Rehabilitation and Therapy Commons^™

Cost-Effectiveness Of High-Intensity Training Vs Conventional Therapy For Individuals With Subacute Stroke, T. George Hornby, Miriam Rafferty, Daniel Pinto, Dustin D. French, Neil Jordan

Physical Therapy Faculty Research and Publications

Objective

This investigation estimated the incremental cost-effectiveness of high-intensity training (HIT) compared with conventional physical therapy in individuals with subacute stroke, based on the additional personnel required to deliver the therapy.

Design

Secondary analysis from a pilot study and subsequent randomized controlled trial.

Setting

Outpatient laboratory setting.

Participants

Data were collected from individuals with locomotor impairments 1-6 months poststroke (N=44) who participated in HIT (n=27) or conventional physical therapy (n=17).

Interventions

Individuals performing HIT practiced walking tasks in variable contexts (stairs, overground, treadmill) while targeting up to 80% maximum heart rate reserve. Individuals performing conventional therapy practiced impairment-based and functional …

Abobotulinumtoxina Efficacy And Safety In Children With Upper Limb Spasticity Previously Treated With Botulinum Toxin, Edward Dabrowski, Mauricio R. Delgado, Joyce Oleszek, Nigar Dursun, Jorge Carranza Del-Rio, Marcin Bonikowski, Benjamin Regnault, Simon Page, Ann Tilton

Conference Presentation Abstracts

Introduction: Primary endpoint analysis of this phase 3 study confirmed abobotulinumtoxinA (aboBoNT-A 8 U/kg and 16 U/kg) significantly reduced hypertonia versus the 2 U/kg low-dose control and was generally well tolerated (Delgado, et al, 2021). However, the impact of previous botulinum neurotoxin (BoNT) injections on treatment outcomes remains largely unexplored.

Methods: We present subgroup analyses of a phase 3 study conducted in children (aged 2-17) with cerebral palsy (Gross Motor Function Classification System [GMFCS] Levels I-IV) and spasticity in ≥1 upper limb. In the first treatment cycle, 210 children were randomized to treatment with aboBoNT-A 2 U/kg, 8 U/kg or …

Switching Adult Patients With Spasticity From Onabotulinumtoxina To Abobotulinumtoxina: A Real-World Data Analysis Across Three Us-Based Treatment Centers, Nate Way, Edward Dabrowski, Mitchell Paulin, Martin Taylor, John Madden, Amandeep Mann, Jonathan Bouchard

Conference Presentation Abstracts

Introduction: The therapeutic impact of botulinum toxin type A (BoNT-A) as first-line treatment for adult focal spasticity is well established across numerous therapeutic guidelines. However, relatively little real-world evidence exists to inform clinician decision-making when considering switching patients between BoNT-A products. This 5-year retrospective study aims to illustrate the safe transitioning of patients from onabotulinumtoxinA (ONA) to abobotulinumtoxinA (ABO) therapy in US centers that have considerable experience with BoNT-A usage in adults with spasticity.

Methods: Chart data from patients with upper limb spasticity (ULS), lower limb spasticity (LLS), or upper and lower limb spasticity (ULS+LLS) aged >18 years were collected …

A Low-Cost Virtual Coach For 2d Video-Based Compensation Assessment Of Upper Extremity Rehabilitation Exercises, Ana Rita Coias, Min Hun Lee, Alexandre Bernardino

Research Collection School Of Computing and Information Systems

Background: The increasing demands concerning stroke rehabilitation and in-home exercise promotion grew the need for affordable and accessible assistive systems to promote patients' compliance in therapy. These assistive systems require quantitative methods to assess patients' quality of movement and provide feedback on their performance. However, state-of-the-art quantitative assessment approaches require expensive motion-capture devices, which might be a barrier to the development of low-cost systems.Methods: In this work, we develop a low-cost virtual coach (VC) that requires only a laptop with a webcam to monitor three upper extremity rehabilitation exercises and provide real-time visual and audio feedback on compensatory motion patterns …

Contributions Of Semantic And Phonological Working Memory To Narrative Language Independent Of Single Word Production: Evidence From Acute Stroke, Rachel Zahn, Tatiana T Schnur, Randi C Martin

