Rehabilitation and Therapy Commons^™

The Interplay Between Pulse Width And Activation Depth In Tens: A Computational Study, Abhishek Datta

Faculty, Staff and Student Publications

Background: Transcutaneous electrical nerve stimulation (TENS) has been a commonly used modality to relieve aches and pain for over 40 years. Commercially available devices provide multiple therapy modes involving a different combination of frequency and pulse width with intensity. While frequency sets sensation, intensity helps determine tolerability, longer pulse width is reported to induce a feeling of deeper stimulation. In fact, longer pulse width has been empirically shown to deliver current into deeper tissues, but in context of other electrical stimulation modalities. The goal of this study was to unpack the relationship between pulse width and activation depth in TENS. …

Breaking Down Silos: Creating And Implementing A Longitudinal Interprofessional Education Curriculum For Graduate Health Science Professional Students, Robert Wellmon, Jill D. Black, Wendy Wachter-Schutz, Kathleen M. Youse, Adrienne N. Pinckney, Lori L. Felker

Health Professions Education

Background. Accreditation standards for graduate health professional programs require the inclusion of interprofessional learning and collaboration (IPL/C) activities in entry-level curricula. This implementation necessitates collaboration among educators from multiple disciplines and openness to innovation and to educate students in a manner that breaks down uni-professional curriculum silos that are known barriers to the creation of meaningful IPL experiences.

Objective. The purpose of this paper is to describe one institution’s process for creating a longitudinal interprofessional education (IPE) curriculum that aligns with accreditation mandates and meets the call to foster IPC competency skills.

Methods. Widener University established an interprofessional thread of …

Post-Stroke Lateropulsion In Australia And New Zealand: A Survey Investigating Current Knowledge, Priorities And Practice, Jessica Nolan, Angela Jacques, Barbara Singer

Research outputs 2022 to 2026

Background: Post-stroke lateropulsion is prevalent and associated with poor rehabilitation outcomes, but evidence to guide rehabilitation of affected stroke survivors is limited. Current post-stroke lateropulsion rehabilitation practice across Australia and New Zealand has not been previously described. Objectives: This study aimed to describe lateropulsion rehabilitation practice in Australia and New Zealand, determine clinicians,’ educators’ and researchers’ opinions about the need for educational resources to guide best-practice, and to identify current barriers to, and enablers of, optimal rehabilitation delivery. Methods: This cross-sectional survey was distributed to stroke rehabilitation clinicians, educators and researchers across Australia and New Zealand using Qualtrics. Data were …

Translating Acceptability To Sustained Delivery: Clinician And Manager Perspectives On Implementing Modified Constraint-Induced Movement Therapy In An Early-Supported Discharge Rehabilitation Service, Ashan Weerakkody, Erin Godecke, Barby Singer

Research outputs 2022 to 2026

Background: Modified constraint-induced movement therapy (mCIMT) improves upper limb (UL) function after stroke. Despite up to one-third of stroke survivors being eligible, clinical uptake remains poor. To address this, a multi-modal behaviour change intervention was implemented across a large seven-site early-supported discharge (ESD) rehabilitation service. This study investigated the acceptability of mCIMT implementation within this ESD service and identified adaptations required for sustained delivery.

Methods: This qualitative study was nested within a mixed-methods process evaluation of mCIMT implementation. Four focus groups (n = 24) comprising therapists (two groups), therapy assistants (one group), and allied health managers (one group) were conducted. …

Investigating The Acceptability Of Modified Constraint-Induced Movement Therapy Among Stroke Survivors And Carers: A Qualitative Study, Ashan Weerakkody, Erin Godecke, Barby Singer

Research outputs 2022 to 2026

Purpose: To investigate the acceptability of modified constraint-induced movement therapy (mCIMT) among stroke survivors and carers within an early-supported discharge (ESD) service, and to inform further adaptations of the program to enhance acceptability. Methods: Qualitative study within a mixed methods process evaluation of mCIMT implementation. Semi-structured interviews were analysed using reflexive thematic analysis and mapped to the Capability, Opportunity, Motivation- Behaviour (COM-B) model. Results: Fifteen stroke survivors and ten carers participated. Five themes were generated and mapped to the COM-B. Participants attributed functional improvements to the program whilst also encountering several challenges with returning home after stroke (Capability- physical); the …

