Rehabilitation and Therapy Commons^™

God, I Hope This Part Of My Life Is Over: A Focused Ethnography Of A Correctional Youth Facility’S Therapeutic Climate, Eric Meyer

Theses & Dissertations

Although all prisons have the same goal of isolating offenders from society, the precise strategies used vary from one jurisdiction to the next. Some prisons use means of punishment to gain inmate compliance. Other prisons concentrate their limited resources on rehabilitation. Contained within the following pages are details of a focused ethnography that was completed in a state correctional youth facility that housed males between the ages of 15 and 21 years, all of whom were convicted of violent crimes. This study had the objective of exploring the climate of therapy in this correctional youth facility where rehabilitative programs were …

Global Initiative Of The University Of Nebraska Medical Center To Improve Physical Therapy Education, Care And Science In China, Betsy J. Becker, Joseph F. Norman, Kyle Meyer, Ka-Chun Siu

Posters and Presentations: Physical Therapy

No abstract provided.

Valuation Of Scholarly Activities For Physical Therapy Faculty, Tony Rost, Mitchell Thompson, Harlan Sayles, Gilbert M. Willett, Betsy J. Becker

Posters and Presentations: Physical Therapy

Purpose/Hypothesis: Physical therapy (PT) faculty are required to participate in scholarly endeavors. Scholarly productivity is frequently evaluated based on quantity of production.^1-3 This approach fails to account for quality (e.g. authorship order, presentation audience, or funding). Study aims: 1) compare PT program scholarly productivity valuations between programs of varying Carnegie Classification, 2) establish a scholarly activity measure which accounts for quality, and 3) provide an applied example of the new measure. Number of Subjects: PT Program Directors from CAPTE institutions (n=226) were surveyed using Dillman’s protocol.⁴

Materials/Methods: Respondents were asked to value (0 – 20) 30 …

User Engagement Associated With Web-Intervention Features To Attain Clinically Meaningful Weight Loss And Weight Maintenance In Rural Women, Patricia A. Hageman, Joseph E. Mroz, Michael A. Yoerger, Carol H. Pullen

Journal Articles: Physical Therapy

Objective: Purely web-based weight loss and weight-loss maintenance interventions show promise to influence behavior change. Yet, little is known about user engagement with features of web-based interventions that predict clinically meaningful weight loss (≥5% bodyweight loss). This study examines level of website feature engagement with the likelihood of attaining ≥5% bodyweight loss after 6 and 18 months participation in a web-based intervention, among rural women at high risk of obesity-related diseases and disability.

Methods: In this secondary analysis of clinical trial data of 201 rural women, we examined weight change and user engagement, measured as clicks on specific web-based intervention …

Early Career Physical Therapy Faculty Networking And Scholarly Productivity: A Mixed-Methods Study, Betsy J. Becker

Theses & Dissertations

While it is well-known that physical therapist (PT) faculty must retain a scholarly agenda, few report being activity engaged and many programs have low scholarly dissemination. There is evidence that knowledge of the make-up of a faculty network leads to improved performance and innovation. The purpose of this explanatory sequential mixed methods study was to explore agency (behaviors and perspectives about career advancement) and the professional network structure and composition of early career PT faculty as they relate to scholarly activity. This dissertation research study included 50 early career faculty who worked in accredited entry-level physical therapy programs.

The quantitative …

Emotional Exhaustion, Depersonalization, And Feelings Of Decreased Personal Accomplishment Oh My: What Message Are We Sending To Our Students?, Nikki Sleddens, Betsy J. Becker

Posters and Presentations: Physical Therapy

PURPOSE:

The purpose of this presentation is to address the issue of burnout amongst PTs through the lens that addressing this issue in our profession may very well be the first step in building resilience in the academic and clinical environments.

METHODS AND/OR DESCRIPTION:

Physical therapy student well-being is a priority for academic institutions. Yet, are we, as academic and clinical faculty, who are responsible for promoting student well-being, “well” ourselves? Could burnout of our academic and clinical faculty impact our student’s wellness? Burnout is a syndrome described as emotional exhaustion, depersonalization, and feelings of decreased personal accomplishment. All effects …

Selective Generation Of Dopaminergic Precursors From Human Fibroblasts By Direct Lineage Conversion, Miao He

