Rehabilitation and Therapy Commons^™

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 …

Errors: Friend Or Foe? The Use Of Errorless Or Trial And Error Learning Strategies In Occupational Therapy Practice When Re-Learning Daily Activities, Jasmine Evans, Alison Guajardo, April Millar

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

We examined literature, within a 20-year period, regarding whether errorless learning strategies or trial and error strategies are more effective for adult patients, with a diagnosis of cerebrovascular accident (CVA) or cognitive deficit, when learning instrumental activities of daily living (IADL) and activities of daily living (ADL). We conducted this in collaboration with Hannah Baldwin, a local practitioner working in an acute care setting, at Swedish Medical Center, in Seattle. The results did not reveal overwhelming evidence to support either strategy, however, we were able to make recommendations within specific situations and for specific diagnoses. Generally, there are a greater …

Assistive Technology Options For Individuals With Quadriplegia, Bri Brown Ots, Natalie Geisler Ots, Hannah Terranova Ots

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

This project was undertaken in collaboration with Sonia Nurkse, MOT, OTR/L and Bridget Tanner, MSOT, OTR/L, two occupational therapists working on the inpatient rehabilitation unit at MultiCare Good Samaritan Hospital in Puyallup, Washington. A systematic review of the literature was conducted to answer the question, “What are the most effective, up-to-date, and user-friendly assistive technology options to support individuals with quadriplegia in functional tasks?” Five databases were searched and through screening and careful review, 19 articles were selected for critical appraisal. Due to the wide variety of devices, some commercially available and other prototypes, we were unable to compare them …

Occupational Therapy Handwriting Interventions On A Systems-Level, Megan Buckingham, Shelby Goodfellow, Catherine Hannan

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

Julie Anderson, DrOT, OTR/L, is an occupational therapist in the Puyallup School District who works with elementary aged students. For this project, Dr. Anderson worked as the primary collaborator with occupational therapy students to answer the question: What is the evidence that occupational therapy interventions at a systems-level improve student's academic performance and skill development outcomes, such as handwriting, in elementary age students with and without disabilities? The results of this descriptive study indicate strong evidence that systems-level interventions, involving an occupational therapist, in a school setting improve at least one area of a student’s skill development. Additionally, any consistent …

Challenges Facing Young Adults With Complex Communication Needs Entering The Adult Health Care System, Molly Stark, Christabelle Francis

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

Barbara Abbott, PhD, OTR/L is a school-based occupational therapist currently working with students grades K-12 in four schools in Kent, WA. The purpose of our project was to identify the most effective service delivery models and/or components of interventions for young adults with complex communication needs to understand their health information. We conducted a systematic review to critically appraise literature published between the years of 1990-2018 to address our research question. Our research yielded a total of seven qualitative and 12 quantitative studies to address our research question. Qualitative data found that individuals with complex communication needs (CCN) experience significant …

Using The Copm With Veterans Who Have Sustained A Stroke, Jolene Fujita, Kimberly Low, Keili Maldonado, Mikayla Wrolstad

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

The authors collaborated with Mary Matthews-Brownell, OTR/L at the American Lake Veterans Affairs (VA). Our research question was, “What evidence is there to support best practices for veteran re-engagement in meaningful activities to promote overall quality of life for veterans who have sustained a stroke?” In response to Mary’s specific interest in the research supporting the use of the Canadian Occupational Performance Measure (COPM) and her desire to have concrete data to support her intervention outcomes, we chose to host an in-service on the use of the COPM for the occupational therapists at the VA.

To monitor the impact of …

Effect Of Occupation-Based Curriculum On Self-Determination For Young Adults With Disabilities, Nicole Gotelli, Spencer Perry

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

Dr. Barbara Abbott, an occupational therapist who managed The Outreach Program (TOP) for the Kent, WA, school district, requested University of Puget Sound occupational therapy graduate students to research the following question: “What is the effectiveness of occupation-based interventions in comparison to traditional instruction for increasing self-determination in young adults with various disabilities?” A literature review was conducted using seven databases to find the available evidence regarding use of occupation-based curricula to impact self-determination of post-secondary adults with disabilities. Due to the emerging nature of the topic, limited evidence was found. However, the findings revealed that both occupation-based and direct …

Outcomes Of Service Delivery Models In School-Based Therapies, Nicholas Kasovac, Daniel Krupicka, Katherine Woodworth, Maryann Zmuda

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

Kristin Brubaker, a licensed occupational therapist in the University Place School District, proposed the following question to a student research team: “What are the student, therapist, and teacher outcomes of different school-based service delivery models?” Following a review of 22 articles with qualitative and quantitative methods, studies were grouped into three categories of school-based service delivery models: collaborative-consultative, mixed, and direct. Research demonstrated that collaborative-consultative service delivery models provide positive outcomes such as stronger relationships between therapists and teachers, opportunities for therapists to implement and adapt intervention techniques within the classroom, increased effectiveness in teaching strategies, and improved academic skills …

Efficacy Of Evidence-Based Exercise As A Treatment For Breast Cancer Related Lymphedema, Eric Kartevold, Katrina Maañao Perez, Malcolm Reed

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

Breast cancer related lymphedema (BCRL) of the upper extremity is a frequent sequela following axillary node dissection (AND). A recent meta-analysis by Gillespie et al. (2018), suggested a 21.4% incidence of chronic arm edema post breast cancer intervention. Gillespie et al. (2018) explained that because of a lack of diagnostic criteria for BCRL, incidence reports varied widely from less than 5% to over 50%.

