Rehabilitation and Therapy Commons^™

The Time For Translation Of Mobile Brain And Body Imaging To People With Stroke Is Now, Brian Greeley, Grant Hanada, Lara A Boyd, Sue Peters

Physical Therapy Publications

No abstract provided.

Producing Precarity: The Individualization Of Later Life Unemployment Within Employment Support Provision, Debbie Rudman, Rebecca Aldrich

Occupational Therapy Publications

There have been marked policy shifts within many nations towards ‘extended work lives’, with such shifts often underpinned by an assumption that individual aging citizens can make the responsible choice to prolong work and thereby avoid dependency on the state. However, possibilities for extended work lives are inequitably distributed, and older workers who become unemployed often face prolonged unemployment and barriers to obtaining sustainable employment. Drawing on findings from an ethnographic study addressing the negotiation of long-term unemployment in two North American cities, this article attends to how jobseekers aged 50 and older, employment support service providers, and organizational stakeholders …

Using Biofeedback To Reduce Spatiotemporal Asymmetry Impairs Dynamic Balance In People Post-Stroke, Sungwoo Park, Chang Liu, Natalia Sánchez, Julie K. Tilson, Sara J. Mulroy, James M. Finley

Physical Therapy Faculty Articles and Research

Background. People poststroke often walk with a spatiotemporally asymmetric gait, due in part to sensorimotor impairments in the paretic lower extremity. Although reducing asymmetry is a common objective of rehabilitation, the effects of improving symmetry on balance are yet to be determined. Objective. We established the concurrent validity of whole-body angular momentum as a measure of balance, and we determined if reducing step length asymmetry would improve balance by decreasing whole-body angular momentum. Methods. We performed clinical balance assessments and measured wholebody angular momentum during walking using a full-body marker set in a sample of 36 people with …

Identifying Risk Factors Of Upper Extremity Injuries In Collegiate Baseball Players: A Pilot Study, Robert Slowik, Christopher Morris, Matthew C. Hoch, Timothy L. Uhl

Physical Therapy Faculty Publications

Background
Repetitive pitching places tremendous forces on the shoulder and elbow which can lead to upper extremity (UE) or lower extremity (LE) overuse injuries.

Purpose
The purpose of this study was to evaluate pre-season physical measurements in collegiate baseball players and track in-season baseball throwing volume to determine which factors may predict throwing overuse injuries.

Study Design
Retrospective Cohort study.

Methods
Baseline preseason mobility, strength, endurance, and perception of function were measured in 17 collegiate baseball pitchers. Participants were then followed during the course of the season to collect rate of individual exposure, estimated pitch volume, and rating of perceived …

A Nation-Wide Survey Of High School Baseball Coaches’ Perceptions Indicates Their Arm Care Programs Play A Role In Injury Prevention, Kyle A. Matsel, E. E. Weiss, R. J. Butler, Matthew C. Hoch, Philip M. Westgate, Terry R. Malone, Timothy L. Uhl

Physical Therapy Faculty Publications

Background
Arm care programs consisting of upper extremity strengthening and stretching have been recommended for injury prevention for pitchers of all ages. There has been no investigation into high school baseball coaches’ usage and perceptions of arm care programs to mitigate physical impairments associated with injuries in baseball players.

Hypothesis/Purpose
The purpose of this study was to investigate the current usage of arm care programs by high school baseball coaches. The primary objective was to determine if coaches use group-based or individualized arm care programs. The secondary objective sought to determine if the use of arm care programs is influenced …

Neuroplasticity Of The Corticospinal System: Applications Of Neuromodulation-Based Therapies, Alzahraa M. Amer

Dissertations, Theses, and Capstone Projects

The motor cortex and corticospinal tract are necessary for producing skilled movements. I use intermittent theta burst stimulation (iTBS), a high-frequency stimulation protocol known to promote neural plasticity, as a tool to characterize short- and long-term plasticity of the CS system.

Although it is well known that activity-dependent motor cortex (MCX) plasticity produces long-term potentiation (LTP) of local cortical circuits, leading to enhanced motor evoked potentials (MEPs), the effects produced by the corticospinal (CS) projection on spinal cord neurons have not yet been thoroughly studied. In Chapter 2, I determined if the CS tract (CST) is capable of producing LTP …

Navigator Role For Promoting Adaptive Sports And Recreation Participation In Individuals With Disabilities, Moriah Iverson, Alexander V. Ng, Alice F. Yan, Kimberley Zvara, Michael Bonk, Deb Falk-Palec, Cherri Sylla, Maurine Strickland, Rachel Preston, Diane W. Braza

Exercise Science Faculty Research and Publications

Objective

The aims of the study were to gain a better understanding of the resources, barriers, and facilitators of participation in adaptive sport and recreational activities as a means of achieving physical activity recommendations in individuals with disability and to understand preferences for a patient navigator service to help mitigate the barriers.

