Rehabilitation and Therapy Commons^™

Fighting For Recovery On Multiple Fronts: The Past, Present, And Future Of Clinical Trials For Spinal Cord Injury, Valerie A Dietz, Nolan Roberts, Katelyn Knox, Sherilynne Moore, Michael Pitonak, Chris Barr, Jesus Centeno, Scott Leininger, Kent C New, Peter Nowell, Matthew Rodreick, Cedric G Geoffroy, Argyrios Stampas, Jennifer N Dulin

Faculty, Staff and Student Publications

Through many decades of preclinical research, great progress has been achieved in understanding the complex nature of spinal cord injury (SCI). Preclinical research efforts have guided and shaped clinical trials, which are growing in number by the year. Currently, 1,149 clinical trials focused on improving outcomes after SCI are registered in the U.S. National Library of Medicine at ClinicalTrials.gov. We conducted a systematic analysis of these SCI clinical trials, using publicly accessible data downloaded from ClinicalTrials.gov. After extracting all available data for these trials, we categorized each trial according to the types of interventions being tested and the types of …

Assessing Ground Reaction Forces And Degenerative Changes Of Sound Limb In Unilateral Lower Extremity Amputees: A Systematic Review, Kira Donnelly, Colin Davis, Nicole Liotta, Angela Perkins, Vibhor Agrawal, Michael Jason Highsmith, Scott Michael Love

Physical Therapy Collection

Abstract Background: There is a rising number of individuals undergoing lower extremity amputation (LEA) and is associated with increased risk of comorbidities. Osteoarthritis (OA) and Degenerative Joint Disease (DJD) are conditions that cause reduction in an individual’s function, independence, and quality of life.

Research Design: A search of multiple databases using terms associated with possible functional declines as evidenced by the International Classification of Functioning, Disability and Health (ICF), followed by assessment of evidence using the PEDro scoring method will be conducted. Multiple reviewers will screen, sort, rate and extract data from articles.

Methods: A computer-aided literature search of PubMed, …

A Proposed Value Metric To Quantify Value In Outpatient Therapy, Bryan Bourcier Dpt, Scs, Thomas Ruediger Dpt, Ocs, Scs, Alexandra Bond Dpt

Other Specialties

ABSTRACT

Study Design: Case report

Objectives: The purpose of this study is to report the steps towards developing a single number Value Metric that represents both the quality and cost of clinical care for outpatient therapy that can be used in real time.

Background: As healthcare continues to move towards value-based and risk-based reimbursement, it is imperative that leaders in outpatient therapy settings understand and can quantify the value of the services that therapists provide.

Methods and Measures: This study proposes a Value Metric to quantify value in outpatient therapy using existing quality and cost data. The Value Metric was …

Osteoporosis Knowledge And Health Beliefs Among Middle-Aged Men And Women In The Southern United States, Stacy Chelf, Robert E. Davis, Martha A. Bass, M. Allison Ford, Ali D. Firouzabadi, Jonathan T. Leo, Vinayak K. Nahar

Faculty and Student Publications

Context: The most common skeletal disease, osteoporosis, causes bone fragility due to decreased bone mass and bone microarchitecture destruction. The health belief model is often applied to asymptomatic, prevention-related diseases such as osteoporosis. Steps to mitigate the insidious nature of osteoporosis, including education, motivation, and monitoring of bone mineral density, must begin at an earlier age. Objectives: This study evaluates the knowledge and health beliefs surrounding osteoporosis in a population of males and females 35–50 years old to determine sex-based differences in osteoporosis knowledge and beliefs and to assess the correlation between perceptions and health motivation. Methods: Participants (81 males, …

Upper Limb Capabilities, Self-Care And Fine Motor Activities With And Without Equipment In Persons With Cervical Spinal Cord Injury At Discharge From Rehabilitation And 1 Year Post-Injury, Ralph J. Marino, David Chen, Sara Mulroy, Edelle Field-Fote, Benjamin Leiby

Department of Rehabilitation Medicine Posters

Introduction: There is little information on the impact of assistive technology or devices (AT) on function. The purpose of this project was to explore the impact of AT on self-care (SC) and fine motor (FM) function in persons with cervical SCI, and to examine the functional capabilities of those who benefit from AT.

Methods: Persons with acute cervical SCI, all levels and AIS grades, with an upper extremity motor score (UEMS) > 0 were enrolled. At discharge from rehabilitation and 1 year post-injury we collected the Capabilities of Upper Extremity questionnaire (CUE-Q), and the combined SC and FM questions of the …

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

Publications and Research

Objectives

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

Design

Retrospective, observational design.

