Rehabilitation and Therapy Commons^™

Stepping On Fall Prevention Project, James P. Gaddi, Jordan T. Bowers, Lea M. K. Fung

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Falls are a major problem in the United States among the older adult population and provide opportunity for community outreach via student-led physical therapy projects. Objective: The purpose of this project was to investigate the relationship between fall related outcome measures and questionnaires with the completion of the Stepping On Fall Prevention program along with evaluating the benefits of Physical Therapy student development with participation in service learning projects. Methods: The research quantified the fall risk of 13 participants with assessment of: gait speed (Timed Up and Go), lower extremity strength (30-Second Chair Stand), balance (4-Stage Balance Test), and …

Quality Assurance Of Service Learning Back School, Eric Bashaw, Vu Pham, Tyler Parvin, Ryan Pauly

UNLV Theses, Dissertations, Professional Papers, and Capstones

Project Execution: Back School: During the 2019-20 academic year, two University of Nevada, Las Vegas Physical Therapy (UNLVPT) core faculty members, along with eight doctor of physical therapy students, provided three student-led, pro-bono back school classes at Volunteers in Medicine of Southern Nevada (VMSN). Each back school class consisted of two, 2-hour sessions where participants were screened for red flags, educated on pain management strategies and common causes of back pain, and given an individual home exercise program. Quality Assurance Surveys: Patient’s and VMSN staff were all given questions in the form of Likert-scale and open-ended questions via printed handouts …

Recruitment And Advocacy For Clinician Involvement In Pro Bono Physical Therapy Service-Learning Program, Gilberto Carrillo, Gavin Brady, Felicia Doblado, Alyssa Woo Hatch

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Service-learning allows Doctor of Physical Therapy (DPT) students to develop important professional skills and addresses community-based needs. When integrated into physical therapy education, it can be a powerful tool for increasing students' altruism and social responsibility. Many clinicians desire to participate in pro bono physical therapy (PT) services. Therefore, the responsibility of promoting and advertising these programs falls upon the student. This paper describes various methods for recruiting clinician involvement to improve the sustainability of a student led pro bono clinic, as well as how the students advocated for pro bono services in the state of Nevada …

Is Decreased Trunk Flexion Angle A Contributing Factor To Patellofemoral Joint Loading In Runners With Patellofemoral Pain?, Christine Duvall, Zachary Clark, Tavin Fox, Caitlin Howden

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis: Reduced trunk flexion during running is theorized to be a contributing factor of elevated patellofemoral joint (PFJ) stress in runners with patellofemoral pain (PFP); thus, the primary purpose of this research study was to determine if runners with PFP would exhibit differences in PFJ stress and trunk flexion angle during running as compared to pain-free runners across three speeds. We hypothesized that runners with PFP would exhibit higher PFJ stress and decreased trunk flexion while running compared to the pain- free runners. Number of Subjects: 7 runners with PFP and 5 similar pain-free control runners. Materials/Methods: Kinematics and kinetics …

A Vicious Cycle Of Fear Of Falling Avoidance Behavior In Parkinson’S Disease: A Path Analysis, Kameron Jacobson, Nicole Matsunami, Hannah Mccarl, Michelle Regis

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Postural instability (PI) in Parkinson’s disease (PD) is associated with several negative down- stream consequences. Objective: The purpose was to explore the validity of a theoretical model of these downstream consequences arranged in a vicious cycle wherein PI leads to decreased balance con!dence, which in turn leads to increased fear of falling (FOF) avoidance behavior, which in turn leads to decreased physical conditioning, which then feeds back and negatively affects PI. Methods: A path analysis of cross!sectional data from 55 participants with PD was conducted. The four con- structs in the model connected in succession were: 1. PI (principal …

Effects Of Bimodal Transcranial Direct Current Stimulation On Modulation Of Spinal Circuitry In People With Chronic Post-Stroke Hemiparesis, John Patrick Gan, Rafael Cabrera, Lana Laudermilch, Benjamin Wolkenhauer

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Stroke can lead to gait abnormalities such as foot drop. Foot drop can result from decreased corticospinal tract input to the ankle dorsiflexors and/or from exaggerated stretch reflexes on the soleus due to reduced reciprocal inhibition from spinal reflex pathways. Transcranial direct current stimulation (tDCS) attempts to modulate corticospinal tract input and spinal reflex pathways by delivering electrical signals to parts of the brain. The degree of neuromodulation from tDCS can be measured through the Hoffman Reflex (H-reflex)—a tool used to estimate alpha motor neuron excitability which is increased in individuals post-stroke. Purpose: The primary purpose of this study …

