Rehabilitation and Therapy Commons^™

Recovery From Covid-19 And Acute Respiratory Distress Syndrome: The Potential Role Of An Intensive Care Unit Recovery Clinic: A Case Report, Kirby P. Mayer, Jamie L. Sturgill, Anna G. Kalema, Melissa K. Soper, Sherif M. Seif, Evan P. Cassity, Jimmi Hatton Kolpek, Esther E. Dupont-Versteegden, Ashley A. Montgomery-Yates, Peter E. Morris

Physical Therapy Faculty Publications

Background

In this case report, we describe the trajectory of recovery of a young, healthy patient diagnosed with coronavirus disease 2019 who developed acute respiratory distress syndrome. The purpose of this case report is to highlight the potential role of intensive care unit recovery or follow-up clinics for patients surviving acute hospitalization for coronavirus disease 2019.

Case Presentation

Our patient was a 27-year-old Caucasian woman with a past medical history of asthma transferred from a community hospital to our medical intensive care unit for acute hypoxic respiratory failure due to bilateral pneumonia requiring mechanical ventilation (ratio of arterial oxygen partial …

Applying The Who Icf Framework To The Outcome Measures Used In The Evaluation Of Long-Term Clinical Outcomes In Coronavirus Outbreaks, Kajal Patel, Sofia Straudi, Ng Yee Sien, Nora Fayed, John L. Melvin, Manoj Sivan

Department of Rehabilitation Medicine Faculty Papers

(1) Objective: The World Health Organization's (WHO) International Classification of Functioning, Disability and Health (ICF) classification is a unified framework for the description of health and health-related states. This study aimed to use the ICF framework to classify outcome measures used in follow-up studies of coronavirus outbreaks and make recommendations for future studies. (2) Methods: EMBASE, MEDLINE, CINAHL and PsycINFO were systematically searched for original studies assessing clinical outcomes in adult survivors of severe acute respiratory distress syndrome (SARS), middle east respiratory syndrome (MERS) and coronavirus disease-19 (COVID-19) after hospital discharge. Individual items of the identified outcome measures were linked …

The Association Between Medication Use And Gait In Adults With Intellectual Disabilities, S. Maas, D. A.M. Festen, Thessa I.M. Hilgenkamp, A. Oppewal

Physical Therapy Faculty Research

Background: Adults with intellectual disabilities (ID) often have polypharmacy and often use antipsychotics. Both polypharmacy and antipsychotics have a negative effect on gait in the general population, but this has not been studied in adults with ID. These negative effects may add to pre‐existing gait disturbances in adults with ID and increase the risk for adverse health outcomes in this population. Therefore, the aim of this study is to investigate the difference in gait parameters between adults with ID with and without polypharmacy and between adults with ID using and not using antipsychotics. Method: The gait parameters of 31 participants …

Differential Rates Of Intravascular Uptake And Pain Perception During Lumbosacral Epidural Injection Among Adults Using A 22-Gauge Needle Versus 25-Gauge Needle: A Randomized Clinical Trial, Robin Raju, Michael Mehnert, David Stolzenberg, Jeremy Simon, Theodore Conliffe, Jeffrey Gehret

Department of Rehabilitation Medicine Faculty Papers

BACKGROUND: Inadvertent intravascular injection has been suggested as the most probable mechanism behind serious neurological complications during transforaminal epidural steroid injections. Authors believe a smaller gauge needle may lead to less intravascular uptake and less pain. Theoretically, there is less chance for a smaller gauge needle to encounter a blood vessel during an injection compared to a larger gauge needle. Studies have also shown smaller gauge needle to cause less pain. The aim of the study was to quantify the difference between a 22-gauge needle and 25-gauge needle during lumbosacral transforaminal epidural steroid injection in regards to intravascular uptake and …

Promoting Interprofessional Collaboration Through Education In The Inpatient Rehabilitation Setting, Emma Murphy

OTD Capstone Projects

As part of a 14-week occupational therapy doctoral capstone project, the author partnered with Vanderbilt Stallworth Rehabilitation Hospital to research and address interprofessional collaboration in the inpatient rehabilitation setting. The project sought to attain a comprehensive assessment of the current interdisciplinary collaboration environment at VSRH, improve communication between the therapy and nursing departments, provide rehabilitation education for nurses on staff-identified topics, and promote interprofessional collaboration as a whole.