Setting

Major medical center in metropolitan area.

Participants

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

Main Outcome Measure

Physical therapists scored patients’ …

Treating Phantom Limb Pain: Cryoablation Of The Posterior Tibial Nerve, Matthew Fiala, Abana Azariah, Jean Woo, Ahmed Kamel Abdel Aal, Alexa Levey

Faculty, Staff and Student Publications

Phantom limb pain (PLP) is a complex pathophysiologic process involving both the central and peripheral nervous system for which there is no definitive treatment. The number of individuals living with amputated limbs is predicted to increase to 3.5 million by 2050, and up to 80% of these patients will have PLP. In this case report, we will demonstrate successful reduction of PLP in a patient with bilateral phantom toe pain utilizing nerve blockade and subsequent cryoablation of the posterior tibial nerves.

Knee Joint Biomechanics During Gait Improve From 3 To 6 Months After Anterior Cruciate Ligament Reconstruction, Kelsey Neal, Jack R. Williams, Abdulmajeed Alfayyadh, Jacob J. Capin, Ashutosh Khandha, Kurt Manal, Lynn Snyder-Mackler, Thomas S. Buchanan

Physical Therapy Faculty Research and Publications

Gait alterations after anterior cruciate ligament reconstruction (ACLR) are commonly reported and have been linked to posttraumatic osteoarthritis development. While knee gait alterations have been studied at several time points after ACLR, little is known about how these biomechanical variables change earlier than 6 months after surgery, nor is much known about how they differ over the entire stance phase of gait. The purpose of this study was to examine knee gait biomechanical variables over their entire movement pattern through stance at both 3 and 6 months after ACLR and to study the progression of interlimb asymmetry between the two …

Efficacy And Safety Of Acupuncture And Or Moxibustion For Managing Primary Dysmenorrhea: A Systematic Review And Meta-Analysis, Weiting Liu, Carol Chunfeng Wang, Khui Hung Lee, Xiaopeng Ma, Timothy Leen Kang

Research outputs 2022 to 2026

Acupuncture and moxibustion have been accepted as add-on options for primary dysmenorrhea (PD); however, the clinical evidence is still inadequate. We searched AMED, CENTRAL, EMBASE, PubMed, Web of Science, CBM, CNKI, VIP, Wangfang database, ANZCTR, ClinicalTrials.gov, and the WHO ICTRP, from their inception to February 2021. The pooled analysis of 13 RCTs with 675 participants for VAS showed that acupuncture and moxibustion were more effective in managing PD than the control group with the MD of −1.93 (95% CI [−2.80, −1.06] and −2.67 (95% CI [−4.96, −0.38]). With the CMSS, seven studies with 487 participants showed that these modalities were …

Blood-Flow-Restriction-Training-Induced Hormonal Response Is Not Associated With Gains In Muscle Size And Strength, Gilberto C. Laurentino, Jeremy P. Loenneke, Carlos Ugrinowitsch, Marcelo S. Aoki, Antonio G. Soares, Hamilton Roschel, Valmor Tricoli

Faculty and Student Publications

The aim of this study was to determine whether increases in post-exercise endocrine response to low-load resistance exercise with blood flow restriction and high-load resistance exercise would have association with increases in muscle size and strength after an 8-week training period. Twenty-nine untrained men were randomly allocated into three groups: low-load resistance exercise with (LL-BFR) or without blood flow restriction (LL), and high-load resistance exercise (HL). Participants from LL-BFR and LL groups performed leg extension exercise at 20% of one repetition maximum (1RM), four sets of 15 repetitions and the HL group performed four sets of eight repetitions at 80% …

Explicit And Implicit Emotion Processing In The Cerebellum: A Meta‑Analysis And Systematic Review, Jordan E. Pierce, Marine Thomasson, Philippe Voruz, Garance Selosse, Julie Péron

Center for Brain, Biology, and Behavior: Faculty Publications

The cerebellum’s role in affective processing is increasingly recognized in the literature, but remains poorly understood, despite abundant clinical evidence for affective disruptions following cerebellar damage. To improve the characterization of emotion processing and investigate how attention allocation impacts this processing, we conducted a meta-analysis on task activation foci using GingerALE software. Eighty human neuroimaging studies of emotion including 2761 participants identified through Web of Science and ProQuest databases were analyzed collectively and then divided into two categories based on the focus of attention during the task: explicit or implicit emotion processing. The results examining the explicit emotion tasks identified …

Refinement & Preliminary Examination Of A Fidelity Assessment For The Spinal Cord Injury -- Movement Index (Sci-Mi), Nicole Gerhardt, Otd(C), Otr/L