Effectiveness Of Immersive Virtual Reality Combined With Task-Specific Training On Hemiplegic Arm Function Following Stroke: A Single Case Series Study, Rahsaan J. Holley

Theses and Dissertations

Motor recovery of the arm following a neurological injury is a common goal of the rehabilitation process for individuals impacted by the condition . Due to the long-term functional implications of impaired arm movement, individuals are often trained to use compensatory strategies to complete functional tasks without incorporating the weakened limb. While compensatory strategies offer stroke survivors the opportunity to regain a level of independence, such approaches fail to directly address the underlying causes of the disability (i.e., limited range of motion, decreased strength, poor coordination, motor planning difficulties) which can unfortunately result in long-term impairment and functional disability.

Motor …

Comparison Of Baumgaertner Reduction Quality Criteria , Chang Criteria And Ap3×Ml3 Classification And Their Ability To Predict Mechanical Complications Of Trochanteric Fractures Fixed With Proximal Femoral Nail, Amr Elhadidy Elhadidy, Ahmed Abdelbadie Ibrahim, Sallam Ibrahim Fawzy, Ehab Youssef Hassanin

Mansoura Medical Journal

Background Trochanteric fractures are common injuries among the elderly. Despite advances in fixation with proximal femoral nails (PFN), Mechanical complication remain significant. Several reduction quality systems have been proposed, but their predictive value and reproducibility remain debated. Aim To evaluate and compare the predictive value and reproducibility of Baumgaertner Reduction Quality Criteria (BRQC), Chang Reduction Quality Criteria (CRQC), and AP3×ML3 classification in patients with AO Foundation/Orthopaedic Trauma Association (AO/OTA) 31-A1 and 31-A2 trochanteric fractures fixed with PFN. Methods A prospective observational study was conducted on 146 patients with 31-A1 and A2 trochanteric fractures treated by PFN. Postoperative radiographs were assessed …

Clear Speech Intervention In Parkinson’S Disease: A Single Case Design Examining Acoustic And Aerodynamic Outcomes Following A Structured Protocol, Zachariah Jordan Backus

Graduate Theses, Dissertations, and Problem Reports (ETD)

ABSTRACT

Clear Speech Intervention in Parkinson’s Disease: A Single Case Design Examining Acoustic and Aerodynamic Outcomes Following a Structured Protocol

Zachariah Backus

Purpose:

Parkinson Disease (PD) is a neuro-progressive movement disorder that impacts all movement of the body, including speech production. Ninety percent of individuals living with PD will experience hypokinetic dysarthria, a motor speech disorder, during the progression of their disease. Clear speech instruction is a treatment strategy used to increase motor speech outcomes in those with PD. Studies have shown positive changes in articulation, prosody, voice, and listener perception measures in those with PD after clear speech instruction …

Development Of Sexual Health Curriculum For West Virginia University’S Occupational Therapy Program, Abigail Jeske

Graduate Theses, Dissertations, and Problem Reports (ETD)

Sexual health is a fundamental aspect of well-being and quality of life and impacts everyone regardless of age, gender, or sexual orientation, and is relevant throughout an individual’s lifespan. Occupational therapists have a valuable role in addressing sex concepts with patients; however, a lack of education and comfort level have been identified as barriers to practitioners addressing the concepts in clinical practice. This Doctoral Capstone Experience aims to answer how the topic of sexual health can be integrated into a lifespan curriculum in formal occupational therapy education. A sexual health curriculum was created and integrated into seven different classes that …

Improving Postpartum Outcomes Through Therapeutic Individual And Group Occupational Therapy Sessions In Hospitalized Antepartum Patients, Melissa C. Learish

Graduate Theses, Dissertations, and Problem Reports (ETD)

