Rehabilitation and Therapy Commons^™

Feasibility And Safety Of Early Post-Covid-19 High-Intensity Gait Training: A Pilot Study, Joakim Halvorsen, Christopher Henderson, Wendy Romney, Magnus Hågå, Tonje Barkenæs Eggen, Jan Egil Nordvik, Ingvild Rosseland, Jennifer Moore

Physical Therapy Faculty Publications

Background: The feasibility and safety of rehabilitation interventions for individuals recovering from COVID-19 after the acute stage is not well understood. This pilot study aims to provide a preliminary investigation of the feasibility and safety of providing high-intensity gait training (HIT) with a targeted cardiovascular intensity of 70–85% of the age-predicted maximum heart rate (HRmax) for individuals undergoing rehabilitation post-COVID-19. Methods: Consecutive patients who were medically cleared for HIT were invited to participate in the study. Participants practiced walking in varied contexts (treadmill, overground, and stairs), aiming to spend as much time as possible within their target cardiovascular intensity zone …

Delirium Education For Family Caregivers Of Patients In The Intensive Care Unit: A Pilot Study, Amanda Wheeler, Elise Bloch, Sarah Blaylock, James Root, Kateriza Ibanez, Newman Newman, Jose Diarte, Louis P. Voigt

Occupational Therapy Faculty Publications

Objectives

Delirium, an acute change in mental state, seen in hospitalized older adults is a growing public health concern with implications for both patients and caregivers; however, there is minimal research on educating caregivers about delirium. Utilizing family caregivers to assist with delirium management in acute care settings demonstrates improved health outcomes supporting the need for patient and family centered care. The primary aims of the study were to determine feasibility of implementing a delirium education video for caregivers of patients in an adult oncology intensive care unit and compare delirium knowledge to caregivers in a control group.

Methods

A …

Essential Content For Teaching Implementation Practice In Healthcare: A Mixed-Methods Study Of Teams Offering Capacity-Building Initiatives, Jessica Reszel, Olivia Daub, Jenny Leese, Hanna Augustsson, Danielle Moeske Bellows, Christine E. Cassidy, Beth E. Crowner, Sandra I. Dunn, Lisa B. Goodwin, Alison M. Hoens, Sarah C. Hunter, Elizabeth A. Lynch, Jennifer Moore, Miriam R. Rafferty, Wendy Romney, Dawn Campbell, Dawn Stacey, Implementation Practice Cbi Study Team, Ian D. Graham

Physical Therapy Faculty Publications

Background

Applying the knowledge gained through implementation science can support the uptake of research evidence into practice; however, those doing and supporting implementation (implementation practitioners) may face barriers to applying implementation science in their work. One strategy to enhance individuals’ and teams’ ability to apply implementation science in practice is through training and professional development opportunities (capacity-building initiatives). Although there is an increasing demand for and offerings of implementation practice capacity-building initiatives, there is no universal agreement on what content should be included. In this study we aimed to explore what capacity-building developers and deliverers identify as essential training content …

Long Duration Sonophoresis Of Diclofenac To Augment Rehabilitation Of Common Musculoskeletal Injuries, Paddy Jarit, Dominic Klyve, Rod Walters

Physical Therapy Faculty Publications

Background: The use of long duration sonophoresis (LDS) for musculoskeletal injuries is a new and emerging treatment option for patients undergoing rehabilitation. The treatment is non-invasive, provides multi-hour mechanical stimulus expediating tissue regeneration and deep tissue heat along with local application of therapeutic compound for improved pain relief. The objective of this prospective case study was to evaluate real-world application of diclofenac LDS as an add-on intervention for patients non-responsive to physical therapy alone. Methods: Patient who failed to respond to at least 4 weeks of physical therapy were treated with the addition of 2.5% diclofenac LDS daily for 4 …

Evidence-Based Practice Confidence And Behavior Throughout The Curriculum Of Four Physical Therapy Education Programs: A Longitudinal Study, Wendy Romney, Nancy M. Salbach, Susan B. Perry, Judith E. Deutsch

Physical Therapy Faculty Publications

Background

Evidence-based practice (EBP) is a foundational process taught in health professional education, yet it is unclear when EBP confidence and skills are obtained. Increases in EBP confidence and behaviors from the start of physical therapy programs to post graduation have been reported in studies that evaluated a single program or used non-valid questionnaires. This study aimed to describe changes in EBP confidence and behavior using validated questionnaires of students from four physical therapy education programs throughout their curriculum and one year post graduation.