Faculty, Staff and Student Publications

Neuropsychological case studies have provided evidence that individuals with semantic, but not phonological, working memory (WM) deficits have difficulty producing phrases containing several content words. These findings supported the claim of a phrasal scope of planning at the grammatical formulation stage of production, where semantic WM supports the maintenance of lexical-semantic representations as they are inserted into slots in phrasal constituents. Recent narrative production results for individuals at the acute stage of stroke supported the role for semantic WM in phrasal elaboration while suggesting a role for phonological WM at a subsequent phonological encoding stage in supporting fluent, rapid speech. …

Using Noise For The Better: The Effects Of Transcranial Random Noise Stimulation On The Brain And Behavior, Onno Van Der Groen, Weronika Potok, Nicole Wenderoth, Grace Edwards, Jason B. Mattingley, Dylan Edwards

Research outputs 2022 to 2026

NEUROSCI BIOBEHAV REV X (X) XXX-XXX 2021.- Transcranial random noise stimulation (tRNS) is a non-invasive electrical brain stimulation method that is increasingly employed in studies of human brain function and behavior, in health and disease. tRNS is effective in modulating perception acutely and can improve learning. By contrast, its effectiveness for modulating higher cognitive processes is variable. Prolonged stimulation with tRNS, either as one longer application, or multiple shorter applications, may engage plasticity mechanisms that can result in long-term benefits. Here we provide an overview of the current understanding of the effects of tRNS on the brain and behavior and …

Location-Specific Cutaneous Electrical Stimulation Of The Footsole Modulates Corticospinal Excitability To The Plantarflexors And Dorsiflexors During Standing, Gagan Gill, Davis A. Forman, Joanna E. Reeves, Janet L. Taylor, Leah R. Bent

Research outputs 2022 to 2026

Non-noxious electrical stimulation to distinct locations of the foot sole evokes location-specific cutaneous reflex responses in lower limb muscles. These reflexes occur at latencies that may enable them to be mediated via a transcortical pathway. Corticospinal excitability to the plantarflexors and dorsiflexors was measured in 16 participants using motor evoked potentials (MEPs). Spinal excitability was measured in eight of the original participants using cervicomedullary motor evoked potentials (CMEPs). Measurements were collected with and without preceding cutaneous stimulus to either the heel (HEEL) or metatarsal (MET) locations of the foot sole, and evoked potentials were elicited to coincide with the arrival …

The Use Of Occupational Therapy Services In Outpatient Mental Health, Kelsey A. Wasik, Matt T. Valois, Kaylee M. Essenberg, Kelcie P. Beck

Masters Theses

The purpose of this study is aimed to explore the structure and utilization details of occupational therapy in outpatient behavioral health settings. Two occupational therapists participated in qualitative phenomenological interviews which were transcribed and analyzed using the thematic approach. A total of two themes emerged: billing and coverage, and education and advocacy. Participants identified there are necessary factors for reimbursement of services, in addition to the need for education and advocacy for occupational therapists to practice in outpatient behavioral health settings. Future research should be aimed at recruiting more participants, occupational therapists, and from other roles in these clinics such …

Comparative Effectiveness Of Jade Stone Mobilisation, Non-Abrasive Cupping, And Manual Drainage Technique In Subjects With Chronic Sinusitis: A Randomized Clinical Trial, Monali Gandhi, Peeyoosha Gurudut Dr.

Internet Journal of Allied Health Sciences and Practice

Purpose: Sinusitis in recent times has been known as one of the major causes for reduced quality of life and work absenteeism. Chronic sinusitis being one of the health hazards affecting QOL of subjects of any age and gender requires a specific therapeutic intervention. Clinical trials that can demonstrate the effectiveness of manual therapy intervention in sinusitis cases are lacking. Hence, this study aims to evaluate and compare the effectiveness of three manual therapy techniques in subjects with chronic sinusitis. Method: The current study is a prospective, parallel arm, randomised clinical trial performed at physiotherapy OPD, tertiary health …

The Feasibility And Efficacy Of Telespirometry For Pulmonary Monitoring Of Cystic Fibrosis: A Systematic Review, Tessa Yap, Anne Jones