Extended hospitalization in the postpartum period is occasionally medically indicated due to a variety of diagnoses, but can pose challenges to the psychosocial well-being of pregnant women, such as social isolation, anxiety, alteration of normal life routines, and less preparation for postpartum life. In acute care settings, however, maternal management tends to focus on physical stabilization rather than holistic maternal care, including opportunities for emotional support, occupational engagement, and postpartum planning. This doctoral capstone project was designed to assess the effect of individualized and group-based occupational therapy interventions for antepartum women who have been hospitalized for extended periods of time, …

The Quick Dash Reformed: Increasing The Holisticity And Occupational Nature Of Upper Extremity Therapeutic Evaluation, Lauren E. Garcia

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: The QuickDASH is one of the most common upper extremity (UE) focused patient-reported outcome measures (PROMs) utilized within current practice. Despite its high utilization rate, there are still many concerns surrounding the QuickDASH, including its applicability to certain populations, difficulty with cross-cultural adaptation, and limited psychosocial evaluation. Purpose: The purpose of this study was to develop and implement a reformed version of the QuickDASH, the OT-DASH, that included modernized and occupation-focused language to achieve increased client applicability and yield more accurate comparisons between client perceptions of dysfunction and their true clinical presentations. Theoretical framework: The Person-Environment-Occupation-Performance model was utilized …

Enhancing Vocational Services Through Support Of Direct Care Staff For Adults With Intellectual Disabilities, Katelyn D. Cardwell

Graduate Theses, Dissertations, and Problem Reports (ETD)

This mixed-method cohort study focused on supporting direct support professionals through burnout education modules. Burnout is a psychological phenomenon characterized by mental, physical, and emotional exhaustion in response to chronic stress in the workplace. Direct support professionals (DSP) provide services that include independent living and vocational skill education to adults with intellectual disabilities. Burnout has negative impacts on work quality, efficiency, and can led to high turnover rates. This project aimed to provide DSP’s with resources to mitigate the risk of burnout. The study utilized semi-structured interviews to help guide the development of education modules for staff. Based on findings …

Sensory Integration In The Intensive Care Unit Environment, Kara M. Lee

Graduate Theses, Dissertations, and Problem Reports (ETD)

Those admitted to the intensive care unit (ICU) commonly experience deficits in areas linked with cognition, mental health, and physical functioning (Rapolthy-Beck et al., 2023). Delirium is the most common complication among individuals who are mechanically ventilated, which can be associated with adverse outcomes, including increased mortality, cognitive decline, and decreased functional outcomes (Martinez et al., 2017). The primary purpose of the capstone project was to create a sensory-based program for patients admitted into the ICU. The program aimed to enhance the quality and consistency of care, ultimately reducing the prevalence of delirium. By doing so, it seeks to improve …

Improving Hospital Discharge Readiness Among Caregivers Of Children With Complex Medical Needs, Megan M. Bruce

Graduate Theses, Dissertations, and Problem Reports (ETD)

Advancements in medicine and technologies have led to an increase in the population of children living with complex and chronic health conditions. Children with medical complexities (CMCs) and their caregivers frequently have challenges navigating home life after transitioning from hospital to home-based care. A 14-week doctoral capstone project was conducted at Dayton Children’s Hospital to improve caregiver readiness for hospital discharge. Project participants included caregivers of CMCs (n = 6) admitted to the hospital and pediatric acute care occupational therapists (n = 4). The Pediatric Readiness for Hospital Discharge Scale – Long Form (Peds-RHDS) was used as a pre-and post-intervention …

Multifaceted Life Skills Training And Job-Orientation Supports For Individuals In Vocational Rehabilitation Programming, Laura R. Mccray

Graduate Theses, Dissertations, and Problem Reports (ETD)

There is growing support for those with an intellectual or developmental disability (IDD) in the transition process and within the workplace, however, there are areas that need to be addressed to facilitate further inclusion and success in this domain. There are structured institutions within the community that extend support for those transitioning out of high school, focusing on aligning with life training and professional skills while promoting societal integration by delivering services directly and avoiding isolation within traditional service environments (Accardo & Whitman, 2011). Growing research highlights the necessity of providing resources that support individuals with intellectual and developmental disabilities …