Patient Engagement In Cosmetic Designing Of Prostheses: Current Practice And Potential Outcome Benefits, Kenneth Repayo, Cailin Mitchell, Matthew Tillitt, Collin Weber

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: Making a prosthesis for an individual with limb loss is a highly personalized process. A currently unexplored area is whether there are tangible benefits in greater patient engagement during the making of their prostheses. We examined the current practice of engaging patients in prosthetic cosmetic designing and identified factors associated with patient outcomes. Methods: This cross-sectional study surveyed 104 prosthetists and 25 prostheses users. The questionnaires covered aspects of prosthetic prescription, users’ perceived level of engagement, and self-reported outcomes. Regression analyses were used to examine the associations between perceived level of engagement, satisfaction, and other outcomes. Results: Among prosthesis …

Effects Of Altered Somatosensory Input On Lower Limb Mechanics Via Different Shoes And Barefoot Walking In Individuals With Chronic Post-Stroke Hemiparesis, Aaron Abraham Simon, Jynelle Marie Guerrero Arches, Megan Leigh Keohane, Wee Jin Jed Lee

UNLV Theses, Dissertations, Professional Papers, and Capstones

[Purpose/Hypothesis] Stroke is a leading cause of disability that results in various neurological deficits. Stroke can cause impaired somatosensory input, which results in decreased balance and gait speed, ultimately increasing fall risks. Therapies to increase somatosensory input have shown promise for people with stroke as well as other neurological populations. However, few studies have systematically investigated varying somatosensory input via different footwear to improve walking in people post-stroke. The purpose of this study was to investigate the effects of altering somatosensory input via different types of footwear (i.e., barefoot, self-selected shoes, and memory foam shoes) on gait kinetics and ankle …

Inter And Intra-Rater Reliability Of Dance Screening Tool, Kathleen Stone, Braden Waters

UNLV Theses, Dissertations, Professional Papers, and Capstones

Previous literature has indicated that injury rates of ballet and modern dancers are among the highest of any physical activity. These injuries can be detrimental to the athlete and can also result in financial burden for dance companies due to time loss related to injuries. Preventative intervention aimed at those who are most at risk for injury can be effective at reducing the cost associated with lost time due to injury. An effective approach to identifying those most at risk for dance related injuries is to administer a functional movement screen. One such movement screen is the ballet-based Dance Technique …

Am-Pac Basic Mobility Inpatient Short Form (Low Function) Psychometrics/Clinimetrics, Meghan Wonderling, David Miller, Selena Soria

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: To determine whether the Activity Measure for Post-Acute Care® Basic Mobility Inpatient Short Form (Low Function) (6-clicks LF) has increased responsiveness for patients with lower levels of physical function compared to the Activity Measure for Post-Acute Care Basic Mobility Inpatient Short Form (6-clicks). Design: Retrospective cohort study using original scores and simulated scores for assessment of internal responsiveness of the 6-clicks LF compared to the 6-clicks. Simulated 6-clicks and 6-clicks LF scores were created as a hypothetical future AM-PAC® score. Results: We found a statistically significant difference between the 6-clicks and simulated 6-clicks, t=24.8, p < 0.00 [two-tailed]. The effect size was large (d=1.2, r=0.51).There was a statistically significant difference between the 6-clicks LF and simulated 6-clicks LF, t=19.7, p < 0.00 [two-tailed]. The effect size was medium (d=0.91, r=0.41). Finally, for patients with a 6-clicks score in the bottom five-percentile (n=27), we found a statistically significant difference between the 6-clicks and 6-clicks LF, t=11.9, p < 0.00 [two-tailed]. Conclusion: Among patients scoring less than 15, the 6-clicks LF has greater internal responsiveness than the 6-clicks and thus demonstrates that the new low-level questions in the 6-clicks LF better quantify low-level patients’ functional level. Research using non-simulated data should be completed in the future to confirm these findings.

The Relationship Between Alternative Fieldwork Approaches And Student Competence And Confidence For Occupational Therapy In Behavioral Health, Kathryn Beckstein, Elizabeth Britton, Codee Colby, Kathleen Melei, Emily Rehmel, Sara Best

Student Journal of Occupational Therapy

Purpose: The purpose of this case-series study was to assess the relationship between three instructional methods that fall within the parameters of the revised Accreditation Council for Occupational Therapy Education fieldwork objective C.1.9 and perceived student competence and confidence in providing therapy services in a behavioral health setting.

