Rehabilitation and Therapy Commons^™

Facilitating Aging In Place And Community By Empowering Participation In Society: A Mixed Methods Study On The Co-Development Of A Theory Of Change With Suburban-Dwelling Older Adults, Emily Balog

Doctor of Philosophy in Translational Health Sciences Dissertations

Background: Baby boomers are steadily aging in America and represent an increased population in nearly every sector. In suburban communities today, older adults make up 51% of the population. Ninety-five percent of all older adults live in community settings and have expressed a desire to avoid costly institutionalization and to remain in their homes and communities, also called aging in place. Older adults in moderate income suburban communities are increasingly at a higher risk for institutionalization should their health or finances decline as the access to their wealth is within the home in which they dwell. This process …

Creation Of A Health And Wellness And Self Care Tool For Mothers Of Infants Requiring A Neonatal Intensive Care Unit Stay, Genevieve Maccarthy

Doctor of Occupational Therapy Capstone Projects

Purpose: Despite occupational therapy’s established role in the neonatal intensive care unit (NICU) in providing family centered intervention, mothers continue to report lack of readiness to discharge home and emotional distress while in the NICU and upon discharge home. Occupational therapists have the unique skillset to promote engagement in meaningful activities and facilitate overall health and wellness for mother’s during and after their NICU stay.

Method: A qualitative survey was distributed to a convenience sample of fifteen participants to identify emotional experiences in the NICU, how these experiences impact each mother fulfilling her role as a primary caretaker, and the …

A Discharge Checklist To Combat Patient Readmission: A Case Study In A Skilled Nursing Facility, Shaylin O’Connell

Doctor of Occupational Therapy Capstone Projects

A Discharge Checklist to Combat Patient Readmission: A Case Study in a Skilled Nursing Facility focuses on the creation of a discharge checklist, as an intervention, to increase the competency for occupational therapists working in skilled nursing facilities discharging clients back to their home environment. A SNF (Skilled Nursing Facility) provides post-acute healthcare services and rehabilitation for patients following a hospitalization prior to discharging home (Burke et al., 2017). This case study for clinical improvement uses the DMAIC (define, measure, analyze, improve, control) quality model and a multiple case study research design for evaluation. The goal of the quality improvement …

Therapist Attitudes Towards Animal Assisted Therapy: A Qualitative Study, Karen Vizaniaris

Doctor of Occupational Therapy Capstone Projects

PURPOSE. To understand the attitudes and perceptions of therapists towards animal assisted therapy (AAT) and towards the barriers and facilitators of implementing AAT into practice. METHOD. This descriptive qualitative studied consisted of ten semi-structured interviews with rehabilitation therapists that were coded for common themes. Data from two Likert-scale questions were analyzed using descriptive statistics. RESULTS. Eight themes emerged from the data including therapists’ attitudes towards animal assisted therapy and their own competence, three core benefits of animal assisted therapy that they identified (increased patient participation, positive emotional/social influence, and contribution to patient-centered goals), and three main barriers towards implementation (scheduling/operations, …

Physical Therapy Considerations For Chronic Kidney Disease And Secondary Sarcopenia, Michael O. Harris-Love, Haniel J. Hernandez, Gideon Obamwonyi

Exercise and Nutrition Sciences Faculty Publications

Chronic kidney disease (CKD) is a progressive condition that may negatively affect musculoskeletal health. These comorbidities may include malnutrition, osteoporosis, and decreased lean body mass. Secondary sarcopenia due to CKD may be associated with mobility limitations and elevated fall risk. Physical therapists are well-positioned among the health care team to screen for secondary sarcopenia in those with CKD and for the treatment of musculoskeletal comorbid conditions that may affect functional performance. Given the consequences of both low muscle mass and low bone mineral density, appropriate and timely physical therapy is important for fall risk assessment and intervention to minimize the …

Taking Steps To Prevent Falls, Kimberly Okechukwu

Doctor of Occupational Therapy Capstone Projects

Fall prevention is imperative in skilled nursing and long-term care facilities. According to the CDC, “about 1,800 older adults living in nursing homes die each year from fall-related injuries and those who survive frequently sustain injuries that result in permanent disability and reduced quality of life”. “Falls can also result in severe pain, high medical costs, fear of falling, less participation in activities, and reduced quality of life “(CDC 2015). Appropriate and effective fall prevention programs need to be established and implemented to reduce falls in nursing homes, which will in turn improve the quality of care.