Effectiveness Of A Cumulative Pediatric-Based Practical Examination At Increasing Student Perceived Competence And Confidence In Working With Pediatric Populations, Nicholas J. Passarelli

Graduate Theses, Dissertations, and Problem Reports (ETD)

Current literature highlights the importance of utilizing practical examinations and actual patients and covering vast pediatric content within occupational therapy curricula. The needs assessment conducted within The West Virginia University Division of Occupational Therapy revealed that the division currently employs all three of these factors within their curriculum, however a gap presented in the combination of these three factors together. This project aimed to diminish this gap through the development, implementation, and execution of a pediatric practical examination, utilizing actual pediatric patients, to determine whether the examination is effective in increasing student perceived competence and confidence in working with pediatric …

Quantitative Assessment Of Knee Joint Stability Using Inertial Measurement Units In Patients With Acl Reconstruction Performing Single-Legged Hopping Tasks, Haley Hartman-Mongold

Graduate Theses, Dissertations, and Problem Reports (ETD)

Purpose: The purpose of this study was to examine proximal tibial IMU accelerations between the involved limb and uninvolved limbs of individuals who have undergone ACL reconstruction performing the single-leg hop test battery and to correlate these results to deficits in quadriceps strength and distance hopped. Methods: Thirty-four subjects (19 male, 15 female; age = 20.5 ± 6.7 years; mass = 76.4 ± 15.8 kg; height = 1.74 ± .08 cm) who have undergone unilateral ACL reconstruction were recruited for this study. An isokinetic dynamometer was used to assess the knee extension peak torque on the involved and uninvolved limbs. …

Gamified Mhealth System For Evaluating Upper Limb Motor Performance In Children: Cross-Sectional Feasibility Study, Md Raihan Mia, Sheikh Iqbal Ahamed, Samuel Nemanich

Computer Science Faculty Research and Publications

Background: Approximately 17% of children in the United States have been diagnosed with a developmental or neurological disorder that affects upper limb (UL) movements needed for completing activities of daily living. Gold-standard laboratory assessments of the UL are objective and precise but may not be portable, while clinical assessments can be time-intensive. We developed MoEvGame, a mobile health (mHealth) gamification software system for the iPad, as a potential advanced technology to assess UL motor functions.

Objective: This feasibility study examines whether MoEvGame can assess children’s whole-limb movement, fine motor skills, manual dexterity, and bimanual coordination. The specific aims were to …

Effect Of Trauma Type And Trauma Burden On Self-Efficacy For Physical Exercise In Military Veterans, Kaley E. Davis, Meghan M. Bennett, Cecilia J. Hillard, Jeffrey Whittle, Zeno Franco, Rachel E. Bollaert, Jacklynn M. Fitzgerald

Exercise Science Faculty Research and Publications

Introduction

United States (U.S.) military veterans experience significant physical health problems. Lifestyle modifications, such as increasing daily physical activity, are often considered the first course of action in treatment for the general public. However, veterans report low levels of physical activity, often due to perceived barriers to engaging in exercise. Trauma exposure type and cumulative trauma burden may be differentially associated with exercise attitudes and behaviors.

Methods

We surveyed U.S. military veterans on perceived self-efficacy to overcome barriers to engaging in exercise and physical activity levels. Additionally, we explored the relationship between the type of traumatic event exposure and cumulative …

Prediction Of Snatch And Clean And Jerk Performance From Physical Performance Measures In Elite Male Weightlifters, Ingo Sandau, Kristof Kipp

Exercise Science Faculty Research and Publications

This study aimed to build a valid model to predict maximal weightlifting competition performance using ordinary least squares linear regression (OLR) and penalized (Ridge) linear regression (penLR) in 29 elite male weightlifters. One repetition maximum (1RM) or 3RM test results of assistant exercises were used as predictors. Maximal performance data of competition and assistant exercises were collected during a macrocycle in preparation for a competition. One repetition maximum snatch pull, 3RM back squat, 1RM overhead press, and body mass were used to predict the 1RM snatch; and 1RM clean pull, 3RM front squat, 1RM overhead press, and body mass were …

Rebuttal: Reduced Oxidative Capacity Of Skeletal Muscle Is Not An Inevitable Consequence Of Adult Ageing, Ian R. Lanza, Christopher W. Sundberg, Jane A. Kent

Physical Therapy Faculty Research and Publications

We thank Drs Marcinek and Ferrucci for their perspective on the inevitability of age-related declines in skeletal muscle oxidative capacity (Marcinek & Ferrucci, 2025). We agree that mitochondria have numerous roles in the cell beyond provision of chemical energy, many of which may be altered by ageing, but our focus in this debate is entirely on its role in energy production.

