Rehabilitation and Therapy Commons^™

Effectiveness Of 3d-Printed Upper Extremity Device For Chronic Neurological Impairment, Joe Kardine, Mba, Ms, Otr/L, Cbis, Mikael Avery, Ms, Otr/L, Alessandro Naopli, Phd, Namrata Grampurohit, Phd, Otr/L, Maryjane Mulcahey, Phd, Otr/L, Mijail Serruya, Md, Phd

Farber Institute for Neuroscience Staff Papers and Presentations

Report on the results of the five adults with UE mobility impairment due to stroke experiences with a lightweight, customized, powered hand orthosis. Study measures utilized were Canadian Occupational Performance Measure, Box and Blocks, and Action Research Arm Test.

Salivary Cortisol Levels And Stress In Adults With Profound Intellectual And Multiple Disabilities Participating In The Structured Water Dance Intervention: A Randomised Controlled Crossover Trial, Lars-Olov Lundqvist, Marie Matérne, Andre Frank, Evalotte Mörelius, Anna Duberg

Research outputs 2022 to 2026

The Structured Water Dance Intervention (SWAN) is a dance-oriented aquatic group activity directed to give opportunities for the joy of movement, relaxation, and reduced stress. This study aimed to evaluate the effects of SWAN on salivary cortisol and stress in adults with profound intellectual and multiple disabilities (PIMD). A total of 34 adults with PIMD at four habilitation centres in Sweden completed the SWAN intervention. The intervention was administered for 40 min once a week during a 12-week period. Saliva cortisol was collected in the morning and evening at baseline one week before the intervention, thrice during the intervention period, …

A Tailored Occupational Therapist-Led Vocational Intervention For People With Stroke: Protocol For A Pilot Randomized Controlled Trial, Sophie O'Keefe, Kathryn Radford, Amanda Farrin, Jodi Oakman, Serena Alves-Stein, Geoffrey Cloud, Jacinta Douglas, Mandy Stanley, Natasha A. Lannin

Research outputs 2022 to 2026

Background: Resuming work after stroke is a common goal of working-age adults, yet there are few vocational rehabilitation programs designed to address the unique challenges faced following stroke. The Work intervention was developed to address these gaps. Objective: This paper presents a protocol that outlines the steps that will be undertaken to pilot both the intervention and trial processes for the Work trial. Methods: The Work trial is a 2-arm, prospective, randomized, blinded-assessor study with intention-to-treat analysis. A total of 54 adults of working age who have experienced a stroke <4 months prior will be randomized 1:1 to either (1) an experimental group who will receive a 12-week early vocational intervention (Work intervention) plus usual clinical rehabilitation or (2) a control group who will receive only their usual clinical rehabilitation. Results: Outcomes include study and intervention feasibility and intervention benefit. In addition to evaluating the feasibility of delivering vocational intervention early after stroke, benefit will be assessed by measuring rates of vocational participation and quality-of-life improvements at the 3- and 6-month follow-ups. Process evaluation using data collected during the study, as well as postintervention individual interviews with participants and surveys with trial therapists, will complement quantitative data. Conclusions: The results of the trial will provide details on the feasibility of delivering the Work intervention embedded within the clinical rehabilitation context and inform future trial processes. Pilot data will enable a future definitive trial to determine the clinical effectiveness of vocational rehabilitation when delivered in the early subacute phase of stroke recovery.

Activity Measure For Post-Acute Care “ 6-Clicks ” Basic Mobility Scores Predict Discharge Destination After Acute Care Hospitalization In Select Patient Groups: A Retrospective, Observational Study, Burke Rehabilitation Hospital, Divya Rajaraman, Sarah Taylor, Kirollos Agayaby, Suzanne Babyar

Publications and Research

Objectives

To establish cutoff scores for the Activity Measure for Post-Acute Care “6-Clicks” standardized Basic Mobility scores (sBMSs) for predicting discharge destination after acute care hospitalization for diagnostic subgroups within an acute care population and to evaluate the need for a second score to improve predictive ability.

Design

Retrospective, observational design.

Setting

Major medical center in metropolitan area.

Participants

Electronic medical records of 1696 adult patients (>18 years) admitted to acute care from January to October 2018. Records were stratified by orthopedic, cardiac, pulmonary, stroke, and other neurological diagnoses (N=1696). Interventions: None

Main Outcome Measure

Physical therapists scored patients’ …

Cost-Effectiveness Of High-Intensity Training Vs Conventional Therapy For Individuals With Subacute Stroke, T. George Hornby, Miriam Rafferty, Daniel Pinto, Dustin D. French, Neil Jordan

Physical Therapy Faculty Research and Publications

Objective

This investigation estimated the incremental cost-effectiveness of high-intensity training (HIT) compared with conventional physical therapy in individuals with subacute stroke, based on the additional personnel required to deliver the therapy.