Internet Journal of Allied Health Sciences and Practice

Background: Spirometry via telehealth (telespirometry) involves remote monitoring of lung function, which is useful to detect pulmonary changes and increase continuity of care for patients with cystic fibrosis (CF). Purpose: This systematic review aims to evaluate the feasibility and efficacy of telespirometry assessments for paediatric and adult CF patients. Method: A comprehensive search of health-related databases (CINAHL, Emcare (Ovid), Medline (Ovid), PEDRo and Scopus) was conducted. For inclusion, patients had to be clinically diagnosed with CF and studies could be of any study design or level according to the National Health and Medical Research Council (NHMRC) evidence hierarchy, had to …

Quality Delivered: How A Pandemic Fostered Innovation And Creative Solutions In Clinical Education, Alice M. Davis, Laura Laporta, Nancy F. Mulligan, Stacy Carmel, Shelene Thomas, Denise O'Dell

Internet Journal of Allied Health Sciences and Practice

Background: Clinical education placements for students enrolled in healthcare programs were abruptly upended in March 2020 due to COVID-19. Programs were faced with decisions of how to mitigate substantive challenges due to an unforeseen pandemic within timeframes that would align with curricular sequences and graduation dates. Schools quickly modified curriculum formats, implemented alternative teaching and learning instruction and developed safety protocols to protect students, clinical faculty, and patients. Purpose: The aim of this study explored the strategies employed by one physical therapy school’s clinical education team, which resulted in successful completion of clinical course requirements and on-time graduation. Method: Data …

Implementation Of Home Exercise Programs In A Pro-Bono Clinic: An Exploratory Study, Joseph M. Day

Internet Journal of Allied Health Sciences and Practice

Purpose: Because the number of return visits in a pro-bono setting is low and distributed over a longer timeframe, home exercise programs (HEP) adherence is crucial for patient success. The purpose of this study is to describe a process for HEP delivery and to collect measures of HEP adherence on patients at a pro- bono physical therapy clinic. Methods: Thirteen participants were instructed to perform at least four exercises at home. Exercises were chosen based on best available practice. Exercise images, instructions, and daily logs were populated using PHYSIOTEC® software. A follow up phone call was conducted approximately 4 days …

A Survey Of Interventions For Cancer Survivors Provided By Occupational Therapy Practitioners, Katie M. Polo, Mary F. Baxter

Internet Journal of Allied Health Sciences and Practice

Purpose: Currently, there is a lack of research exploring evidence-based occupational therapy intervention practices at the activity level in survivorship care, which is important to identify for future research and clinical needs of the profession. The purpose of this study was to describe what activity level interventions OT practitioners are using and report any practice trends that might exist. Method: A cross-section design was used with non-probability purposive sampling to recruit occupational therapy practitioners working with adults living with and beyond cancer. A three-phase process for survey development and implementation was used, as recommended by the literature, for improving content …

Extended Scope Physiotherapists Are Effective And Safe In The Emergency Department: A Systematic Review And Meta-Analysis, Brittany Souter, Anne Jones, Lorraine Sheppard, Michael Crowe

Internet Journal of Allied Health Sciences and Practice

Purpose: Extended scope physiotherapists (ESPs) are an innovative approach to service delivery that have emerged in response to increasing pressures on emergency departments (EDs). While previous systematic reviews have suggested that ESPs have a positive impact on ED outcomes, clinical practice recommendations based on limited evidence highlight a pressing need for evaluation studies to truly determine their effectiveness and safety in this setting. Therefore, the objective of this systematic review and meta-analysis was to evaluate the clinical effectiveness and safety of ESPs when delivering services in EDs. Method: Systematic literature searches were conducted using the online databases: Medline (Ovid), CINAHL …

A Qualitative Study Of The Process Undergraduate Health Professions Students Utilize While Conducting A Scoping Review, Dawn De Vries, Betsy Williams

Internet Journal of Allied Health Sciences and Practice

Purpose: The purpose of this research study was to inform pedagogy on the effectiveness of journaling as a tool to gauge synthesis and application of course content to a scoping review. The research question asked is “Is reflective journaling effective in helping undergraduate health profession students understand and apply course research concepts and ideas directly to an academic project?” The researchers used a reflective journaling activity to enhance student learning and to explore student application of course lectures to a scoping literature review. Method: Students were required to complete the journaling activities as a class assignment. Four journal …