Status Of The Entry-Level Clinical Doctorate In Occupational Therapy Education, Tara N. Ruppert

Doctor of Occupational Therapy Capstone Projects

Occupational therapy education has accepted two degree paths for entry-level practice since 2007 – the Masters in Occupational Therapy (MOT) and the Clinical Doctorate in Occupational Therapy (OTD). A national debate exists about this approach, with strong voices on each side but there is a gap in the research supporting either side. A cohort study was used to gather data from program directors of entry-level occupational therapy programs in the U.S. to determine if there are trends, common perceptions, or predictive factors regarding which degree is supported by a program. Trends were identified, as were some common perceptions regarding the …

Hippotherapy Capstone, Autumn O'Hara

Doctor of Occupational Therapy Capstone Projects

Therapists work with many children with many different diagnoses. One of the most prevalent diagnosis is Autism Spectrum Disorder (ASD). According to recent statistics, available from the Centers for Disease Control and Prevention (CDC), 1 in 68 children are diagnosed with ASD; which is a developmental disability that can cause social and behavioral challenges (CDC, 2016). ASD can also be defined as a complex group of neurodevelopmental disorders characterized by deficits in social interaction and verbal and nonverbal communication, as well as restricted, repetitive interests (APA, 2016). Therapist also work with individuals who have other diagnoses and deficits, including but …

Return To University After A Stroke: An Autoethnography, Rachel Sieber

Doctor of Occupational Therapy Capstone Projects

Background and Aims: Return to university presents a unique transition for the person with stroke who may demonstrate with impairments and may have difficulties while engaging in this change. This study will explore elements that comprise the needs and factors of the stroke survivor and supports or accommodations that may improve success of the student returning to university.

Methods: An autoethnography was used with narrative journals and poems dated June 2003 to October 2005, interviews with friends, family and professors and a literature review. Data analysis included an open-coding procedure to find themes from the journal entries, interviews and narrative …

Decreasing Social Isolation Through An Intergenerational Social Engagement Program, Jacqueline Kendona

Doctor of Occupational Therapy Capstone Projects

Social isolation is the absence of meaningful contact with others. Older adults who perceived themselves as socially isolated are at risk of negative health outcomes. A person’s psychological wellbeing can be improved through engaging in meaningful leisure activities.

The Intergenerational Social Engagement Program, or the ISEP, was developed to connect older adults and high school students to help decrease social isolation in older adults. The ISEP incorporates concepts from the Canadian Model of Occupational Performance and is intended for implementation in senior living communities. The program is to be led by an occupational therapist. Occupational therapy practitioners have an understanding …

Eccentric Exercise Program Design: A Periodization Model For Rehabilitation Applications, Michael O. Harris-Love, Bryant Seamon, Tomas I. Gonzales, Haniel J. Hernandez, Donte Pennington, Brian Hoover

Exercise and Nutrition Sciences Faculty Publications

The applied use of eccentric muscle actions for physical rehabilitation may utilize the framework of periodization. This approach may facilitate the safe introduction of eccentric exercise and appropriate management of the workload progression. The purpose of this data-driven Hypothesis and Theory paper is to present a periodization model for isokinetic eccentric strengthening of older adults in an outpatient rehabilitation setting. Exemplar and group data are used to describe the initial eccentric exercise prescription, structured familiarization procedures, workload progression algorithm, and feasibility of the exercise regimen. Twenty-four men (61.8 ±6.3 years of age) completed a 12-week isokinetic eccentric strengthening regimen involving …

Teft Fasi Alpha Test Report, Barbara Gage, Trudy Mallinson, Laurie Lyons, Joyce Maring, Ken Harwood, Anju Paude, Alex Gorsky, Beth Jackson, Pat Rivard, Lisa Gold, Allison Weaver, Kerry Lida

Physical Therapy and Health Care Sciences Faculty Publications

No abstract provided.

Neurobehavioral Function In Adults Recovering Consciousness After Severe Traumatic Brain Injury: A Scoping Review, Jennifer Weaver, Ann Guernon, Trudy Mallinson, Theresa Louise-Bender Pape, Thomas Harrod

Clinical Research and Leadership Faculty Posters and Presentations

This scoping review aims to report the findings of current literature examining the assessment of neurobehavioral function and recovery along the continuum of disorders of consciousness (DOC) from coma to full consciousness.

