Rehabilitation and Therapy Commons^™

Evidence-Based Review Of Interventions For Medically At-Risk Older Drivers, Sherilenne Classen, Miriam Monahan, Beth Auten, Abraham Yarney

Collected Faculty and Staff Scholarship

OBJECTIVE. To conduct an evidence-based review of intervention studies of older drivers with medical conditions.

METHOD. We used the American Occupational Therapy Association’s classification criteria (Levels I–V, I 5 highest level of evidence) to identify driving interventions. We classified studies using letters to represent the strength of recommendations: A 5 strongly recommend the intervention; B 5 recommend intervention is provided routinely; C 5 weak evidence that the intervention can improve outcomes; D 5 recommend not to provide the intervention; I 5 insufficient evidence to recommend for or against the intervention.

RESULTS. For clients with stroke, we recommend a graded simulator …

Driving Errors In Parkinson’S Disease: Moving Closer To Predicting On-Road Outcomes, Sherrilene Classen, Babetter Brumback, Miriam Monahan, Irene I. Malaty, Ramon L. Rodriguez, Michael S. Okun, Nikolaus R. Mcfarland

Collected Faculty and Staff Scholarship

Age-related medical conditions such as Parkinson’s disease (PD) compromise driver fitness. Results from studies are unclear on the specific driving errors that underlie passing or failing an on-road assessment. In this study, we determined the between-group differences and quantified the on-road driving errors that predicted pass or fail on-road outcomes in 101 drivers with PD (mean age 5 69.38 ± 7.43) and 138 healthy control (HC) drivers (mean age 5 71.76 ± 5.08). Participants with PD had minor differences in demographics and driving habits and history but made more and different driving errors than HC participants. Drivers with PD failed …

Test Of Ideational Praxis (Tip): Preliminary Findings And Interrater And Test–Retest Reliability With Preschoolers, Shelly J. Lane, Carol K. Ivey, Teresa A. May-Benson

Occupational Therapy Publications

Praxis is the ability of the brain to develop an idea for action and plan, organize, and execute unfamiliar motor actions. It enables purposeful interaction with people and things in the environment. Ideation is central to praxis but has been little researched. This study investigated the reliability of the Test of Ideational Praxis (TIP) and examined ideational praxis in typical preschoolers. TIP performance for 78 preschoolers ages 3, 4, and 5 yr was videotaped and scored by two trained raters. The TIP has strong interrater reliability, supporting earlier findings. Further, we documented test–retest stability over 2 wk. As a group, …

Assessing Function And Endurance In Adults With Spinal And Bulbar Muscular Atrophy: Validity Of The Adult Myopathy Assessment Tool., Michael O. Harris-Love, Lindsay Fernandez-Rhodes, Galen Joe, Joseph A. Shrader, Angela Kokkinis, Alison La Pean Kirschner, Sungyoung Auh, Cheunju Chen, Li Li, Ellen Levy, Todd E. Davenport, Nicholas A. Di Prospero, Kenneth H. Fischbeck

Exercise and Nutrition Sciences Faculty Publications

Purpose. The adult myopathy assessment tool (AMAT) is a performance-based battery comprised of functional and endurance subscales that can be completed in approximately 30 minutes without the use of specialized equipment. The purpose of this study was to determine the construct validity and internal consistency of the AMAT with a sample of adults with spinal and bulbar muscular atrophy (SBMA).

Methods. AMAT validity was assessed in 56-male participants with genetically confirmed SBMA (mean age, 53 ± 10 years). The participants completed the AMAT and assessments for disease status, strength, and functional status. Results. Lower AMAT scores were associated with longer …

A Stepped-Wedge Cluster Randomised Controlled Trial For Evaluating Rates Of Falls Among Inpatients In Aged Care Rehabilitation Units Receiving Tailored Multimedia Education In Addition To Usual Care: A Trial Protocol, Anne-Marie Hill, Nicholas Waldron, Christopher Etherton-Beer, Steven Mcphail, Katharine Ingram, Leon Flicker, Terry P. Haines

Physiotherapy Papers and Journal Articles

INTRODUCTION:

Falls are the most frequent adverse event reported in hospitals. Approximately 30% of in-hospital falls lead to an injury and up to 2% result in a fracture. A large randomised trial found that a trained health professional providing individualised falls prevention education to older inpatients reduced falls in a cognitively intact subgroup. This study aims to investigate whether this efficacious intervention can reduce falls and be clinically useful and cost-effective when delivered in the real-life clinical environment.