Methods

One hundred and eighty-one students from a potential pool of 269 (67.3%) consented to participate. …

Occupational Therapy Newsletter, Summer 2022, Occupational Therapy Department

News, Magazines and Reports

Highlights: Letter from Department Chair and Program Director Dr. Sharon McCloskey -- 20th year program celebration slideshow -- Alumna Anastasiya Akay advocates for orphans in Ukraine -- Faculty focus on Amanda Wheeler (PhD, OTR/L) -- Dr. Sheelagh Schlegel (DrHSc, MPH, OTR/L, CHES, CAPS) facilitates patient simulations -- Dr. Lola Halperin (Ed.D., OTR/L) presents at the ConnOTA and AOTA conferences and participates in the Dean's Speaker Series -- Dr. Sharon McCloskey (Ed.D., MBA, OT/L, DipCOT, CTP) presents "Understanding the Impact of Trauma and ACE's on Learning and Participation in Schools" -- Pilot social simulation training program for occupational therapy students -- …

Occupational Therapy Newsletter, Spring 2022, Occupational Therapy Department

News, Magazines and Reports

Letter from Department Chair and Program Director, Sharon McCloskey -- This academic year includes the 20th cohort attending -- The OT program remains fully accredited -- Letter from the newsletter editor, Carissa Scheier -- Dr. Jody Bortone, founding chair retires after 22 years -- Emma Bass receives Christine E. Bushar Award -- Dr. Jaimee Hegge receives the CHP Alumni Leadership Award -- Dr. Lola Halperin facilitates trainings on the use of play to foster development among children exposed to adversity -- Dr. Halperin also provided an online workshop Understanding Schizophrenia and Occupational Therapy for Individuals Affected by It, for the …

Initial Steps For Integrating Academic Electronic Health Records Into Clinical Curricula Of Physical And Occupational Therapy In The United States: A Survey-Based Observational Study, Stephen C. Burrows, Lola Halperin, Eric C. Nemec, Wendy Romney

Healthcare Informatics Faculty Publications

Training programs must be designed to prepare physical and occupational therapy students for using Electronic Health Records (EHR) and interprofessional collaboration. This report aims to describe physical and occupational therapy students' perceptions of integrating Academic EHR in their Problem-Based Learning (PBL) curricula in the College of Health Professions, Sacred Heart University, Fairfield, Connecticut, the United States. A paper-based case approach to PBL was adapted by creating patient cases in an Academic EHR (AEHR). Students were asked to complete chart reviews and review provider notes to enhance their learning. An online survey was conducted to determine their perceptions of using AEHR …

Doctoral Physical Therapy Students' Increased Confidence Following Exploration Of Active Video Gaming Systems In A Problem-Based Learning Curriculum In The United States: A Pre-And Post-Intervention Study, Michelle E. Wormley, Wendy Romney, Diana Veneri, Andrea Oberlander

Physical Therapy Faculty Publications

Purpose: Active video gaming (AVG) is used in physical therapy (PT) to treat individuals with a variety of diagnoses across the lifespan. The literature supports improvements in balance, cardiovascular endurance, and motor control; however, evidence is lacking regarding the implementation of AVG in PT education. This study investigated doctoral physical therapy (DPT) students' confidence following active exploration of AVG systems as a PT intervention in the United States.

Methods: This pretest-posttest study included 60 DPT students in 2017 (Cohort 1) and 55 students in 2018 (Cohort 2) enrolled in a problem-based learning curriculum. AVG systems were embedded into patient cases …

Physical Activity Interventions In Children With Juvenile Idiopathic Arthritis: A Systematic Review Of Randomized Controlled Trials, Maura D. Iversen, Marie Andre, Johan Von Heideken

Physical Therapy Faculty Publications

Introduction: Children with juvenile arthritis (JA) experience pain, stiffness, fatigue, and decreased motion leading to difficulties with daily activities and low physical activity (PA). PA is critical to improve health and function and mitigate JA-associated symptoms. This study evaluated the evidence for PA interventions in children with JA.