The purpose of this review was to determine the efficacy of exercise in the self-management of BCRL, including the types and frequency of exercise. Protocols from 24 articles on the self-management of BCRL, including exercise as …

Biopsychosocial Factors That Hinders And/Or Facilitate Successful Return To Work: A Review Of Literature And Knowledge Of Translation, Natacha Chimenti, Lianna Wong

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

Two community practitioners collaborated with the University of Puget Sound Occupational Therapy program and submitted the following clinical question: “What bio/psycho/social factors have been identified to hinder and/or facilitate successful return to work in addition to traditional work hardening/conditioning intervention for adults?” A literature review discovered 47 articles ranging from systematic reviews, descriptive, qualitative, outcome, and experimental studies. Evidence was synthesized by two reviewers into a critically appraised topic (CAT). Numerous facilitating (job satisfaction, employment accommodation, social support, multidisciplinary approach) and hindering factors (social isolation, depression, pain, self-perceived disability) were identified affecting one’s ability to return to work after various …

Pip/Dip Joint Capsule Stiffness: Current Evidence For Effective Interventions, Chloe Mcnutt Ots, Nicole Nguyen Ots, Ciara Caldwell Ots

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

This research aimed to identify and analyze intervention approaches to remediate Proximal and Distal Interphalangeal (PIP/DIP) joint capsule stiffness and was performed to inform practice of hand therapists in an outpatient occupational therapy (OT) clinic. The treatment protocols were analyzed according to practicality for the practice and overall efficacy. Ten databases were searched to collect appropriate data based on a specific predetermined list of search terms. Articles were examined against specific inclusion and exclusion criteria, and sixteen were eventually selected for analysis. Six different intervention strategies emerged from the research including occupation-based practice, electromagnetotherapy, technology-assisted therapy, orthoses, and preparatory methods/modalities. …

Social Emotional Learning Strategies For Students In Self-Contained Classrooms: A Systematic Review And Quick Reference Guide For Evidence-Informed Curricula Selection, Amelia Jones, Paige Kensil, Jared Peltzman, Erica Petru

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

This research project was conducted in collaboration with Heather Austin, OTR/L and the Puyallup School District. Through discussion with Heather, we determined that there is a need to study the efficacy of social-emotional learning (SEL) curricula for children with severe disabilities who often do not receive the same comprehensive SEL instruction as their peers in general education classrooms. A mixed-methods systematic review of the literature was conducted on strategies and interventions for SEL for students ages 3-12 years old in classrooms that serve students with severe disabilities. We analyzed 19 articles published in peer-reviewed journals by reviewing each for statistically …

The Effects Of Occupation-Based Activities On Problem Behaviors And Quality Of Life Of People With Dementia, Kelly Souza, Nicole Utt

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

Cathryn Schaffer and Sonia Nurkse, occupational therapists in an inpatient rehabilitation unit at Good Samaritan of Multicare in Puyallup, WA, proposed a research question: Can occupation-based activities be used to improve quality of life and/or reduce problem behaviors in adults with dementia-related cognitive impairment? Five databases were searched for articles published from 2007 to 2017, resulting in 23 articles that met search criteria. Interventions that did not take extensive time, training, or resources were included with the intention that they would be easily incorporated into a caregiver or health professional’s routine. Multiple interventions were found that address problem behaviors and/or …

School-Based Service Delivery Models And Interventions For Handwriting, Rachel Arnold, Hannah Michlmayr, Kiley Throop

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

This project was part of a research initiative in collaboration with Wendi Trummert, DrOT, OTR/L, a practicing school-based occupational therapist in the Puyallup School District. The purpose of our project was to compare the effectiveness of certain service delivery models and intervention approaches to improve handwriting outcomes for school-aged children. Our search of the literature yielded a total of 20 applicable research studies, which utilized a wide variety of models and approaches. There was limited research specifically comparing service delivery and/or specific components of handwriting interventions. Our findings indicated that there are a variety of effective service delivery models and …

Emerging Opportunities: Lymphedema Management And The Potential For Surveillance Methods In A Primary Care Model, Claire Brummet, Nicole Chang, Kayleigh Odgear

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

Heidi Shaffer, OTR/L, MSM, CLT-LANA at MultiCare-Gig Harbor was interested in how early intervention, namely intervening at Stage 0, related to better outcomes for oncology patients at risk of lymphedema. This question was developed from a desire to follow-up prior student research relating to the usefulness of the LDEX in lymphedema management, however current literature did not indicate the LDEX as an early intervention method. Although the authors did not exclude other types of cancer, the research only reflected breast cancer outcomes. Overall, strong evidence was found that exercise is not contraindicated for clients at risk of breast cancer related …