Flexible Coordinator And Switcher Hubs For Adaptive Task Control, Carrisa V. Cocuzza, Takuya Ito, Douglas H. Schultz, Dabielle D. Bassett, Michael W. Cole

Center for Brain, Biology, and Behavior: Faculty Publications

Functional connectivity (FC) studies have identified at least two large-scale neural systems that constitute cognitive control networks, the frontoparietal network (FPN) and cingulo-opercular network (CON). Control networks are thought to support goal-directed cognition and behavior. It was previously shown that the FPN flexibly shifts its global connectivity pattern according to task goal, consistent with a “flexible hub” mechanism for cognitive control. Our aim was to build on this finding to develop a functional cartography (a multimetric profile) of control networks in terms of dynamic network properties. We quantified network properties in (male and female) humans using a high-control-demand cognitive paradigm …

Doing Nonbinary Gender: The Occupational Experience Of Nonbinary Persons In The Environment, Karen Mccarthy, Meghan Ballog, Maria Mayela Carranza, Katherine Lee

Occupational Therapy | Faculty Scholarship

Understanding the effect of the environment is fundamental to grasping the occupational experiences of nonbinary individuals. Current research in occupational science addresses the occupations of the transgender population but often fails to distinguish between the binary and nonbinary experience. There is an absence of occupational science research that solely focuses on the nonbinary experience. This study focuses on nonbinary individuals and aims to illuminate the environmental factors that support or hinder occupational engagement for nonbinary individuals. Using a descriptive qualitative research design, we conducted two interviews per participant and photo-elicitation. Data analysis resulted in three themes: binary environments and safe …

Strategies For Hybrid Teaching, Julia Bilotta

OTD Capstone Projects

This project aimed to work alongside the occupational therapy department at Belmont University to research, develop, and disseminate strategies for hybrid teaching. As the early days of the COVID-19 pandemic required universities to rapidly switch to online teaching, the need for strategies to complete this effectively arose. Moving months ahead to present day, Belmont University has adapted a hybrid model for teaching, which includes both online and in-person learning. With that being said, the department of occupational therapy expressed the need for lab experiences and clinical skill competencies that follow the ACOTE standards, that can be delivered through a virtual …

Understanding The Impact Of Social Distancing On Older Adults And Senior Centers To Better Adapt Towards A New Normal, Salina Jivan

Student Capstone Papers

COVID-19 brought about social distancing mandates that posed as a new barrier to meaningful social participation in the community. The purpose of this project was to understand the impact of social distancing on older adults and senior organizations to better inform the role of OT in helping seniors adapt towards a new normal within the community. A qualitative study and needs assessment were performed through phone interviews with seniors and organizations that support them from around the United States. Themes highlighted seniors desire for social contact and cautious return to the community once mandates are lifted. Both seniors and organizations …

An Examination Of Acute Cross-Over Effects Following Unilateral Low Intensity Concentric And Eccentric Exercise, William Miller, Sunggun Jeon, Xin Ye

Faculty and Student Publications

We compared the effects of low intensity concentric (CON) and eccentric (ECC) exercise on the force and neural responses of the dominant (exercised) elbow flexors (EFs), and studied if these conditions could induce cross-over effects to the contralateral (non-exercised) EFs. Fifteen subjects (8 males) completed all conditions (CON and ECC: 6 sets of low intensity exercise to failure; control: rest) in separate visits with a randomized order. Maximal isometric force and electromyography (EMG) of the dominant and contralateral EFs were assessed at pre, immediate-, 24-, and 48-h-post. Two-factor (condition and time) linear mixed-model analyses were performed to examine the force …

Occupational Therapy And Accessibility In The Outdoors And Summer Camps, David M. Lewis

Student Capstone Papers

Opportunities for positive youth development (PYD) are promoted through both outdoor and camp experiences. The experiences provided by the outdoors and camps are ideal for developing physically, cognitively, socially, emotionally, and spiritually. These areas of PYD are further generalizable to several aspects of occupational performance and participation, while continuing to have benefits throughout the lifespan. While the outdoors and camps provide these valuable opportunities for development, the environments and contexts of these opportunities are often limiting factors for individuals with disabilities. Utilizing an occupational therapy approach allows for further understanding of how to promote inclusion and accessibility practices in these …

The Effects Of Human Visual Sensory Stimuli On N1b Amplitude: An Eeg Study, Damien Moore, Toshikazu Ikuta, Paul D. Loprinzi

Faculty and Student Publications

Sensory systems are widely known to exhibit adaptive mechanisms. Vision is no exception to input dependent changes in its sensitivity. Recent animal work demonstrates enhanced connectivity between neurons in the visual cortex. The purpose of the present experiment was to evaluate a human model that noninvasively alters the amplitude of the N1b component in the visual cortex of humans by means of rapid visual stimulation. Nineteen participants (Mage = 24 years; 52.6% male) completed a rapid visual stimulation paradigm involving black and white reversal checkerboards presented bilaterally in the visual field. EEG data was collected during the visual stimulation paradigm, …

