Rehabilitation and Therapy Commons^™

Avoiding 30-Day Readmissions Of Acute Mi Patients Utilizing Cardiac Rehabilitation, Patricia T. Forsberg

Doctor of Nursing Practice (DNP) Projects

A significant number of Acute Myocardial Infarction (AMI) patients were readmitted to an urban San Francisco Medical Center within 5-7 days post discharge this year. Two of the main identified causes were symptom management issues and medication instructions, both of which are part of the discharge instructions. It’s not surprising that 80% of all discharge teaching is forgotten by patients by the time they hit the parking lot. With the recommended timeframe for post discharge follow up appointments at 48 to 72 hours post discharge and as those appointments are not typically available within the recommended timeframe, patients are more …

Improving Interdisciplinary Communication To Improve Patient Satisfaction, Jennifer J. Barnes

Master's Projects and Capstones

The Clinical Nurse Leader project took place at a Magnet Hospital in Northern California. It involved the nursing staff on a 23-bed Post-Surgical Medical Surgical unit, as well as the therapists providing care to their diverse patient population. The goal was to improve interdisciplinary communication to decrease the frequency of missed or postponed therapy sessions. A review of literature revealed that this preventable issue could be the most significant factor resulting in an extended length of stay and affecting overall patient satisfaction. Project data was gathered from a variety of sources, including a unit assessment, shadowing therapists, interviews with key …

Physical Therapy Management Of A Patient After A Subacromial Decompression With Acromioplasty And Bursectomy: A Case Report, Brianne Landholt

Case Report Posters

Background: Subacromial impingement results from repetitive trauma to structures underneath the subacromial arch which can lead to: A decrease in the subacromial space, impingement of the soft tissue, a decrease in functional abilities. Conservative treatment can include: Physical therapy, nonsteroidal anti-inflammatory drugs (NSAIDS), corticosteriod injections, surgical option includes a subacromial decompression (SAD). There is conflicting evidence on the benefits of surgery. Literature is lacking supportive evidence of SAD without RTC repair or performing SAD with both an acromioplasty and bursectomy. Purpose: The purpose of this case report was to investigate the functional outcomes of a patient after SAD with an …

Physical Therapy Management Of A Manual Laborer With Chronic Rotator Cuff Tendinopathy: A Case Report, Samuel Lasher

Case Report Papers

Background and Purpose: Rotator cuff tendinopathy (RCT) is a chronic tendon injury that can have significant impact on an individual’s occupation, recreation and personal life. Currently there is a paucity of information detailing physical therapy (PT) interventions for individuals with RCT, who must continue working. The purpose of this case report was to report a clinical experience detailing the PT management of a patient with RCT, who secondary to occupational obligations must continue to participate in activities harmful to her condition. Case Description: The patient was a 44 year-old, female, who worked as a manual laborer. She was diagnosed with …

Physical Therapy Management Of A Patient With Stroke Utilizing Muscular Facilitation Techniques In A Skilled Nursing Facility: A Case Report, Erin Bayne

Case Report Papers

Background and Purpose: Stroke is the leading cause of long term disability in the United States. Hemiparesis is an impairment following stroke, however trunk musculature asymmetry is also common and is often overlooked when assessing a patient’s muscular control. Trunk musculature is an essential link between the upper and lower extremities during activities of daily living and impairments in trunk musculature can result in decreased safety and balance. The purpose of this case report is to provide the framework for treatment and an overview of the care plan for a patient following stroke, with special attention to trunk musculature facilitation. …

Physical Therapy Management Of A Manual Laborer With Chronic Rotator Cuff Tendinopathy: A Case Report, Samuel Lasher

Case Report Posters

Background: Tendinopathy is characterized by tendon thickening, localized pain and chronic degeneration reflective of failed healing. 38% of manual laborers who participate in daily moderate to heavy lifting will experience Rotator Cuff Tendinopathy(RCT). There is a lack of research investigating the PT management of manual laborers who have RCT, but must continue to participate in harmful activities to fulfill occupational responsibilities. Purpose: The purpose of this case report was to describe the PT management of a patient with rotator cuff tendinopathy who, due to work requirements continued to participate in activities detrimental to the health of the supraspinatus and function …

