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Rehabilitation and Therapy Commons

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Selected Works

2015

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Articles 1 - 30 of 89

Full-Text Articles in Rehabilitation and Therapy

An Improved Murine Femur Fracture Device For Bone Healing Studies, Joseph Marturano, Benjamin Cleveland, Melissa Bryne, Shannon O'Connell, John Wixted, Kristen Billiar Dec 2015

An Improved Murine Femur Fracture Device For Bone Healing Studies, Joseph Marturano, Benjamin Cleveland, Melissa Bryne, Shannon O'Connell, John Wixted, Kristen Billiar

Kristen L. Billiar

Murine models are commonly used to investigate bone healing and test new treatments before human trials. Our objective was to design an improved murine femur fracture device and determine optimal mass and velocity settings for maximal likelihood of transverse fracture. Fracture reproducibility was maximized using an adjustable kinetic energy level, a novel mouse positioning system and an electromagnet striker release assembly. Sixty wild-type mice of 8-12-week-old male and female with a weight of 26.4+/-6.1g were subjected to an experimental postmortem fracture in the left and right femur (n=120) using variable kinetic energy inputs. A best-fit prediction equation for transverse fracture …


Acute Effects Of Whole-Body Vibration On Lower Extremity Muscle Performance In Persons With Multiple Sclerosis, Kurt Jackson, Harold Merriman, Paul Vanderburgh, C. Brahler Dec 2015

Acute Effects Of Whole-Body Vibration On Lower Extremity Muscle Performance In Persons With Multiple Sclerosis, Kurt Jackson, Harold Merriman, Paul Vanderburgh, C. Brahler

C. Jayne Brahler

Background and Purpose: Whole-body vibration (WBV) is a relatively new form of exercise training that may influence muscle performance. This study investigated the acute effects of high (26 Hz) and low (2 Hz) frequency WBV on isometric muscle torque of the quadriceps and hamstrings in persons with multiple sclerosis (MS).

Participants and Method: Fifteen individuals (mean age = 54.6 years, SD = 9.6) with MS and Expanded Disability Status Scale (EDSS) scores ranging from 0-6.5 (mean = 4.2, SD = 2.3) participated in this randomized cross-over study. Following baseline measures of isometric quadricep and hamstring torque, subjects were exposed to …


Biomechanical Investigation Of A Novel Ratcheting Arthrodesis Nail, Jeremy Mccormick, Xinning Li, Douglas Weiss, Kristen Billiar, John Wixted Dec 2015

Biomechanical Investigation Of A Novel Ratcheting Arthrodesis Nail, Jeremy Mccormick, Xinning Li, Douglas Weiss, Kristen Billiar, John Wixted

Kristen L. Billiar

BACKGROUND: Knee or tibiotalocalcaneal arthrodesis is a salvage procedure, often with unacceptable rates of nonunion. Basic science of fracture healing suggests that compression across a fusion site may decrease nonunion. A novel ratcheting arthrodesis nail designed to improve dynamic compression is mechanically tested in comparison to existing nails. METHODS: A novel ratcheting nail was designed and mechanically tested in comparison to a solid nail and a threaded nail using sawbones models (Pacific Research Laboratories, Inc.). Intramedullary nails (IM) were implanted with a load cell (Futek LTH 500) between fusion surfaces. Constructs were then placed into a servo-hydraulic test frame (Model …


Self-Reported Load Carriage Injuries In Australian Regular Army Soldiers, Rob Orr, Rodney Pope, Julia Coyle, Venerina Johnston Dec 2015

Self-Reported Load Carriage Injuries In Australian Regular Army Soldiers, Rob Orr, Rodney Pope, Julia Coyle, Venerina Johnston

Rodney P Pope

Access abstract in the Conference Abstract E-book, page 115


Incidence Rates Of Reported Work Health & Safety Incidents & Injuries In Part-Time & Full-Time Australian Army Personnel, Rodney Pope, Dylan Macdonald, Rob Orr Dec 2015

Incidence Rates Of Reported Work Health & Safety Incidents & Injuries In Part-Time & Full-Time Australian Army Personnel, Rodney Pope, Dylan Macdonald, Rob Orr

Rodney P Pope

Aims: 1. To investigate & compare the incidence rates of WHS incidents & injuries in ARES & ARA populations, reported in the WHSCAR database 2. To compare these injury incidence rates to injury rates reported by other injury surveillance systems for comparable army populations


