Rehabilitation and Therapy Commons^™

Movement Snacks: A Novel Program For Breaking Up Sedentary Time In The Workplace, Daniel Murty Spt, Michael Westbrooks Spt, Kendra Guest Spt

Physical Therapy Research Symposium

Purpose: Sedentary behavior is prevalent in developed nations and associated with higher mortality. Cumulative and continuous time spent sitting in the workplace are independently associated with metabolic health risk. While walking breaks are one option to decrease sedentary time, another is to perform exercises with the potential to improve balance, which declines with age and sedentary lifestyles. The purpose of this pilot study was to determine the acceptability of a novel program of diverse movements to reduce sedentary time at work, and the effectiveness of the program at improving balance.

Number of Subjects: 34

Materials and Methods: Participants were recruited …

The Ability Of The Movement Assessment For Children (Mac) To Predict Fine And Gross Motor Development In Typically Developing Children At A Five And A Half Year Follow Up, Lauren Christianson, Brady Houbrick, Elizabeth Peterson, Joe Weber

Physical Therapy Research Symposium

Purpose: The purpose of this study was to determine the long-term (5.5-year) predictive validity of the Movement Assessment for Children (MAC).

Background: Many pediatric examinations of motor development attempt to detect developmental delays in infancy so that early intervention may be implemented. Some tests have shown strong predictive validity within the first 12 months of development, but no test has illustrated long-term (>5 years) predictive power. The Movement Assessment for Children has demonstrated excellent inter-rater reliability, consistent test-retest scores, strong construct validity and responsiveness to change, but the predictive validity remains unknown.

Methods: Eight typically developing children were recruited …

Mirror Visual Feedback Therapy For Treatment Of Phantom Limb Pain: A Clinical Practice Guideline, Erick Moon, Roger Allen, Garret Hoskins

Physical Therapy Research Symposium

Authors: Garrett B Hoskins, SPT; Erick T Moon, SPT; Roger J. Allen, PT, PhD

Mirror visual feedback therapy for treatment of phantom limb pain: a clinical practice guideline.

Purpose: A growing number of recent controlled studies report mirror visual feedback therapy (MT) holds promise for treatment of phantom limb pain (PLP) following amputation, via facilitation of neuroplastic cortical remodeling. However, available research reports typically do not contain sufficient detail regarding the MT components utilized to allow clinicians to implement protocols found to be effective. The purpose of this study was to synthesize a clinical practice guideline, based on a systematic …

Comparing Seated Pressures In Daily Wheelchair And Sports Equipment And Investigating The Skin Protective Effects Of Padded Shorts., Torey M. Anderson Ba, Spt, Kaitlynn L.C. Mckirgan Bs, Spt, Dr. Jennifer Hastings Pt, Phd, Ncs

Physical Therapy Research Symposium

Background:

Adaptive sports are promoted for individuals with spinal cord injury to increase overall health and prevent cardiovascular and metabolic diseases, but the potential risk of pressure ulcer development with adaptive equipment (AE) is a concern. Current research has found seated pressures in AE that exceed clinically accepted values but no studies have measured pressure with a padded short to assess for its potential pressure reducing effects.

Objective:

Our study sought to evaluate average and peak seating pressure in both static and dynamic sport-specific positions, with and without the presence of three types of over-the-counter padded bicycle shorts, …

International Service Learning: An Overview, Kaitlynn L.C. Mckirgan Spt, Daniel Murty Spt, Dr. Holly Roberts Pt, Dpt, Gcs, Ncs

Physical Therapy Research Symposium

International Service Learning: An Overview

Kaitlynn McKirgan, SPT; Daniel Murty, SPT; Dr. Holly Roberts, PT, DPT, GCS, NCS

Affiliation: 1. The School of Physical Therapy, University of Puget Sound

Abstract

Purpose

A wide range of healthcare disciplines including nursing, public health, occupational therapy, and physical therapy (PT) now recognize global health participation and education as a necessary component of healthcare education. Increasingly, students applying to and choosing which PT program to attend must now consider the design, purpose, benefits, and potential drawbacks of such a program in their education. The purpose of this report is to provide an overview of …

Facilitators And Barriers To Neonatal Intensive Care Unit Follow-Up Program Attendance: A Critically Appraised Topic, Ciara Clark, Mariko Rudy, Lauren Maher

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

Kari Tanta, PhD, OTR/L, FAOTA is the rehabilitation manager of the neonatal intensive care unit (NICU) and the NICU follow-up (NFU) program at Valley Medical Center (VMC). To address the problem of decreased NFU attendance, the following clinical question was asked: “For families with an infant who has been discharged from a NICU, which factors promote or discourage utilization of follow-up services?” Numerous facilitators and barriers affecting attendance were identified relating to severity of infant illness, parent socioeconomic status and education levels, and pragmatic factors including timing of scheduling.