Materials and methods: A systematic review of randomized controlled trials (RCTs) of PA interventions in children with JA was conducted. Ovid (Medline), Cochrane Library, EMBASE, and CINAHL databases were searched for papers published in English between 1/1/1946 and 9/1/2021. Studies which concurrently assessed medical interventions were excluded. Participant and intervention characteristics and …

Reporting Of Harm In Randomized Controlled Trials Of Therapeutic Exercise For Knee Osteoarthritis: A Systematic Review, Johan Von Heideken, Sana Chowdhry, Joanna Borg, Khara James, Maura D. Iversen

Physical Therapy Faculty Publications

Objective: The Consolidated Standards of Reporting Trials (CONSORT) recommends reporting adverse events (AEs) and dropouts (DOs) with their definitions. The purpose of this study was to identify how AEs and DOs were reported in randomized controlled trials (RCTs) of therapeutic exercise for knee osteoarthritis (OA).

Methods: Data sources were the Cochrane Library, EMBASE, PUBMED, and CINAHL. Databases were searched to identify RCTs of therapeutic exercise for Knee OA published from January 1, 1980, through July 23, 2020. Researchers independently extracted participant and intervention characteristics and determined whether a clear statement of and reasons for AEs and DOs existed. The primary …

The Why, Where, And How Clinical Reasoning Model For The Evaluation And Treatment Of Patients With Low Back Pain, Sean P. Riley, Brian T. Swanson, Joshua Cleland

Physical Therapy Faculty Publications

Objective

The objective of this theoretical clinical reasoning model is to provide a framework to help clinicians integrate linear and non-linear clinical reasoning approaches to minimize clinical reasoning errors related to logically fallacious thinking and cognitive biases.

Methods

This masterclass proposes a hypothesis-driven and probabilistic approach that uses clinical reasoning for managing LBP that seeks to eliminate the challenges related to using any single diagnostic paradigm.

Conclusions

This model integrates the why (mechanism of primary symptoms), where (location of the primary driver of symptoms), and how (impact of mechanical input and how it may or may not modulate the patient's …

Flop To Flip: Integrating Technology And Team-Based Learning To Improve Student Engagement, Diana Veneri, Elizabeth M. Mongillo

Physical Therapy Faculty Publications

Purpose: The first attempt to develop and instruct a new course in evidence-based practice in a physical therapy curriculum proved problematic. The purpose of this paper is to describe the method of revising this traditionally taught course using a combination of flipping the classroom, team-based learning, and technology. Methods: Working with an Instructional Design Specialist, a weekly online preparatory module was created for each content topic using a variety of multimedia learning provisions including micro learning videos (PowerPoint with voiceover), transcript of the PowerPoint, a list of vocabulary words, reading, Quizlet, Flipgrids and Concept Checks. Each week’s module was introduced …

The Quality Of Intervention Reporting In Trials Of Therapeutic Exercise For Hip Osteoarthritis: A Secondary Analysis Of A Systematic Review, Louise C. Burgess, Thomas C. Wainwright, Khara A. James, Johan Von Heideken, Maura D. Iversen

Physical Therapy Faculty Publications

Background: Therapeutic exercise is recommended as a core treatment for hip osteoarthritis (HOA). Whilst it is widely accepted that exercise can improve pain and disability, optimal type and dose of exercise are yet to be agreed upon. This may, in part, be attributed to the wide variation and inadequate reporting of interventions within the literature. This study evaluates the quality of intervention reporting among trials of therapeutic exercise in HOA.

