Rehabilitation and Therapy Commons^™

From Classroom To Practice: Implementing The Core Set Of Outcome Measures In A Student-Led Clinic, Anders Brown Spt, Amy Zhou Spt, Holly Roberts Pt, Dpt, Phd, Ncs

Physical Therapy Research Symposium

Background: Literature suggests that Clinical Practice Guidelines (CPGs) are insufficient for facilitating behavior change in clinicians. However, translating research to clinical practice is essential for evidence-based practice. Prior to publication of the Core Set of Outcome Measures (CSOMs) for Adults with Neurologic Conditions CPG, all recommended outcome measures (OMs) were included in the University of Puget Sound curriculum. Beginning Fall 2018, didactic instruction adjusted such that clinical decision-making for the CSOMs was instructed as outlined in the CPG.

Purpose: To determine whether utilization of CSOMs in a student-led neurologic outpatient physical therapy clinic changed after students received intentional didactic instruction …

What Motivates Highly Active Mothers? A Self-Determination Theory Perspective, Natalie Mcdaniel Spt, Stephane Robert Spt, Danny Mcmillian Pt, Dsc, Ocs

Physical Therapy Research Symposium

What Motivates Highly Active Mothers? A Self-Determination Theory Perspective

Natalie McDaniel, SPT; Stephane Robert, SPT

Mentor: Danny McMillian, PT, DSc, OCS

Background: Physical inactivity is a major global health concern linked to high mortality rates. Extensive research demonstrates the role of physical activity (PA) in enhancing overall well-being, longevity, and disease prevention. Mothers living with children face significant challenges in pursuing PA.

Purpose: This qualitative research uses Self-Determination Theory (SDT) to investigate experiences and beliefs influencing PA motivation and satisfaction in highly active mothers.

Methods: (N=5). Participants completed the Motives for Physical Activities Measure - Revised (MPAM-R) and the Basic …

Is There A Relationship Between Lived Discrimination And Chronic Pain? - A Pilot Study, Jordan Taylor Kasube Spt, Erin P. O'Neill Spt, Sean White Spt, Karin Steere Dpt, Phd

Physical Therapy Research Symposium

Background: The complexity of the human experience of pain involves myriad biological, psychological, and social factors, each contributing uniquely to the overall experience. Recent literature illustrates the impact of social determinants on health outcomes, including an association between chronic pain and lived-discrimination. Heart rate variability (HRV) is used as a measure of systemic health, with diminished HRV often accompanying chronic pain.

Purpose: The primary aim of this study is to provide a pilot feasibility protocol to investigate the relationship between lived discrimination and HRV across the spectrum of pain duration.

Methods: HRV data was collected from 39 participants while seated …

Is Upright Exploratory Play Influenced By Partial Body Weight Support In Infants With Down Syndrome?, Sofia Hardin Spt, Christa Lum Spt, Julia Looper Pt, Phd, Reham Abuatiq, Mia Hoffman, Alyssa Fiss Pt, Phd, Heather Feldner Pt, Phd

Physical Therapy Research Symposium

Is Upright Exploratory Play Influenced by Partial Body Weight Support in Infants with Down Syndrome?

Sofia Hardin, SPT; Christa Lum, SPT

Mentor: Julia Looper, PT, PhD

Background: Children with Down syndrome (DS) typically present with delayed gross motor skills, which may negatively impact their development in other realms, such as cognition and language. The partial body-weight supported system (PBWSS) is a possible early intervention for infants with DS in physical therapy settings and in the community to facilitate motor development through exploratory play.

Purpose: To explore the effects of a PBWSS on upright play positions during exploratory play among infants …

Effects Of Treadmill Interventions On Infants With Developmental Delays Presenting With Mild And Severe Impairments: A Case Series, Eric Nguyen Spt, Nicolle Gerchak Spt

Physical Therapy Research Symposium

Background: Physical development delays can severely limit a child’s ability to explore and learn about their environment. Evidence supports that this exploration promotes a child’s development in cognition, language acquisition, social skills, and further physical skills. Thus, interventions that target and improve early mobility can be highly valuable to a child’s life. Treadmill training in infants with developmental delays has shown to be an effective intervention in moving infants toward earlier independent walking and improved gross motor function.