Pain Education Training In New York State Physical Therapy Programs: What We Do Well, Where The Gaps Are, And What Can Be Improved, Joseph Tatta, Marcia Spoto, Joseph Lorenzetti

Internet Journal of Allied Health Sciences and Practice

Purpose: Essential pain education produces graduates who are competent in contemporary pain management. Despite various educational resources, surveys demonstrate minimal pain content in entry-level physical therapist education programs. This paper examines 1) the learning content of pain education and faculty expertise teaching core pain content, 2) whether pain education content is sufficient to prepare physical therapists to meet the needs of contemporary pain management, and 3) whether standardization of pain education in entry level Doctor of Physical Therapy (DPT) programs is advantageous. Methods: A pain education survey was developed and sent to all accredited DPT program directors in New York …

Investigating Doctor Of Physical Therapy Student Stress During Pandemic Related Curricular Changes, Keithann Halle, Jennifer D. Hastings

Internet Journal of Allied Health Sciences and Practice

Introduction: Stress level in physical therapy students has been a focus of research due to multiple documented effects related to physical health, mental health, and ability to learn. Self-reflection has also been a focus of education research, relating it to personal learning, critical thinking, and demonstrable development of professional behaviors and skills. The aim of this study is to investigate student stress in response to programmatic changes wrought by the pandemic and whether stress impacted student self-reflection. Review of literature: Self-reflection is positively associated with growth of professional behavior and academic performance. Student level of self-reflection has been shown to …

The Effect Of Tai Chi On Dynamic Balance In Younger Adults: Implication For Physical Therapy Practice, Anthony O'Neill, Debra A. Beazley, Lori Bolgla

Internet Journal of Allied Health Sciences and Practice

Purpose: The objective of this study was to investigate the effect of Tai Chi on the dynamic balance in younger, active community-based adults with no history of lower extremity injury or balance problems. Methods: Fourteen subjects (4 males / 10 females; age 23.6 + 6.2 years-old; height 166.5 ± 11.1 cm; weight 75.9 ± 19.3 kg) completed a 13-week undergraduate Tai Chi course. Dynamic balance was assessed at the beginning and the end of the course using the Y-Balance test. Results: Post-hoc testing showed significant improvements in anterior (P=0.007) and posterior lateral (P=0.003) reach distances with …

Attitudes Toward Covid-19 Vaccination Among Occupational Therapy Professionals And Students In Early 2021, Stephen A. Cage, Brandon J. Warner, Diana M. Gallegos, Heidi M. Cage, Diane P. Brown Phd, Otr

Internet Journal of Allied Health Sciences and Practice

Purpose: After the widespread transmission of the novel coronavirus that causes COVID-19, the first COVID-19 vaccination received emergency use authorization in the United States in December of 2020. Current research has shown the authorized COVID-19 vaccines to be safe and effective at preventing severe illness. At the time of this study, there appears to be no published research on the attitudes and receipt of COVID-19 vaccinations among occupational therapy professionals and students. The purpose of this study is to describe the attitudes and receipt of COVID-19 vaccinations among occupational therapy professionals and students in early 2021. Methods: A total of …

Dérivation De Règles De Prédiction Clinique Pour Dépister Les Patients Ayant Une Lombalgie Non Aiguë Manifestant Un Succès Thérapeutique Lors D’Un Programme D’Exercice De Stabilisation Lombaire, Christian Larivière, Marie-France Coutu, Sharon M. Henry, Richard Preuss, Nicolas Roy, Khalil Rabhi

Rapports de recherche scientifique

Les exercices physiques permettent de réduire la douleur et les incapacités chez les gens souffrant d’une lombalgie non aiguë (> 3-4 semaines), mais ces effets sont limités. Pour rehausser l’efficacité de ce type d’intervention, il faut déterminer quels patients répondent le mieux à chaque modalité d’exercice (arrimage patient/intervention) et pour quelles raisons (mécanismes sous-jacents). Dans la présente recherche, l’intérêt est porté à un programme d’exercices de stabilisation lombaire (PESL), une modalité active d’exercice gagnant en crédibilité et en popularité. Deux objectifs ont été poursuivis : (1) finaliser l’étape de dérivation de règles de prédiction clinique (RPC) de succès^[1] pour …