Whole Body Angular Momentum Characterizes Reactive Balance Adaptations And Perturbation Intensity, Mitchell D. Adam, Delaney Mcelvain, T. George Hornby, Allison S. Hyngstrom, Brian D. Schmit

Physical Therapy Faculty Research and Publications

Identifying measures which accurately quantify reactive balance adaptation during walking is essential to understand how emerging perturbation-based gait paradigms impact stability over the course of an intervention. These perturbation paradigms have shown promise in reducing falls for numerous clinical populations, however tracking progress in objective terms throughout an intervention remains challenging. Whole body angular momentum (H) may be particularly suited to detect subtle adaptations in the reactive balance response and is applicable within numerous perturbation environments. We assessed the ability of young healthy adults to adapt to varying intensities of discrete, unexpected, treadmill-based perturbations directed mediolaterally, anteriorly, and posteriorly during …

Perspectives Of Midwives And Nurse Practitioners In Kentucky On Exercise Counseling During Pregnancy: A Qualitative Study, Madhawa Perera, Taniya S. Nagpal, Maire M. Blankenship, Dano Tolusso, Jordyn Cox, Dilini Prashadika, Mark Schafer, Rachel A. Tinius

Physical Therapy Faculty Research and Publications

Introduction

Healthcare professionals are in an optimal position to deliver exercise information to pregnant women, yet previous research suggests this seldom happens. Midwives and nurse practitioners, who may have more time with pregnant women, are particularly well suited for this role.

Objectives

This qualitative study examined the exercise advice and counseling provided by midwives and nurse practitioners in Kentucky, focusing on the barriers they face.

Methods

Twenty-one midwives and nurse practitioners were recruited until the sample size reached saturation. A survey with open-ended questions was distributed to potential participants in regional hospitals, universities, and professional associations. The framework method was …

Age-Related Differences In Eye Movements And The Association With Archimedes Spiral Tracing Performance In Young And Older Adults, Brittany Heintz Walters, Wendy E. Huddleston, Kristian M. O'Connor, Jinsung Wang, Marie K. Hoeger Bement, Kevin G. Keenan

Physical Therapy Faculty Research and Publications

Age-related hand motor impairments may critically depend on visual information though few studies have examined eye movements during tasks of hand function in older adults. The purpose of this study was to assess eye movements and their association with performance while tracing on a touchscreen in young and older adults. Eye movements of 21 young (age 20–38 years; 12 females, 9 males) and 20 older (65–85 years; 10 females, 10 males) adults were recorded while performing an Archimedes spiral tracing task, a common clinical assessment sensitive to age-associated impairments in hand function. Participants traced an Archimedes spiral template on a …

Reduced Oxidative Capacity Of Skeletal Muscle Is Not An Inevitable Consequence Of Adult Ageing, Ian R. Lanza, Christopher W. Sundberg, Jane A. Kent

Physical Therapy Faculty Research and Publications

Skeletal muscles support posture and locomotion, thermoregulation, cardiorespiratory function, metabolic health and other important aspects of life. Muscles generate chemical energy by synthesizing ATP through the creatine kinase reaction, glycolysis, and oxidative phosphorylation (oxphos), the latter of which produces the majority of ATP in the cell. Oxidative phosphorylation occurs in the mitochondrion, which is structured as a reticulum located near the ATPases responsible for powering the cross-bridge cycle, calcium pumps and membrane homeostasis (Glancy et al., 2015). Energy production in mitochondria is accomplished by coupling the oxidation of reducing equivalents (NADH, FADH₂) in the electron transport chain (ETC) …