Purpose: This study aims to explore the potential benefits of an established treadmill training program in infants with varying degrees of motor …

Covid Restrictions Did Not Decrease Physical Activity In Community-Dwelling Older Adults, Jillian Stoewer Spt, Cara Filce Spt, Holly J. Roberts Pt, Phd, Gcs, Ncs

Physical Therapy Research Symposium

Background

Understanding the long-term impacts of COVID-19-related stay-at-home orders on physical activity can help clinicians prepare for consequences that may impact their patient populations.

Purpose

This study examined effects of the 2020 COVID-19 stay-at-home orders on physical activity levels in community-dwelling older adults including the number of hours they spent walking outside of the home and working/volunteering in the community.

Methods

Eighty-nine participants completed a monthly Physical Activity Scale for the Elderly (PASE) for 10 months. One-way repeated measures ANOVAs with post hoc analyses were calculated to determine differences among PASE scores, PASE item 2 scores, and work/volunteer hours at …

A Systematic Review Of Chronic Pain Mechanism Differential Assessment Strategies For Physical Therapy, Kate Hovde Spt, Kenny Li Dpt, Kylie Wong Bs, Roger Allen Phd, Pt

Physical Therapy Research Symposium

Background

Recently, the International Association for the Study of Pain (IASP) redefined pain, the American Physical Therapy Association proposed pain education guidelines, and a new pain mechanism category (PMC) was defined as “nociplastic pain”. IASP defines three PMCs - nociceptive, neuroplastic, and nociplastic.

Purpose

Identify current clinical assessment strategies for differentiating between nociceptive, neuropathic, and nociplastic chronic pain, feasible for implementation by physical therapists (PTs).

Methods

In 2020, investigators independently searched databases for studies evaluating assessment methods differentiating “nociceptive,” “neuropathic,” “central,” “mixed pain” and “central sensitization,” with follow-up on “nociplastic pain”. A qualitative systematic review was performed utilizing defined inclusion …

Motivational Characteristics And Fulfillment Of Psychological Needs Among Physically Active Undergraduate Students, Rohan Cobb-Ozanne Spt, Kayla Renee Withers Spt, Danny Mcmillian Pt, Dsc

Physical Therapy Research Symposium

Background: Physical activity (PA) guidelines describe positive correlations between PA and health outcomes. Self-determination theory (SDT) was used to identify motivational factors crucial to a physically active lifestyle.

Purpose: Identify and analyze how motivational characteristics, fulfillment of psychological needs, and individual experiences/beliefs influence PA.

Methods: Participants defined as moderately to vigorously physically active by the International Physical Activity Questionnaire were recruited using nominated sampling and public advertising. Motivational characteristics and psychological needs were assessed using SDT, Motives for Physical Activities Measure – Revised (MPAM-R), and The Basic Psychological Need Satisfaction and Frustration Scale – General (BPNSF). Semi-structured interviews were recorded …

Pain Catastrophizing, Pain Intensity And Perceived Injustice Do Not Predict Hrv In Acute Pain, Jacqueline Diulio Spt, Hailey Kettel Spt, Karin Steere Dpt, Phd

Physical Therapy Research Symposium

BACKGROUND: The nature of chronic pain conditions is well documented, with systemic biological, psychological and social factors interacting in an emergent fashion. Autonomic nervous system dysregulation, reflected as decreased heart rate variability (HRV), is suggested to be a biomarker of systemic dysfunction. Previous research has demonstrated correlations between numerous chronic pain disorders and diminished HRV.

PURPOSE: To determine the relationship between pain and HRV in the acute phase of pain, and to examine the predictive value of psychosocial variables on HRV. This study is meant to enhance our sense of how early in the pain experience decreased HRV may occur. …

Investigating Professional Development: Comparing Students Self-Assessment With Assessment Of The Clinical Instructors, Johana Kontarovsky Spt, Jennifer Hastings Pt, Phd

Physical Therapy Research Symposium

Investigating Professional Development: Comparing Students Self-Assessment with Assessment of the Clinical Instructors

Johana Kontarovsky, SPT
Mentor: Jennifer Hastings PT, PhD

Background: Professional behavior and self-assessment are aspects that are paramount to being a successful medical professional.

Purpose: This purpose of this study was to look at the development of professionalism in the cohort of 2020 at our institution. The concept was to investigate the students’ use of reflection as a foundation for personal and professional development.