Profession Related Intra-Correlation Satisfaction Levels In Palestinian Physiotherapists: An Exploratory Study, Yousef Al Hamdan, Mosab Amoudi, Wael Abuhassan

Journal of the Arab American University مجلة الجامعة العربية الامريكية للبحوث

Aim of Study: The aim of the present study was to investigate the level of job satisfaction of physiotherapists in Palestine and to how much extent those levels are intra-correlated.

Methods: Researchers used the cross-sectional descriptive analytical approach, where data was collected through a questionnaire. The target population was physiotherapists in Palestine. A sample of 60 physiotherapists was conveniently selected. Program of SPSS was used to analyze data, where means were extracted, in addition to percentages and standard deviations to answer study questions.

Results: The research results showed that the overall mean of the sample responses on …

Efektivitas Pemberian Lumbar Stabilization Exercise Terhadap Peningkatan Kemampuan Fungsional Pada Kasus Low Back Pain Myogenic: Literature Review, Sabilla Nur Hikhmah, Mita Noviana, Riza Pahlawi

Jurnal Fisioterapi Terapan Indonesia

Low back pain is the most common symptom experienced by people of all ages. However, low back pain myogenic can cause pain, spasms, muscle weakness, limited range of motion (ROM), and muscle imbalances, resulting in decreased core and lower back muscles, and limited mobility of the lumbar spine, causing a decrease in ability functional. In Indonesia, the prevalence of people affected by myogenic LBP has increased, almost 75% of them are related to work. From the search results with various databases, 75 articles were found which were then filtered and 21 articles were selected. But of the 21 articles, there …

Analisis Interaksi Postur Dengan Peralatan Kerja Menggunakan Metode Rapid Office Strain Assessment (Rosa) Pada Pekerja Kantor X, Muhammad Luthfi

Jurnal Fisioterapi Terapan Indonesia

Workers in any industry are at risk for Work-related Musculoskeletal Disorders (WMSDs) including office administration workers. This study aims to analyze the interaction of posture with work equipment using the rapid office strain assessment (ROSA) method to assess the ergonomic risk factor. This study found typing is an area requiring ergonomic intervention with chair is more influential (52%) than monitors and other office equipment (48%). Meanwhile other equipment that affects worker posture is mouse and keyboard (62%) compared to telephone and monitor (38%). WMSDs in office administration workers are strongly affected by the chair, mouse and keyboard.

Studi Kasus Penatalaksanaan Terapi Okupasi Bersumberdayamasyarakat Dalam Aktivitas Memasak Pada Penderita Strokedi Desa Setisari, Hermito Gidion, Muhammad Luthfi, Dini Fajariani, Aditya Denny Pratama

Jurnal Fisioterapi Terapan Indonesia

Stroke is a health problem that affects a person's independence. Occupational therapists can carry out community-based occupational therapy (TOBM) in intervening in stroke patients. The aim of this intervention is to improve the patient's ability to cook from an occupational therapy perspective. In community service through TOBM, stroke patients in Siteari village were given an intervention for 1 month to assess an increase in independence in cooking. There are results that TOBM can increase patient independence in cooking.

Efektivitas Terapi Latihan Terhadap Kemampuan Fungsional Post Rekonstruksi Acl Grade 2, Faizah Abdullah Djawas, Prasasti Prasasti

Jurnal Fisioterapi Terapan Indonesia

Introduction: Anterior Cruciate Ligament rupture is a condition with a tear in the ACL ligament, caused by direct or indirect contact in the knee. Various problems in patients with post-ACL reconstructions include a limited range of motions (ROM), decreased muscle strength, and decreased functional ability. Exercise therapy in CKCE, OKCE, and core stability is believed to improve functional abilities by decreasing pain and improving ROM and muscle strength. The purpose of this study is to determine the effectiveness of exercise therapy on functional ability in post-reconstructionACL grade 2. Method: Single case study, physiotherapy intervention in a 19-year-old male. Exercise therapy …