•This study is designed to capture the range of constructs researchers have used to measure NBF during recovery of consciousness.

•The research question for this review was: “What constructs are most frequently used to assess neurobehavioral function in adults recovering consciousness after severe TBI?”

Using Xbox Kinect Motion Capture Technology To Improve Clinical Rehabilitation Outcomes For Balance And Cardiovascular Health In An Individual With Chronic Tbi, Shane Chanpimol, Bryant A. Seamon, Haniel J. Hernandez, Michael O. Harris-Love, Marc R. Blackman

Exercise and Nutrition Sciences Faculty Publications

Background

Motion capture virtual reality-based rehabilitation has become more common. However, therapists face challenges to the implementation of virtual reality (VR) in clinical settings. Use of motion capture technology such as the Xbox Kinect may provide a useful rehabilitation tool for the treatment of postural instability and cardiovascular deconditioning in individuals with chronic severe traumatic brain injury (TBI). The primary purpose of this study was to evaluate the effects of a Kinect-based VR intervention using commercially available motion capture games on balance outcomes for an individual with chronic TBI. The secondary purpose was to assess the feasibility of this intervention …

Development Of The Motivation Assessment For Team Readiness, Integration, And Collaboration (Matricx) Self-Scored Report Form: A Qualitative Study On Translating Measurement Findings For Team Development, John Liu Jr.

Doctor of Occupational Therapy Capstone Projects

The Motivation Assessment for Team Readiness, Integration, and Collaboration (MATRICx) has been shown to provide information on intrapersonal readiness to collaborate within a team. This study aims to understand and develop an innovative approach to presenting a self-scoring format for the MATRICx and to determine how results of the assessment tool could be interpreted to understand individual motivation in collaborative healthcare and biomedical teams. The MATRICx Report Form is a self-scoring version of the MATRICx that can help users interpret their own motivational profile. A qualitative study was conducted to examine user’s experience with the report form, ways of interpreting …

Interrater Reliability Of Quantitative Ultrasound Using Force Feedback Among Examiners With Varied Levels Of Experience, Michael O. Harris-Love, Catheeja Ismail, Reza Monfaredi, Haniel J. Hernandez, Donte Pennington, Paula Woletz, Valerie Mcintosh, Bernadette Adams, Marc R. Blackman

Exercise and Nutrition Sciences Faculty Publications

Background. Quantitative ultrasound measures are influenced by multiple external factors including examiner scanning force. Force feedback may foster the acquisition of reliable morphometry measures under a variety of scanning conditions. The purpose of this study was to determine the reliability of force-feedback image acquisition and morphometry over a range of examiner-generated forces using a muscle tissuemimicking ultrasound phantom.

Methods. Sixty material thickness measures were acquired from a muscle tissue mimicking phantom using B-mode ultrasound scanning by six examiners with varied experience levels (i.e., experienced, intermediate, and novice). Estimates of interrater reliability and measurement error with force feedback scanning were determined …

A Randomized Controlled Trial Of Exercise In Spinal And Bulbar Muscular Atrophy., Joseph A Shrader, Ilona Kats, Angela Kokkinis, Cris Zampieri, Ellen Levy, Galen O Joe, Joshua G. Woolstenhulme, Bart E Drinkard, Michaele R Smith, Willie Ching, Laboni Ghosh, Derrick Fox, Sungyoung Auh, Alice B Schindler, Kenneth H Fischbeck, Christopher Grunseich

Physical Therapy and Health Care Sciences Faculty Publications

OBJECTIVE: To determine the safety and efficacy of a home-based functional exercise program in spinal and bulbar muscular atrophy (SBMA).

METHODS: Subjects were randomly assigned to participate in 12 weeks of either functional exercises (intervention) or a stretching program (control) at the National Institutes of Health in Bethesda, MD. A total of 54 subjects enrolled, and 50 completed the study with 24 in the functional exercise group and 26 in the stretching control group. The primary outcome measure was the Adult Myopathy Assessment Tool (AMAT) total score, and secondary measures included total activity by accelerometry, muscle strength, balance, timed up …

Progressive Supranuclear Palsy Treatment- A Systematic Review, Samah Hassan Hajjar, James K. Cooper

GW Research Days 2015

Introduction

Progressive Supranuclear Palsy (PSP) is an uncommon neurodegenerative disease associated with postural instability, falling, and memory loss. Because of clinical similarities, it is often classified as atypical Parkinson's disease. PSP may present abruptly with a relatively rapid decline, leading to death in a few years. Different therapeutic approaches have been suggested for PSP, but their efficacy is unclear. To our knowledge, there has been no systematic review of PSP treatment.