Profiling A Workplace Physiotherapy And Rehabilitation Program Within A Police Force, Rob Orr, M Hua, Michael Stierli Dec 2015

Profiling A Workplace Physiotherapy And Rehabilitation Program Within A Police Force, Rob Orr, M Hua, Michael Stierli

Rob Marc Orr

Access abstract in the Conference Abstract E-book, page 116


Leg Power As An Indicator For Risk Of Injury Or Illness In Police Recruits, Rob Orr, Rodney Pope, Samantha Peterson, Michael Stierli, Ben Hinton Dec 2015

Leg Power As An Indicator For Risk Of Injury Or Illness In Police Recruits, Rob Orr, Rodney Pope, Samantha Peterson, Michael Stierli, Ben Hinton

Rob Marc Orr

Access abstract in the Conference Abstract E-book, page 123


Incidence Rates Of Reported Work Health & Safety Incidents & Injuries In Part-Time & Full-Time Australian Army Personnel, Rodney Pope, Dylan Macdonald, Rob Orr Dec 2015

Incidence Rates Of Reported Work Health & Safety Incidents & Injuries In Part-Time & Full-Time Australian Army Personnel, Rodney Pope, Dylan Macdonald, Rob Orr

Rob Marc Orr

Aims: 1. To investigate & compare the incidence rates of WHS incidents & injuries in ARES & ARA populations, reported in the WHSCAR database 2. To compare these injury incidence rates to injury rates reported by other injury surveillance systems for comparable army populations


Sedentary Behavior And Related Factors Among Full-Time, University Faculty, Anna Greer, Mary Keenan Dec 2015

Sedentary Behavior And Related Factors Among Full-Time, University Faculty, Anna Greer, Mary Keenan

Anna E. Greer

Purpose– Sedentary behavior, independent of physical activity, is a risk factor for both morbidity and mortality. Little is known about factors related to sedentary behavior. The purpose of this paper is to examine the relationship between sedentary behavior and the demographic characteristics, perceived physical activity (PA) environment, and PA behaviors of 72 full-time, university faculty members. Design/methodology/approach– For this cross-sectional study, data were collected online using Survey Monkey®. Findings– Participants spent an average of 473 and 328 minutes/weekend day in sedentary activity. There was a positive correlation between minutes spent in vigorous PA and minutes spent sedentary while watching TV …


Load Carriage Distance Run And Pushups Tests: No Body Mass Bias And Occupationally Relevant, Paul M. Vanderburgh, Nicholas S. Mickley, Philip A. Anloague, Kimber Lucius Dec 2015

Load Carriage Distance Run And Pushups Tests: No Body Mass Bias And Occupationally Relevant, Paul M. Vanderburgh, Nicholas S. Mickley, Philip A. Anloague, Kimber Lucius

Philip A. Anloague

Recent research has demonstrated body mass (M) bias in military physical fi tness tests favoring lighter, not just leaner, service members. Mathematical modeling predicts that a distance run carrying a backpack of 30 lbs would eliminate M-bias. The purpose of this study was to empirically test this prediction for the U.S. Army push-ups and 2-mile run tests. Two tests were performed for both events for each of 56 university Reserve Offi cer Training Corps male cadets: with (loaded) and without backpack (unloaded). Results indicated signifi cant M-bias in the unloaded and no M-bias in the loaded condition for both events. …


Acute Effects Of Whole-Body Vibration On Lower Extremity Muscle Performance In Persons With Multiple Sclerosis, Kurt Jackson, Harold L. Merriman, Paul M. Vanderburgh, C. Jayne Brahler Nov 2015

Acute Effects Of Whole-Body Vibration On Lower Extremity Muscle Performance In Persons With Multiple Sclerosis, Kurt Jackson, Harold L. Merriman, Paul M. Vanderburgh, C. Jayne Brahler

Harold L. Merriman

Background and Purpose: Whole-body vibration (WBV) is a relatively new form of exercise training that may influence muscle performance. This study investigated the acute effects of high (26 Hz) and low (2 Hz) frequency WBV on isometric muscle torque of the quadriceps and hamstrings in persons with multiple sclerosis (MS). Participants and Method: Fifteen individuals (mean age = 54.6 years, SD = 9.6) with MS and Expanded Disability Status Scale (EDSS) scores ranging from 0-6.5 (mean = 4.2, SD = 2.3) participated in this randomized cross-over study. Following baseline measures of isometric quadricep and hamstring torque, subjects were exposed to …