Design

Clinical, academic, and community stakeholders applied a community-engaged research approach to develop online surveys and focus group questions for adults with a disability or parents of a child with a disability to meet study objectives.

Results

One hundred ninety-eight adults and 146 parents completed the online surveys. …

Influence Of The Bar Position On Joint-Level Biomechanics During Isometric Pulling Exercises, Nayun Ahn, Hoon Kim, John Krzyszkowski, Stuart Roche, Kristof Kipp

Exercise Science Faculty Research and Publications

The purpose of this study was to investigate the influence of the bar position on ankle, knee, and hip net joint moments (NJMs), relative muscular effort (RME), and vertical ground reaction forces (GRFs) during isometric pulling exercises, such as the isometric midthigh pull. Eight female lacrosse athletes performed maximal effort isometric pulls at 3 different bar positions (low: above patella, mid: midthigh, and high: crease of hip) while motion capture and GRF data were recorded. Net joint moments were calculated with inverse dynamics. Relative muscle effort was defined as the ratio between the inverse dynamics NJMs and the maximum theoretical …

Examining Complementary Health Approaches And Integrative Health (Chaih) Practices Among Occupational Therapists In The United States: A Mixed Methods Approach, Sarah M. Renner

Dissertations

The use of complementary health approaches and integrative health (CHAIH) is increasing among adults and children in the United States and continues to grow within various health care settings. With Health and Wellness identified as a key practice area for occupational therapists and the American Occupational Therapy Association supporting the use of CHAIH in occupational therapy (OT) practice, practitioners must offer safe, research-driven treatments supporting this movement. Research around CHAIH continues to grow; yet the gaps in the literature make it difficult to determine how CHAIH is being used in OT practice as well as the practitioner’s perspectives on the …

Characterization, Implementation, And Impact Of Low Stimulation Precautions In Acute Neurological Injury, Alexis Kurek

Dissertations

Recommendations provided by clinical and professional organizations that encourage providing patients with a low stimulation environment following acquired brain injury are prevalent but supported by expert opinion only. Such recommendations are based on extrapolation of what is known about physiological response to environmental stimuli, however such findings are not specific to the patients with acquired brain injury. Recommendations for low stimulation environments lack guidance for their application and implementation of precautions, and there have been no studies investigating their effectiveness at improving clinical outcomes.

The objective of this study is to determine what patient characteristics are associated with prescription of …

Insights From An Inaugural Eight-Month Interprofessional Collaborative Co-Design Educational Experience Between Occupational Therapy And Industrial Design, Rebecca Brown, Kimberly S. Mollo, Madalyn Peterson, Mikael Avery, Eric Schneider, Tod Corlett

Department of Occupational Therapy Faculty Papers

The design of the built environment greatly impacts how all types of individuals and populations actively participate in their daily lives. Lack of access in the built environment for disabled populations remains a daily reality, negatively impacting engagement and life satisfaction, leading to isolation, loneliness, and depression. A university in the Northeastern United States sought to expand current constructs of the end-user and environment within a universal design (UD) perspective. On an eight-month inaugural interprofessional collaborative co-design experience, third-year occupational therapy doctoral (OTD) students were embedded in a first-year masters of industrial design (MSID) curriculum, which ran the course of …

Reducing Delirium In Patients With Covid-19, Allison E. Brewer Mot/S, Amy Carver Mot/S, Allison Nance Mph, Mot/S, Mallori Rodrigue Mot/S, Olivia Smith Mot/S

Master of Occupational Therapy Student Critically Appraised Topics

The purpose of our critically appraised topic is to synthesize the best current evidence regarding interventions that would be effective in reducing delirium in patients with COVID-19 in the acute care setting. The final portfolio contains a total of five research articles. Study designs include three randomized controlled trials, one non randomized controlled trial, and one quasi-experimental quantitative design. All studies relate directly to interventions within the OT scope of practice and were implemented in the acute care setting. Due to limited research on the novel coronavirus, these findings apply to critically ill patients but are not specific to patients …