Methods: The Self Reflection and Insight Scale (SRIS) was given to the SPTs September and December 2017 as well as May of 2020. The …

The Relationship Of Catastrophization, Pain Intensity, And Heart Rate Variability In Acute Pain - A Pilot Study, Carolyn Barbee Spt, Elizabeth A. Waddell Spt, Karin Steere Dpt

Physical Therapy Research Symposium

Background: Reduction in heart rate variability (HRV) can strongly and independently predict adverse health outcomes.Chronic pain conditions are associated with reduced HRV, and HRV may be a biomarker for predicting chronic pain.

Purpose: While pain intensity and catastrophization are associated with chronic pain,the aim of this study is to investigate their relationship with HRV in individuals with acute pain.

Methods: Fourteen subjects from two facilities participated. Data from two participants was excluded. HRV was collected while seated as participants completed an iPad survey. Raw inter-beat interval (IBI) data was analyzed with Kubios software.

Results: Multiple regression analyses were …

Influences Of Balance Confidence, Fear Of Falling, And Fall History On Physical Activity Levels In Community-Dwelling Older Adults, Alison Yang Spt, Holly Roberts Pt, Phd

Physical Therapy Research Symposium

Background: Physical activity levels generally decline with increasing age. Few studies have examined the influences of balance confidence, fear of falling, and fall history on physical activity levels in older adults.

Purpose: To determine the relationships between balance confidence, fear of falling, fall history, and physical activity level in community-dwelling older adults.

Methods: Eighty-eight participants completed the Activities-specific Balance Confidence Scale (ABC), Fear of Falling Avoidance Behavior Questionnaire (FFABQ), and a self-reported fall history. They reported their monthly activity levels using the Physical Activity Scale for the Elderly (PASE). Pearson correlation coefficients (r) were used to analyze …

Resiliency, Anxiety And Depression Amongst Dpt Students - A Survey During The Covid-19 Pandemic, Michaela Corbitt Spt, Amber Odo Spt, Robert Boyles Pt, Dsc, Ocs, Faaompt

Physical Therapy Research Symposium

Resiliency, Anxiety and Depression Amongst DPT Students–A Survey of Three Cohorts During the COVID-19 Pandemic

Michaela Corbitt, SPT; Amber Odo, SPT

Mentor: Robert Boyles, PT, DSc

Background: Doctor of Physical Therapy (DPT) programs are challenging due to the academic rigor, fast-paced learning environment, tuition cost, and feelings of inadequacy. Resiliency involves the ability to cope with stressors presented in daily life. Higher levels of resiliency has been associated with lower levels of depression, stress, and anxiety. This negative correlation may be key for preventing burnout, increasing life satisfaction, and prolonging careers for DPT graduates.

Purpose: To assess resiliency, anxiety and …

Treadmill Training For Infants With Down Syndrome: A Case Study, Mary Ngo Spt, Anna Paradee Spt, Julia Looper Pt, Phd

Physical Therapy Research Symposium

Background: Children with Down syndrome (DS) experience motor delays particularly with ambulation. Previous research has suggested that a 5 time per week, 8 minute per session protocol for treadmill training (TT) was effective in earlier acquisition of walking.

Purpose: To examine the effectiveness of a home-based 2 time per week, 20 minute per session TT protocol on the development of independent step taking in an infant with DS.

Methods: A 20-month-old boy with DS, underwent a repair for esophageal atresia at 5 months, and currently uses a feeding tube. He was independently sitting and non-ambulatory. Weekly Zoom meetings were conducted …

Strengths-Based Interventions To Support Positive Role Identity In Home Health Practice, Sarah Kiefer

School of Occupational Therapy Master's Capstone Projects (2016-2021)

The author collaborated with a home health occupational therapist in Western Washington. The therapist’s research question was, “What evidence is there to support strengths-based therapy interventions effective in supporting positive role identity in adults with physical disabilities who are receiving home health or outpatient rehabilitation services?” Home health practitioners may not account for a client’s mental health challenges that impact role identity. A client’s sense of role identity can influence re-engagement in meaningful activities that support quality of life. The evidence review found that role identity concepts, like autonomy, are considered to be important, but often measured as secondary outcomes. …