Methods: Randomised controlled trials (RCTs) were sourced in a systematic review, completed in August 2020. Two raters independently used the Template for Intervention Description and Replication (TIDieR) and Consensus on …

Interweaving Teaching Strategies In Interprofessional Education: A Pilot Study With Graduate Occupational Therapy And Physician Assistant Students, Eric C. Nemec, Lola Halperin, Jaimee Betts Hegge

Physician Assistant Studies Faculty Publications

The importance of interprofessional education (IPE) has been emphasized by the World Health Organization and is currently required by both the occupational therapy (OT) and physician assistant (PA) education accreditation agencies in the United States. Moreover, a growing body of evidence suggests that IPE fosters learners’ understanding of the roles different disciplines play in healthcare delivery and prepares future health professionals for patient-centered care. Authors designed and implemented an IPE event aimed to foster the following core Interprofessional Education Collaborative (IPEC) competencies among graduate OT and PA students: Values/Ethics for Interprofessional Practice, Roles and Responsibilities, Interprofessional Communication, and Teams and …

Physical Examination Findings In Patients With Protracted Concussion And The Impact Of An Integrative Concussion Rehabilitation Protocol, Lauren Ziaks, Chelsea Brown, Maura D. Iversen

Physical Therapy Faculty Publications

Purpose: To describe physical examination (PE) findings of individuals with protracted concussion recovery and evaluate an integrated primitive reflex (PR) disinhibition, vision, and vestibular rehabilitation intervention. Method: Retrospective study of 82 patients with protracted concussion (60.98% female) who received ≥ 2 phases of treatment. Following a baseline PE, patients completed the Post-Concussion Symptom Survey (PCSS), Activities-Based Balance Confidence Questionnaire (ABC), Dizziness Handicap Index (DHI), and Acquired Traumatic Brain Injury (aTBI) Vision Questionnaire. A subset of patients (Group 1), completed a final PE and second questionnaire administration. Descriptive statistics characterized the sample. T-tests and Wilcoxon rank sum tests compared characteristics of …

Measures Of Pediatric Function And Physical Activity In Arthritis, Anna E. Greer, Maura D. Iversen

Exercise Science Faculty Publications

Physical function can be assessed through physical examination with the use of performance-based measures and patient-reported outcome measures (PROMs). Each form of assessment provides a unique contribution to the understanding of the impact of rheumatologic conditions on the patient. PROMs of physical function (PF) are an important component of the assessment of children with arthritis and have been included in the recommended core set of measures for childhood arthritis and musculoskeletal conditions. These measures provide the child’s or parent’s perspective of function within the context of daily living. Measures of PF include both generic measures, which are designed for use …

Physical Inactivity: A Behavioral Disorder In The Physical Therapist’S Scope Of Practice, Matthieu P. Boisgontier, Maura D. Iversen

SHU Faculty Publications

In health, the gold standard is a state of complete physical, mental, and social well-being.This state is weakened by physical inactivity, which involves a higher risk of cardiovascular disease, hypertension, diabetes, cancer, depression, and obesity. Moreover, 6% to 10% of all deaths from non-communicable diseases worldwide can be attributed to physical inactivity. These adverse effects of physical activity provide evidence that physically active individuals are closer to the gold standard of health than inactive individuals. Therefore, physical activity – not inactivity – should be the standard reference behavior. In this framework, physical inactivity is a clinically significant disturbance in an …

Sustained Acoustic Medicine Combined With A Diclofenac Ultrasound Coupling Patch For The Rapid Symptomatic Relief Of Knee Osteoarthritis: Multi-Site Clinical Efficacy Study, Alex Madzia, Chirag Agrawal, Paddy Jarit, Stephanie Petterson, Kevin Plancher, Ralph Ortiz

Physical Therapy Faculty Publications

Background:

Sustained Acoustic Medicine (SAM) is an emerging, non-invasive, non-narcotic, home-use ultrasound therapy for the daily treatment of joint pain. The aim of this multi-site clinical study was to examine the efficacy of long-duration continuous ultrasound combined with a 1% diclofenac ultrasound gel patch in treating pain and improving function in patients with knee osteoarthritis.

Methods:

The Consolidated Standards of Reporting Trials (CONSORT) were followed. Thirty-two (32) patients (18-males, 14-females) 54 years of average age with moderate to severe knee pain and radiographically confirmed knee osteoarthritis (Kellgren-Lawrence (KL) grade II/III) were enrolled for treatment with the SAM device and diclofenac …

Non-Thrust Cervical Manipulations Reduce Short-Term Pain And Decrease Systolic Blood Pressure During Intervention In Mechanical Neck Pain: A Randomized Clinical Trial, Emmanuel Yung, Cheongeun Oh, Michael Wong, Jason K. Grimes, Erica M. Barton, Muhammad I. Ali, Allison Breakey

Physical Therapy Faculty Publications

Objectives: To evaluate the association of resting blood pressure with pain response and evaluate the cardiovascular effects of anterior-to-posterior [AP] versus lateral [LAT] techniques of cervical spine non-thrust manipulation [NTM].