Theses & Dissertations

Transplantation of dopaminergic precursors (DPs) is a promising therapeutic strategy of Parkinson’s disease (PD). However, limited cell source for dopaminergic precursors has become a major obstacle for transplantation therapy. In the first part of the study, we demonstrated that Foxa2 is superior to Lmx1a in inducing dopaminergic neuronal differentiation from induced neural progenitor cells (iNPCs). Based on the results above and some other published results, our group demonstrated that mouse fibroblasts can be reprogrammed into induced dopaminergic precursors (iDPs) through ectopic expression of transcription factors Brn2, Sox2 and Foxa2(1). In the current study, we hypothesized that similar strategy …

Effects Of Two High-Frequency Physical Therapy Programs On Balance, Gait, Fatigue, And Quality Of Life In People With Multiple Sclerosis, Min Liu

Theses & Dissertations

Multiple sclerosis (MS) is an inflammatory disease involving the inflammation and demyelination in both brain and spinal cord. MS typically affects people in early adulthood in the range of 20-40 years old, and most patients with MS experience symptoms on a daily basis, such as walking difficulties, balance impairment, and fatigue, which can be disabling and impact the Quality of Life (QOL).

The main purpose of this investigation is to determine if our novel, adaptive, high-frequency physical therapy protocol, compared with the conventional therapeutic exercise protocol, has the potential to improve participants’ dynamic balance, gait, fatigue, and overall QOL based …

Health And Appearance Reasons For Weight Loss As Predictors Of Long-Term Weight Change, Joseph E. Mroz, Carol H. Pullen, Patricia A. Hageman

Journal Articles: Physical Therapy

This study investigated whether women's initial reasons (health, appearance to others, or appearance to self) for wanting to lose weight influenced their weight change over a 30-month web-based intervention. Multilevel modeling with 1416 observations revealed that only appearance in relation to one's self was a significant (negative) predictor. Women highly motivated to lose weight to improve their appearance in relation to themselves gained weight at 30 months, whereas those not motivated for this reason achieved clinically significant weight loss. Results suggest examining participants' initial reasons for weight loss as an important component of intervention failure or success.

Transforming Physical Therapy Education Through The Use Of Social Network Analysis, Betsy J. Becker, Sara E. Bills

Posters and Presentations: Physical Therapy

PURPOSE

Social Network Analysis (SNA) is a quantitative method to study the patterning and effect of relationships and how individual connections form into social structures that influence outcomes of the group. The purpose of this study is to explain the underpinnings of SNA and its application to PT education for student success and faculty development. This study is innovative and will be beneficial to the profession because there is currently no published literature exploring how PT education is influenced by social structures.

METHODS/DESCRIPTION

The aims of this study are to describe SNA and outline its potential to transform PT education. …

Use Of A Team Building Activity To Teach Clinical Decision-Making Concepts To Physical Therapy Students, Robert Fuchs, Betsy J. Becker

Posters and Presentations: Physical Therapy

PURPOSE : The purpose of this research was to find out if a team building exercise carried out by student groups will facilitate learning how to make clinical decision involving concepts from the International Classification of Function (ICF).

SIGNIFICANCE: Scant literature exists regarding the concept of integrating student and expert team case-based learning with the ICF to develop clinical decision-making skills.

SUBJECTS: Subjects were 213 first-year physical therapy students in the DPT program at UNMC in the first semester of the curriculum of years 2013-2016.

METHODS AND MATERIALS: A patient case was developed which included clinical decision-making steps using concepts …

Filling The Gap. Clinical Skill Acquisition With Interactive Online Modules To Supplement Traditional Instruction, Keriann Shaw, Betsy J. Becker, Nicole M. Sleddens, Robin High

Posters and Presentations: Physical Therapy

PURPOSE

The purpose of this study was to assess the effectiveness of interactive e-learning modules to supplement traditional instruction for range of motion (ROM) clinical skill acquisition in a doctor of physical therapy(DPT) curriculum.

BACKGROUNDS/SIGNIFICANCE

Online resources have become highly favored to augment learning especially by millennials for convenience, self-paced content, and versatility in learning styles. It has been reported that elearning platforms are as effective as traditional face-to-face instruction, but may be best utilized as an adjunctive resource for teaching psychomotor skills. Student confidence has also been analyzed with reports of increased self-efficacy with use of online learning materials. …

Evaluation Of A Student-Centered Digital Education Project In Health Science Education, Betsy J. Becker