Preventing Pneumonia Through Early Mobilization Of Critically Ill Adults, Elizabeth G. Barton, Tedrin N. Elion, Caleb J. Harbor, Alexandria M. Keathley, Madison R. Payne, Hailey N. Warrington

Master of Occupational Therapy Student Critically Appraised Topics

The purpose of this critically appraised topic (CAT) is to investigate early mobilization and its effect on preventing pneumonia in adults in the intensive care unit (ICU). The final portfolio contains four research articles from both national and international journals. Study designs included two meta-analyses, one case series, and one retrospective study. All four of the articles specifically described the effects of early mobilization on individuals in the hospital and ICU and showed positive results in reducing the likelihood of developing pneumonia. This CAT will be used to draft new practice guidelines for mentoring new managers in both occupational therapy …

Increasing Confidence And Mental Health In Caregivers, Lucy D. Diangelo, Libby Lowry, Kayla Mcdaniel, Clare Sauser, Shelby Terry, Erin Williams

Master of Occupational Therapy Student Critically Appraised Topics

The purpose of our critically appraised topic is to synthesize the highest-level evidence available regarding interventions for increasing confidence and mental health outcomes in caregivers taking loved ones home from inpatient rehabilitation. The final portfolio contains six research articles from peer-reviewed journals. Study designs include randomized control trials, a systematic review, and a pretest-posttest without a control group. All studies relate directly to the components of the PICO question. Four of the articles discussed both caregiver confidence and mental health while two articles discussed only mental health. There is strong evidence to support that in-person hands on training, in person …

Space Retrieval Training For Memory Enhancement In Adults With Dementia, Lauren Camenzind, Molly Kafader, Rachel Schwam, Mikayla Taylor, Zoie Wilkes, Madison Williams

Master of Occupational Therapy Student Critically Appraised Topics

The final portfolio contains 8 research articles from national and international journals. Study designs include one systematic review, one randomized control trial with pretest-posttest design, three small-scale randomized control trials, one quasi-experimental study with no control, one time-series study, and one case study. All studies relate directly to components of the evidence-based practice question and will be used to draft new recommendations for implementation regarding spaced retrieval training for memory enhancement in adults with dementia. Seven out of the eight articles looked at the effects of SR techniques on functional tasks. Articles looked at eating difficulty (1), independent use of …

Long-Term Outcomes In Children With Acute Flaccid Myelitis, Megan D. Henley, Lindie Hill, Sydney Inman, Molly Grace King, Sam Lopez, Carley Mahaffey

Master of Occupational Therapy Student Critically Appraised Topics

The purpose of our critically appraised topic is to combine the best evidence regarding the long-term outcomes in children with acute flaccid myelitis (AFM) regarding posture and movement, gross and fine motor control, and activities of daily living (ADL) performance. The final portfolio contains eight articles. The study designs of these articles include a retrospective cohort study, two retrospective non-randomized studies without a control group, a retrospective review, a nationwide follow-up questionnaire analysis study, a case report, a case series, and a multiple quantitative case study. All studies related directly to our evidence-based PICO question and were used to determine …

Exercise Interventions For Adults With Burn Injuries, Liz Burton, Carolyn Knight, Brittney Malone, Lexie Rivers, Rachel Walker, James Wright

Master of Occupational Therapy Student Critically Appraised Topics

The purpose of this critically appraised topic (CAT) is to provide the highest quality of evidence available on the implementation of exercise interventions in the early burn rehabilitation phase in adult burn victims. This portfolio contains four peer-reviewed research articles from national and international journals. The study designs include one systematic review and meta analyses, one retrospective cohort study and two randomized control trials. These articles covered three types of exercise interventions including resistance training, mobility training, and physiotherapy. Overall, the clinical bottom line of this CAT is that exercise interventions in early burn rehabilitation may be effective in improving …

Reducing Stress, Anxiety, And Depression For Nicu Parents, Amy Patton, Kylie Dunavan, Kyla Key, Steffani Takahashi, Kathryn Tenner, Megan Wilson

Master of Occupational Therapy Student Critically Appraised Topics

This project aims to appraise evidence of the effectiveness of various practices on reducing stress, anxiety, and depression among parents of infants in the neonatal intensive care unit (NICU). The project contains six research articles from both national and international journals. Study designs include one meta-analysis, one randomized controlled trial, one small scale randomized controlled trial, one prospective phase lag cohort study, on pretest-posttest study, and one mixed-methods pretest-posttest study. Recommendations for effective interventions were based on best evidence discovered through quality appraisal and study outcomes. All interventions, except for educational programs and Kangaroo Care, resulted in a statistically significant …