METHODS:

A stepped-wedge cluster randomised trial will be used across eight subacute units (clusters) which will be randomised to one of four …

Psychometric Properties Of The Compulsive Exercise Test In An Adolescent Eating Disorder Population, Pam Formby, Hunna J. Watson, Anna Hilyard, Kate Martin, Sarah J. Egan

Physiotherapy Papers and Journal Articles

The objective of this study was to evaluate the factor structure, validity, and reliability of the Compulsive Exercise Test (CET) in an adolescent clinical eating disorder population. The data source was the Helping to Outline Paediatric Eating Disorders (HOPE) Project, a prospective ongoing registry study comprising consecutive paediatric tertiary eating disorder referrals. Adolescents (N = 104; 12-17 years) with eating disorders completed the CET and other measures. Factor structure, convergent validity, and internal consistency were evaluated. Despite failing to identify a factor structure, the study provided clear evidence of the multidimensionality of the measure. The total score correlated significantly …

Efficacy Of A Carbon Fiber Orthotic Toe-Off Brace In Adults With Cerebral Palsy, June Kume, John R. Magel, Erin Dicandia, Justine Hoffman, Robert Issing, Joshua Little, Tyler Roden

The School of Health Sciences Publications and Research

Purpose/Hypothesis : This pilot study evaluated the effects of a unique carbon fiber ankle/foot orthosis for individuals diagnosed with foot drop (“Toe-Off” design, Allard USA, Inc). We hypothesized that use of this brace would be useful for adults with cerebral palsy (CP) as evidenced by improved gait characteristics including gait endurance and balance.

Number of Subjects : A convenience sample of 4 patients, between the ages of 29 and 55, with diagnoses of cerebral palsy, was successfully recruited from United Cerebral Palsy (UCP) of Suffolk (Central Islip, NY). All individuals received regular physical therapy at UCP prior to and throughout …

Adult-Acquired Flatfoot Deformity And Age-Related Differences In Foot And Ankle Kinematics During The Single-Limb Heel-Rise Test, Ruth L. Chimenti, Joshua Tome, Cody D. Hillin, Adolph S. Flemister, Jeff Houck

Faculty Publications - College of Physical Therapy

STUDY DESIGN: Cross-sectional laboratory study.

OBJECTIVE: To compare single-limb heel-rise performance and foot-ankle kinematics between persons with stage 2 adult-acquired flatfoot deformity (AAFD) and healthy controls.

BACKGROUND: The inability to perform a single-limb heel rise is considered a positive functional diagnostic test for AAFD. However, which foot motions contribute to poor performance of this task are not known.

METHODS: Fifty individuals participated in this study, 20 with stage 2 AAFD (mean +/- SD age, 57.6 +/- 11.3 years), and 15 older participants (age, 56.8 +/- 5.3 years) and 15 younger participants (age, 22.2 +/- 2.4 years) without AAFD as control …

Altered Tendon Characteristics And Mechanical Properties Associated With Insertional Achilles Tendinopathy, Ruth L. Chimenti, Adolph S. Flemister, Joshua Tome, James M. Mcmahon, Marie A. Flannery, Ying Xue, Jeff R. Houck

Faculty Publications - College of Physical Therapy

Study Design: Case-control laboratory study.

Objectives: To compare tendon characteristics (shape, composition) and mechanical properties (strain, stiffness) on the involved side of participants with insertional Achilles tendinopathy (IAT) to the uninvolved side and to controls, and to examine if severity of tendon pathology is associated with severity of symptoms during function.