Department of Occupational Therapy Posters and Presentations

Introduction: Assessment fidelity refers to the adherence to intended procedures and guidelines when administering an assessment (Mowbray et al., 2003; Walton et al., 2020). Clinical outcome assessments (COAs) play a crucial role in the assessment of treatment effects in clinical trials. However, there is a scarcity of fidelity assessments for COAs, which has the potential to impact the accurate evaluation of treatment effects (Richardson et al., 2016). The Spinal Cord Injury Movement Index (SCI-MI) is a performance-based COA being developed with the intent to be used in spinal cord injury (SCI) clinical trials. As the stakes in SCI clinical trials …

Energy Drink Usage By Students Attending An Online University, Jodi Lynn Hutak, Ali Boolani, Lauri O. Byerley

School of Medicine Faculty Publications

Objective: This study determined the frequency, reasons for, and side effects of energy drinks (ED) consumption among online students. Participants: Students attending an online university. Methods: Participants were recruited by email and completed a 59-question survey about their prior months ED practices using a combination of validated surveys previously published examining similar constructs in on-campus students. Results: 307 students (age = 32.4 ± 6.5yrs) completed the survey, and 88% reported consuming EDs. Students’ reasons for consuming ED included school (p < .001), work (p < .001), an event/competition (p < .001), pick me up (p < .001), lack of rest (p < .001), more energy (p < .001), and staying awake while driving (p < .001). Only individuals who consumed > 10 ED/month reported side effects of headaches (p = .01) and speeding (p=.01). Conclusions: In our sample, a majority of …

An Occupational Therapy Guidebook For Individuals With Substance Use Disorder, Cassidy B. Ardoin

Student Capstone Papers

Individuals with substance use disorder (SUD) experience barriers and challenges that impact their daily occupational performance, engagement, well-being, and quality of life. In addition to disrupting and distorting an individual’s unique occupational outcomes, SUDs can limit, replace, and dictate an individual’s daily meaningful activities, habits, routines, and skills that support healthy occupational engagement. Occupational therapy (OT) practitioners have a unique and valuable role in SUDs treatment as they are equipped to identify these barriers and implement strategies for supportive skill development or restoration. Based on the literature review conducted, OT practitioners do not have an OT practice guideline, protocol, or …

Notes From An Epicenter: Navigating Behavioral Clinical Trials On Autism Spectrum Disorder Amid The Covid-19 Pandemic In The Bronx, Alaina S Berruti, Roseann C Schaaf, Emily A Jones, Elizabeth Ridgway, Rachel L. Dumont, Benjamin E Leiby, Catherine Sancimino, Misung Yi, Sophie Molholm

Department of Occupational Therapy Faculty Papers

Background: The COVID-19 pandemic impacted nearly all facets of our daily lives, and clinical research was no exception. Here, we discuss the impact of the pandemic on our ongoing, three-arm randomized controlled trial (RCT) Sensory Integration Therapy (SIT) in Autism: Mechanisms and Effectiveness (NCT02536365), which investigates the immediate and sustained utility of SIT to strengthen functional daily-living skills and minimize the presence of maladaptive sensory behaviors in autistic children.

Main text: In this text, we detail how we navigated the unique challenges that the pandemic brought forth between the years 2020 and 2021, including the need to rapidly …

Batok: The Exploration Of Indigenous Filipino Tattooing As A Resistive Collective Occupation, Chelsea Ramirez, Karen Mccarthy, Ana Cabalquinto, Carmela Dizon, Mai Santiago

Occupational Therapy | Faculty Scholarship

Batok (also known as Fatek/Burik/Tatak/Batek/Patik) is an Indigenous Filipino tattooing practice where the practitioner marks the skin by hand-tapping the ink using bone/wood implements. Previous research on tattooing from an occupational science perspective has considered European tattooing and its engagement and implication on the individual. This qualitative research explores how batok is experienced by the person and their identified community. Three Filipino participants with batok, and four family or community members were interviewed. Thematic analysis highlighted three themes recognized as Kapwa, Revealing One’s Batok, and Decolonization and Reclamation as a Cultural Practice. These themes are situated in the lens of …

Establishing A Sustainable Occupational Therapy Student-Led Pro Bono Clinic At The University Of Saint Augustine In Austin, Texas, Daija Chumley

Student Capstone Papers

Under-resourced and underserved communities across the United States experience significant health disparities. These communities lack access to valuable services resulting in health inequities that impinge on their health, quality of life, and engagement in meaningful occupations. There is a need for occupational therapy to provide valuable services to the under-resourced and underserved community to address the historical inequity that impacts their overall quality of life. Universities have the potential to fulfill the gaps within these communities by establishing a pro bono clinic. The purpose of this capstone project is to establish a sustainable occupational therapy pro bono clinic at the …