Lack Of Medicaid Funding For Occupational Therapy Serving The Autism Spectrum Disorder Population Ages 0-5 Years, Nadia Yala

Honors Theses

The prevalence of autism in the United States is currently 1 in 68 children (Autism Alliance of Michigan, 2014). This is considered an epidemic. There are a variety of treatments available in the state of Michigan for children with autism, such as occupational therapy, speech therapy, physical therapy, and applied behavior analysis (ABA). Effective April 1^st, 2013, Michigan increased their funding cap for ABA therapy for treating children with autism. However, there is a lack of knowledge within the community and amongst professionals in regards to the critical treatment occupational therapy practitioners provide and as a result, there …

Improving Functional Mobility Following A Basal Ganglia Stroke, John Covilli

Case Report Posters

Background: The basal ganglia are located in the and are involved in voluntary motor control, emotional reactions, and cognition. The putamen is housed in the basal ganglia, and is involved in learning and motor skills. Stroke is the 4th leading cause of death in the U.S. and leads to 1 out of every 19 deaths. Stroke is the largest cause of disability in older adults, and the largest consumer of rehabilitation services in the U.S. Hypertension is a major risk factor for causing a stroke, and over 90% of patients that have had a basal ganglia stroke have also had …

The Role Of An International Cross Cultural Interprofessional Healthcare Immersion Program In Doctor Of Physical Therapy Education: An Educational Case Report, Jayme Keith

Case Report Posters

Purpose: The purpose of this educational case report is to describe an interprofessional international cross-cultural immersion healthcare program and to discuss the role of this program in the development of Doctor of Physical Therapy (DPT) students’ cultural competence, interprofessionalism, and social responsibility. Description: The Ghana Cross Cultural Health Immersion (GCCHI) program provides annual primary health care services and education in Sekondi, Takeradi and outlying communities in Ghana. Student and faculty participants from the University of New England (UNE) work in conjunction with the Ghana Health Services, Cape Coast University medical students and community health workers in order to meet the …

The Role Of An International Cross Cultural Interprofessional Healthcare Immersion Program In Doctor Of Physical Therapy Education: An Educational Case Report, Jayme Keith

Case Report Papers

Background and Purpose: Today’s healthcare team requires providers to be culturally sensitive and competent interprofessional collaborators. Interprofessional Education (IPE) helps to provide a collaborative foundation for healthcare providers. Cross-cultural immersion (CCI) educational programs foster cultural awareness. Service-learning (SL) programs create opportunities for students to have interprofessional and cross cultural experiences. The purpose of this educational case report is to describe an interprofessional international cross-cultural immersion healthcare program and to discuss the role of this program in the development of (DPT) students’ cultural competence, interprofessionalism, and social responsibility. Case Description: The Ghana Cross Cultural Healthcare Immersion (GCCHI) is a University based …

Improving Independent Functional Mobility Following A Left Basal Ganglia Hemorrhagic Stroke: A Case Report, John Covilli

Case Report Papers

Background and Purpose: The purpose of this case report is to compile and summarize the physical therapy management for improving independent functional mobility following a left basal ganglia hemorrhagic stroke in the outpatient setting. Additionally, this report will provide a brief overview of the presentation and medical management of a left basal ganglia hemorrhagic stroke. Case Description: The patient, JD, had a stroke on 2012 and was left with multiple impairments ranging from his cognition to his strength and active range of motion. This case covers his physical therapy management over a 12 week period with hour long appointments twice …

Postoperative Management And Core Stabilization Interventions For A Semi-Pro Football Athlete Following Lumbar Discectomy: A Case Report, Isaiah Iaea

Case Report Papers

Although there is evidence to support a high success rate to return to work in the general population and to sports play in athletes following discectomy, less is known regarding the interventions that played a role in their return. The following case describes the interventions and management of a recreational football player following discectomy. Case description: The patient was a self-described highly active 24-year-old male post discectomy. The patient had pain, poor body mechanics, gait abnormalities, range of motion deficits, and strength deficits of his low back and lower extremities. Physical therapy interventions included soft tissue mobilization, stretching, exercise, and …

Test-Retest Reliability And Minimal Detectable Change Of The Modified Fresno Test Of Evidence Based Practice In Dpt Students, Erin Pike, Lisa Gerhardt