Background: Despite the severity and chronicity of IAT, the quality of theoretical evidence available to guide the development of exercise interventions is low. While tendon pathology of midportion Achilles tendinopathy has been described, there are few studies specific to IAT.

Methods: Twenty individuals with unilateral IAT and 20 age- …

Exercise Dosage And Pelvic Floor Muscle Function In Young Women With And Without Urinary Incontinence, Briana Dewitt

2014 Symposium

Approximately 38% of young, healthy females who have never been pregnant experience urinary incontinence (UI). Some research suggests there may be a correlation between the amount and intensity of physical activity and pelvic floor muscle dysfunction leading to UI in this population. This study used trans-abdominal real-time ultrasound imaging to describe pelvic floor performance in forty-eight females aged 18-30 (n=11 with reported UI, three of whom reported experiencing moderate to severe UI). While vigorous exercise was not significantly related to presence of UI, pelvic floor 64 contraction performance was significantly worse in those women with UI. These findings suggest that …

Pni Biomarkers And Health Outcomes In College Women, Shih-Yu Lee, Mugdha Vasireddi, Yuping Chen, Yong Tai Wang, Julia Hilliard

Physical Therapy Faculty Publications

Sleep disturbance has been found to trigger a stress response with a subsequent activation of the psychoneuroimmunological (PNI) pathway associated with adverse health outcomes. This study aimed to assess the association among selected PNI biomarkers, sleep disturbances, and adverse health outcomes (depressive symptoms, physical symptoms). A stratified, quota sample (14 poor sleepers and 15 good sleepers) was drawn from a pool of healthy college women from a larger scale of study. The participants reported their sleep, stress, depressive, and physical symptoms. Wrist actigraphy was used to collect objective sleep data, and the Enzyme-Linked ImmunoSorbent Assay was used to assess PNI …

Game Analysis, Validation, And Potential Application Of Eyetoy Play And Play 2 To Upper-Extremity Rehabilitation, Yuping Chen, Michelle Caldwell, Erica Dickerhoof, Anastasia Hall, Bryan Odakura, Kimberly Morelli, Hsin-Chen Fanchiang

Physical Therapy Faculty Publications

Objective. To describe and analyze the potential use of games in the commercially available EyeToy Play and EyeToy Play 2 on required/targeted training skills and feedback provided for clinical application. Methods. A summary table including all games was created. Two movement experts naïve to the software validated required/targeted training skills and feedback for 10 randomly selected games. Ten healthy school-aged children played to further validate the required/targeted training skills. Results. All but two (muscular and cardiovascular endurance) had excellent agreement in required/targeted training skills, and there was 100% agreement on feedback. Children’s performance in required/targeted training skills (number of unilateral …

Embracing And Enacting An ‘Occupational Imagination’: Occupational Science As Transformative, Debbie Rudman

Occupational Therapy Publications

This paper addresses the question of how occupational science can move forward in its development as a socially and politically engaged discipline. It is argued that a transformative approach to scholarship needs to be embraced, and that enacting such an approach requires a radical reconfiguration of the sensibility underpinning occupational science. After reviewing the key defining characteristics of a transformative paradigmatic approach, key insights regarding how to foster a radical sensibility in occupational science are drawn from C. Wright Mills (1959) conceptualization of ‘the sociological imagination’. Embracing an occupational imagination premised on these key insights would foster the transformative potential …

Interleukin-1 Receptor Antagonist Modulates Inflammation And Scarring After Ligament Injury, Connie S. Chamberlain, Ellen M. Leiferman, Kayt E. Frisch, Sarah E. Duenwald-Kuehl, Stacey L. Brickson, William L. Murphy, Georffrey S. Baer, Ray Vanderby