Posters and Presentations: Physical Therapy

Student-centered learning is essential and evidence shows higher levels of achievement when students are engaged with educational activities that include critical thinking and effective communication in addition to creativity. The aim of this prospective cohort study was to evaluate a student-centered digital education project during a course about physical therapy (PT) management of chronic diseases. The objectives of this student project were to apply content through a well thought-out digital project and critically analyze information considering multiple points of view. Each project was evaluated by faculty using a rubric, and students completed a self- and peer-assessment. All projects were shared …

Web-Based Interventions Alone Or Supplemented With Peer-Led Support Or Professional Email Counseling For Weight Loss And Weight Maintenance In Women From Rural Communities: Results Of A Clinical Trial., Patricia A. Hageman, Carol H. Pullen, Melody A. Hertzog, Bunny J. Pozehl, C Eisenhauer, Linda S. Boeckner

Journal Articles: Physical Therapy

Objective. This trial compared the effectiveness of a web-based only (WO) intervention with web-based supplemented by peer-led discussion (WD) or professional email counseling (WE) across 3 phases to achieve weight loss and weight maintenance in women from underserved rural communities. Methods. 301 women (BMI of 28-45 kg/m(2)) randomly assigned to groups participated in guided weight loss (baseline to 6 months), guided weight loss and maintenance (6 to 18 months), and self-managed weight maintenance (18 to 30 months). Results. Retention was 88.7%, 76.5%, and 71.8% at 6, 18, and 30 months, respectively. Intent-to-treat analyses demonstrated no group differences in change in …

Identification And Intervention For Action Planning Deficits In Children With Hemiplegic Cerebral Palsy, Swati M. Surkar

Theses & Dissertations

The primary purpose of this investigation was to describe and quantify action-planning deficits during goal-directed movements in children with hemiplegic cerebral palsy (HCP). Three specific topics were addressed: brain activation, kinematics, and the use of visual input. First, we assessed prefrontal cortex (PFC) activation during complex goal-directed actions in children with HCP. The outcome suggested that children with HCP have higher PFC activation than age matched typically developing (TD) children during action planning, potentially due to the difficulty in allocating attentional resources for simultaneously processing the cognitive (i.e., attention, memory, information processing) and motor demands of the goal-directed task. Reduced …

Click Here! E-Learning Modules For Innovative Instruction And Learning, Nicole M. Sleddens, Betsy J. Becker, Sara E. Bills

Posters and Presentations: Physical Therapy

Purpose: Re-designing all or portions of a course with a fresh perspective can re-energize faculty and make the content more engaging for the learner. Teaching the millennial generation is also prompting faculty to revisit educational strategies. The use of electronic learning platforms, such as eLearning modules, is an innovative learning strategy with several reported benefits including flexibility and convenience for usage, ability for learners to study at their own pace and adaptability to different learning styles. Using technology that is free or already available to faculty, even the novice designer can begin development of these useful study tools. The key …

Use Of Distance Delivery Interventions (Web-Based, Mhealth, Telehealth) For Hard-To-Reach, Vulnerable Midlife And Older Individuals, Patricia A. Hageman

Posters and Presentations: Physical Therapy

As older adults may lack access to professional services and/or have limited transportation to seek care, the increasing availability of technologies for self-monitoring, safety, and/or preventive or therapeutic management may show promise for reaching vulnerable older adults. This presentation will describe several types of distance delivery platforms, such as web-based, mHealth, and/or telehealth, which may have applications to older adults in arenas of education, clinical practice or research. This session will highlight the benefits and limitations of these technologies, and will summarize current research about the effectiveness of using these technologies with midlife and older individuals.

Objectives:

1. Identify benefits and …

Mobility Of Individuals With Multiple Sclerosis And The Influence Of Physical Therapy, Brenda L. Davies

Theses & Dissertations

One main purpose was to explore the compensatory gait strategies of individuals with multiple sclerosis (MS). To address this purpose, we quantified the mechanical work generated by the lower extremity joints during walking. The outcomes from this investi­gation suggested that individuals with MS redistribute positive mechanical work during walking to the hip in order to compensate for a reduced ability of the ankle to generate positive mechanical work. Additionally, we also explored the motor control of the ankle as a potential contributing factor to the mobility limitations of individuals with MS. The outcomes from this investigation indicated that individuals with …

Measurement Of Daily Energy Expenditure In Individuals With Chronic Heart Failure, Yanlong Li

Theses & Dissertations

Being able to accurately monitor and quantify the amount of physical activity an individual with chronic heart failure (CHF) performs can be of assistance in developing appropriate interventions. This thesis attempted to evaluate the validity of the RT3 accelerometer (RT3) and 7-day Physical Activity Recall Questionnaire (7 day PAR) in measuring the daily activity levels of community dwelling individuals with CHF. Fifty-four individuals with CHF participated in a 7 day session to estimate their daily physical activity by using the RT3 accelerometer and 7-day PAR questionnaire. In addition, 15 of the 54 individuals participated in a second study in with …