Exercise: An Antecedent Based Intervention To Address Sensory Motor Needs And Learning Readiness, Laura Greiss Hess, Heather Maurin Nov 2015

Exercise: An Antecedent Based Intervention To Address Sensory Motor Needs And Learning Readiness, Laura Greiss Hess, Heather Maurin

Laura Greiss Hess

“Exercise (ECE) is a strategy that involves an increase in physical exertion as a means of reducing problem behaviors or increasing appropriate behavior while increasing physical fitness and motor skills” “ECE can be used effectively to address behavior, school-readiness, academic, and motor skills.” NPDC Exercise Fact Sheet, 2014


Effects Of Sertraline Treatment For Young Children With Fxs, Andrew Ligsay, Laura Greiss Hess, Sarah Fitzpatrick, Kerrie Lemons Chitwood, Jonathan Polussa, Salpi Siyahian, Randi Hagerman Nov 2015

Effects Of Sertraline Treatment For Young Children With Fxs, Andrew Ligsay, Laura Greiss Hess, Sarah Fitzpatrick, Kerrie Lemons Chitwood, Jonathan Polussa, Salpi Siyahian, Randi Hagerman

Laura Greiss Hess

Selective serotonin reuptake inhibitors (SSRIs) help treat many of the phenotypic manifestations of fragile X syndrome (FXS) including anxiety, sensory processing challenges, and communication and intellectual deficits. However, the efficacy of SSRIs has not been previously studied in children with FXS under five-years-old. The purpose of this study was to elucidate group differences in behavior and developmental outcome measures for young children with FXS when treated with sertraline compared to placebo.


Assistive Technology Enhancement Of Written Expression For Individuals With Neurodevelopmental Disorders, Laura Hess, Kerrie Lemons Chitwood, Susan Harris Nov 2015

Assistive Technology Enhancement Of Written Expression For Individuals With Neurodevelopmental Disorders, Laura Hess, Kerrie Lemons Chitwood, Susan Harris

Laura Greiss Hess

This study involves the use of computer software to assess the use of assistive technology (AT) in individuals with neurodevelopmental disorders. We will present an update of the subjects in the study, including research issues, subject diagnoses and diagnostic trends as assessed through baseline and follow-up testing.


Assistive Technology Enhancement Of Written Expression For Individuals With Neurodevelopmental Disorders [Poster], Laura Hess, Kerrie Lemons Chitwood, Susan Harris Nov 2015

Assistive Technology Enhancement Of Written Expression For Individuals With Neurodevelopmental Disorders [Poster], Laura Hess, Kerrie Lemons Chitwood, Susan Harris

Laura Greiss Hess

The purpose of this project is to carry out an intensive training program in subjects with a broad range of neurodevelopmental disabilities to assess the efficacy of assistive technology (AT) intervention.


Sensory Processing Correlates Of Occupational Performance In Children With Fragile X Syndrome: Preliminary Findings, G. T. Baranek, Y. H. Chin, L. G. Hess, J. G. Hatton, S. R. Hooper Nov 2015

Sensory Processing Correlates Of Occupational Performance In Children With Fragile X Syndrome: Preliminary Findings, G. T. Baranek, Y. H. Chin, L. G. Hess, J. G. Hatton, S. R. Hooper

Laura Greiss Hess

This timely source book, featuring the latest in research (2000 - 2003) from the American Journal of Occupational Therapy in one easy reference, covers topics such as handwriting, ADHD, motor skills, sensory issues, play, physical disability, autism, school performance, stigma, and self-image. ~ Publisher


Gross Motor Development, Movement Abnormalities, And Early Identification Of Autism, Sally Ozonoff, Gregory S. Young, Stacy Goldring, Laura Greiss Hess, Andriana M. Herrera, Joel Steele, Suzanne Macari, Susan Hepburn, Sally J. Rogers Nov 2015

Gross Motor Development, Movement Abnormalities, And Early Identification Of Autism, Sally Ozonoff, Gregory S. Young, Stacy Goldring, Laura Greiss Hess, Andriana M. Herrera, Joel Steele, Suzanne Macari, Susan Hepburn, Sally J. Rogers

