Rehabilitation and Therapy Commons^™

The Teaching Self-Reflection Tool And Skills Checklist, Arlene Lorch, Otd, Otr/L, Ches

Department of Occupational Therapy Faculty Papers

OBJECTIVE.

To provide occupational therapy faculty with a collaborative system to review and improve teaching skills within the educational program.

METHOD.

Six faculty members completed a self-assessment using self-reflection tools and feedback from an interview with a fellow faculty member serving as consultant. Surveys evaluated perceptions of the experience.

RESULTS.

Survey responses indicated strong approval of the peer review process as a valuable method for faculty development. Results identified aspects of the process that needed revision, specifically, the burden of time required to complete the process.

CONCLUSION.

Findings support the need for a peer review process because it benefits faculty, …

Age-Related Modifications To The Magnitude And Periodicity Of Neuromuscular Noise, Niklas König Ignasiak

Physical Therapy Faculty Articles and Research

Background: Evaluation of task related outcomes within geriatric and fall-prone populations is essential not only for identification of neuromuscular deficits, but also for effective implementation of fall prevention strategies. As most tasks and activities of daily living are performed at submaximal force levels, restoration of muscle strength often does not produce the expected benefit in functional capacity. However, it is known that muscular control plays a key role in the performance of functional tasks, but it remains unclear to what degree muscular control and the associated neuromuscular noise (NmN) is age-related, particularly in the lower-extremities.

Objectives: The aim of this …

Obesity And Physical Function In Rural Women Who Enroll In A Lifestyle Modification Intervention For Reducing Blood Pressure, Patricia A. Hageman, Carol H. Pullen, Paul J. Dizona, Kristin Schmidt, Linda S. Boeckner

Journal Articles: Physical Therapy

Purpose: Rural women have high prevalence of obesity and prehypertension. Obesity, if associated with poor physical function, may have implications for applying activity guidelines for women volunteering for lifestyle modification. This study examined associations of body mass index (BMI) and percent body fat with measures of 1-mile walk time, post-walk perceived exertion, and 10-repetition chair stands in rural women ages 40-69.

Methods: Cross-sectional baseline data were collected using standardized methods from 289 rural women with prehypertension who volunteered for a lifestyle clinical trial for reducing blood pressure. ANOVAs and linear regression were used for analysis.

Results: With exception of the …

Two Phase 3, Multicenter, Randomized, Placebo-Controlled Clinical Trials Of Fampridine-Sr For Treatment Of Spasticity In Chronic Spinal Cord Injury., D. D. Cardenas, J. F. Ditunno, V. Graziani, A. B. Mclain, D. P. Lammertse, P. J. Potter, M. S. Alexander, R. Cohen, A. R. Blight

Department of Rehabilitation Medicine Faculty Papers

STUDY DESIGN: Two randomized, double-blind, placebo-controlled trials.

OBJECTIVE: To evaluate the efficacy and safety of fampridine sustained-release tablets (fampridine-SR) 25 mg twice daily for moderate-to-severe spasticity in patients with chronic spinal cord injury (SCI).

SETTING: United States and Canada.

METHODS: Patients with incomplete chronic SCI were randomized to twice daily fampridine-SR 25 mg or placebo, with a 2-week single-blind placebo run-in, a 2-week titration, 12 weeks of stable dosing, 2 weeks of downward titration and 2 weeks of untreated follow-up. Co-primary end points were the change from baseline, averaged over the double-blind treatment period, for Ashworth score (bilateral knee flexors …

An Intervention For Sensory Difficulties In Children With Autism: A Randomized Trial., Roseann C Schaaf, Teal W. Benevides, Zoe Mailloux, Patricia Faller, Joanne Hunt, Elke Van Hooydonk, Regina Freeman, Benjamin E Leiby, Jocelyn Sendecki, Donna Kelly