Methods: The study included a convenience sample of (n=49) graduate students enrolled in an entry-level Doctor of Occupational Therapy program and a Doctor of Physical Therapy program in the Midwest. The participants attended a presentation on bipolar disorder and were randomly assigned to engage in one of three instructional methods: …

Neurophysiological Assessments Of Brain And Spinal Cord Associated With Lower Limb Functions In Children With Cerebral Palsy: A Protocol For Systematic Review And Meta-Analysis, Leonard Ubalde, Jing Nong Liang

Physical Therapy Faculty Research

Background: Task-dependent neurophysiological adaptations in people with cerebral palsy have been examined using various techniques such as functional magnetic resonance imaging, peripheral nerve stimulation in order to assess H-reflexes, and transcranial magnetic stimulation. This activity-dependent plasticity is hypothesized to improve specific gross motor function in individuals with cerebral palsy. Although these adaptations have been examined extensively, most studies examined tasks utilizing the upper limbs. The aim of this review is to assess the neurophysiological adaptations of the central nervous system in individuals with cerebral palsy during lower limb functional tasks. Methods: A systematic review and meta-analysis will be conducted to …

Zero Balancing And Occupational Therapy: Removing Restrictions To Life Flow, Deanna Waggy Otr, Loren Waggy Otr

Journal of Transformative Touch

Zero Balancing is an effective complementary and integrative health treatment tool for Occupational Therapy practitioners. It helps remove restrictions and restore balance to a patient’s life flow, improving overall occupational performance.

Functional Outcomes Of Infants With Chiari Ii Malformation With Tracheostomy And Home Ventilator Dependence, Abbigayle Carlson

Research Days

Background: Chiari II malformation is relatively common with an incidence of about 1 in 1000 live birth and is associated with reduced life expectancy. Characteristic features are beaked midbrain, downward displacement of the tonsils, and cerebellar vermis, and spinal myelomeningocele that can be associated with hydrocephalus needing ventriculoperitoneal shunt (VP shunt). Mortality is about 50-70% if not recognized early. Survivors have high morbidity and develop neurologic abnormalities and significant developmental delays. Long-term outcome is poorly understood.

Objective: Not much has been published that describes the outcome of infant with Chiari II malformation that received tracheostomy for long-term ventilator support. Our …

Occupational Therapist Role In Post-Secondary Education Transition Program: Emphasis On Self-Advocacy Skills, Nikki K. Voorhees

Student Capstone Papers

It is becoming increasingly important for individuals to obtain post-secondary education in order to gain employment (Alverson et al., 2019; Chandroo et al., 2018). This increased importance to attend post-secondary education makes it imperative for students who are graduating from high school to be fully prepared for the transition to post-secondary education (Rothman et al., 2008). The transition from high school to post-secondary education is difficult for any individual. However, it is even more difficult for students with learning differences, as they tend to have problems in the areas of social skills, communication, problem solving, self-advocacy, and executive functioning (Alverson …

A National Study On The Relationship Between Programmatic Factors And Athletic Training Education Board Of Certification Pass Rates, Leslie Rippon

Seton Hall University Dissertations and Theses (ETDs)

In athletic training (AT) education, the first-time BOC pass rate is a significant marker of a program’s success, and the Commission on Accreditation of Athletic Training Education (CAATE) requires programs to maintain a first-time 3-year aggregate BOC examination pass rate over 70%. There is limited published research on BOC pass rates on Professional Masters’ (PM) programs. Therefore, it is essential to identify modifiable factors that have a relationship with first-time pass rates. This study's aim was to investigate the relationships between programmatic factors and the first-time BOC pass rate for PM AT students while controlling for student and institutional factors. …

Utilization Of Inertial Measurement Units For Determining The Sequential Chain Of Baseball Strike Posture, Yun-Ju Lee, Po-Chieh Lin, Ling-Ying Chen, Yu-Jung Cha, Jing Nong Liang

Physical Therapy Faculty Research

The purpose of this study was to employ inertial measurement units (IMU) with an eyetracking device to investigate different swing strategies between two levels of batters. The participants were 20 healthy males aged 20 to 30 years old, with ten professional and ten amateur batters. Eye gaze position, head, shoulder, trunk, and pelvis angular velocity, and ground reaction forces were recorded. The results showed that professional batters rotated segments more rhythmically and efficiently than the amateur group. Firstly, the professional group spent less time in the preparation stages. Secondly, the maximum angular velocity timing of each segment of the professional …