Research Report Posters

Poster presenting a research study whose purpose was to determine the test-retest reliability and MDC of the MFT in first, second, and third year DPT students, and to compare the mean total score of the MFT among the three student groups. Using a simple random sample, 21 students were recruited from each of the three UNE DPT classes. The participants completed the MFT twice, separated by 14 days, in a UNE classroom. Students in the third year class completed the validated 13-item MFT and, due to a photocopying error, students in the first and second year class completed an 11-item …

Postoperative Management And Core Stabilization Interventions For A Semi-Pro Football Athlete Following Lumbar Discectomy: A Case Report, Isaiah Iaea

Case Report Posters

Background: Many cases of low back pain (LBP) are idiopathic in nature, however, LBP in result of a herniated intervertebral disc exerting pressure on the nerve root may require lumbar discectomy to relieve sciatica and radiating pain. Although there is evidence to support successful return to work in the general population and return to sports in professional athletes, less is known regarding the interventions that played a role in their return. Purpose: The purpose of this case report is to describe the physical therapy management and core stabilization interventions for a semi-pro football athlete following lumbar discectomy who sustained a …

Effect Of Dual Tasking On Walking Over Even And Uneven Surfaces In Functionally Independent Community Older Adults, Olajide L. Kolawole

Seton Hall University Dissertations and Theses (ETDs)

While several studies have reported a decrement in performance by older adults while walking and concurrently performing a dual task on even surfaces, to date the effects of dual tasking while walking on uneven surfaces commonly found in the community has received less attention. Thus, we sought to test the hypothesis that an incremental decrement in gait parameters will be observed, when walking on an uneven versus an even surface and furthermore, that this decrement would be dependent upon the concurrent performance of a secondary cognitive and/or motor task in functionally independent-living-community older adults.

Dynamic Gait Index assessed the subject’s …

Sailing As A Therapy Modality For Occupational Therapy; Requirements Prior To Participation, Carrie Bell

Honors Theses

Many outdoor activities are currently being utilized by recreational therapists to aid in the development of play and leisure skills, education, social skills training, and even therapeutic community. The process of using these outdoor activities can aid clients in emotional, physical, cognitive and social functions. Although these types of activities have been primarily utilized in recreational therapy intervention sessions, these activities carry the potential to also fit within the domain of occupational therapy. In order to engage in the recreational activity of sailing, persons must have specific cognitive, physical, emotional and social abilities. The purpose of this study is to …

The Effects Of Robot-Assisted Gait Training And Task-Specific Training On Adl Function And Mobility For A Patient After A Stroke: A Case Report, Maegen Johnson

Case Report Papers

Background and Purpose: Robot-assisted gait devices have become increasingly popular as they have been shown to increase the likeliness of independent ambulation in patients who have had a stroke, while also decreasing the physical burden on the physical therapist. However, there has been minimal research investigating the impact of these devices on activities of daily living (ADL) function. Therefore, the purpose of this case report is to describe the impact of robot-assisted gait training with task specific training on the ADL function and functional mobility of an individual who experienced a stroke. Case Description: The patient was a 71-year-old male …

Outpatient Physical Therapy Management Of A Patient Three Months Following Left Shoulder Arthroscopic Repair Of A Type-Ii Slap Lesion: A Case Report, Charles Dowd

Case Report Papers

Background and Purpose: Research demonstrates a drastic increase in the prevalence of type-II superior labral anterior-posterior (SLAP) lesion repairs, and its surgical correction has become the favored method of treatment, because of its ability to effectively improve quality of life (QOL). The purpose of this case report is to document the examination, evaluation, and plan of care (POC) concerning a patient who was referred to physical therapy (PT) three months following the surgical correction of a type-II SLAP lesion. Case Description: The patient was a middle-aged male who was referred to PT for evaluation and treatment following an arthroscopic repair …

Effectiveness Of Tailored Lifestyle Interventions, Using Web-Based And Print-Mail, For Reducing Blood Pressure Among Rural Women With Prehypertension: Main Results Of The Wellness For Women: Dashing Towards Health Clinical Trial., Patricia A. Hageman, Carol H. Pullen, Melody A. Hertzog, Linda Boeckner

Journal Articles: Physical Therapy

Background Lifestyle modification is recommended for management of prehypertension, yet finding effective interventions to reach rural women is a public health challenge. This community-based clinical trial compared the effectiveness of standard advice to two multi-component theory-based tailored interventions, using web-based or print-mailed delivery, in reducing blood pressure among rural women, ages 40–69, with prehypertension.