Faculty Publications - Biomedical, Mechanical, and Civil Engineering

Ligaments have limited regenerative potential and as a consequence, repair is protracted and results in a mechanically inferior tissue more scar-like than native ligament. We previously reported that a single injection of interleukin-1 receptor antagonist (IL-1Ra) delivered at the time of injury, decreased the number of M2 macrophage-associated inflammatory cytokines. Based on these results, we hypothesized that IL-1Ra administered after injury and closer to peak inflammation (as would occur clinically), would more effectively decrease inflammation and thereby improve healing. Since IL-1Ra has a short half-life, we also investigated the effect of multiple injections. The objective of this study was to …

Occupational Therapy And Health Sciences News, January 2014, Occupational Therapy Department

News, Magazines and Reports

2013, a year in review. In OT we have 2 new faculty members, Sharon McCloskey and Lola Halperin. The Health Sciences program is pleased to welcome Dr. Raja Staggers-Hakim. Student events. Faculty achievements.

Physical Therapy In Wound Healing, Edema, And Urinary Incontinence, Jakub Taradaj, Tomasz Urbanek, Luther C. Kloth, Marco Romanelli

Physical Therapy Faculty Research and Publications

No abstract provided.

Contributions Of The Pre-Bötzinger Complex And The Kölliker-Fuse Nuclei To Respiratory Rhythm And Pattern Generation In Awake And Sleeping Goats, Hubert Forster, Joshua M. Bonis, Katie L. Krause, Julie Wenninger, Suzanne Neumueller, Matthew Hodges, Lawrence Pan

Physical Therapy Faculty Research and Publications

We investigated in three groups of awake and sleeping goats whether there are differences in ventilatory responses after injections of Ibotenic acid (IA, glutamate receptor agonist and neurotoxin) into the pre-Bötzinger complex (preBötC), lateral parabrachial (LPBN), medial (MPBN) parabrachial, or Kölliker-Fuse nuclei (KFN). In one group, within minutes after bilateral injection of 10 μl IA (50 mM) into the preBötC, there was a 10-fold increase in breathing frequency, but 1.5 h later, the goats succumbed to terminal apnea. These data are consistent with findings in reduced preparations that the preBötC is critical to sustaining normal breathing. In a second group, …

The Role Of Aerobic Physical Fitness In Overweight Adolescents, Stacy Stolzman, Jenna Speltz, Katherine Hoffmeister, Michael E. Danduran, Joseph Skelton, Paula Papanek, April L. Harkins, Marie K. Hoeger Bement

Physical Therapy Faculty Research and Publications

No abstract provided.

An Evidence-Based Practice Educational Intervention For Athletic Trainers: A Randomized Controlled Trial, Cailee E. Welch, Bonnie L. Van Lunen, Dorice A. Hankemeier

Rehabilitation Sciences Faculty Publications

Context: As evidence-based practice (EBP) becomes a necessity in athletic training, Web-based modules have been developed and made available to the National Athletic Trainers' Association membership as a mechanism to educate athletic trainers (ATs) on concepts of EBP.

Objective: To assess the effect of an educational intervention on enhancing knowledge of EBP among ATs.

Design: Randomized controlled trial.

Setting: Web-based modules and knowledge assessment.

Patients or Other Participants: A total of 164 of 473 ATs (34.7% response rate), including professional athletic training students, graduate students, clinical preceptors, educators, and clinicians, were randomized into a control group (40 men, 42 women) …

Perceived Outcomes Of Web-Based Modules Designed To Enhance Athletic Trainers' Knowledge Of Evidence-Based Practice, Cailee E. Welch, Bonnie L. Van Lunen, Dorice A. Hankemeier, Aimee L. Wyant, Jessica M. Mutchler, William A. Pitney, Danica G. Hays

Rehabilitation Sciences Faculty Publications

Context: The release of evidence-based practice (EBP) Web-based learning modules to the membership of the National Athletic Trainers' Association has provided athletic trainers (ATs) the opportunity to enhance their knowledge of the various EBP concepts. Whereas increasing the knowledge of EBP among ATs is important, assessing whether this newfound knowledge is being translated into clinical practice and didactic education is crucial.

Objective: To explore the effectiveness of an educational intervention regarding EBP on the didactic instruction patterns of athletic training educators and the clinical practice behaviors of clinicians.