Department of Occupational Therapy Faculty Papers

This study evaluated a manualized intervention for sensory difficulties for children with autism, ages 4-8 years, using a randomized trial design. Diagnosis of autism was confirmed using gold standard measures. Results show that the children in the treatment group (n = 17) who received 30 sessions of the occupational therapy intervention scored significantly higher (p = 0.003, d = 1.2) on Goal Attainment Scales (primary outcome), and also scored significantly better on measures of caregiver assistance in self-care (p = 0.008 d = 0.9) and socialization (p = 0.04, d = 0.7) than the Usual Care control group (n = …

A Multidisciplinary Approach To The Prevention Of Infant Torticollis And Plagiocephaly, Anne H. Zachry, S. K. Slaughter

Faculty Presentations

Research suggests that parents are more likely to carry out positioning recommendations from a health care professional than any other source. Occupational therapy practitioners can play an important role in educating parents, caregivers, and healthcare providers about the importance of providing tummy time and limiting infant time spent in baby gear.

A Transformative Experience For Occupational Therapy Students In A Simulated Learning Environment, Kitsum Li, Barbara Mccamish

Collected Faculty and Staff Scholarship

Simulation is being integrated into nursing and medical curriculum nationally and it is well integrated into the Nursing program at Dominican University of California, However, use of simulation in allied health professionals is only an emerging practice. The aim of this program is to integrate simulation into the OT curriculum in order to facilitate the development of therapy foundation skill.

Treatment For Cervicobrachial Pain Syndrome; A Comparison Of Direct And Indirect Manual Therapies, Brianna Palmer

Critically Appraised Topics (CAT)

An appraisal was made on a randomized controlled trial by Allison et al, which compared direct and indirect manual therapies for treating cervicobrachial pain syndrome. The direct therapy group (NT) received neural mobilizations, and the indirect therapy group (AT) received joint mobilizations for the glenohumeral joint and thoracic spine.

Per the Northwick Park Questionnaire and the Short Form-McGill Pain Questionnaire, decreases in pain were statistically significant for both groups from pre-assessment to post-assessment, but not between groups. When using the Visual Analog Scale, a statistically significant improvement was found for both groups over the treatment period, though only the NT …

Four Week Lumbopelvic-Hip Complex Intervention Program And Its Effects On Tuck Jump Assessment In Active Youth, Gretchen D. Oliver, Terry Dewitt

Articles

Injury in youth physical activity has become a major concern with the rising rate of participation. Lumbopelvic-hip complex (LPHC) stability, also known as core stability, has been found to contribute to proper force dissipation and ultimately more effective mechanics. Therefore, the purpose of this study was to examine the effects of a LPHC neuromuscular strengthening program on at-risk youth using the Tuck Jump Assessment. Forty-five youth grades 6, 7, and 8 participated in the Tuck Jump Assessment. Then those participants who scores were indicative of 'at risk' were enrolled in a four-week LPHC intervention program. Those participants whose sores did …

Home-Based Multidisciplinary Rehabilitation Following Hip Fracture Surgery: What Is The Evidence?, Kathleen Donohue, Richelle Hoevenaars, Jocelyn Mceachern, Erica Zeman, Saurabh Mehta

Physical Therapy Faculty Research

Objective. To determine the effects of multidisciplinary home rehabilitation (MHR) on functional and quality of life (QOL) outcomes following hip fracture surgery.

Methods. Systematic review methodology suggested by Cochrane Collaboration was adopted. Reviewers independently searched the literature, selected the studies, extracted data, and performed critical appraisal of studies. Summary of the results of included studies was provided.

Results. Five studies were included. Over the short-term, functional status and lower extremity strength were better in the MHR group compared to the no treatment group (NT). Over the long-term, the MHR group showed greater improvements in balance confidence, functional …

Sex Differences In White Matter Development During Adolescence: A Dti Study, Yingying Wang, Chris Adamson, Weihong Yuan, Mekibib Altaye, Anna W. Byars, Scott K. Holland