A Manualized Occupational Therapy Mindfulness Module For Clients With Ptsd, Michael Ramirez

Student Capstone Papers

Posttraumatic stress disorder (PTSD) adversely impacts an individual’s functioning across areas of daily occupation. There is a paucity of literature addressing occupational therapy (OT) for people with PTSD. The literature has advocated for the development of a manualized OT intervention with the inclusion of mindfulness as one of its components. To date, a mindfulness-based OT treatment guide or manualized program specifically for clients with PTSD has not yet been developed. The aim of this paper is to bridge a gap in the literature and to develop a resource for occupational therapists to employ mindfulness as a clinical intervention with clients …

Assessing The Needs And Barriers Of Esports Players In Participating In Esports And Daily Life, Kristen Musacco, Susan Macdermott, Stephanie Stoltenberg

Summer 2022 Virtual OTD Capstone Symposium

The purpose of this study is to determine the occupational needs and barriers faced by esports players as they participate in daily life and advocate for occupational therapy's potential role. A qualitative survey of 9 participants and 6 interviews were given. Thematic analysis identified themes of stigma surrounding seeking medical intervention in esports, as well as negative perceptions of how esports are viewed. Experience with an ergonomics specialist contributed to the understanding of basic ergonomics principles, proper measurement, and assessment of stations. This needs assessment provided a basis for understanding participant experiences in relation to the role occupational therapists in …

Occupational Therapy And Continuous Care: Pediatric Rehabilitation For Children With Medically Complex Conditions And Severe Burns, Elise M. Mueller

Occupational Therapy Capstone Presentations

This capstone focused on developing advanced clinical knowledge and skills to treat children with medically complex conditions and severe burns. This project also incorporated interdisciplinary communication, leadership, and academic education. It took place at Madonna Rehabilitation Hospital and ChildServe Medical Daycare. The population consisted of patients treated on the pediatric floor within an inpatient rehabilitation hospital, children receiving occupational therapy services in a pediatric outpatient setting, and children appropriate for medical daycare. At Madonna Rehabilitation Hospital, 12 clients under the age of 21 and four clients over 21 received occupational therapy in the inpatient setting, and six children received outpatient …

Advancing The Assessment And Treatment Of Signs And Symptoms Of Parkinson Disease, David Scott May

WUSM Theses and Dissertations – All Programs

People with PD often report signs and symptoms that negatively impact quality of life. Among these are balance difficulties, impaired gait, and FOG. New treatment and assessment strategies for these signs and symptoms are needed, as current techniques are limited. While new treatment and assessment strategies continue to emerge, gaps in knowledge persist. Deep brain stimulation (DBS) has been utilized in many people with PD throughout the 21st century, but it is unknown specifically how subthalamic nucleus deep brain stimulation (STN-DBS) affects balance. Alternative treatment strategies, such as a dental mouthpiece, have also been proposed. While dental mouthpieces have shown …

Exploring The Meaningful Qualities Of Transactions In Virtual Environments For Massively Multiplayer Online Role-Playing Gamers, Karen Mccarthy, Shasta Rice, Amanda Flores, John Miklos, Alex Nold

Occupational Therapy | Faculty Scholarship

To date, most research on massively multiplayer online role-playing games (MMORPGs) has focused on the effects playing MMORPGs have on players’ health and wellness. The virtual environment of MMORPGs has yet to be explored as a space where meaningful occupations occur. This qualitative descriptive study examined the virtual environment using a transactional perspective to describe the qualities of gaming to which MMORPG players ascribe meaning. Participants included six MMORPG players with experience playing World of Warcraft, Runescape, or Guild Wars 2. Data were gathered using interviews, participant observation, and a focus group, and analyzed using thematic analysis. Three themes were …

The Role Of Occupational Therapy In Unplanned Motherhood, Cierra Stewart, Karen Park

Summer 2022 Virtual OTD Capstone Symposium

For women experiencing unplanned pregnancy, the thought of becoming a mother can increase stress and affect the mother’s mental health. Maternal adjustment can include depression, anxiety, worry, stress, and happiness (Mihelic et al., 2016). The impact that this new role has effects daily demands, leading to a disruption in occupational engagement, environmental changes, and overall less time for the mother (Horne et al., 2005). There is currently not a well-defined role for occupational therapy within pregnancy medical clinics to support women experiencing unplanned pregnancy and their transition to motherhood. The purpose of this project is to provide care to new …

Occupational Therapy's Role In Athletic Retirement, Diana Mellin, Karen Park, Madison Harris