Objective

To determine the effectiveness PSP treatments.

Methods

A systematic review of published literature was completed. We searched using PubMed and SCOPUS for related articles. The search terms are …

Church Pew Exercise Integrated With Conventional Physical Therapy Following Total Knee Arthroplasty (Tka): Case Report, Randell Gonzales, Jerome V. Danoff

Exercise and Nutrition Sciences Faculty Publications

Background and Purpose: Physical therapy treatment following Total knee Arthroplasty (TKA) consists of a combination of strengthening and range of motion exercises. The exercise technique, church pew exercise (CPE), has been proposed to enhance quadriceps facilitation and improve function. This is a technique that has the patient standing and rocking forward/back. The backward motion is arrested by engagement of the upper calf against a solid object, creating a sudden flexion torque at the knee and a sudden extension torque at the hip. The combination of CPE with standard physical therapy is claimed to provide better quadriceps control and faster walking …

A Case-Based Reasoning (Cbr) Model For The Integration Of Insurance Policy And Regulations In Professional Physical Therapist Education, Rhea Cohn, Kenneth Harwood, Heather Richards, Karen Schlumpf

Physical Therapy and Health Care Sciences Faculty Publications

No abstract provided.

Quantitative Ultrasound: Measurement Considerations For The Assessment Of Muscular Dystrophy And Sarcopenia, Michael O. Harris-Love, Reza Monfaredi, Catheeja Ismail, Marc R. Blackman, Kevin Cleary

Exercise and Nutrition Sciences Faculty Publications

Diagnostic musculoskeletal ultrasound has potential clinical utility in characterizing pathological muscle tissue. Sonography has been long proposed as method of assessing muscle damage due to neuromuscular diseases such as muscular dystrophy, and more recently, changes in body and tissue composition associated with muscle wasting disorders such as sarcopenia. The use of quantitative ultrasound as an adjunct diagnostic procedure has different technical challenges than the traditional use of ultrasound in clinical medicine. Operator-dependent technique and variation are critical considerations when obtaining measures of echointensity (i.e., tissue composition estimates) and tissue dimensions (i.e., muscle thickness) – key elements of the ultrasound assessment …

Use Of Excimer Laser For Morphea, Samah Hassan Hajjar, Sarah Beggs, Alison Ehrlich

GW Research Days 2014

Background and Objectives:

Morphea, also known as localized scleroderma, is a sclerotic inflammatory disorder that primarily affects the skin but has the potential to involve fascia, muscle and bones. With no cure for this disfiguring disease, therapeutic modalities including topical regiments, immunosuppressive agents, antimalarial medications, and phototherapy are used to manage the symptoms and progression. While many treatments options are available, they vary in efficacy.

Methods:

We present a case of a 28-year-old woman with active sclerotic plaques distributed along her neck, left flank. She had previously failed therapy with topical steroids and methotrexate, and was started on hydroxychloroquine 400 …

In A 36-Year-Old Woman With Neck Pain, Will Manipulation And Mobilization Be Beneficial For Reducing Her Reports Of Neck Pain?, Holly Jonely, David A. Scalzitti

Physical Therapy and Health Care Sciences Faculty Publications

<LEAP> highlights the findings and application of Cochrane reviews and other evidence pertinent to the practice of physical therapy. The Cochrane Library is a respected source of reliable evidence related to health care. Cochrane systematic reviews explore the evidence for and against the effectiveness and appropriateness of interventions—medications, surgery, education, nutrition, exercise—and the evidence for and against the use of diagnostic tests for specific conditions. Cochrane reviews are designed to facilitate the decisions of clinicians, patients, and others in health care by providing a careful review and interpretation of research studies published in the scientific literature.1 Each article in …

Assessing Function And Endurance In Adults With Spinal And Bulbar Muscular Atrophy: Validity Of The Adult Myopathy Assessment Tool., Michael O. Harris-Love, Lindsay Fernandez-Rhodes, Galen Joe, Joseph A. Shrader, Angela Kokkinis, Alison La Pean Kirschner, Sungyoung Auh, Cheunju Chen, Li Li, Ellen Levy, Todd E. Davenport, Nicholas A. Di Prospero, Kenneth H. Fischbeck

Exercise and Nutrition Sciences Faculty Publications

Purpose. The adult myopathy assessment tool (AMAT) is a performance-based battery comprised of functional and endurance subscales that can be completed in approximately 30 minutes without the use of specialized equipment. The purpose of this study was to determine the construct validity and internal consistency of the AMAT with a sample of adults with spinal and bulbar muscular atrophy (SBMA).