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

Adolescence is a complex transitional period in human development, composing physical maturation, cognitive and social behavioral changes. The objective of this study is to investigate sex differences in white matter development and the associations between intelligence and white matter microstructure in the adolescent brain using diffusion tensor imaging (DTI) and tract-based spatial statistics (TBSS). In a cohort of 16 typically-developing adolescents aged 13 to 17 years, longitudinal DTI data were recorded from each subject at two time points that were one year apart. We used TBSS to analyze the diffusion indices including fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity …

Computer-Based Cognitive Retraining For Adults With Chronic Acquired Brain Injury: A Pilot Study, Kitsum Li, Julie Robertson, Joshua Ramos, Stephanie Gella

Collected Faculty and Staff Scholarship

This study evaluated the effectiveness of a computer-based cognitive retraining (CBCR) program on improving memory and attention deficits in individuals with a chronic acquired brain injury (ABI). Twelve adults with a chronic ABI demonstrating deficits in memory and attention were recruited from a convenience sample from the community. Using a quasi-experimental one-group pretest–posttest design, a significant improvement was found in both memory and attention scores postintervention using the cognitive screening tool. This study supported the effectiveness of CBCR programs in improving cognitive deficits in memory and attention in individuals with chronic ABI. Further research is recommended to validate these findings …

Giving Back: Physiatry, Program & Patients, Seyed Amir Tahaei, Md, John F. Ditunno, Jr, Md, Frank Naso, Md, John L. Melvin, Md

Department of Rehabilitation Medicine Faculty Papers

“Giving Back” is a Jefferson tradition beginning with Dr. William Schmidt (JMCF1917-1959), who together with Dr. Frank Krusen (JMC 1921) served as Presidents of the American Academy of Physical Medicine and Rehabilitation (AAPM&R) in 1943 and 1941 respectively. Other Jefferson graduates and faculty have also served as President of the Academy including Drs. Bender (1973), Ditunno (1981), Reinstein (1993), Melvin (1998) and recent presidents in 2009-2013, Betsy Sandel (JRR 1984), Mike Lupinacci (Jefferson Resident teaching faculty) and Alberto Esquenazi (JMCF 2000). Both Krusen and Schmidt were founding members of the American Board of PM&R in 1947. Over the years many …

The Fieldwork Planning Matrix – Maximizing The Learning Environment In Non-Traditional Community Based Settings, Arlene Lorch, Otd, Otr/L, Ches, Tina Angelis, Edd, Otr/L

Department of Occupational Therapy Posters and Presentations

OBJECTIVES

•Learn about a matrix guided tool utilized to plan and structure unique fieldwork experiences.

•Identify key elements associated with “matrix” implementation.

•Understand multi-faceted uses of the manual.

BACKGROUND - NONTRADITIONAL FW

•More community-based sites are needed to meet FW placement demand

•Typically, these FW sites rely upon non-traditional, distant supervision.

•These learning environments require high degree of structure to support experiential self-directed learning

•High structure requires detailed planning

•A planning matrix method to maximize the learning environment is proposed.

Creating An Infrastructure To Support Faculty Outcomes Research On Teaching And Learning, Susan Toth-Cohen, Phd, Otr/L, Susan Wainwright, Phd, Pt

Department of Occupational Therapy Posters and Presentations

This presentation discusses the Teaching and Learning Initiative (TLI), a comprehensive program for building faculty capacity to design and implement educational research in a school of health professions. The TLI is a staged program based on Eade's (1997) approach to capacity building, which the authors apply to the academic environment. The TLI consisted of 4 stages:

1. Initial planning and data gathering.

2. Training faculty in educational outcomes research.

3. Faculty submission of educational outcomes research for intramural funding.

4. Participatory action research approach to further develop faculty capacity for the scholarship of teaching and learning, including educational outcomes …

Can The Upper Limb Tension Test 1 (Ultt1) Stand Alone In Diagnosing Median Nerve Compression In Adult Patients With Carpal Tunnel Syndrome (Cts)?, Brianna Palmer

Critically Appraised Topics (CAT)

An appraisal was made on a validity study by Vanti et al, regarding the upper limb neurodynamic test 1 (ULTT1) for diagnosing carpal tunnel syndrome (CTS). The selected paper included current patients at an occupational medicine clinic with suspected CTS and referral for nerve conduction study (NCS).