Methods 289 women with prehypertension enrolled in the Wellness for Women: DASHing towards Health trial, a 12-month intervention with 12-month follow-up. Women were randomly assigned to groups using a 1:2:2 ratio, comparing standard advice (30-minute counseling session) to two interventions (two 2-hour counseling sessions, 5 phone …

Physical Therapy Management Of A Patient With Guillain-Barre Syndrome During And After Pregnancy: A Case Report, Sarah Kou

Case Report Posters

Background: Guillain Barre Syndrome (GBS) is a disorder in which the body’s immune system attacks part of the peripheral nervous system. The cause of GBS is still unknown, with suspicions of viral or bacterial infection preceding diagnosis. It can affect people of all ages, gender, or ethnic background, with equal incidence rates in both men and women. The incidence rate for GBS is rare, affecting 1-2 persons in 100,000 annually. Usually begins with distal, symmetrical, onset of paraesthesia, followed by progressive limb weakness. Pain is a common symptom, typically described as a deep ache or cramp in the buttocks, thighs, …

Physical Therapy Management Of A Patient With A Transtibial Amputation Using An Over-Ground Body Weight Support System: A Case Report, Elizabeth Kelly

Case Report Posters

Background: Peripheral Arterial Disease (PAD): Narrowing of the vessels secondary to atherosclerotic plaque buildup, results in ischemia to extremities which can lead to intermittent claudication, decreased distal pulses, impaired healing. Lower Extremity Amputation: 54% of amputations in the USA are due to PAD, either alone or in conjunction with diabetes (Kalapatapau V. et al), transtibial and transfemoral most common, best outcomes with multidisciplinary approach. Body Weight Support (BWS) Systems: Commonly used in patients after stroke or incomplete spinal cord injury; methods: treadmill or over-ground, over-ground allows for assistive device training and varying terrains; parameters: high-intensity, high-repetition, task-specific; lack of research …

Physical Therapy For A Patient With Poor Balance Secondary To Charcot-Marie Tooth Disease And Chronic Low Back Pain: A Case Report, Nicole Christine

Case Report Posters

Background: Charcot-Marie-Tooth disease (CMT) is one of the most common inherited neuromuscular disorders with a prevalence rate of 1 in 2,500 in the United States. CMT is a form of muscular dystrophy, and is an umbrella term for certain inherited genetic disorders that affect the peripheral nervous system. The genetic disorder is characterized by muscular wasting, weakness, and sensory loss, and is most severe in the distal lower extremities. Common symptoms include foot drop, high-stepped gait with frequent tripping or falls, foot deformities such as high arches and hammer toes, and loss of muscle bulk in the distal lower extremities. …

Outpatient Interventions For Femoral Acetabular Impingement Complicated By Hip Osteoarthritis, Labral Tear And L5 Sacralization: A Case Report, Brianna Palmer

Case Report Posters

Background: Femoral Acetabular Impingement (FAI) is a known cause of hip pain in adolescents and young adults produced by altered hip joint mechanics. Types of FAI include Cam deformity, Pincer deformity or a combination. Abnormal abutment of the femoral head on the acetabular rim, especially during hip flexion and internal rotation (IR) causes a sharp, pinching pain in the groin and lateral hip. Chronic FAI can lead to hip osteoarthritis (OA) and labral and/or chondral defects. It is unknown if there is a correlation between FAI and sacralization.

Outpatient Physical Therapy Following Surgical Debridement Of Osteochondritis Dissecans Of The Talar Dome: A Case Report, Angela Serrani

Case Report Papers

Background: Osteochondritis Dissecans (OCD) is an alteration of subchondral bone with possible disruption of the surrounding articular cartilage. Hypothesized causes of the chondral defect include repeated trauma or vascular disruption within the joint. Surgical treatment may be used to relieve symptoms of OCD and improve function. Purpose: The purpose of this paper is to describe physical therapy treatment and outcomes for a patient following surgical debridement of OCD of the talar dome. Case Description: The patient was a 27 year old female with a history of frequent ankle sprains. She reported a specific incident earlier this year that led to …

Primary Care In Geriatrics: Context, Opportunities, And Resources For Occupational Therapy, Catherine V. Piersol, Phd, Otr/L

Department of Occupational Therapy Posters and Presentations

Learning Objectives:

1. Discuss health care delivery trends and system changes that offer opportunities for occupational therapy in primary care for older adults in the community.