The Impact Of E-Learning On Physical Therapy Students’ Clinical Skill Development, Taylor Majerus, Marissa Johnson, Betsy J. Becker

Posters and Presentations: Physical Therapy

Purpose: The purpose of this special interest report is to review the effectiveness of e-learning in comparison to traditional classroom learning by exploring different methods of implementation of e-learning into PT curriculum

Description: Education delivery via e-Learning is becoming a common teaching mode that appeals to students because it can be completed asynchronously at a self-directed pace and reviewed anytime, anywhere and as often as necessary for understanding. Translating knowledge from eLearning materials to skill performance is important to consider for PT students due to the requirements of psychomotor performance and demonstration of appropriate affective professional behaviors.

Literature review: A …

Using Active Learning Strategies To Teach Dpt Students How To Assertively Address Inappropriate Patient Sexual Behavior (Ipsb), Betsy J. Becker, Kathleen G. Volkman, Robin R. High

Posters and Presentations: Physical Therapy

PURPOSE/HYPOTHESIS

Inappropriate sexual behavior is defined as a “verbal or physical act of an explicit, or perceived, sexual nature, which is unacceptable within the social context in which it is carried out.” In a survey of U.S. PTs, 86% of the respondents reported experiencing at least one type of IPSB. PT education programs are required to teach concepts of professional duty, communication skills, and cultural competency, however, management techniques of IPSB in the clinic are not uniformly taught in schools. The use of active learning methods such as role play simulation and small group discussion has been successful with other …

Feasibility Of Mhealth Technology Use Among A Sample Of Isolated Rural Men At High Risk For Cardiovascular Disease, Betsy J. Becker, Christine M. Eisenhauer, Carol H. Pullen, Paul J. Dizona, Patricia A. Hageman

Posters and Presentations: Physical Therapy

Purpose/Hypothesis: Isolated rural men are considered a health disparities group at high risk for cardiovascular disease. The increasing availability of technologies for self-monitoring for healthy eating, activity and weight loss (ie mHealth) may show promise for engaging rural men in lifestyle modification. This study investigated the feasibility of men from rural isolated areas to use a fitness monitor with text messaging support over a 3- week period. The study examined the men’s daily monitor use for tracking activity and eating, and assessed via written survey, their perspectives about mHealth.

Number of Subjects: Twelve men, ages 40 to 69, from …

The Feedforward And Feedback Controls On Gait In Adults With Diabetes, Chun-Kai Huang

Theses & Dissertations

There are nearly 26 million people with diabetes mellitus (DM) in the US, and half of chronic DMs develop somatosensory deficits due to diabetic polyneuropathy or diabetic peripheral neuropathy (DPN). The absence or impaired somatosensory feedback (e.g. touch sensation or joint proprioception) resulted from the damage of large nerve fiber, and motor deficits such as attenuated muscle strength and abnormal plantar pressure of lower extremity have been identified in DPN, and these sensorimotor impairments lead to an increased number of falls. To reduce the risk of falling, a well-coordinated and adapted limb movement driven by the feedforward (anticipatory) and feedback …

Postural Responses To Perturbations Of The Vestibular System During Walking In Healthy Young And Older Adults, Jung Hung Chien

Theses & Dissertations

It has been shown that approximate one-third of US adults aged 40 years and older (69 million US citizens) have some type of vestibular problems. These declining abilities of the vestibular system affect quality of life. Difficulties in performing daily activities (dressing, bathing, getting in and out of the bed and etc.) have been highly correlated to loss of balance due to vestibular disorders. The exact number of people affected by vestibular disorders is still difficult to quantify. This might be because symptoms are difficult to describe and differences exist in the qualifying criteria within and across studies. Thus, it …

Health Related Quality Of Life In Persons With Type 2 Diabetes In A Rural Community Served By A Critical Access Hospital, Betsy J. Becker, Terry F. Nelson, Robin High, Pat Hauer

Posters and Presentations: Physical Therapy

Purpose

Type 2 diabetes poses significant health concerns and severe complications can result. The prevalence of type 2 diabetes is greater in rural than urban areas with rural populations exhibiting higher blood glucose (A1C). The purpose of this study was to determine whether health related quality of life (QOL) varies by gender and diabetes control (A1C) in rural persons with type 2 diabetes.