Governor Gains: A Remote Program Connecting Home And School, Madison L. Michels

Occupational Therapy Capstone Presentations

The purpose of this capstone project was to create and implement the Governor Gains remote home program aimed at increasing parent involvement in home-based activities to promote academic performance among children with disabilities. This capstone experience was completed within the Pierre, SD Public School System, specifically with elementary-aged students. An occupational therapy student worked with a faculty mentor (OTD), site mentor(OTR/L), and interprofessional team (physical therapists, speech therapists, psychologists, and general and special education teachers) to complete this project. The capstone project began with advanced clinical practice then transitioned into program development. Governor Gains provided a focus on fine motor …

Occupational Therapy Services For Sheltered Individuals Experiencing Homelessness, Ariana Oorlog

Occupational Therapy Capstone Presentations

There is a need for interventions to help people experiencing homelessness learn home management, transportation, and health maintenance skills. The purpose of this capstone experience was to administer an occupational therapy program to support sheltered adults experiencing homelessness to improve their preparedness in obtaining and maintaining housing, community reintegration, and long-term success in life. I completed the capstone experience at Hope Street of Siouxland, a sober living home for adult males who are recovering from homelessness, addiction, and mental illness. I completed a Needs Assessment and developed the program based on the identified needs of Hope Street guests. The program …

The Effect Of Obstacle Intervals On Foot Integrated Pressure And Obstacle Negotiation Strategy, Zhuo Wang

Theses & Dissertations

When stepping over a single obstacle, despite of some spatiotemporal parameter changes, the impulse of the leading and trailing leg stays the same. This is considered an efficient obstacle avoidance strategy. However, research has shown that the strategy of multiple obstacles negotiation is different from a single obstacle crossing. Would this efficient strategy still exist during multiple obstacles negotiation? This study attempted to answer this question. Nineteen healthy young adults were recruited in this study. Each participant was required to complete 15 trials under 3 conditions: one-step, two-step, and three-step intervals. Data were collected for foot integrated pressure (FIP), walking …

Adaptation Of Human Locomotion And Unilateral Limb Loading During Different Inclination Treadmill Walking, Yuhang Zhang

Theses & Dissertations

Human locomotion is adaptive in any external environment or different terrains, which has been widely investigated. For example, people can walk at different walking speeds in each leg on a split-belt treadmill. However, human locomotor behaviors are passively adapted during the split-belt treadmill walking. Therefore, the knowledge of how humans actively adjust the flexibility of locomotion is limited by using the split-belt treadmill. To address this gap, this study investigated the flexibility of locomotion by using a 4-lb ankle weight on the dominant leg to induce the asymmetric walking pattern when walking on the inclined, declined, and level treadmill. Twenty …

Is The Walking Pattern Similar Between Slope Walking And Obstacle Negotiation?, Jiani Lu

Theses & Dissertations

Studying biomechanical characteristics of human motion sheds light on the motor control strategies in the central nervous system. Slope walking and obstacle negotiation appear to have some similarities in control strategies based on subjective observation, but these two motions have never been compared objectively in biomechanics literature. This study aimed to investigate the similarities between obstacle negotiation and slope walking in kinematics and muscle activity. The similarities were determined by the correlation of the maximum heel elevation and muscle co-activation index between obstacle negotiation and inclined treadmill walking. The strength of correlation was compared in four different pairs of conditions: …

Caregiver Perceptions Of Environmental Modifications For Sensory Processing, Jaimie Lynn Smith

Occupational Therapy Capstone Presentations

This capstone project explored in-depth clinical practice skills in sensory based therapy along with caregiver perceptions of sensory environmental modifications. In person and telehealth treatment sessions focused on the achievement of sensory based goals. A three-part continuing education course was also completed to expand knowledge and understanding of sensory environmental modifications and strategies that were family friendly. The main project was to gain an understanding of caregiver perceptions of sensory environmental modifications. This was accomplished through interviews with families that focused on sensory aspects of the environmental, completion of Participation and Sensory Environmental Questionnaire, and feel-good menus. After environmental recommendations …

Complex Conditions Of The Hand: A Resource For Rural Therapists, Jay D. Cooper

Occupational Therapy Capstone Presentations

The purpose of this project was to address multiple disparities in the complex treatment of upper extremity conditions and injuries in the rural therapy setting with an accessible educational resource. These disparities include the lack of continuing education specifically targeted at the rural healthcare setting, the barriers to unique occupation-based treatment which occupational therapists are obligated to administer, and the need to provide information regarding hand therapy protocols to bridge the communication gap between hand specialists and rural therapists. The project was completed at the Monument Health Orthopedic and Specialty Hospital in Rapid City, SD, in an outpatient hand therapy …