Transition In Occupations Of Refugees During Resettlement, Karen Mccarthy, Jacqueline-Elizabeth Cantrell, Jennifer Daine, Kimberley K. Banuelos, Adam Chan

Occupational Therapy | Faculty Scholarship

Background: Human displacement is a social problem that has occupational implications. There is a significant gap in the research focusing on the refugee experience and the impact of this experience on their occupations as they transition to living in the US. This study seeks to capture the experience of refugees and the impact of this transition to the US on a broad array of occupations.

Method: This research is a qualitative study. Data was collected through semi-structured interviews with two participants who have legal status as refugees living in the US.

Results: Thematic analysis generated three themes: …

Validating Tackle Mechanics In American Football: Improving Safety And Performance, Arthur C. Maerlender, Caitlin J. Masterson, Rex Norris, Adam Hinthorne

Center for Brain, Biology, and Behavior: Faculty Publications

Research has helped to understand the risks of injuries of tackling in American football and rugby; however, approaches to teaching and analysis are not well-documented. Shoulder-led tackling has been proposed as a safer approach to tackling even though data on the effectiveness for safety and defensive performance is limited. Additionally, some have argued that safety and effectiveness are incompatible. The purpose of the study was to validate a specific sequence of tackling actions as a tool for teaching safer and more effective tackling skills. Results suggested tackle scores help predict presence of head contact, and that higher tackle scores were …

Middle Cerebral Artery Occlusion And The Effects Of Physical Therapy In The Skilled Nursing Facility: A Case Study, Delany Faiman

Physical Therapy Scholarly Projects

Background and Purpose: Stroke is the leading cause of disability and fifth leading cause of death among adults in the Unites States. This case study evaluates the effectiveness of inpatient physical therapy following a right middle cerebral artery occlusion and the outcomes throughout the weeks of treatment.

Case Description: The patient was an 80-year-old male who received physical therapy within the hospital for six days before he was referred to a skilled nursing facility. The patient completed four total weeks of skilled physical therapy in the nursing home prior to discharge.

Intervention: The therapy provided to the …

Direct Healthcare Costs Associated With Oligoarticular Juvenile Idiopathic Arthritis At A Single Center, Amit Thakral, Daniel Pinto, Michael Miller, Megan L. Curran, Marisa Klein-Gitelman, Dustin D. French

Physical Therapy Faculty Research and Publications

Oligoarticular juvenile idiopathic arthritis (JIA) is a common disease in pediatric rheumatology. The management of oligoarticular JIA can result in a considerable economic burden. This study is a four-year, retrospective cost identification analysis performed to determine the annual direct cost of care for patients with oligoarticular JIA and possible predictive clinical factors. Direct healthcare costs were defined as those associated with office visits, laboratory studies, hospital admissions, joint injections, medications, infusions, radiology tests, and emergency room visits. Disease characteristics and patient information included ANA status, gender, age at diagnosis, duration from diagnosis to initial visit during the study period, and …

Introducing Occupational Balance And Mindfulness-Based Stress Reduction To Women At The New Beginnings Center, Piper Cleveland

OTD Capstone Projects

The New Beginnings Center is a workout facility that provides coaching in nutrition, fitness, and health behaviors for women experiencing obesity in low socioeconomic classes. The purpose of this project was to enhance the current 12-week curriculum based on reserch and client feedback, as well as create a potfolio for the marketing team of evidence and testamonies. The two curriculum additions focused on stress reduction through occupational balance and mindfulness. In the "Schedule Redesign" class, we focused on the importance of finding maladaptive time use in their schedule (e.g. watching too much TV, laying in bed too long, etc.) and …

A Smartphone-Based Support Group For Alcoholism: Effects Of Giving And Receiving Emotional Support On Coping Self-Efficacy And Risky Drinking, Woohyun Yoo, Dhavan V. Shah, Ming-Yuan Chih, David H. Gustafson

Health and Clinical Sciences Faculty Publications

The purpose of this study was to investigate the nature and effects of exchanging emotional support via a smartphone-based support group for patients with alcohol dependence. Of the 349 patients who met the Diagnostic and Statistical Manual of Mental Disorders (4th ed.) criteria for alcohol dependence, 153 patients participated in the discussion group within the Addiction-Comprehensive Health Enhancement Support System, a smartphone application aimed at reducing relapse. This was developed to prevent problem drinking by offering individuals in recovery for alcohol dependence automated 24/7 recovery support services and frequent assessment of their symptom status as part of their addiction care. …