Methods: Forty-three (23 females) participants with non-chronic neck pain (mean age 29.00 ± SD 9.09 years) randomly received AP or LAT NTM to the cervical spine. Blood pressure and heart rate were measured before, during, and after the intervention. Disability and pain were measured pre- and post-intervention.

Results: Resting systolic blood pressure (SBP) was significantly associated with average pain reduction two days later on univariate and multivariate analyses (coefficients −0.029 …

Schizophrenia Spectrum Disorders: Linking Motor And Process Skills, Sensory Patterns, And Psychiatric Symptoms, Lola Halperin, Janet Falk-Kessler

Occupational Therapy Faculty Publications

Background: Consistent evidence suggests sensory abnormalities and skill deficits in people with Schizophrenia Spectrum Disorder (SSD). Further exploration of their sensory patterns and performance skills is warranted to promote community participation among these individuals.

Method: This study examined sensory patterns and motor and process skills in relationship to psychiatric symptoms in adult patients with SSD. Participants were evaluated using the Adolescent/Adult Sensory Profile, the Assessment of Motor and Process Skills, and the Brief Psychiatric Rating Scale.

Results: Of the 18 participants, the majority showed sensory differences, deficits in motor and process skills, and the presence of moderate to severe symptoms. …

Occupational Therapy In Haiti: A Pilot Study To Identify Intervention Methods Used During Short-Term Medical Missions, Sheelagh M. Schlegel, Kathleen Mathieson

Occupational Therapy Faculty Publications

Due to the shortage of occupational therapists (OTs) in Haiti and over 800,000 individuals with disabilities, most occupational therapy assessments and interventions are provided by OTs on short-term medical missions (STMMs). Learning which methods OT use to provide assessments and interventions during these STMMs is the first step to understanding how to facilitate followup and carry-over for clients and ensure longevity for STMMs in Haiti. This study used a cross-sectional, descriptive design to gather data on methods used by OTs. Thirty-three OTs, who travelled to Haiti on STMMs, completed a 16-question, online survey. The most common method provided by OTs …

Missing Pieces And Misconceptions: Public Understanding Of Occupational Therapy, Heather Miller-Kuhaneck, Erin Coutts, Brenna Destefano, Andrea Gallo, Caitlin Kaczynski, Giana Marucci, Kristen Mourao, Jennifer Vialonga

Occupational Therapy Faculty Publications

The students of Gamma Nu Chapter of Pi Theta Epsilon at Sacred Heart University completed a qualitative project examining the public perceptions of occupational therapy. This poster is their presentation to the state OT association, ConnOTA.

Reliability And Relationship Of The Fear-Avoidance Beliefs Questionnaire With The Shoulder Pain And Disability Index And Numeric Pain Rating Scale In Patients With Shoulder Pain, Sean P. Riley, Vincent Tafuto, Mark Cote, Jean-Michel Brismée, Alexis Wright, Chad Cook

Physical Therapy Faculty Publications

Purpose: The purpose of this study was to determine: 1) the test–retest reliability of Fear-Avoidance Beliefs Questionnaire (FABQ) Work (FABQW) subscale, FABQ Physical Activity (FABQPA) subscale, Shoulder Pain and Disability Index (SPADI) Pain subscale, SPADI Disability subscale, and Numeric Pain Rating scale (NPRS); and 2) the relationship between the FABQPA, FABQW, SPADI pain, SPADI disability, and NPRS after 4 weeks of pragmatically applied physical therapy (PT) in patients with shoulder pain. Design: Prospective, single-group observational design. Methods: Data were collected at initial evaluation, the first follow-up visit prior to the initiation of treatment, and after 4 weeks of treatment. …

The Efficacy Of Custom And Prefabricated Orthotic Interventions For Common Running Related Injuries, Jake Tavernite