Using Wainner’s Criteria to indicate a positive ULTT1, calculated sensitivity was 0.9167 and specificity was 0.150. In limiting criteria for a positive test by requiring provocation of 1^st-3^rd digits only, the sensitivity decreased to 0.5417, however specificity increased to 0.70.

This study was effective in defining the inclusion criteria for …

Contributions Of The Kölliker-Fuse Nucleus To Coordination Of Breathing And Swallowing, Joshua M. Bonis, Suzanne E. Neumueller, K. L. Krause, Lawrence Pan, Matthew R. Hodges, Hubert V. Forster

Physical Therapy Faculty Research and Publications

Herein we compare the effects of perturbations in the Kölliker–Fuse nucleus (KFN) and the lateral (LPBN) and medial (MPBN) parabrachial nuclei on the coordination of breathing and swallowing. Cannula was chronically implanted in goats through which ibotenic acid (IA) was injected while awake. Swallows in late expiration (E) always reset while swallows in early inspiration (I) never reset the respiratory rhythm. Before cannula implantation, all other E and I swallows did not reset the respiratory rhythm, and had small effects on E and I duration and tidal volume (V_T). However, after cannula implantation in the MPBN and …

Effect Of Mandibular Mobilization On Electromyographic Signals In Muscles Of Mastication And Static Balance In Individuals With Temporomandibular Disorder: Study Protocol For A Randomized Controlled Tria, Yasmin El Hage, Fabiano Politti, Dowglas F. Magalhaes De Soura, Carolina Marciela Herpich, Igor Phillip Dos Santos Gloria, Cid Andre Fidelis De Paula Gomes, Ana Paula Amaral, Nivea Cristina De Melo, Thais Correa Da Silva, Edgar Edmur Camargo Arruda, Cesar Ferreira Amorim, Inae Caroline Gadotti, Tabajara Oliveira Gonzalez, Fausto Berzin, Sandra Kalil Bussadori, Marilia Barbosa Santos Garcia, Bruno Roberto Borges Barbosa, Daniela Aparecida Biasotto-Gonzalez

Department of Physical Therapy Faculty Publications

Background

The stomatognathic system and dysfunction in this system may be related to postural control. The proposal of the present study is to assess the effect of mandibular mobilization in individuals with temporomandibular disorder using surface electromyography of the muscles of mastication and stabilometric variables.

Methods/Design

A randomized, controlled, blind, clinical trial will be carried out, with the participants divided into three groups: 1) facial massage therapy (control group), 2) nonspecific mandibular mobilization and 3) specific mandibular mobilization. All groups will be assessed before and after treatment using the Research Diagnostic Criteria for Temporomandibular Disorders, surface electromyography of the masseter …

Ferreira Named Chair Of Physical Therapy, Becky St. Clair

Lake Union Herald

No abstract provided.

Evidence-Based Practice In Occupational Therapy Curricula., Tina Angelis, Edd, Otr/L, Thomas G Dimarco, Susan Toth-Cohen, Edd, Otr/L

Department of Occupational Therapy Faculty Papers

The purpose of this study is to describe currently used educational strategies for teaching evidence-based practice (EBP) in entry-level master's degree occupational therapy programs in the United States. Fifty-eight entry-level occupational therapy program directors completed a survey. Results showed that occupational therapy programs consistently use a wide variety of EBP resources for teaching EBP including database searches, literature reviews, and the development of a research proposal. Less commonly used strategies include the use of case stories and journal clubs. The current study provides a baseline of existing strategies taught in entry level programs that may be built upon to gather …

An Organization-Wide Service Improvement Approach, Jennifer Jasmine Arfaa, Phd, Mhsa, Cynthia Line, Phd, Nora Kramer, Msn, Rn, Karen Montoro, Rn, Richard D. Blob,, Maria Francesco, Jaime Stazi, Rn, Elisabeth Kunkel, Md, Susan Krekun, Md, Lizanne Mason, Rn, Kathy Evans, Rn, Lorraine Weikel, Rn, Ann D. Clark, Ms, Otr/L, Ray Wisniewski, Teresa Heavens

Department of Nursing papers and presentations

APPROACH TO PROBLEM SOLVING

High priority index questions from HCAHPS and Press Ganey surveys, including overall ratings, communication with RNs and MDs, hospital environment and response to concerns and complaints, were targeted for improvement. These high priority indices served as the basis for redesigning Patient Services using a multi-faceted approach to improve patients’ experiences.