Effect Of Motor-Assisted Elliptical Training Speed And Body Weight Support On Center Of Pressure Movement Variability, Farahnaz Fallahtafti, Chase M. Pfeifer, Thad W. Buster, Judith M. Burnfield

Department of Mechanical and Materials Engineering: Faculty Publications

Background: A motor-assisted elliptical trainer is being used clinically to help individuals with physical disabilities regain and/or retain walking ability and cardiorespiratory fitness. Unknown is how the device’s training parameters can be used to optimize movement variability and regularity. This study examined the effect of motor-assisted elliptical training speed as well as body weight support (BWS) on center of pressure (CoP) movement variability and regularity during training. Methods: CoP was recorded using in-shoe pressure insoles as participants motor-assisted elliptical trained at three speeds (20, 40, and 60 cycles per minute) each performed at four BWS levels (0%, 20%, 40%, and …

Improved Urinary Continence For Stroke Survivors In Inpatient Rehab, Lauren Logan, Evelyn Laws, Charmika Schuster, Emily Sharawara, Steven Anderson, Shireen Hussien, Robin Nelson, Ann Sandstedt, Nadine Tranquilla, Natalie Swearingen, Diane Clark

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No abstract provided.

Resistance Exercise Intensity Does Not Influence Neurotrophic Factors Response In Equated Volume Schemes, Leandro Lodo, Alexandre Moreira, Reury Frank P Bacurau, Carol D. Capitani, Wesley P. Barbosa, Marcelo Massa, Brad J. Schoenfeld, Marcelo S. Aoki

Publications and Research

The aim of the present study was to evaluate the effects of 2 different intensities of resistance training (RT) bouts, performed with the equated total load lifted (TLL), on the acute responses of neurotrophic factors (NFs) (brain-derived neurotrophic factor [BDNF]; and nerve growth factor [NGF]), as well as on metabolic (lactate concentration) and hormonal (salivary cortisol concentration) responses. Thirty participants (males, 22.8 ± 2.3 years old, 177 ± 6.8 cm, 75.5 ± 7.9 kg, n = 15; and females, 22.2 ± 1.7 years, 163.7 ± 6.5 cm, 57 ± 7.6 kg, n = 15) performed 2 separate acute RT bouts …

Cardiorespiratory Fitness Diminishes The Effects Of Age On White Matter Hyperintensity Volume, Nathan F. Johnson, Ahmed A. Bahrani, David K. Powell, Gregory A. Jicha, Brian T. Gold

Physical Therapy Faculty Publications

White matter hyperintensities (WMHs) are among the most commonly observed marker of cerebrovascular disease. Age is a key risk factor for WMH development. Cardiorespiratory fitness (CRF) is associated with increased vessel compliance, but it remains unknown if high CRF affects WMH volume. This study explored the effects of CRF on WMH volume in community-dwelling older adults. We further tested the possibility of an interaction between CRF and age on WMH volume. Participants were 76 adults between the ages of 59 and 77 (mean age = 65.36 years, SD = 3.92) who underwent a maximal graded exercise test and structural brain …

Comparison Of Machine Learning Models: Gesture Recognition Using A Multimodal Wrist Orthosis For Tetraplegics, Charlie Martin

The Journal of Purdue Undergraduate Research

Many tetraplegics must wear wrist braces to support paralyzed wrists and hands. However, current wrist orthoses have limited functionality to assist a person’s ability to perform typical activities of daily living other than a small pocket to hold utensils. To enhance the functionality of wrist orthoses, gesture recognition technology can be applied to control mechatronic tools attached to a novel fabricated wrist brace. Gesture recognition is a growing technology for providing touchless human-computer interaction that can be particularly useful for tetraplegics with limited upper-extremity mobility. In this study, three gesture recognition models were compared—two dynamic time-warping models and a hidden …

Corticospinal Activity During A Single-Leg Stance In People With Chronic Ankle Instability, Masafumi Terada, Kyle B. Kosik, Ryan S. Mccann, Colin Drinkard, Phillip A. Gribble

Athletic Training and Clinical Nutrition Faculty Publications

PURPOSE: The aim of the study was to determine whether corticospinal excitability and inhibition of the tibialis anterior during single-leg standing differs among individuals with chronic ankle instability (CAI), lateral ankle sprain copers, and healthy controls.