Knowledge translation activities undertaken included collaboration with University of Washington (UW) …

Gender Dysphoria And The Role Of Occupational Therapy, Melanie Murphy, Julie Tinsley Schaefer, Enjoli Washington

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

Prompted by Kristin Brubaker, a licensed pediatric occupational therapist who works at the Center for Therapeutic Intervention (CTI) in Gig Harbor, WA, the researchers set out to answer the following question: “What evidence supports the use of occupational therapy (OT) interventions in improving the psychosocial health of children and youth between the ages of 0 to 25 experiencing gender dysphoria (GD)?” After reading and evaluating 29 articles from qualitative and quantitative research, systematic reviews, and additional evidence, the researchers concluded that occupational therapists can assist this population by affirming the experience of GD, encouraging exploration of gender identity, providing a …

Using Sensation In Pediatric Occupational Therapy, Kaitlin Gaspich, Sydney Anderson, Catherine Terhune, Emiline Gonzalez

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

Molly McBroom, OTR/L, of Mary Bridge Children’s Therapy Unit (CTU) requested University of Puget Sound occupational therapy (OT) graduate students research the following question: “What is the effectiveness of using sensory based intervention (SBI) or Ayres’ sensory integration^® (ASI)and neurodevelopmental treatment (NDT) approach with children with sensory processing disorder (SPD), autism spectrum disorder (ASD), and/or attention-deficit/hyperactivity disorder (ADHD) on behavior?” A systematic review of the literature resulted in eight out of 12 studies reporting positive findings. Four of the studies examined ASI and four examined SBI. The other four studies showed inconclusive or negative results. Overall, no clear conclusions …

Interventions For Sleep Problems In Pediatrics, Chelsea Rogers, Marie Trevisan, Maureen Traxler

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

Julie Anderson, DrOT, OTR/L, will be conducting screenings and providing treatment for children with sleep problems in the Puyallup School District of Washington. To assist her in this emerging practice area, a systematic search and critical appraisal of research published between 2000 and January, 2017 was completed to address the question, “What is the current evidence regarding sleep intervention effectiveness in school-aged children?” The majority of research has investigated the use of behavioral interventions for improving child sleep. These studies included children with developmental disabilities (DD), attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), oppositional defiant disorder (ODD), sensory …

Cognitive And Occupationally-Based Assessments In Acute Care: For Individuals With Acquired Brain Injury, Jillian Harrison, Stephanie Lenk, Brooke Logan

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

The student researchers collaborated with Marcy Boschee, OTR/L, an occupational therapist practicing in the acute care unit at St. Joseph's Medical Center in Tacoma, WA to investigate two clinical questions: [1] “What evidence is there for the effectiveness of the Montreal Cognitive Assessment (MoCA) in predicting functional cognitive impairment of patients 18-years-old and older in acute care who have sustained an ABI?” and [2] “Which occupationally-based cognitive assessments, feasible to use in the acute care setting, are most effective at predicting functional impairment in patients 18-years-old and older with mild to severe ABI?” A systematic review was conducted and 29 …

Rate And Duration Of Adaptive Equipment Use Post-Discharge And Factors Affecting Use Post-Discharge, Elizabeth Goodwin, Elizabeth Siska, Jamie Theuer

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

Patients in in-patient rehabilitation are often discharged with adaptive equipment in order to be safe and independent in their homes, as is the case for patients at ManorCare, a skilled nursing facility in Tacoma, Washington. However, if adaptive equipment that is functionally necessary is not being used by the patient, it can lead to reduced independence and safety, potentially resulting in incidents that result in injury and re-admittance. Therefore, Rehabilitation Director Joette Jindra, OTR/L requested research to understand the factors that contribute to continued use or non-use after discharge to assist therapists in their clinical decision-making when making equipment provisions …

Impact Of Trauma On Brain Morphology & Maladaptive School Behaviors, Brandon Escobar, Sharlene Lavaris, Teresa Le

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

Wendi Trummert, DrOT, OTR/L, the collaborating clinician for this project, works with students in a self-contained program. Wendi wanted to know how childhood trauma affects brain structure and morphology and how it is linked to behaviors seen in children affected by trauma. A synthesis of all articles looking at the brain reveals differences in both structure and function in the brains of individuals exposed to childhood trauma versus those not exposed (e.g. Daniels, Lamke, Gaebler, Walter, & Scheel, 2013; McGowan et al., 2009; Saleh et al., 2017). A synthesis of articles looking at maladaptive behaviors finds that those often seen …

Lymphedema Assessments, Jessica Enyeart, Cullyn Foxlee, Divina Ramolete, Connie Colleen Wyatt