Writing Across the Curriculum

One of the most popular sports in the world is running. Nearly 17 million people in the United States alone crossed finish lines in road races in 2017.¹ Unfortunately, there is an extremely high rate of running related injuries (RRI) that prevent or hinder individuals from training and competing. A 2007 systematic review revealed that the incidence of lower extremity running related injuries ranges from 19.4% to 79.3%.² Orthotics are frequently prescribed as a conservative treatment option for various injuries such as plantar fasciitis (PF), patellofemoral pain syndrome (PFPS), medial tibial stress syndrome (MTSS), and stress fractures. Although …

Effects Of International Service Learning On Development Of Intercultural Competence, Sharon M. Mccloskey

Occupational Therapy Faculty Publications

As the United States becomes an increasingly multicultural society (Colby & Ortman, 2014; Perez & Hirschman, 2009), there are greater opportunities for cross-culture interactions, especially in settings for healthcare practitioners. The profession of occupational therapy demands future practitioners understand culture and become skilled in the delivery of culturally competent care (AOTA, 2014). The purpose of this study was to examine the effects of international service learning (ISL) on the development of intercultural competence in graduate occupational therapy students. Inquiry for this research followed a mixed-methods explanatory sequential design. Study participants were graduate occupational therapy students who engaged in an international …

Reliability Of Smartphone Inclinometry To Measure Upper Cervical Range Of Motion., Paul A. Ullucci, Frank Tudini, Matthew F. Moran

Physical Therapy Faculty Publications

Context: Assessment of upper cervical range of motion (UCROM) and mobility is commonly performed in the clinical setting for patients suffering from headache, neck pain and vestibular dysfunction. Reliable and reproducible measurement of this motion is often difficult or too expensive to perform in the clinical setting. Smartphone applications, utilizing the device's internal gyroscope, offer an easy and inexpensive means of measuring UCROM, but their reliability has not been reported in the literature.

Objective: Assess the reliability of an inclinometer application, installed on two different devices (iPhone6 (IP), Andriod (AN)), to measure UCROM in a healthy population.

Design: Two examiners …

Fms Squat Assessment And 2d Video Motion Analysis As Screening Indicators Of Low Back Pain: A Cross Sectional Case- Study, Tracy Donlon, Britanny Franklin, Courtney Machamer, Christina Mogelnicki, Jeffrey Verneus, Christopher Taber

Exercise Science Faculty Publications

Aim: Low back pain (LBP) is a disabling condition to individuals in the United States and physical therapy (PT) has been proven to be a beneficial treatment by analyzing their movement patterns. The main objective of this study was to analyze the deep squat component of the Functional Movement Screen (FMS) as an indicator of LBP while simultaneously using 2-D analysis. Method: This cross-sectional case study included 36 participants that completed a total of six deep squats. Three raters scored the FMS score of each participant. Results: The association between FMS score and the presence of LBP showed to be …

A Pilot Professional Development Program For Occupational Therapy Practitioners Who Work In Home Settings: Knowledge Translation On Urinary Incontinence, Jaimee Betts Hegge

Occupational Therapy Faculty Publications

The purpose of this project was to increase the knowledge and confidence of home based occupational therapy practitioners working with adults and older adults who have urinary incontinence. The knowledge translation model of education is used to educate health care providers to improve integration of new information. The Reflective Questioning Framework for coaching can be effective with increasing knowledge and confidence of practitioners that are integrating new learning into their daily home care practice. This project investigated how these two approaches to education impacted occupational therapy practitioners perceived level of knowledge and confidence treating urinary incontinence in adult and older …

Sensory, Motor And Process Skills As Compared To Symptom Severity In Adult Patients With Schizophrenia, Lola Halperin

Occupational Therapy Faculty Publications

Schizophrenia is a serious mental illness affecting millions of Americans. It is characterized by positive and negative symptoms; cognitive impairments; and sensory, motor, and process skill deficits; as well as compromised motor learning, functional difficulties, and diminished quality of life. Neuroscientists attribute the above deficits to abnormal brain development, exaggerated synaptic pruning, and neurodegenerative processes, causing disrupted connectivity and diminished plasticity in the brain, neurotransmitter dysfunction, and impaired sensory processing.

Presently, there is no cure for schizophrenia. Numerous medications and rehabilitation modalities exist; however, many of the affected individuals continue to struggle daily. Recovery of these individuals implies symptom management …