METHODS: Twenty-three participants with CAI, 23 lateral ankle sprain copers, and 24 healthy control participants volunteered. Active motor threshold (AMT), normalized motor-evoked potential (MEP), and cortical silent period (CSP) were evaluated by transcranial magnetic stimulation while participants performed a single-leg standing task.

RESULTS: Participants with CAI had significantly longer CSP at 100% of AMT and lower normalized MEP at 120% of AMT compared to …

Immediate Effects Of Anodal Transcranial Direct Current Stimulation On Postural Stability Using Computerized Dynamic Posturography In People With Chronic Post-Stroke Hemiparesis, Jing Nong Liang, Leonard Ubalde, Jordon Jacklin, Peyton Hobson, Sara Wright-Avila, Yun-Ju Lee

Physical Therapy Faculty Research

Postural stability is commonly decreased in individuals with chronic post-stroke hemiparesis due to multisystemic deficits. Transcranial direct current stimulation (tDCS) is a non-invasive method to modulate cortical excitability, inducing neuroplastic changes to the targeted cortical areas and has been suggested to potentially improve motor functions in individuals with neurological impairments. The purpose of this double-blinded, sham-controlled study was to examine the acute effects of anodal tDCS over the lesioned motor cortex leg area with concurrent limits of stability training on postural control in individuals with chronic post-stroke hemiparesis. Ten individuals with chronic post-stroke hemiparesis received either anodal or sham tDCS …

Self Regulation Protocol For Move Inclusive Dance, Rebecca Denton

OTD Capstone Projects

Due to the prevalence of autism, Down Syndrome, and sensory processing disorder in the dancers of MOVE Inclusive Dance, a self regulation protocol was formed. This protocol will help the dancers transition from the studio to recital hall in a sensory inclusive way. The protocol is a holistic program that lasts 6 weeks and encompasses numerous aspects including yoga, sensory room, visual supports, social narratives, and optional nutrition guide.

Occupational Therapy’S Role In Assisting With Community Reintegration For Survivors Of Human Trafficking, Jane Jany Huynh

Student Capstone Papers

Victims of human trafficking are exposed to traumatic experiences that affect their physical, psychological, cognitive, and social health. As survivors enter the healing stage and progressed in their journey to community reintegration, the complex traumatic experiences may affect their independence with occupational tasks.

This capstone explored the areas where occupational therapy can assist with community reintegration for survivors of human trafficking. Interviews were conducted through casual conversation using the modified Canadian Occupational Therapy Measure, (COPM) as guidance, and the Quality of Life Scale (QOLS) was used to gather baseline data.

Survivors identified priorities of their everyday living and the barriers …

Optimal Interventions To Address Drop Foot And Increase Gait Speed In Stroke Populations, Christopher Tran, Tommy Ngo, Dana Hazlett, Ethan Jung, Faris Alshammari

San Marcos, Summer 2020

Background: The mechanism of stroke or cerebral vascular accident (CVA) is an interruption of blood flow to the brain, which can result in many different neuromuscular impairments including drop foot. There is limited research focusing on comparative interventions for gait improvement in early stroke.

Purpose: The purpose of this study was to review the various physical thereapy interventions to benefit patients with drop foot following a single stroke.

Methods: A comprehensive systematic search was conducted within the PubMed and ProQuest databases. This study examined papers assessing conventional physical therapy for stroke patients with drop foot who had their 1st stroke …

Understanding The Impact Of Social Distancing On Older Adults And Senior Organizations To Better Adapt Towards A New Normal, Salina Jivan

San Marcos, Summer 2020

COVID-19 brought about social distancing mandates that posed as a new barrier to meaningful social participation in the community. The purpose of this project was to understand the impact of social distancing on older adults and senior organizations to better inform the role of OT in helping seniors adapt towards a new normal within the community. A qualitative study and needs assessment were performed through phone interviews with seniors and organizations that support them from around the United States. Themes highlighted seniors desire for social contact and cautious return to the community once mandates are lifted. Both seniors and organizations …

The Occupation Of Training Service Dogs: A Therapeutic Intervention For Combat Veterans With Ptsd, Denae A. Padilla, Jessica De Brun

San Marcos, Summer 2020

There are few interventions that present opportunities to engage in meaningful occupation (Kashiwa et al., 2017) to help Veterans reintegrate into the civilian lifestyle that create a desire to participate and attend therapy (Goetteret al., 2015).

The purpose of this study is to explore the effectiveness of training service dogs as an occupation and means of social support for combat Veterans living with PTSD with the following objectives:

• explore an occupation basedintervention that addresses low retention rates in occupational therapy.
• teach coping mechanisms and provide social support as a by-product to training service dogs in order to assist in reintegration …