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

Heidi Shaffer, a MultiCare occupational therapist specializing in lymphedema (LE) management, proposed the research question of whether bioimpedance spectroscopy (BIS) via the L-Dex (U400 Impedimed) is the most reliable, valid, cost-effective and time-efficient assessment tool on the market for measuring LE in comparison to circumferential measurements (CM). Shaffer currently uses the L-Dex in practice and hoped to substantiate its psychometrics from the literature to promote its clinical usage and potentially obtain consistent insurance coverage. A critical appraisal of the literature revealed a strong correlation between BIS and CM, suggesting that both can be used reliably and validly in clinical practice. …

School-Based Tier Ii And Iii Rti Interventions For Children Affected By Trauma, Sarah Ladderud, Maria Randall, April Crabtree

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

We partnered with Wendi Trummert, DrOT, OTR/L, an occupational therapist in a school district in Puyallup, Washington. We collaborated to examine what school-based Tier II & Tier III Response to Intervention (RTI) interventions can be used by occupational therapists, teachers, and paraeducators to improve school participation in children aged 3-13 who have experienced trauma. It was found that various forms of Cognitive Behavioral Therapy (CBT) interventions may reduce post-traumatic stress disorder (PTSD) symptoms, depression, and anxiety in children age birth - 13 who have experienced trauma. CBT was the most effective intervention based on the current literature. Additionally, there is …

Strategies For Effective Collaboration Among Multidisciplinary Teams: Integration Of An Aba Professional, Elizabeth Schroeder, Kalene Lynch, Allison Turgeon

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

Our collaborating practitioner (CP), Kari Tanta, PhD, OTR/L, FAOTA, manages Valley Medical Center which is a multidisciplinary pediatric outpatient therapy clinic. Dr. Tanta was seeking research to support incorporating an applied behavior analysis (ABA) professional into VMC’s practice. The focused question became, “What are strategies to promote successful collaboration when integrating a Board Certified Behavior Analyst (BCBA) into an established multidisciplinary pediatric clinic to promote best practice for clients?” From September 2016 - January 2017, 26 articles were analyzed using a critically appraised topic (CAT) table. The literature indicated effective health care team collaboration yields positive patient outcomes, provided strategies …

Determining The Efficacy Of The Use Of Instrument Assisted Soft Tissue Mobilization In Hand Therapy, Kaitlin Chaput, Sarah Clue, Yoseph Kim, Evan Kimpton

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

In collaboration with Brian Chase, CHT, OTR/L of NW Sports Physical Therapy in

Tacoma, WA, our research group addressed his question of whether instrument assisted soft tissue mobilization (IASTM) is effective for clients and if so, are certain brands such as Graston Technique (GT) or Astym more effective. Through our careful review of the literature, summarized in a critically appraised topic format, we found that the majority of studies (case reports and experimental studies) found that IASTM treatments improved scores on outcome measures including return to occupation, range of motion, pain, and grip and pinch strength over baseline measurements. However, …

A Review Of Health Related Quality Of Life Assessments For Patients With Lymphedema, Bonnie C. Blair, Gina M. Dellino, Jennifer E. Thomas

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

In collaboration with Heidi Shaffer, one of the occupational therapists on staff at the MultiCare lymphedema clinic in Gig Harbor, Washington, we sought to answer the question “Which patient-reported outcome assessments are most valid and reliable in measuring health-related quality of life (HRQoL) in patients with lymphedema?” We conducted a systematic literature review to answer this question. In reviewing selected databases, 19 articles were chosen to appraise the evidence supporting psychometric properties and clinical utility of 10 HRQoL assessments used for patients with lymphedema. The Disability of the Arm, Shoulder and Hand (DASH) and Lymphedema Life Impact Scale (LLIS) assessments …

Social Skills Interventions For Adolescents With Asd, Adhd, And Other Comorbidities, Margaret Batson, Sarah Elliott, Gary Lam, Nora Seimears

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

This project was part of a research initiative to collaborate with Kristin Brubaker, MSOT, OTR/L, practicing pediatric occupational therapist at the Center for Therapeutic Intervention (CTI). CTI is an outpatient, private pediatric occupational therapy clinic in Gig Harbor, WA. The purpose of our project was to determine existing and effective interventions to improve social skills in adolescents, ages 11 to 18 years, with autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), sensory processing disorder (SPD) and other sensory processing issues. Our search of the literature yielded a total of 22 research studies, with the majority representing group-based interventions. Limited …

Utilization Of Physical Therapy During Student Service Learning Project To Guatemala, Lucas Willers, Hannah Hourie-Collins, Bonnie Cramer

Physical Therapy Research Symposium

Title: Utilization of Physical Therapy During Student Service Learning Project to Guatemala