Developing A Practical Application Of The Isometric Squat And Surface Electromyography, David Phillips, Angelic Rose Del Vecchio, Kevin Carroll, Evan L. Matthews

Department of Exercise Science and Physical Education Scholarship and Creative Works

Electromyography (EMG) is a research tool used in gait analysis, muscle coordination evaluation, clinical evaluation and sports techniques. Electromyography can provide an insight into neural adaptations, cross education effects, bilateral contraction deficiencies, and antagonist activity in exercise-related movements. While there are clear benefits to using EMG in exercise-related professions, accessibility, cost, and difficulty interpreting the data limit its use in strength and clinical settings. We propose a practical EMG assessment using the isometric squat to identify compensatory activation patterns and report early observations. Ten healthy participants were recruited. Participants performed a 2-min isometric handgrip protocol and an isometric squat protocol. …

Challenges For Children And Adolescents With Autism And Their Families During The Covid-19 Pandemic, Orsolya Pachner, Gabor Aranyi

Journal of Global Awareness

The restrictions and lockdown measures implemented in response to the Covid-19 pandemic have posed a pronounced risk to the mental health of people with autism and their families. We discuss specific difficulties affecting children and adolescents with autism and their families during the pandemic, drawing on a broad range of recently published research in many countries and regions. A global perspective is adopted to provide an overview of the state of affairs and identify good practices. We consider challenges in four areas: research and practice related to autism, challenges facing children and adolescents with autism, specific difficulties in their education …

Weight Reduction Motivation In Osteoarthritis Patients Through Nurse Practitioner Driven Education And Follow-Up: A Pilot Project, Caoilfhionn Mulvey, Martha Fuller Phd

Doctor of Nursing Practice Final Manuscripts

Purpose of Project: The ultimate goal of this short-term pilot project is for

overweight or obese osteoarthritis patients to increase their knowledge on the benefits of

weight loss and physical activity. Research shows that for every kilogram of weight lost,

2.2–4.0 kilograms of weight is taken off of the joint and could reduce joint pain up to

thirty to fifty percent and improve quality of life. Following education from the provider,

patients will understand the correlation of osteoarthritis symptom management with

weight loss.

EBP Model/Frameworks: This project utilizes the Iowa Model of Evidence-Based

Practice to Promote Quality Care. This addresses …

Music As A Gateway To Healing Speech Disorders And Mental Health Holistically In The Patient With Aphasia: A Literature Review, Susan Warren

Expressive Therapies Capstone Theses

People with some types of post-stroke aphasia often experience depression as well as loss of speech. Music therapy has unique properties that allow it to be used therapeutically to treat both speech impairment and depression yet it is rarely used to treat both disorders. This literature review seeks to examine the underlying causes for this discrepancy, review methods used by practitioners to treat both disorders and suggest future directions for additional research and implications for the treatment of patients with aphasia who have both language impairment and depression.

Exploring The Therapeutic Relationship As A Central Focus Through Expressive Arts Therapy In Oncology, Akshata Parekh

Expressive Therapies Capstone Theses

The treatment for cancer can be physically, mentally, emotionally and socially challenging. These treatments have side effects like physical body pain, hair loss, changes in weight, energy, nausea and more. These physical changes impact the social, mental and emotional well-being of the patient and makes this journey of the life-threating prognosis of cancer very tough to confront. Expressive arts therapy provides a safe space for the patients to address their mental health concerns as a result of this treatment. The Capstone Thesis Project explored expressive arts therapy interventions with 95 patients through single or multiple sessions while going through their …

Making Room: Addressing The Counter-Therapeutic Nature Of Psychiatric Hospitalization Through Containment- Based Group Expressive Therapy, Max Sandor Copans

Expressive Therapies Capstone Theses

The process of hospitalization and the environment of a typical psychiatric hospital is often counter-therapeutic. To challenge this problem, clinicians may introduce the concept of psychological containment. To elaborate, being hospitalized anywhere can be disorienting, frightening and even traumatic. This problem is only further exacerbated in psychiatric hospitals where patients may be disorganized, manic, or struggling with psychosis. Furthermore, psychological containment is essentially the ability for psychiatric patients to prevent their intense emotions from effecting others negatively, and to act with resiliency when other patients are unable to contain their own disruptive behaviors. This paper utilizes both an initial literature …