Evidence Supporting The Effectiveness Of Standardized Assessments At Predicting Safe Performance Of Activities Of Daily Living For Patients In Skilled Nursing Facilities, Jenna Mangiagli, Bridget Manion, Mckenzie Roque, Olivia Wasilenski

School of Occupational Therapy Master's Capstone Projects (2016-2021)

The research question was “What is the evidence to support the effectiveness of standardized assessments at predicting safe performance of ADLs for patients in skilled nursing facilities (SNFs)?” The literature review results indicate that there is strong evidence to support the effectiveness of the Barthel Index (BI), Modified Barthel Index (MBI), and Functional Independence Measure (FIM) at predicting safe performance of ADLs for patients in SNFs. It is recommended that practitioners use the MBI to predict safe performance of ADLs for patients at intake and discharge from SNFs. To support implementation of the research findings, a fact sheet and pre-recorded …

Improving Recidivism And Outcomes Within Inpatient Psychiatric Hospitals, Brooke Harrison, Madison Mainard, Marissa Mclellan, Kate Ricke

School of Occupational Therapy Master's Capstone Projects (2016-2021)

In collaboration with a local occupational therapist in the adult inpatient acute mental health unit at a small urban hospital in Western Washington, we conducted a systematic literature review to determine which strategies are most effective in reducing readmission to inpatient adult psychiatric facilities for individuals experiencing homelessness and/or substance abuse. Overall results found housing assistance, 24/7 resource access, interdisciplinary teams, and holistic individualized care to be effective in the reduction of recidivism for individuals experiencing homelessness and/or substance abuse. Interventions focused on money management, diagnosis education, and community reintegration were also supported. Evidence indicated systemic social and legislative reform, …

Effectiveness Of Auditory Interventions On Children's Attention, Engagement, Self-Regulation, And Auditory Discrimination, Victoria Brager, Claira Geller, Jessica Kresl, Emily Waham

School of Occupational Therapy Master's Capstone Projects (2016-2021)

Sensory-based interventions are commonly used in occupational therapy practice to support children and youth with disabilities that may impact occupational performance. Auditory interventions are a specific sensory intervention centered around the use of sounds thought to create neural changes in the brain resulting in improved functional performance (Wink, McKeown, & Casey, 2017). Four occupational therapy research students collaborated with a local pediatric occupational therapist who was interested in obtaining updated evidence on auditory interventions with children. Researchers screened and systematically reviewed the literature to address the question, "Do auditory interventions improve self-regulation, engagement, auditory discrimination, and/or attention for children?" Upon …

Addressing Attention Difficulties In School-Aged Children Through Interventions Targeting On-Task Behavior And School Performance, Loran Edwards Ots, Rebekah Jugensen Ots, Jessica Oppenheimer Ots, Michelle Parker Ots

School of Occupational Therapy Master's Capstone Projects (2016-2021)

Tomi Johnson, OTR/L, the primary collaborator for this project, is an occupational therapist with the Kent School District (KSD) working with children in grades K-6. She worked with occupational therapy (OT) students to answer the question: Which school-based related service interventions are effective in improving school performance in children with attention challenges. The results of this systematic review identified six intervention modalities that can be implemented by occupational therapists to address attention challenges in school-aged children including: (1) self-monitoring, (2) school-to-home daily report cards, (3) physical activity, (4) sensory supports, (5) high tech, and (6) metacognitive and behavioral training. Based …

Nonpharmacological Pain Management Strategies For Infants In The Pediatric Intensive Care Unit, Kasen Boie, Kylie Farrenkopf, Hannah Henrikson, Lauren Kikumoto

School of Occupational Therapy Master's Capstone Projects (2016-2021)

Developmentally appropriate care is a central feature of rehabilitation in the pediatric intensive care unit (PICU), but the hospital environment often fails to meet the specific needs of infants, impacting the quality of care that they receive. The infant rehabilitation team at Oregon Health and Science University Doembecher Children’s Hospital collaborated with student researchers to identify the most effective nonpharmacological pain strategies in order to communicate these strategies to other allied health professionals. The final practice question was “What are the most effective nonpharmacological pain management practices for optimal developmental outcomes for infants 12 months old and younger in the …

Center-Based Treadmill Training For An Infant With Down Syndrome Not Yet Pulling To Stand, Amber Calhoun Spt, Summer Halle Spt, Julia Looper Pt, Phd

Physical Therapy Research Symposium

Background: Infants with Down Syndrome (DS) are typically delayed in ambulation and motor development. The effects of center-based treadmill training (TT) on the rate of development in infants with DS are documented in children who are pulling to stand. However, evidence is lacking on TT effects below this developmental level at onset.