At Thomas Jefferson University Hospital (TJUH), high performance on the Patient Experiences of Care Survey has been driven by a successful multi-tiered approach to patient services:

·Hospital leadership guided and implemented new approaches to ensure excellence in patient services is an ever-present and obtainable goal

·Physician …

The Role Of Rehabilitation Following Autologous Chondrocyte Implantation: A Retrospective Chart Review, Jenny L. Toonstra, Jennifer Sebert Howard, Timothy L. Uhl, Robert A. English, Carl G. Mattacola

Physical Therapy Faculty Publications

PURPOSE/BACKGROUND: Clinical outcomes following autologous chondrocyte implantation (ACI) are influenced by multiple factors, including patient demographics, lesion characteristics, quality of the surgical repair, and post-operative rehabilitation. However, it is currently unknown what specific characteristics of rehabilitation have the greatest influence on clinical outcomes following ACI. The purpose of this study was to conduct a retrospective chart review of patients undergoing ACI with the intent to describe this patient population's demographics, clinical outcomes, and rehabilitation practices. This study aimed to assess the consistency of the documentation process relative to post-operative rehabilitation in order to provide information and guide initiatives for improving …

Clinical Reasoning In The Use Of Slings For Patients With Shoulder Subluxation After Stroke: A Glimpse Of The Practice Phenomenon In California, Kitsum Li, Naoko Murai, Simon Chi

Collected Faculty and Staff Scholarship

Literature reports the frequent use of shoulder slings by occupational therapists for the management of post-stroke shoulder subluxation despite the low evidence for its efficacy. To understand the clinical context that defies current research evidence, a survey was distributed among California occupational therapists. One hundred and sixty-eight participants responded to the survey, answering questions regarding the occurrences and clinical reasoning in the use of shoulder sling with patients post stroke. 81.5% of the respondents reported the use of shoulder sling. However, the actual sling prescription was limited to 28.4% of their patients. Slings were primarily prescribed for upper extremity management …

New Phenotype Of Parsonage-Turner Syndrome Involving Radial And Proximal Median Nerve: A Case Report, Matthew Mcauliffe, Md, Nancy Vuong, Md, Adam L. Schreiber, Do

Department of Rehabilitation Medicine Faculty Papers

History

A 74-year-old woman developed sudden severe left shoulder, arm, and forearm pain that suddenly developed. This pain lasted approximately 2 months. Approximately 1-2 months after the resolution of the first pain she developed a different type of pain which she described as a tingling, burning, pins and needle sensation that radiated from her shoulder past her elbow into the dorsal and palmar aspect of her hand in the thumb, index, and long fingers. Additionally, she developed numbness in her hand along the palmar thumb, index, and long fingers. Two months following the onset of the initial type of pain, …

Trans-Sacrococcygeal Joint Ganglion Impar Injection For Treatment Of Pudendal Neuralgia (3 Cases Report), Matthew Mcauliffe, Md, Linqiu Zhou, Md

Department of Rehabilitation Medicine Faculty Papers

History

Three patients, 2 male and 1 female were diagnosed with pudendal neuralgia. The female patient developed pudendal neuralgia secondary to post-herpetic neuralgia. The two male patients were caused from likely repetitive sitting injury. One patient was a truck driver causing him to sit for long periods of time and the other patient was a professional writer. The three patient initially all attempted conservative therapies, however their pain persisted. They elected to undergo Trans-sacrococcygeal joint ganglion impar injection for treatment of pudendal neuralgia.