Laura Greiss Hess

Gross motor development (supine, prone, rolling, sitting, crawling, walking) and movement abnormalities were examined in the home videos of infants later diagnosed with autism (regression and no regression subgroups), developmental delays (DD), or typical development. Group differences in maturity were found for walking, prone, and supine, with the DD and Autism-No Regression groups both showing later developing motor maturity than typical children. The only statistically significant differences in movement abnormalities were in the DD group; the two autism groups did not differ from the typical group in rates of movement abnormalities or lack of protective responses. These findings do not …


Acute Reperfusion Therapy In St-Elevation Myocardial Infarction From 1994-2003, Brahmajee K. Nallamouthu, Martha E. Blaney, Susan M. Morris, Lori Parsons, Dave P. Miller, John G. Canto, Hal V. Barron, Harlan M. Krumholz Nov 2015

Acute Reperfusion Therapy In St-Elevation Myocardial Infarction From 1994-2003, Brahmajee K. Nallamouthu, Martha E. Blaney, Susan M. Morris, Lori Parsons, Dave P. Miller, John G. Canto, Hal V. Barron, Harlan M. Krumholz

Susan Morris

Background—Appropriate utilization of acute reperfusion therapy is not a national performance measure for ST-elevation myocardial infarction at this time, and the extent of its contemporary use among ideal patients is unknown.

Methods—From the National Registry of Myocardial Infarction, we identified 238,291 patients enrolled from June 1994 to May 2003 who were ideally suited for acute reperfusion therapy with fibrinolytic therapy or primary percutaneous coronary intervention. We determined rates of not receiving therapy across 3 time periods (June 1994–May 1997, June 1997–May 2000, June 2000– May 2003) and evaluated factors associated with underutilization.

Results—The proportion of ideal patients …


Motor Abilities Of Children Diagnosed With Fragile X Syndrome With And Without Autism, C. Zingerevich, L. G. Hess, K. Lemons Chitwood, S. W. Harris, D. Hessl, K. Cook, R. J. Hagerman Nov 2015

Motor Abilities Of Children Diagnosed With Fragile X Syndrome With And Without Autism, C. Zingerevich, L. G. Hess, K. Lemons Chitwood, S. W. Harris, D. Hessl, K. Cook, R. J. Hagerman

Laura Greiss Hess

Background—Previous studies suggested that children diagnosed with Fragile X Syndrome (FXS) often meet criteria for autism or PDD. This study describes the fine motor abilities of children diagnosed with FXS with and without autism spectrum disorder, and compares the motor scores of those groups controlling for cognitive level. Method—Forty-eight children, ages 12-76 months (SD=16) diagnosed with FXS were assessed with the Mullen Scales of Early Learning, and the Autism Diagnostic Observation Schedule (ADOS). Their parents were interviewed with the Autism Diagnostic Interview-Revised (ADI-R). We used a one-way analysis of variance (ANOVA) to determine if the fine motor scale of the …


Effects Of Sertraline Treatment For Young Children With Fxs, Laura Greiss Hess, Peter Mundy, Randi Hagerman Nov 2015

Effects Of Sertraline Treatment For Young Children With Fxs, Laura Greiss Hess, Peter Mundy, Randi Hagerman

Laura Greiss Hess

Phenotypic manifestations for young children with fragile X syndrome (FXS) include: anxiety, sensory processing challenges, global language and communication deficits and intellectual and developmental disabilities. Many of these symptoms can be treated with medications, including selective serotonin reuptake inhibitors (SSRIs). However to date a clinical trial has not been conducted for children under five years old. This study investigated the following question: Are there group differences on developmental outcome measures for those children treated with sertraline compared to placebo?