Methods. AMAT validity was assessed in 56-male participants with genetically confirmed SBMA (mean age, 53 ± 10 years). The participants completed the AMAT and assessments for disease status, strength, and functional status. Results. Lower AMAT scores were associated with longer …

Intensive Goal-Directed Treatments In Enriched Environments Augments Patient Outcomes Post-Stroke, Blake A. Kandah, Michael A. Klonowski, Ryan M. Pelo, Nicole M. Williams, Raquel V. Santiago, Christopher K. Thompson, Kristan A. Leech, Carey L. Holleran, Abigail L. Leddy, T. George Hornby

GW Research Days 2013

Objective: Previous research indicates that patients post-stroke, average 400-800 steps within physical therapy sessions and demonstrate heart rate values of 24-35% of HR Max. This dosage and intensity is inadequate to promote neuroplastic changes and maximize recovery. The goal of this study was to quantify and examine the amount of high-intensity stepping practice that was delivered within an Acute Inpatient Rehabilitation (AIR) setting for individuals with sub-acute stroke.

Methods: 14 patients with a diagnosis of sub-acute stroke were admitted to AIR. Standardized outcomes included the 6-Minute Walk Test (6MWT), 10-Meter Walk Test (10MWT), the Berg Balance Scale (BBS) and the …

Few U.S. Public Health Schools Offer Courses On Palliative And End-Of-Life Care Policy, Dale Lupu, Caroline Deneszczuk, Tara Leystra, Rebecca Mckinnon, Victoria Seng

Physical Therapy and Health Care Sciences Faculty Publications

Background: Palliative care has been identified by the World Health Organization (WHO) as a critical policy element for the relief of suffering, yet palliative care policy receives minimal attention in mainstream U.S. public health journals, conferences, or textbooks. In the ’90s, documentation of the lack of attention to end-of-life and palliative care in medical and nursing curricula led to concerted efforts to improve medical and nursing education in palliative care. No such educational effort has yet been directed toward public health professionals.

Objective: This study's objective was to quantify current course offerings covering palliative and end-of-life care from a public …

The Development And Testing Of The Continuity Assessment Record And Evaluation (Care) Item Set: Final Report On Care Item Set And Current Assessment Comparisons: Volume 3 Of 3, Barbara Gage, Ann Deutsch, Laura Smith, Carole Schwartz, Jessica Ross, Laurie Coots, Karen Reilly, Judith Hazard Abbate, Kate Shamsuddin, Benjamin Silver, Christopher Murtagh, Margaret Stineman, Trudy Mallinson

Clinical Research and Leadership Faculty Publications

No abstract provided.

The Development And Testing Of The Continuity Assessment Record And Evaluation (Care) Item Set: Final Report On Reliability Testing, Volume 2 Of 3, Barbara Gage, Laura Smith, Jessica Ross, Laurie Coots, Tracy Kline, Kate Shamsuddin, Karen Reilly, Judith Hazard Abbate, Zachariah Gage-Croll, Anne Deutsch, Trudy Mallinson

Clinical Research and Leadership Faculty Publications

No abstract provided.

The Development And Testing Of The Continuity Assessment Record And Evaluation (Care) Item Set, Volume 1 Of 3, Barbara Gage, Roberta Constantine, Jyoti Aggarwal, Melissa Morley, Vera Kurlantzick, Shulamit Bernard, Dianne Munevar, Megan Garrity, Laura Smith, Dan Barch, Anne Deutsch, Trudy Mallinson, Linda Ehrlich-Jones

Clinical Research and Leadership Faculty Publications

No abstract provided.

Rasch Analysis Of Repeated Measures, Trudy Mallinson

Health, Human Function, and Rehabilitation Sciences Faculty Publications

Repeated measures are common in rehabilitation studies where patients are scored on assessments at both admission and discharge. Yet repeated measures produce dependencies among responses. This paper presents an alternative approach that avoid dependencies in the data.