Comparing The Effectiveness Of Activity-Based Interventions And Rote Exercises In Skilled Nursing Facilities, Loren Burnett, Kelsey Tasoe, Kirsten Woodard

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

Joette Jindra, OTR/L and director of rehabilitation at ManorCare in Tacoma, WA was interested in learning what type of interventions should be utilized by the therapists on her team. Therefore, the purpose of this critically appraised topic (CAT) was to examine the current literature on the effectiveness of activity-based intervention (meaningful or nonmeaningful) and rote exercise for improving physical performance outcomes in patients residing in skilled nursing facilities (SNF). The student researchers examined the literature on articles comparing the outcomes of activity-based interventions to those of rote exercise. Articles describing the outcomes of the two interventions independently were also examined. …

Efficacy Of Myofascial Release, Michelle Chait Ots, Erin Eaton Ots, Tiffany Farley Ots

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

In collaboration with Tomi Johnson and Domonique Herrin, hand therapists working in a MultiCare rehabilitation clinic, we sought to answer the question: In adults with upper extremity and cervical spine orthopedic and peripheral nerve conditions, does myofascial release (MFR) lead to functional outcomes (such as decreased pain or disability, or increased range of motion etc.), compared to therapeutic exercises, other manual therapeutic techniques, and/or modalities? Twenty-three research articles, systematic reviews and meta-analyses were included in our evaluation of the research. Based on our findings, moderate evidence exists to support the use of MFR in the upper extremity and its effectiveness …

Sensory-Based Interventions In Schools, Ashley Davies, Leilani Jones, Katrina Larossa, Julia Shure

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

Dr. Jamie Palmer, DrOT/L of Central Kitsap school district requested that University of Puget Sound occupational therapy (OT) students research the impact of sensory-based interventions (SBIs) on attention, behavior, and academic performance for children in preschool to high school with or without diagnoses. Based on a systematic review of 33 studies, the evidence for the use of SBIs in the classroom to improve academic performance, behavior and attention is preliminary and ranges from limited to moderate depending on the specific type of SBI. The use of those specific SBIs with limited to moderate evidence is recommended for students whose demographic …

Utilizing The Cognitive Orientation To Occupational Performance Approach For Improved Performance And Executive Functioning, Casey Mendoza, Caitlin Mitchell, Emily Reynolds

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

The Outreach Program (TOP) in the Kent School District assists young adults in their transition from high school to adulthood. The research team and Dr. Abbott, an occupational therapist at TOP, sought to address whether better outcomes when teaching instrumental activities of daily living (IADLs) to adolescents with intellectual disabilities occur when addressing underlying performance skills and client factors through the Cognitive Orientation to Occupational Performance (CO-OP) approach or when addressing them through traditional occupational therapy practices. There is strong evidence to support CO-OP as an effective strategy to improve performance and moderate evidence indicating that it improves executive functioning …

Impacts Of Schoolwide Social Skills Curricula On Elementary Students With Diverse Needs, Lauren Fong, Lindsey Lambert, Alyssa Ode

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

Julie Anderson, DrOT, OTR/L, an occupational therapist in a school district in Puyallup, Washington was seeking research to support the students in her district who require additional support for their social and emotional development. She requested occupational therapy graduate students from the University of Puget Sound to research the following question: “What is the current evidence for schoolwide social skills curricula that are implemented in an elementary school for children in kindergarten through sixth grade with diverse needs?” A systematic review of the literature resulted in 31 studies indicating a wide range of schoolwide social skills curricula that yield positive …

Critically Appraised Topic: Maintenance & Generalization Of Social Skills & Social Skills Guide, Alanna Flynn, Megan John, Maddie Mcbroom

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

Research was conducted to investigate the evidence for generalizability and/or long term maintenance of social skills intervention for individuals with autism spectrum disorder (ASD) ages 13-21 years. The question was created at the request of Kari Tanta PhD, OTR/L, FAOTA of the Valley Medical Center Children’s Therapy. The literature review was conducted, generating 17 articles that matched the inclusion and exclusion criteria. The process involved rigorous article review via several databases and saturating the available literature from various professions. There is strong evidence to support the use of social skill intervention for adolescents with ASD. Furthermore, the evidence supports the …

State Of Evidence For Everyday Technology Use In Upper Extremity Motor Recovery Post-Stroke, Claire Ferree, Dillon Oldham, Amanda Robert, Alana Yee

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

The research team, in consultation with collaborating clinician Sarah Bicker, an OTR/L at Harborview Medical Center, researched everyday technology applications. The team conducted a systematic review considering what evidence exists about the effectiveness of commercially available everyday technology (ET) for improving upper extremity motor control and/or motivation to participate in therapy in clients post-stroke. The evidence was promising in support of the use of ET as indicated by improved upper extremity motor control outcomes and client and clinician reports of satisfaction, motivation, and engagement in post-stroke rehabilitation. Clinicians should consider the benefits of implementing ET for upper extremity motor recovery …

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 …