Purpose: To explore the impact of a center-based TT program on an infant with DS who is unable to pull to stand.

Methods: The participant was unable to pull to stand at onset of the case study. Initial exam consisted of anthropometric measurements, walking 5 minutes on TM, …

The Short-Term Effects Of Thoracic Transverse Mobilization In Patients With Subacromial Shoulder Pain, Hannah Descoteaux Spt, Kyle Morris Spt, Sarah Taketa Spt, Robert Boyles Pt, Dsc, Ocs, Faaompt

Physical Therapy Research Symposium

Background: There is evidence that thoracic manipulation is effective for treating subacromial shoulder pain (SSP). However, evidence is limited for thoracic mobilization. Manipulation is not safe for all patients; therefore, effects of thoracic mobilization on SSP needs to be researched further.

Purpose: To measure the effects of thoracic spine transverse mobilization (TSTM) and a home exercise in patients with SSP immediately after treatment, and 48 hours later. Shoulder range of motion (ROM), shoulder pain, and patient perception of treatment effects were assessed.

Methods: This is a single treatment pretest/posttest design consisting of eight patients (five females, three males; mean age …

Common Experiences And Beliefs Among Highly-Active, Previously-Sedentary, Middle-Aged Adults, Jordan Hirae Spt, Erin Krekling Spt, Elizabeth Piper Spt, Danny Mcmillian Pt, Dsc, Ocs, Cscs

Physical Therapy Research Symposium

BACKGROUND: Physical Activity (PA) Guidelines recommend reducing sedentarism and describes correlations between adequate PA and improving health outcomes. The self-determination theory (SDT) was used to identify motivational factors crucial to a physically active lifestyle.

PURPOSE: Identify and analyze how motivational characteristics, fulfillment of psychological needs, and individual experiences/beliefs influence an individual’s motivation for PA.

METHODS: Participants (3 females, 2 males; age 36-55) were recruited using nominated sampling and public advertising. Current levels of moderate-to-high PA were determined by the International Physical Activity Questionnaire and previous-sedentarism was self-reported as a minimum of 18 months. The SDT was the …

Patient-Reported, Not Performance Based, Outcome Measures Are Correlated With Future Falls In Community Dwelling Older Adults, Alex Carr Spt, Hannah Johnson Spt, Elise Whisler Spt, Holly Roberts Pt, Phd

Physical Therapy Research Symposium

Background: One-third of community-dwelling older adults fall at least once a year, yet many commonly used performance-based outcome measures for falls have ceiling effects. Additionally, psychological factors such as fear of falling and avoidance behaviors may contribute to fall risk.

Purpose: To determine whether balance confidence, fear of falling avoidance behaviors, or performance on high-level mobility outcome measures can predict falls in community-dwelling older adults.

Methods: Eighty-nine participants (76 ± 7 years) completed the Activities-specific Balance Confidence Scale (ABC), Fear of Falling Avoidance Behaviors Questionnaire (FFABQ), Functional Gait Assessment (FGA), and Community Balance & Mobility Scale (CB&M) and then recorded …

Feasibility Of Twice A Week In-Clinic Treadmill Intervention In Infants With Down Syndrome, Taylor Clark Spt, Nicole Craig Spt, Katie Westin Spt, Laura Zuniga-Morales Spt, Julia Looper Pt, Phd

Physical Therapy Research Symposium

Background: Children with Down syndrome (DS) on average take independent steps at 24-26 months compared to 12 months for typically developing children. In-home treadmill training has been shown to be an effective intervention to reduce delayed walking onset for infants with DS.

Purpose: To see if 20 minutes of in clinic treadmill training twice a week for infants with DS is a feasible intervention.

Methods: Participants must pull to stand independently but not yet walk. Pre-intervention testing included 5 minutes of treadmill walking and scores for sections D and E of Gross Motor Function Measure (GMFM). 20 minute treadmill sessions …

Comparison Of Balance Confidence, Balance Performance, And Falls Among Age Groups For Community-Dwelling Older Adults, Lindsay Dirringer Spt, Ana Sabates Spt, Holly Roberts Pt, Phd

Physical Therapy Research Symposium

Background: Balance confidence and performance is crucial for fall prevention among the elderly but the correlation with age is unknown.

