35.6 kg/m2), men (N = 17) and women (N = 90) completed a 3-month WL intervention. Participants attended weekly behavioral sessions, comply with a reduced calorie diet, and complete 100 min of physical activity (PA)/wk. Cognitive function tasks at baseline included Flanker (attention), Stroop (executive control) and working memory, demographics, body weight and cardiovascular fitness were assessed at baseline. Session attendance, adherence …