Authors: Bonnie Cramer SPT, Hannah Hourie-Collins SPT, Lucas Willers SPT, Holly Roberts PT, DPT, GCS, NCS

Affiliation: School of Physical Therapy, University of Puget Sound

Purpose: The purpose of this project was to collect demographic information for a descriptive analysis of patients accessing physical therapy services in rural Guatemala over the course of a week-long international service learning project by student physical therapists. The goal of the international service learning project was to provide skilled physical therapy to resource limited communities, experience the Guatemalan culture, and develop the …

Utilization Of The Progressive Return To Activity Following Acute Concussion Clinical Recommendations, Elena Liroff, Erika Schultz, Holly Roberts

Physical Therapy Research Symposium

Purpose:

Since 2000, almost 300,000 concussions have been reported in the military population. Concussions were labeled the signature injury of the wars in Iraq and Afghanistan. Prevalence of concussions and implications for service members prompted the Defense Centers of Excellence (DCoE) for Psychological Health and Traumatic Brain Injury to introduce the Progressive Return to Activity Progression Following Acute Concussion/Mild Traumatic Brain Injury clinical recommendations in 2014 to guide cognitive and physical rehabilitation of concussion. The purpose of this study was to identify utilization rates of the DCoE clinical practice recommendations and to identify barriers to implementation that affect clinician adherence. …

Relationship Between Delayed Pain Flares, Psychogenic Stress And Free Thyroxine In Patients With Phantom Limb Pain., Arista Ip, Eva Fazzini, Roger Allen Phd, Pt

Physical Therapy Research Symposium

Purpose/Hypothesis: Prior research established that free thyroxine (FT4) sharply increases ten days after significant psychogenic stressors and these elevations are correlated with episodic pain flares in patients with various neuropathic pain conditions. This relationship has yet to be studied in patients with phantom limb pain (PLP). This study’s purpose was to investigate the relationship between psychogenic stress, subsequent peaks in FT4 and PLP flares.

Number of Subjects: Participants were two males with PLP due to amputation. Participant 1 had intact thyroid function, while Participant 2 had a history of thyroidectomy and was taking synthetic thyroxine.

Materials/Methods: Over 10 weeks, participants …

The Use Of Heel Lifts For Individuals With Parkinson’S Disease To Improve Postural Stability., Cassandra Repasky, Connor Brown, Mckenna Mcnabb, Jennifer Hastings

Physical Therapy Research Symposium

Background: Parkinson’s Disease (PD) is a progressive, neurodegenerative condition that results in resting tremors, slowed movement (bradykinesia), rigidity, and postural instability. People with PD develop a standing alignment often referred to as a “stooped posture”; flexed hips, kyphotic spine, forward shoulders, forward head, and downward head tilt. Concurrently, this population has high prevalence of impaired standing and dynamic balance, decreased muscle strength, slower gait, and slower anticipatory and reactionary body adjustments. We propose plantarflexion contractures contribute to instability by causing an altered alignment and decreasing the available range for reactive excursion in lower extremity.

Purpose: To investigate if postural alignment, …

Manual Therapy And Exercise In Treatment Of Patients With Cervical Radiculopathy: A Protocol For A Case Series, Andrew E. Didricksen Spt, Justin Y. Higa Spt, Daniel T. Kobayashi Spt, Robert Boyles

Physical Therapy Research Symposium

Study Design: Manual therapy and exercise in the treatment of patients with cervical radiculopathy: A protocol for a case series.

Background: Cervical radiculopathy (CR) most commonly originates from space occupying lesions, resulting in upper extremity radicular pain. Numerous physical therapy interventions are available for treating CR symptoms, however present practice patterns incorporate the application of a combination of interventions with inconclusive or mixed results. Clinical practice guidelines advocate for the utilization of thoracic manipulation to treat CR.

Objectives: It is hypothesized that the use of specific manual therapy techniques combined with exercise will have a positive effect on CR as …

Low Back Injuries In Male Ballet Dancers: A Review Of The Literature, Dr. Karin Steere, Amanda Duncan, Kaitlyn Johnstone, Emma Lux

Physical Therapy Research Symposium

TITLE: Low Back Injuries in Male Ballet Dancers: A Review of the Literature

ABSTRACT BODY:

Purpose: Repetitive practice of motions that can require extremes for hip and lumbar spine range of motion increase injury risk for dancers. Male dancers have increased risk of lost dancing days from injury related to lifts of female dancers. This is a review of the available literature examining spine injuries in male dancers.

Methods: A literature search was performed using the keywords: male, dancer, ballet, pain, injury, and low back pain. The following databases were used: Cochrane Library, CINAHL, Pubmed, and PEDro. To expand our …