Purpose: Identify changes in balance confidence, balance performance and falls of older age.

Methods: 90 community-dwelling older adults (76+7 years, 54 female, 34 fallers) completed the Activity Specific Balance Confidence Scale (ABC), Fear Avoidance Beliefs Questionnaire (FABQ), Community Balance and Mobility Scale (CB&M), and Functional Gait Assessment (FGA), and self-reported falls for 6 months. Scores on outcome measures and fall rates were compared using a one-way repeated measures ANOVA for age groups 65-74, 75-84, and 85+.

Results: There were no …

The Effects Of Heel Lifts On Dynamic Measures Of Gait And Static Posture In Individuals With Parkinson’S Disease, Elizabeth Jusko Spt, Breanna Roderos Spt, Sarah Uno Spt, Jennifer Hastings Pt, Phd

Physical Therapy Research Symposium

Background: One classic symptom of Parkinson’s Disease (PD) is a “stooped posture” characterized by multiple postural malalignments, which increases fall risk. In 2018, we addressed this posture with in-shoe heel lifts (HLs) and found significant improvements to static postural alignment and perceived stability as well as a correlation between the Falls Efficacy Scale and plantarflexion (PF) contractures. These findings are consistent with a Wright & DiBello (2020) study that found HLs can promote a normalization of joint alignment up the kinetic chain.

Purpose: To validate our prior findings and determine if HLs can improve dynamic measures of gait such as …

Autonomic Nervous System Changes In Individuals With Anxiety And Depression Across The Lifespan: A Systematic Review, Justin Peterson Spt, Brandon Funk Spt, Rachel C. Sannicandro Spt, Anna K. Ortung Spt, Karin Steere Dpt

Physical Therapy Research Symposium

BACKGROUND AND AIMS: As a measure of systemic health, heart rate variability (HRV) can strongly and independently predict adverse future prognosis.1–3 Reduced HRV has been correlated to numerous chronic conditions such as cardiovascular disease and chronic pain.4 Evidence suggests that psychiatric disorders can have similar systemic effects.5 Anxiety and depression are two of the most common psychiatric disorders in the world.6 The primary aim of this systematic review is to determine the relationship between anxiety and/or depression and heart rate variability across the age spectrum.

METHODS: Online databases including PubMed, Google Scholar, Ovid, and CINAHL were searched for papers dated …

A Global Perspective Of Postural-Related Shoulder Pain (Prsp), Zoe Geiger, Kiley Pinder, Kasey Cottrill, Holly Roberts

Physical Therapy Research Symposium

Background: During a physical therapy service trip to Zacapa, Guatemala, in March 2019, ten of 106 patients were treated for symptoms of PRSP. Their pain was often exacerbated by repetitive work-related tasks performed with poor posture such as doing laundry by hand, carrying loads overhead, manual labor, and childcare.

Methods: A brief review of the literature was performed to determine global differences in PRSP and effective treatment interventions. PubMed, Collins Memorial Library, and Google Scholar were searched using search terms including “postural-related”, “work-related”, “shoulder pain”, and “global”.

Results: Nine full-text articles were retrieved and reviewed. PRSP was reported in Ethiopian …

Autonomic Nervous System Changes In Individuals With Chronic Pain: A Systematic Review Of The Literature, Dr. Karin Steere, Jason Steere Dpt, Kasey Cottrill, Zoe Geiger

Physical Therapy Research Symposium

PURPOSE: The aim of this review was to investigate the relationship between heart rate (HR) or blood pressure (BP) and chronic pain conditions.

BACKGROUND: Treatment of chronic pain has placed enormous economic burden on the healthcare system. Autonomic nervous system (ANS) dysregulation is correlated to chronic pain. One measure of ANS dysregulation is heart rate variability (HRV), and decreased HRV can predict adverse future prognosis in a variety of conditions. While HRV validly measures ANS dysregulation, inexpensive and quicker measurements of HR and BP have been less investigated.

METHODS: Searches in PubMed, Ovid, Google Scholar, and CINAHL were performed using …