Exploring The Usefulness Of Mindfulness Practices Through Zoom Meetings In Reducing Anxiety And/Or Stress Of Adults With Learning And Developmental Disabilities During The Covid-19 Pandemic, Thatiane Abra

Expressive Therapies Capstone Theses

This thesis explored which mindfulness meditations or mindfulness practices could be beneficial in the online sessions, the extent to which adults with learning and developmental disabilities could learn the practices remotely, and how stress and anxiety disorders could be reduced through online mindfulness interventions. Furthermore, it was also necessary to address the online sessions as the only mental health treatment possibility during the Coronavirus pandemic for the clients observed and the benefits and limitations of these interventions. Additionally, the importance of structure and routine for this population, the multi-modal structure of the interventions, and how attunement plays an important role …

The Use Of Mindfulness Meditation To Increase The Efficacy Of Mirror Visual Feedback For Reducing Phantom Limb Pain In Amputees, Nicolas Sebastian Mills

Doctoral Dissertations

Phantom limb pain is a chronic pain condition that negatively impacts the lives of over half of amputees, and results in considerable morbidity. Currently, there is no gold standard for treatment for phantom limb pain. However, a frequently used intervention is the use of mirror visual feedback, in which the amputee watches the reflection of the adjacent non-amputated limb move and exercise. In the last few decades, mindfulness-based interventions have been increasingly used with individuals living with different types of chronic pain. This study attempts to discover if the addition of a mindfulness-based intervention, such as guided meditation, will augment …

The Effects Of The Mckenzie Method And Strengthening/Stabilization Exercises In Patients With Chronic Nonspecific Low Back Pain., Lufei Harder

Honors College Theses

Background & objective: Low back pain is a frequent problem that the majority of people will face at some point in their lifetime. Exercise has been advocated as an effective treatment for chronic nonspecific low back pain; however, there is a lack of consensus on the best form of exercise treatment. This review was designed to compare the effectiveness of the McKenzie Method against stabilization/strengthening exercises in patients with chronic nonspecific low back pain.

Methods: A literature review examining McKenzie and stabilization exercises for chronic nonspecific low back pain were identified from three databases.

Results: A total of nine articles …

Icf Linking Of Patient-Reported Therapy Goals For Children With Acquired Upper Extremity Impairment, Jenny M. Dorich, Roger Cornwall, Timothy L. Uhl

Physical Therapy Faculty Publications

BACKGROUND: Patient reported outcome measures are used to evaluate hand therapy outcomes. Yet, limited evidence is available regarding the outcomes children desire from hand therapy.

PURPOSE: To determine the desired treatment outcomes of children with acquired upper extremity impairments.

STUDY DESIGN: Descriptive case series METHODS: Two raters independently applied International Classification of Function, Disability and Health (ICF) linking rules to the Canadian Occupational Performance goals of 151 children, age 6-18, receiving occupational therapy for acquired upper extremity impairments. Prevalence of the linked ICF codes was examined using frequency distributions. Kappa and the proportion of positive agreement assessed inter-rater agreement of …

The Role Of Pre-Season Health Characteristics As Injury Risk Factors In Female Adolescent Soccer Players, Brent Harper, Adrian Aron, Emmanuel John

Physical Therapy Faculty Articles and Research

[Purpose] Determine if female adolescent soccer players with a history of concussion, impaired K-D scores, and pre-season subjective complaints of neck pain, dizziness, and headache were predisposed to additional risk of musculoskeletal or concussive injury during 10-weeks of competitive play. [Participants and Methods] Twenty-three female high school soccer athletes provided concussion history and reported pre-season subjective complaints. K-D testing was performed pre and postseason. During the 10-week season, all injuries, preventing participation in practice or game, were recorded. [Results] Six reported a history of concussion. Of those six, three injuries were reported, including two concussions and a hamstring strain. Baseline …

Dancer Screening Clinic, Kristen Manaloto, John Lencioni, Laura Nguyen

UNLV Theses, Dissertations, Professional Papers, and Capstones

Dance students at the University of Nevada, Las Vegas (UNLV) do not have access to sports medicine specialists, thus a pro-bono dance clinic was created as a service-learning project by the UNLV Department of Physical Therapy (UNLVPT) in 2018. In the second year of the service-learning project, three graduate students from the UNLVPT program, under the supervision of a clinical faculty member, have continued to provide free dance specific injury prevention screenings and management to students within the UNLV Department of Dance. To improve clinic operation and services, the group emphasized communication and accessibility as areas of growth. Injury prevention …