Subjects

We surveyed 615 persons with type 2 diabetes who receive care at a critical access hospital that serves a seven county rural area in a Midwestern state.

Methods

This study was a cross-sectional mail survey including …

Effectiveness Of Tailored Lifestyle Interventions, Using Web-Based And Print-Mail, For Reducing Blood Pressure Among Rural Women With Prehypertension: Main Results Of The Wellness For Women: Dashing Towards Health Clinical Trial., Patricia A. Hageman, Carol H. Pullen, Melody A. Hertzog, Linda Boeckner

Journal Articles: Physical Therapy

Background Lifestyle modification is recommended for management of prehypertension, yet finding effective interventions to reach rural women is a public health challenge. This community-based clinical trial compared the effectiveness of standard advice to two multi-component theory-based tailored interventions, using web-based or print-mailed delivery, in reducing blood pressure among rural women, ages 40–69, with prehypertension.

Methods 289 women with prehypertension enrolled in the Wellness for Women: DASHing towards Health trial, a 12-month intervention with 12-month follow-up. Women were randomly assigned to groups using a 1:2:2 ratio, comparing standard advice (30-minute counseling session) to two interventions (two 2-hour counseling sessions, 5 phone …

Multidisplinary Simulation In Physical Therapist Assistant Education, Betsy J. Becker, Nikki Sleddens, Ian Thompson

Posters and Presentations: Physical Therapy

Background and Purpose: Clinical simulation has been shown to be an effective method of teaching students in a controlled environment. Utilizing a realistic setting with built-in controls, allows students to practice skills, receive instructor feedback and complete self-assessments to refine performance prior to participation in terminal clinical education. Small group instructor-led debriefing is also an essential part of the process to facilitate reflection on performance. Currently there are very few published reports of multidisciplinary simulation including physical therapist assistant (PTA) students with high fidelity simulation mannequins and live standardized patients. Traditionally PTA students have very little, if any, actual …

Evidence For The Use Of Exercise In Patients With Breast Cancer To Reduce Cancer-Related Fatigue, Betsy J. Becker

Posters and Presentations: Physical Therapy

Background & Purpose:

Cancer-related fatigue is the most commonly reported side effect of cancer treatment and affects 70-100% of patients. According to the 2013 National Comprehensive Cancer Network Guidelines on Cancer-Related Fatigue, institutions should assess the quality of fatigue management in their continuous quality improvement projects. In addition, the Guidelines also state that Medicare contracts should reimburse for fatigue management and disability insurance should include coverage for the continuing effects of fatigue.

Exercise has been suggested for breast cancer survivors as an intervention to reduce cancer-related fatigue both during and after cancer treatment. However, it has been reported that only …

Obesity And Physical Function In Rural Women Who Enroll In A Lifestyle Modification Intervention For Reducing Blood Pressure, Patricia A. Hageman, Carol H. Pullen, Paul J. Dizona, Kristin Schmidt, Linda S. Boeckner

Journal Articles: Physical Therapy

Purpose: Rural women have high prevalence of obesity and prehypertension. Obesity, if associated with poor physical function, may have implications for applying activity guidelines for women volunteering for lifestyle modification. This study examined associations of body mass index (BMI) and percent body fat with measures of 1-mile walk time, post-walk perceived exertion, and 10-repetition chair stands in rural women ages 40-69.

Methods: Cross-sectional baseline data were collected using standardized methods from 289 rural women with prehypertension who volunteered for a lifestyle clinical trial for reducing blood pressure. ANOVAs and linear regression were used for analysis.

Results: With exception of the …

Integrating Best Evidence Into Practice: Outcomes Of A Community-Based 12-Week Exercise And Education Intervention In Women With Cancer, Betsy J. Becker, Katherine J. Jones, Patricia A. Hageman, Ruth Vangerpen

Posters and Presentations: Physical Therapy

Objective

Cancer-related fatigue is the most commonly reported side effect of cancer treatment, affecting 70-100% of patients and current literature suggests exercise is an important component of managing this side effect. The specific objective of this project was to evaluate the effectiveness of a 12-week evidence-based cancer exercise and education intervention on outcomes of fatigue, pain, depression, sleep disturbance and quality of life for women with cancer; the intervention was delivered by an interprofessional team in a medically-based wellness center.

Methods

The team was led by a physical therapist and included medical and radiation oncologists, general surgeons, nurses and cancer …