Design: Qualitative study.

Setting: Individual telephone interviews.

Patients or Other Participants: A …

Future Directions Of Evidence-Based Practice In Athletic Training: Perceived Strategies To Enhance The Use Of Evidence-Based Practice, Cailee E. Welch, Dorice A. Hankemeier, Aimee L. Wyant, Danica G. Hays, William A. Pitney, Bonnie L. Van Lunen

Rehabilitation Sciences Faculty Publications

Context: The shift to a culture of evidence-based practice (EBP) in athletic training is a necessary step in both the optimization of patient care and the advancement of athletic trainers (ATs) as health care professionals. Whereas individuals have gained knowledge in this area, most ATs still are not practicing in an evidence-based manner. Exploring perceived strategies to enhance the use of EBP will help to determine the best approaches to assist ATs in applying EBP concepts to practice to improve patient care.

Objective: To explore beneficial strategies and techniques ATs perceived would promote successful implementation of EBP within athletic training …

Expert Consensus And Recommendations On Safety Criteria For Active Mobilization Of Mechanically Ventilated Critically Ill Adults, Carol L. Hodgson, Kathy Stiller, Dale M. Needham, Claire J. Tipping, Megan Harrold, Claire E. Baldwin, Scott Bradley, Sue Berney, Lawrence R. Caruana, Doug Elliott, Margot Green, Kimberley Haines, Alisa Higgins, Kirsi-Maija Kaukonen, Isabel A. Leditschke, Marc R. Nicols, Jennifer Paratz, Shane Patman, Elizabeth Skinner, Paul J. Young, Jennifer M. Zanni, Linda Denehy, Steven A. Webb

Physiotherapy Papers and Journal Articles

Introduction:

The aim of this study was to develop consensus recommendations on safety parameters for mobilizing adult, mechanically ventilated, intensive care unit (ICU) patients.

Methods:

A systematic literature review was followed by a meeting of 23 multidisciplinary ICU experts to seek consensus regarding the safe mobilization of mechanically ventilated patients.

Results:

Safety considerations were summarized in four categories: respiratory, cardiovascular, neurological and other. Consensus was achieved on all criteria for safe mobilization, with the exception being levels of vasoactive agents. Intubation via an endotracheal tube was not a contraindication to early mobilization and a fraction of inspired oxygen less than …

An Audit Of Antenatal Education Facilitated By Physiotherapists In Western Australian Public Hospitals, Judy Wilson, Richard G. Berlach, Anne-Marie Hill

Physiotherapy Papers and Journal Articles

This paper reports on the delivery of antenatal education by physiotherapists in Western Australia in 2012, including the location of antenatal education providers, number of mothers attending, qualifications of physiotherapists involved, allocation of physiotherapy hours, the content of the education, and strategies used to enhance learning in the classes. A survey was emailed to the physiotherapists in 31 hospitals with maternity services that were funded by the Department of Health Western Australia. Antenatal education facilitated by a physiotherapist was provided at 25/30 (83.3%) hospitals. Four physiotherapists had postgraduate women’s health qualifications and all the antenatal education classes provided information about …

Professional Behavior In Physical Therapist Educational Programs: Perspectives Of Selected Senior Faculty, Tamara L. Little Phelan

All Faculty Scholarship

Purpose: The purpose of this study was to analyze how selected senior instructors in physical therapist educational programs define and seek to impart information on professional behavior. Methods: A qualitative case study approach was used to gather data from eight instructors teaching in four physical therapist educational programs in a selected region. Each interview was analyzed as an individual case study, followed by a cross case analysis to identify common themes. Results: Interpretational analysis using a process of constant comparison revealed nine common themes: 1) Instructors found it difficult to broadly define professional behavior. 2) Instructors expect students to be …

Illusory Touch Temporarily Improves Sensation In Areas Of Chronic Numbness: A Brief Communication, Benedict Martin Wand, Samantha Eve Stephens, Effie Ida Marquita Mangharam, Pamela Jane George, Max Bulsara, Neil Edward O'Connell, G Lorimer Moseley