Combined Erp/Fmri Evidence For Early Word Recognition Effects In The Posterior Inferior Temporal Gyrus, Joseph Dien, Eric S. Brian, Dennis L. Molfese, Brian T. Gold

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

Two brain regions with established roles in reading are the posterior middle temporal gyrus and the posterior fusiform gyrus. Lesion studies have also suggested that the region located between them, the posterior inferior temporal gyrus (pITG), plays a central role in word recognition. However, these lesion results could reflect disconnection effects since neuroimaging studies have not reported consistent lexicality effects in pITG. Here we tested whether these reported pITG lesion effects are due to disconnection effects or not using parallel ERP/fMRI studies. We predicted that the Recognition Potential (RP), a left-lateralized ERP negativity that peaks at about 200–250 ms, might …

Latent Modulation Of Neuropathic Pain Intensity Via Hypothalamus-Pituitary-Thyroid Axis Of Psychogenic Stress, Roger J. Allen

All Faculty Scholarship

Background: In patients with complex regional pain syndrome (CRPS) delayed pain flares consistently occur ten days following salient psychogenic stress episodes. Timing of latent flares suggests pain modulation via hypothalamus-pituitary-thyroid (HPT) axis hormones.

Objective: To determine if thyroxine (T₄) may modulate latent stress-related neuropathic pain flare intensity, temporal relationships between daily stress, serum T₄ levels, and perceived pain intensity in patients with CRPS were investigated.

Patients and Methods: Daily, for ten weeks, three patients with type I CRPS and no thyroid pathology Hx provided blood samples for T₄ assay and ratings of stress and pain. Measures …

Early Intervention Provider Use Of Child Caregiver-Teaching Strategies, Philippa Campbell, Phd, Catherine Ehret-Coletti, Ms

Department of Occupational Therapy Faculty Papers

Most current early intervention approaches emphasize the importance of a provider role as teacher or coach, a role in which providers give parents or other caregivers information about how to optimize children’s growth and development (Stremel & Campbell, 2007). However, few studies have examined the information that should be provided for caregivers or how this information is best delivered to caregivers although a number of rating scales are able to distinguish between roles of direct service provider for the child (e.g., traditional) and triadic interaction among provider, caregiver, and child (Campbell & Sawyer, 2007; Salisbury & Cushing, 2013). Related factors …

Changes In Hemodynamic Responses In Chronic Stroke Survivors Do Not Affect Fmri Signal Detection In A Block Experimental Design, Nutta-On Promjunyakul, Brian D. Schmit, Sheila Schindler-Ivens

Physical Therapy Faculty Research and Publications

The use of canonical functions to model BOLD-fMRI data in people post-stroke may lead to inaccurate descriptions of task-related brain activity. The purpose of this study was to determine whether the spatiotemporal profile of hemodynamic responses (HDRs) obtained from stroke survivors during an event-related experiment could be used to develop individualized HDR functions that would enhance BOLD-fMRI signal detection in block experiments. Our long term goal was to use this information to develop individualized HDR functions for stroke survivors that could be used to analyze brain activity associated with locomotor-like movements. We also aimed to examine the reproducibility of HDRs …

You've Got A Friend In Me: Effectiveness Of Social Skills Interventions For Children With Adhd, Michelle Carlton, Kelly Davis, Jacquelyn Matlack, Marietta Van Ness

Collaborative Research and Evidence shared Among Therapists and Educators (CREATE Day)

Children diagnosed with ADHD present with the core symptoms of inattention and hyperactivity/impulsivity, which lead to challenges with school based activities, including peer interactions, academics, and extracurricular activities (McClelland, Morrison, & Holmes, 2000; Hoza, 2007). Current research identifies social skills interventions as a potential strategy for occupational therapists (OTs) to address these participation challenges of children with ADHD, however there is a multitude of interventions that fall under this umbrella. The variety of social skills interventions allows for flexibility and diversity in implementation, but poses the challenge of choosing the most effective intervention. This choice should be informed by evidence-based …