Advanced Practice In Aquatic Therapy: Exploring Occupational Therapy In An Aquatic Environment, Brenna K. Barash

Occupational Therapy Capstone Presentations

Properties of water have been utilized as a therapeutic treatment method for the past 100 years (Becker, 2009). Aquatic-based occupational therapy services are used as an adjunct to traditional land-based occupational therapy intervention (Franken et al., 2013). The OTS developed a 14-week capstone project with assistance provided by faculty and site mentors. The purpose of this capstone project was to develop aquatic-based intervention skills and explore the use and benefits of aquatic-based occupational therapy in patient care. To facilitate appropriate outcomes, three learning objectives with numerous project deliverables were developed. In order to demonstrate competence and understanding of aquatic-based occupational …

Exploring Occupational Therapy With Athletes Using Principles Of Lifestyle Redesign® To Support Academic Success And Life Balance., Michaela M. Dendinger

Occupational Therapy Capstone Presentations

Occupational therapists have a range of skills that can benefit a variety of populations. Despite these skills, occupational therapy has limited exploration within the field of athletics. The capstone project gave insight to the services occupational therapy can provide to the student-athlete population. Through the lens of Lifestyle Redesign®, the Student-Athlete Wellness Program was created to support student-athlete academic success and life balance. Following a needs assessment an online program was developed. The program was provided to students and athletes a University in the Midwest U.S. The program attracted 21 student-athletes and five students. Limited participation in surveys provided difficulties …

Creating Inclusive Classroom Environments Through Education And Coaching, Leah Hagen

Occupational Therapy Capstone Presentations

The aim of this capstone project was to educate teachers on inclusive practices and strategies to create an inclusive classroom environment for students with disabilities and at-risk needs. An educational workshop including eight hours of asynchronous pre-recorded modules and four one-hour synchronous sessions was created. The workshop covered the following topics: Introduction to inclusion, accommodations and modifications, assistive technology, supporting sensory needs, supporting physical needs, supporting academic and learning needs, supporting social, emotional, and behavioral needs, virtual inclusion, empowering students, and creating an inclusive classroom environment. Optional inclusive classroom coaching sessions were offered to promote implementation of inclusive practices and …

Quantifying Fear Of Falling By Utilizing Objective Body Sway And Muscle Contraction Measures, Chenfan Gui

Theses & Dissertations

Fear of falling (FOF) is a psychological condition that can lead to increased morbidity and mortality in the elder population. However, the subjective and multidimensional nature of FOF resulted in the limitations of existing FOF measurements, which could influence the quality of those studies. The present study aimed to quantify FOF by using objective center of pressure (COP) trajectories and muscle contraction of the lower extremity to compensate for those limitations. Nineteen young healthy adults (24 years ± 2.47) were recruited in the present study. Subjects were required to watch three 360-degree videos, one control video and two roller coaster …

Culminating Capstone Project: Critical Illness Myopathy, Min S. Yu

Department of Occupational Therapy Entry-Level Capstone Projects

The capstone project was completed in the focus area of clinical practice skills at AdventHealth hospital. The objective was to educate the rehabilitation team on critical illness myopathy (CIM), a condition that was requested to be further investigated by Megan Graf, OTR/L, who served as the capstone mentor. Through an extensive search, a literature review was completed. The rehabilitation team was informed scholarly and clinically with a PowerPoint presentation. Currently there is a gap within the literature between occupational therapy and CIM. Conversely, physical therapy had a plethora of research conducted on patients with CIM

Essential Competencies For Occupational Therapy In End-Of-Life Care, Karmella Bognot

UNLV Theses, Dissertations, Professional Papers, and Capstones

Occupational therapists carry an abundance of expertise in helping patients and caregivers navigate the end-of-life journey. The lack of knowledge of OT’s role impacts occupational therapy utilization and service provision in hospice. It reduces opportunities for this population to increase their understanding on how to maintain quality-of-life. The more a patient is able to do lessens the burdens shouldered by the caregiver. Education on pain management and promoting comfort are typical priorities addressed; however, not enough training is focused on maximizing independence or engagement in occupations. Competencies encompass a unique set of skills, knowledge, and abilities necessary for successful performance …