Summer 2022 Virtual OTD Capstone Symposium

Athletic retirement is described as a life transition involving withdrawal from the athletic role. Throughout the process of athletic retirement, individuals experience a loss of identity, roles, routines, and social support which has shown to negatively impact their overall mental health and well-being (Marterella & Smoot, 2017). This study investigated elite athletes’ experiences throughout their transition to athletic retirement, a ten-question online survey and semi-structured interviews were administered. Themes that emerged from the data are occupational adjustment and relearning roles, experiencing a crossroads of identity, external expectations, and pressures. Participants shared experiencing a period of burnout and detachment right after …

Supporting Rural Seniors Aging In Place Using Telehealth, Angel Alexander Gomez, Susan Macdermott

Summer 2022 Virtual OTD Capstone Symposium

Background: The United States is witnessing a demographic shift in that the number of Americans aged 65 and older is projected to nearly double from 52 million in 2018 to 95 million by 2060; the percentage of the 65 and older age group will increase from 16 % to 23 % (Administration for Community Living, 2018). In this ever-growing population, the American Association of Retired Persons (AARP) 2018 survey found that 76% of Americans over the age of 50 would prefer to remain in their current residence and 77% would like to continue living in their community as long as …

Transportation As A Barrier To Healthcare Access For Older Adults Of Low Socioeconomic Status, Yanira Barajas, Susan Macdermott, Jazminne Orozco Arteaga

Summer 2022 Virtual OTD Capstone Symposium

The older adult population of those in the age group 65+ is one of the fastest growing populations in the following years. This project sought to identify what barriers older adults of low socioeconomic status face when trying to access transportation to healthcare appointments. The project also sought to understand what barriers healthcare professionals saw when their senior clients tried using transportation as well as what opportunities occupational therapists have to address the barriers if any. There was a theme of disconnect which appeared between healthcare professionals and their senior clients across multiple healthcare disciplines. This project was able to …

An Exploration Of The Lifestyle Of Rodeo Athletes, Brooke Tunnell, Susan Macdermott, Becki Cohill

Summer 2022 Virtual OTD Capstone Symposium

Rodeo is considered one of the most rapid-growing sports across many nations and consists of highly talented, tough athletes (Haney & Pearson, 1999). There is a gap in the research that examines the occupation of rodeo through an occupational therapy and occupational science perspective. Occupational science, the study of human occupation, focuses on how the form, function, and meaning of daily activities influence health and well-being (Larson & Zemke, 2003). Form, function, and meaning guided the mixed-method research study utilizing survey, interview, narrative prompt, and photo elicitation. Three themes were extracted from the data and embodied the personal and occupational …

The Role Of Ot In Adapted Crossfit, Emily Adams

Student Capstone Papers

Background: A quarter of adults are diagnosed with a disability in the United States, with almost half considered being inactive (CDC, 2020). The population of persons with disabilities (PWD) are at higher risk for secondary health concerns due to a sedentary lifestyle (Diaz et al., 2019). CrossFit recently implemented their first adaptive division in 2021 (CrossFit, LLC, 2022), however there continue to be barriers preventing PWD from participating in CrossFit.

Problem/Purpose: PWD may experience limited access to CrossFit due to structural and social barriers to access equipment and participating in movements. The purpose of this project was to …

Perceptions Of Using Diabetic Alert Dogs To Promote Occupations And Quality Of Life, Haley Speake, Rocio Alvarenga, Adam Gibson

Summer 2022 Virtual OTD Capstone Symposium

This capstone project consisted of a pilot phenomenological qualitative research study with the goal of assessing diabetic alert dogs' impact on their owners' occupations and quality of life from the owner's perspective. Individuals with type 1 diabetes that personally own a diabetic alert dog were interviewed virtually using a semi-structured approach. The goal of the interview questions was to gather information regarding health management, daily occupations, and quality of life. Gaps in the research were identified, and it was found that few research studies focused on the impact or benefits of a diabetic alert dog from the owner’s perspective. Therefore, …

Occupational Therapy Program For Pace Center For Girls, Natalie Vish

Department of Occupational Therapy Entry-Level Capstone Projects

An occupational therapy handbook was created for future occupational therapy students and occupational therapy assistant students to utilize when completing fieldwork rotations at Pace Center for Girls. The handbook was created to address core occupations through a trauma-informed and gender-sensitive perspective. An occupational therapy program utilizing mindfulness and sensory-based approaches at Pace Center for Girls may provide alternative and effective solutions for this at-risk female adolescent population as literature reveals that survivors of complex trauma often do not respond to traditional psychiatric treatment approaches.