Physiotherapy Papers and Journal Articles

Background. Creating the visual illusion of touch can improve tactile perception in healthy subjects. Objective. We were interested in seeing if creating the illusion of touch in an insensate area could improve sensation in that area. Methods. Fourteen people with chronic numbness participated in a randomized crossover experiment. The 4 conditions were the following: (a) stimulation over the unaffected limb with mirror visual feedback (experimental condition), (b) stimulation over the affected limb with mirror visual feedback, (c) stimulation over the unaffected limb without mirror visual feedback, and (d) stimulation …

Moving In An Environment Of Induced Sensorimotor Incongruence Does Not Influence Pain Sensitivity In Healthy Volunteers: A Randomised Within-Subject Experiment, Benedict Wand, Lareina Szpak, Pamela J. George, Max Bulsara, Neil Edward O'Connell, G. Lorimer Moseley

Physiotherapy Papers and Journal Articles

Objectives: It has been proposed that in the same way that conflict between vestibular and visual inputs leads to motion sickness, conflict between motor commands and sensory information associated with these commands may contribute to some chronic pain states. Attempts to test this hypothesis by artificially inducing a state of sensorimotor incongruence and assessing self-reported pain have yielded equivocal results. To help clarify the effect sensorimotor incongruence has on pain we investigated the effect of moving in an environment of induced incongruence on pressure pain thresholds (PPT) and the pain experienced immediately on completion of PPT testing.

Methods: Thirty-five healthy …

Exploring The Role And Skill Set Of Physiotherapy Clinical Educators In Work Integrated Learning, Susan Edgar, Joanne Connaughton

Physiotherapy Papers and Journal Articles

Clinical educators are under increasing pressures in the workplace to provide quality education of healthcare students within varying supervision frameworks. Along with facilitating the teaching of clinical skills, clinical educators play a support role for students and so require more than expert clinical abilities in their vital position linking institutions and the healthcare environment. Twelve physiotherapy clinical educators attended one of two focus groups exploring their opinions on the role and skill set of clinical educators in work-integrated learning (WIL).Clinical educators described their role, their skills, challenges they faced supporting the needs of students, as well as future training requirements. …

Movement Restriction Does Not Modulate Sensory And Perceptual Effects Of Exercise-Induced Arm Pain, Markus Hubscher, Simon Tu, Tasha Stanton, G Lorimer Moseley, Benedict M. Wand, John Booth, James H. Mcauley

Physiotherapy Papers and Journal Articles

BACKGROUND:

Movement restriction has been proposed as an important modulator of changes in sensory and perceptual function and motor imagery performance that are observed in musculoskeletal pain syndromes. There are no empirical data to support this view.

PURPOSE:

The primary objective of this experiment was to determine the effects of movement restriction on local and widespread sensory, perceptual and motor imagery changes after exercise-induced muscular pain. Further objectives were to investigate whether changes in sensory perception are correlated with pain intensity and tactile acuity or motor imagery performance.

METHODS:

In forty healthy volunteers, delayed onset muscle soreness (DOMS) of the …

Data Note: Are Young Adults With Intellectual Disabilities Getting Work Experiences From Participating In The Vocational Rehabilitation Program?, Alberto Migliore, Jean Winsor

Data Note Series, Institute for Community Inclusion

To learn about whether young adults with intellectual disabilities in the vocational rehabilitation (VR) program are getting work experience, we examined the age at application of people with intellectual disabilities who exited the VR program in 2012.

Data Note: Vocational Rehabilitation Closure Trends For Individuals With Intellectual Disabilities: A Snapshot Of Five U.S. Territories, Jean Winsor, Daria Domin

Data Note Series, Institute for Community Inclusion

Beginning in FY2013, the Administration on Intellectual and Developmental Disabilities requested that each Project of National Significance include the five primary territories of the United States in data collection and analysis efforts. The five territories included in this analysis are American Samoa, Guam, Northern Marianas, Puerto Rico, and the Virgin Islands of the United States.