Family Meanings, Contexts And Hopes Within A Clinical Trial, Laura Greis Hess, Cynthia Carter Ching, Randi Hagerman Nov 2015

Family Meanings, Contexts And Hopes Within A Clinical Trial, Laura Greis Hess, Cynthia Carter Ching, Randi Hagerman

Laura Greiss Hess

These qualitative analyses are a component of the clinical trial: “Effects of Sertraline Treatment for Young Children with FXS: Examination of Developmental Outcomes and Family Contexts.” We argue that inclusion of a sociocultural perspective within the context of a clinical trial affords consideration of: A dynamic view of development – simultaneous consideration of biological and sociocultural factors (Vygotsky, 1978). Application of a bioecological framework and consideration of ever changing nested settings and contexts over time (Bronfenbrenner, 2005)


Mild Cognitive Impairment In Heart Failure Affects Care Transition, Kitsum Li, Kristin Myers Nov 2015

Mild Cognitive Impairment In Heart Failure Affects Care Transition, Kitsum Li, Kristin Myers

Kitsum Li

Objectives After attending the presentation, the audiences will be able to: Understand the importance of cognition in everyday activity and the cognitive hierarchy to guide practice. Recognize the incidence of mild cognitive impairment in individuals with heart failure. Understand how mild cognitive impairment may affect heart failure self- care practice and hospitalization readmission. Identify the evidence that support use of cognitive screen to identify mild cognitive impairment in individuals with heart failure. Compare the evidence among three cognitive screens (Mini-mental Status Exam, Montreal Cognitive Assessment and St. Louis University Mental State Exam). (Using Montreal Cognitive Assessment as an example)Identify cognitive …


A Transformative Experience For Occupational Therapy Students In A Simulated Learning Environment, Kitsum Li, Barbara Mccamish Nov 2015

A Transformative Experience For Occupational Therapy Students In A Simulated Learning Environment, Kitsum Li, Barbara Mccamish

Kitsum Li

Simulation is being integrated into nursing and medical curriculum nationally and it is well integrated into the Nursing program at Dominican University of California, However, use of simulation in allied health professionals is only an emerging practice. The aim of this program is to integrate simulation into the OT curriculum in order to facilitate the development of therapy foundation skill.


Clinical Reasoning In The Use Of Slings For Patients With Shoulder Subluxation After Stroke: A Glimpse Of The Practice Phenomenon In California, Kitsum Li, Naoko Murai, Simon Chi Oct 2015

Clinical Reasoning In The Use Of Slings For Patients With Shoulder Subluxation After Stroke: A Glimpse Of The Practice Phenomenon In California, Kitsum Li, Naoko Murai, Simon Chi

Kitsum Li

Literature reports the frequent use of shoulder slings by occupational therapists for the management of post-stroke shoulder subluxation despite the low evidence for its efficacy. To understand the clinical context that defies current research evidence, a survey was distributed among California occupational therapists. One hundred and sixty-eight participants responded to the survey, answering questions regarding the occurrences and clinical reasoning in the use of shoulder sling with patients post stroke. 81.5% of the respondents reported the use of shoulder sling. However, the actual sling prescription was limited to 28.4% of their patients. Slings were primarily prescribed for upper extremity management …


Computer-Based Cognitive Retraining For Adults With Chronic Acquired Brain Injury: A Pilot Study, Kitsum Li, Julie Robertson, Joshua Ramos, Stephanie Gella Oct 2015

Computer-Based Cognitive Retraining For Adults With Chronic Acquired Brain Injury: A Pilot Study, Kitsum Li, Julie Robertson, Joshua Ramos, Stephanie Gella

Kitsum Li

This study evaluated the effectiveness of a computer-based cognitive retraining (CBCR) program on improving memory and attention deficits in individuals with a chronic acquired brain injury (ABI). Twelve adults with a chronic ABI demonstrating deficits in memory and attention were recruited from a convenience sample from the community. Using a quasi-experimental one-group pretest–posttest design, a significant improvement was found in both memory and attention scores postintervention using the cognitive screening tool. This study supported the effectiveness of CBCR programs in improving cognitive deficits in memory and attention in individuals with chronic ABI. Further research is recommended to validate these findings …


Does Therapeutic Horseback Riding Decrease Balance Deficits In Community-Dwelling Older Adults?, Salwa Yaser, Lisa Mrsny, Krystin Beeman, Skyler Moon, Kitsum Li Aug 2015

Does Therapeutic Horseback Riding Decrease Balance Deficits In Community-Dwelling Older Adults?, Salwa Yaser, Lisa Mrsny, Krystin Beeman, Skyler Moon, Kitsum Li