Design

Secondary analysis from a pilot study and subsequent randomized controlled trial.

Setting

Outpatient laboratory setting.

Participants

Data were collected from individuals with locomotor impairments 1-6 months poststroke (N=44) who participated in HIT (n=27) or conventional physical therapy (n=17).

Interventions

Individuals performing HIT practiced walking tasks in variable contexts (stairs, overground, treadmill) while targeting up to 80% maximum heart rate reserve. Individuals performing conventional therapy practiced impairment-based and functional …

Total Knee Arthroplasty Assessments Should Include Strength And Performance-Based Functional Tests To Complement Range-Of-Motion And Patient-Reported Outcome Measures, Jacob J. Capin, Michael J. Bade, Jason M. Jennings, Lynn Snyder-Mackler, Jennifer E. Stevens-Lapsley

Physical Therapy Faculty Research and Publications

Range of motion (ROM) and pain often define successful recovery after total knee arthroplasty (TKA), but these routine clinical outcomes correlate poorly or not at all to functional capacity after TKA. The purpose of this Perspective is to underscore the importance of muscle strength and performance-based functional tests in addition to knee ROM and patient-reported outcome (PRO) measures to evaluate outcomes after TKA. Specifically: (1) muscle strength is the rate-limiting step for recovery of function after TKA; (2) progressive rehabilitation targeting early quadriceps muscle strengthening improves outcomes and does not compromise ROM after TKA; (3) ROM and PROs fail to …

Survey Of Confidence And Knowledge To Manage Patellofemoral Pain In Readers Versus Nonreaders Of The Physical Therapy Clinical Practice Guideline, Richard W. Willy, Lisa T. Hoglund, Neal R. Glaviano, Lori A. Bolgla, David M. Bazett-Jones

Department of Physical Therapy Faculty Papers

Objectives: To compare beliefs of physical therapists (PTs) who read the clinical practice guideline (CPG) for the management of individuals with patellofemoral pain (PFP) to those who have not read the CPG.

Design: Cross-sectional study.

Setting: Online survey.

Participants: 494 currently licensed/registered PTs or physiotherapists.

Main Outcome Measures: Respondents answered Likert-based or open-ended questions regarding the diagnosis, prognosis, risk factors, and management of individuals with PFP, as well as confidence for managing individuals with PFP, especially the ability to identify beneficial and non-beneficial interventions. We dichotomized responses into participants who read (READERS) and did not read (NonREADERS) the CPG.

Results: …

Predicting Duration Of Outpatient Physical Therapy Episodes For Individuals With Spinal Cord Injury Based On Locomotor Training Strategy, Mauricio Garnier-Villarreal, Daniel Pinto, Chaithanya K. Mummidisetty, Arun Jayaraman, Candy Tefertiller, Susan Charlifue, Heather B. Tayler, Shuo-Hsiu Chang, Nicholas Mccombs, Catherine L. Furbish, Edelle C. Field-Fote, Allen W. Heinemann

Physical Therapy Faculty Research and Publications

Objective

To characterize individuals with spinal cord injuries (SCI) who use outpatient physical therapy or community wellness services for locomotor training and predict the duration of services, controlling for demographic, injury, quality of life, and service and financial characteristics. We explore how the duration of services is related to locomotor strategy.

Design

Observational study of participants at 4 SCI Model Systems centers with survival. Weibull regression model to predict the duration of services.

Setting

Rehabilitation and community wellness facilities at 4 SCI Model Systems centers.

Participants

Eligibility criteria were SCI or dysfunction resulting in motor impairment and the use of …

Psychosocial Outcomes Of Orthopedic Injuries: An Analysis Of The Relationship Between The Athlete And The Athletic Trainer, Hannah Barnett

Honors Projects

An analysis on the impact of the level of social support from athletic trainers on the outcomes of orthopedic injuries in athletes. The foundational model for this research is Wiese-Bjornstal’s Integrated Model (1998). This model examines the effect of athletes’ emotional responses on their recovery. Social support from the athletic trainer can help mediate negative emotional responses and encourage positive emotional responses, which is why social support is crucial to recovery. Athletes with higher levels of perceived social support from their athletic trainers had more success with rehabilitation. This report consists of a review of the existing literature on psychosocial …

Developing Peri-Operative Rehabilitation In Degenerative Cervical Myelopathy [Ao Spine Recode-Dcm Research Priority Number 6]: An Unexplored Opportunity?, Timothy F. Boerger, Allison S. Hyngstrom, Julio C. Furlan, Sukhvinder Klasi-Ryan, Armin Curt, Brian K. Kwon, Shekar N. Kurpad, Michael G. Fehlings, James S. Harrop, Bizhan Aarabi, Vafa Rahimi-Movaghar, James D. Guest, Jefferson R. Wilson, Benjamin M. Davies, Mark R. N. Kotter, Paul A. Koljonen

Physical Therapy Faculty Research and Publications

Study Design

Narrative review.