Efektifitas Acbt Dalam Meningkatkan Ekspansi Dada Pada Kasus Bronchiectasis : Studi Kasus, Riza Pahlawi, Aditya Denny Pratama, Mita Noviana, Anastasia Viastuti Iskandar

Jurnal Fisioterapi Terapan Indonesia

Bronchiectasis is a major chronic disease characterized by infection, inflammation, and permanent dilation of the bronchial walls. Interaction of chronic infection, exacerbation, and inflammation resulting in lung injury. Patients with bronchiectasis have several clinical manifestations of primary bronchiectasis, which is the occurrence of recurrent, chronic infections. In patients with bronchiectasis, mechanical efficiency of breathing leads to decreased rib movement and increased abdominal movement leading to a paradoxical breathing pattern. Treatment goals include achieving symptom control, preventing or reducing exacerbations. Various alternative airway techniques have been used in the physiotherapeutic management of patients with bronchiectasis. Techniques are considered the way to …

Efektivitas Balance Dan Core Exercise Untuk Meningkatkankeseimbangan Statis Pada Kasus Stroke Hemiparese Sinistra, Aditya Denny Pratama, Fatimah Fatimah, Mita Noviana, Riza Pahlawi

Jurnal Fisioterapi Terapan Indonesia

Stroke is a rapidly developing loss of brain function due to interruption of the blood supply to the brain. This can be caused by a blockage or bleeding in the blood vessels in the brain. The purpose of this study is to find out and understand how the effectiveness of balance and core exercise is to improve static balance in cases of left hemiparese stroke at Karmel Stroke Services. Of the various physiotherapy methods that can be done to overcome problems that can arise such as muscle weakness, balance disorders, posture disorders, and Activity Daily Living (ADL) disturbances in cases …

Reaching Out To Occupational Therapists, Alan Fyall

Rosen Research Review

Accessible tourism is a growing area of tourism research. The belief that all tourism facilities, products, and services should be accessible to those with disabilities drives research in tourism ethics and sustainability. However, a key voice is being ignored. Occupational therapists play a critical role in enabling people with disabilities to participate in the activities of daily life, including leisure. Dr. Alan Fyall believes it is time for interdisciplinary research with occupational therapists to properly understand accessible tourism.

Paired Associative Stimulation Applied To The Cortex Can Increase Resting-State Functional Connectivity: A Proof Of Principle Study, Andrew Hooyman, Alexander Garbin, Beth E. Fisher, Jason J. Kutch, Carolee J. Winstein

Physical Therapy Faculty Articles and Research

Introduction
There is emerging evidence that high Beta coherence (hBc) between prefrontal and motor corticies, measured with resting-state electroencephalography (rs-EEG), can be an accurate predictor of motor skill learning and stroke recovery. However, it remains unknown whether and how intracortical connectivity may be influenced using neuromodulation. Therefore, a cortico–cortico PAS (ccPAS) paradigm may be used to increase resting-state intracortical connectivity (rs-IC) within a targeted neural circuit.

Purpose
Our purpose is to demonstrate proof of principle that ccPAS can be used to increase rs-IC between a prefrontal and motor cortical region.

Methods
Eleven non-disabled adults were recruited (mean age 26.4, sd …

Bilateral Upper Extremity Motor Priming (Bump) Plus Task-Specific Training For Severe, Chronic Upper Limb Hemiparesis: Study Protocol For A Randomized Clinical Trial, Mary Ellen Stoykov, Olivia M Biller, Alexandra Wax, Erin King, Jacob M Schauer, Louis F Fogg, Daniel M Corcos

Department of Occupational Therapy Faculty Papers

BACKGROUND: Various priming techniques to enhance neuroplasticity have been examined in stroke rehabilitation research. Most priming techniques are costly and approved only for research. Here, we describe a priming technique that is cost-effective and has potential to significantly change clinical practice. Bilateral motor priming uses the Exsurgo priming device (Exsurgo Rehabilitation, Auckland, NZ) so that the less affected limb drives the more affected limb in bilateral symmetrical wrist flexion and extension. The aim of this study is to determine the effects of a 5-week protocol of bilateral motor priming in combination with task-specific training on motor impairment of the affected …