Kitsum Li

Hippotherapy and therapeutic riding (TR) provide pleasurable activity and physical exercise to individuals and yet limited study is available on its therapeutic value to improve balance in older adults. In this study, the researchers measured the benefit of TR on balance and quality of life in communitydwelling older adults. A convenience sample of individuals 65 years and older was recruited from a local community. The study is a single-blind, pretest-posttest, controlled study of a 10-session TR program with a Professional Association of Therapeutic Horsemanship (PATH) trained and certified TR instructor. Each TR session included grooming and tacking, mounting, a warm-up …


Clinical Reasoning In The Use Of Slings For Patients With Shoulder Subluxation After Stroke: A Glimpse Of The Practice Phenomenon In California, Kitsum Li, Naoko Murai, Simon Chi Aug 2015

Clinical Reasoning In The Use Of Slings For Patients With Shoulder Subluxation After Stroke: A Glimpse Of The Practice Phenomenon In California, Kitsum Li, Naoko Murai, Simon Chi

Kitsum Li

Literature reports the frequent use of shoulder slings by occupational therapists for the management of post-stroke shoulder subluxation despite the low evidence for its efficacy. To understand the clinical context that defies current research evidence, a survey was distributed among California occupational therapists. One hundred and sixty-eight participants responded to the survey, answering questions regarding the occurrences and clinical reasoning in the use of shoulder sling with patients post stroke. 81.5% of the respondents reported the use of shoulder sling. However, the actual sling prescription was limited to 28.4% of their patients. Slings were primarily prescribed for upper extremity management …


Does Therapeutic Horseback Riding Decrease Balance Deficits In Community-Dwelling Older Adults?, Salwa Yaser, Lisa Mrsny, Krystin Beeman, Skyler Moon, Kitsum Li Aug 2015

Does Therapeutic Horseback Riding Decrease Balance Deficits In Community-Dwelling Older Adults?, Salwa Yaser, Lisa Mrsny, Krystin Beeman, Skyler Moon, Kitsum Li

Kitsum Li

Hippotherapy and therapeutic riding (TR) provide pleasurable activity and physical exercise to individuals and yet limited study is available on its therapeutic value to improve balance in older adults. In this study, the researchers measured the benefit of TR on balance and quality of life in communitydwelling older adults. A convenience sample of individuals 65 years and older was recruited from a local community. The study is a single-blind, pretest-posttest, controlled study of a 10-session TR program with a Professional Association of Therapeutic Horsemanship (PATH) trained and certified TR instructor. Each TR session included grooming and tacking, mounting, a warm-up …


Computer-Based Cognitive Retraining For Adults With Chronic Acquired Brain Injury: A Pilot Study, Kitsum Li, Julie Robertson, Joshua Ramos, Stephanie Gella Aug 2015

Computer-Based Cognitive Retraining For Adults With Chronic Acquired Brain Injury: A Pilot Study, Kitsum Li, Julie Robertson, Joshua Ramos, Stephanie Gella

Kitsum Li

This study evaluated the effectiveness of a computer-based cognitive retraining (CBCR) program on improving memory and attention deficits in individuals with a chronic acquired brain injury (ABI). Twelve adults with a chronic ABI demonstrating deficits in memory and attention were recruited from a convenience sample from the community. Using a quasi-experimental one-group pretest–posttest design, a significant improvement was found in both memory and attention scores postintervention using the cognitive screening tool. This study supported the effectiveness of CBCR programs in improving cognitive deficits in memory and attention in individuals with chronic ABI. Further research is recommended to validate these findings …


Does Therapeutic Horseback Riding Decrease Balance Deficits In Community-Dwelling Older Adults?, Salwa Yaser, Lisa Mrsny, Krystin Beeman, Skyler Moon, Kitsum Li Aug 2015

Does Therapeutic Horseback Riding Decrease Balance Deficits In Community-Dwelling Older Adults?, Salwa Yaser, Lisa Mrsny, Krystin Beeman, Skyler Moon, Kitsum Li

Kitsum Li

Hippotherapy and therapeutic riding (TR) provide pleasurable activity and physical exercise to individuals and yet limited study is available on its therapeutic value to improve balance in older adults. In this study, the researchers measured the benefit of TR on balance and quality of life in communitydwelling older adults. A convenience sample of individuals 65 years and older was recruited from a local community. The study is a single-blind, pretest-posttest, controlled study of a 10-session TR program with a Professional Association of Therapeutic Horsemanship (PATH) trained and certified TR instructor. Each TR session included grooming and tacking, mounting, a warm-up …