Objective

Degenerative cervical myelopathy is one of the most frequent impairments of the spinal cord encountered internationally in adults. Currently, surgical decompression is the recommended treatment for people with DCM (PwCM) presenting with moderate to severe symptoms or neurological deficits. However, despite surgical intervention, not all patients make a complete recovery due to the irreversible tissue damage within the spinal cord. The objective of this review is to describe the state and gaps in the current literature on rehabilitation for PwCM and possible innovative rehabilitation strategies.

Methods

Literature search.

Results

In other neurological disorders such as …

Blood Flow Restriction Training After Patellar Instability (Brains Trial), Benjamin D. Brightwell, Austin V. Stone, Xiaojuan Li, Peter A. Hardy, Katherine L. Thompson, Brian W. Noehren, Cale A. Jacobs

Orthopaedic Surgery and Sports Medicine Faculty Publications

Background

Patellar instability is a common and understudied condition that disproportionally affects athletes and military personnel. The rate of post-traumatic osteoarthritis that develops following a patellar dislocation can be up to 50% of individuals 5–15 years after injury. Conservative treatment is the standard of care for patellar instability however, there are no evidence-informed rehabilitation guidelines in the scientific literature. The purpose of this study is to assess the effectiveness of blood-flow restriction training (BFRT) for patellar instability. Our hypotheses are that this strategy will improve patient-reported outcomes and accelerate restoration of symmetric strength and knee biomechanics necessary to safely return …

Rehabilitation Care At The Time Of Coronavirus Disease-19 (Covid-19) Pandemic: A Scoping Review Of Health System Recommendations, Ahmed M Negm, Adrian Salopek, Mashal Zaide, Victoria J Meng, Carlos Prada, Yaping Chang, Preeti Zanwar, Flavia H Santos, Elena Philippou, Emily R Rosario, Julie Faieta, Jason R Falvey, Amit Kumar, Timothy A Reistetter, Vanina Dal Bello-Haas, Jonathan F Bean, Mohit Bhandari, Patricia C Heyn

College of Population Health Faculty Papers

Purpose: The coronavirus disease-19 (COVID-19) was declared a pandemic by the World Health Organization in March 2020. COVID-19, caused by SARS-CoV-2 has imposed a significant burden on health care systems, economies, and social systems in many countries around the world. The provision of rehabilitation services for persons with active COVID-19 infection poses challenges to maintaining a safe environment for patients and treating providers. Materials and Methods: Established frameworks were used to guide the scoping review methodology. Medline, Embase, Pubmed, CINAHL databases from inception to August 1, 2020, and prominent rehabilitation organizations' websites were searched. Study Selection: We included articles and …

The Fit-For-Purpose Model: Conceptualizing And Managing Chronic Nonspecific Low Back Pain As An Information Problem, Benedict M. Wand, Aidan G. Cashin, James H. Mcauley, Matthew K. Bagg, Gemma M. Orange, G. Lorimer Moseley

Physiotherapy Papers and Journal Articles

Chronic nonspecific low back pain (CNSLBP) is a complex and multifaceted problem. The following Perspective Piece tries to help make sense of this complexity by describing a model for the development and maintenance of persistent low back pain that integrates modifiable factors across the biopsychosocial spectrum. The Fit-for-Purpose model (FFPM) posits the view that chronic nonspecific low back pain represents a state in which the person in pain holds strong and relatively intransient internal models of an immutably damaged, fragile, and unhealthy back, and information that supports these models is more available and trustworthy than information that counters them. This …

Statistical Analysis Plan For The Stepped-Wedge Clinical Trial Healing Right Way - Enhancing Rehabilitation Services For Aboriginal Australians After Brain Injury, Elizabeth Armstrong, Tapan Rai, Deborah Hersh, Sandra Thompson, Juli Coffin, Natalie Ciccone, Leon Flicker, Dominique Cadilhac, Erin Godecke, Deborah Woods, Colleen Hayward, Graeme J. Hankey, Meaghan Mcallister, Judith Katzenellenbogen

Research outputs 2022 to 2026

Background: Aboriginal Australians are known to suffer high levels of acquired brain injury (stroke and traumatic brain injury) yet experience significant barriers in accessing rehabilitation services. The aim of the Healing Right Way trial is to evaluate a culturally secure intervention for Aboriginal people with newly acquired brain injury to improve their rehabilitation experience and quality of life. Following publication of the trial protocol, this paper outlines the statistical analysis plan prior to locking the database. Methods: The trial involves a stepped wedge design with four steps over 3 years. Participants were 108 adult Aboriginal Australians admitted to one of …