2. Describe the contributions of occupational therapy on the interprofessional primary care team.

3. Utilize current resources and evidence that support the role of occupational therapy in geriatric primary care.

Agenda:

1. Overview of primary care.

2. Health trends and reform initiatives that open doors for occupational therapy.

3. Opportunities (and barriers) for occupational therapy in primary care

4. Current NIH funded study testing a primary care occupational therapy intervention.

5. Resources and Discussion. …

Use Of Mobility Devices In Developing Countries; A Comparative Literature Review Introducing The Contextual Factors Surrounding Accessibility And Use Of Mobility Devices In Ghana, Bangladesh, And Guatemala., Bethany Shadel

Honors Theses

Disability in the developing world encompasses 10% of the global population and much of that population requires the use of a mobility device in order to engage in meaningful occupation. The use and accessibility of mobility devices is shaped by the significance of the barriers surrounding mobility. This research looks comparatively at the factors affecting accessibility and the use of mobility devices in three developing countries; Ghana, Bangladesh, and Guatemala. Trends within literature revealed that economic, environmental, and cultural barriers all had an impact on accessibility. Overall, this study determines that accessibility solutions are not possible without removing barriers to …

Progressive Strengthening And Postural Training In A Patient With Leg Length Discrepancy And Anterior Pelvic Tilt In A Physical Therapy Outpatient Setting: A Case Report, Oana Butnarasu

Case Report Papers

Background & Purpose: Leg length discrepancy (LLD) is a frequent orthopedic problem that presents as either shortening or lengthening of one of the lower limbs. Patients with LLD often present with gait compensation pattern, scoliosis, back and/or lower extremity pain. The purpose of this case report is to describe the physical therapy management of a patient with LLD who experienced pain in the left lower extremity and a left anterior pelvic tilt. Case Description: MT was a 15 year old male who presented to outpatient PT clinic accompanied by his mother with the chief complaint of pain in his left …

Leadership Styles Of Clinical Coordinators And Clinical Instructors In Physical Therapy Clinical Education, Allison Kellish

Seton Hall University Dissertations and Theses (ETDs)

The APTA has identified the roles of the CCCE and CI as leaders in physical therapy clinical education. In the literature there appears to be an absence of studies examining the CCCE and CI leadership style and its impact on the preparation for clinical instruction, extra effort, job satisfaction and effectiveness of quality clinical education. The purpose of this study was to examine the leadership styles of CIs and CCCEs and to discern if there was a correlation between CI’s and CCCE’s perceptions of leadership style and perceptions of leadership effectiveness based upon three leadership outcomes. The second purpose of …

An Examination Of The Mental Health Services Provided To Students At Western Michigan University, Melissa Rex

Honors Theses

Introduction: All college students will experience stress related to academic demands, changing social situations and new environments. For some students, these multiple stressors can create overwhelming challenges. Students who are not able to receive needed support may be unable to successfully navigate the world of higher education, and are at higher risk of developing mental illness. The purpose of this study is to assess mental health services available at Western Michigan University (WMU) in comparison to other similar size universities within the state.

Method: The information used in this study was collected via several methods. Information was gathered from …

Sensor Technology For Supporting Independence Among Cognitively Impaired Elders, Kelsey Wright

Honors Theses

Dementia is the most expensive disease in the United States and its prevalence is rapidly increasing as the older adult population grows. The number of older adults diagnosed with dementia living alone is also rising, which brings about numerous safety risks. Due to the declining cognitive skills and behavior changes seen with dementia, it is important find approaches for monitoring their safety. This literature review discusses commercially available monitoring systems and empirical studies using sensor technology with older adults. It also describes a current pilot study that is exploring the use of sensor technology in the homes of cognitively impaired …