Rehabilitation and Therapy Commons^™

Integrating Technology To Support Learning And Accessibility In Counselor Education And Supervision, Yung-Chen Jen Chiu, Heekyung Lee, Junfei Lu, Kayi Ntinda, Roy K. Chen, Yuleinys A. Castillo

School of Rehabilitation Services & Counseling Faculty Publications

The rapid evolution of technology has profoundly impacted the delivery of counseling services and the field of counselor education. This transformation has introduced both opportunities and challenges for students from underrepresented backgrounds, including students with disabilities. This chapter delves into the integration of technology in counselor education and supervision, highlighting considerations of diversity, equity, inclusion, and accessibility. It explores strategies to enhance accessibility, including improved access to program information, optimized class preparation, and enhanced quality of clinical supervision. Key implications for counselor educators and supervisors include bolstering their own technological proficiency, familiarity with legal and ethical considerations, enhancing disability awareness, …

Systems Evaluation Supporting Feeding Program Development, Marquetta Moore

Occupational Therapy Doctorate Capstone Projects

Background: Prior to the development of a feeding therapy program, a system evaluation was completed in an outpatient pediatric therapy clinic. Changes were implemented to support the program, while planning and the initial phases of the feeding therapy program began.

Purpose: The purpose of this project was to enhance daily clinic operations and initiate the development of a feeding therapy program, with a focus on establishing evidence-based, family-and child-centered care.

This capstone project addressed the following objectives:

1. Assess clinic systems to identify strengths and weaknesses as well as threats and opportunities while evaluating existing processes that may impact program …

Addressing Fine Motor Skills In Kindergarten Through Embedding Occupational Fine Motor Skills In Classrooms, Mary L. Hesterwerth

Occupational Therapy Doctorate Capstone Projects

Background: Fine motor and visual–motor delays are becoming more common among young children, driven by the shift from traditional physical play to screen time and worsened by the COVID-19 pandemic. These issues are particularly concerning for kindergarten students, whose academic demands for handwriting and classroom participation are increasing despite their limited prior school experience.

Purpose: This Capstone project aimed to evaluate the effects of an occupational therapist-led training workshop for kindergarten teachers, focusing on how it helps integrate fine motor activities into daily bellwork routines. The main research question was whether this Tier 1, classroom-based strategy could enhance students’ fine …

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. …

Modified Constraint-Induced Movement Therapy After Stroke: A Process Evaluation Of Implementation In An Early-Supported Discharge Rehabilitation Service, Ashan Bimalka Weerakkody

Theses: Doctorates and Masters

Background

Modified constraint-induced movement therapy (mCIMT) improves upper limb (UL) function after stroke, but its routine delivery in rehabilitation settings remains limited.

Aims

The objectives were to determine the feasibility, acceptability, and sustainability of implementing mCIMT within an early-supported discharge (ESD) rehabilitation service, using existing resources and staffing.

Aims were to:

• Develop and deliver a multi-modal behaviour change intervention to clinicians to increase mCIMT delivery.
• Explore the acceptability of mCIMT among stroke survivors, carers, therapists, and allied health managers.
• Identify program adaptations to better suit stakeholder needs.
• Evaluate the process of implementing mCIMT in the ESD service.

Methods

This thesis …

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 …

Mental Health And Belongingness Of Doctor Of Physical Therapy Students: A Mixed Methods Study Centering Black Student Voices, Robyn Redline

Graduate Research Theses & Dissertations

Background: Despite efforts to increase recruitment and enrollment, the physical therapy profession lacks Black students and clinicians. Racially marginalized students have higher rates of academic difficulty during physical therapy education (PTE) than White students. Mental health and belongingness have been proposed as prerequisites for reaching academic achievement and attaining one’s full potential. Conversely, poor mental health and lack of belongingness during PTE may contribute to the underrepresentation of Black Doctor of Physical Therapy (DPT) students and clinicians. Yet not enough is known about the relationships between mental health, belongingness, and the academic achievement of DPT students. Purpose: This study aimed …

Ultrasound-Guided Percutaneous Needle Barbotage And Ultrasonic Tenotomy For Rotator Cuff Calcific Tendinopathy, Toru Omodani

Rehabilitation Practice and Science

Rotator cuff calcific tendinopathy (RCCT) is a common source of shoulder pain caused by calcium deposits within the rotator cuff tendons. Ultrasound-guided interventions have emerged as effective, minimally invasive alternatives to surgery for symptomatic cases unresponsive to conservative treatments. This review summarizes two primary techniques: percutaneous needle barbotage and percutaneous ultrasonic tenotomy. In needle barbotage, one or two needles are inserted under ultrasound guidance to inject and aspirate saline, thereby fragmenting and removing the calcific deposit. This method yields rapid pain relief and improved shoulder function, with follow-up imaging often demonstrating near-complete deposit resolution. For particularly hard or recalcitrant deposits, …

Ultrasound-Guided Injection In Meralgia Paresthetica: A Narrative Review, Jia-Chi Ko, Tyng-Guey Wang, Shaw-Gang Shyu

Rehabilitation Practice and Science

Meralgia paresthetica (MP) is a neuropathic pain syndrome resulting from compression or irritation of the lateral femoral cutaneous nerve (LFCN). Traditional diagnostic approaches rely on clinical assessments and electrodiagnostic testing. Ultrasound has emerged as a non-invasive, cost-effective modality for detailed visualization of the LFCN and guiding treatment interventions.

This review explores the anatomical considerations of the LFCN, its common etiological factors, clinical presentation, current management strategies, and ultrasound-guided injection techniques. While LFCN exhibits notable anatomical variability, and it is susceptible to external compression near the inguinal ligament. Some potential causes reveal as obesity, diabetes mellitus, or surgical interventions. Patients typically …

Bridging Clinical Capacity And Real-World Performance: Upper And Lower Limb Accelerometry In Pediatric Cerebral Palsy Rehabilitation, Youngsub Hwang, Jeong-Yi Kwon

Rehabilitation Practice and Science

The rehabilitation of children with cerebral palsy (CP) has progressively evolved from therapist-centered, impairment-focused models to child- and family-centered approaches that emphasize real-world participation. This narrative review summarizes conceptual and practical shifts in CP rehabilitation, highlighting the distinction between motor capacity and real-world performance. Accelerometry is a critical objective tool for assessing lower and upper limb physical activity. Devices such as StepWatch and ActiGraph provide ecologically valid data on lower limb activity levels, step counts, and energy expenditure. Studies have shown reduced physical activity in children with CP compared to their typically developing peers, with variations in age and GMFCS …

A Rare Case Of Bilateral Supraspinatus Tendon Tears With Unilateral Musculotendinous Junction Involvement In An Elderly Patient, Kanyamas Poompreecha, Patsaree Pattanasuwanna, Ya-Chu Hsu

Rehabilitation Practice and Science

Rotator cuff (RC) tears are a common cause of shoulder pain in the elderly, though tears at the musculotendinous junction (MTJ) are uncommonly observed. We present a rare case of bilateral supraspinatus tendon tears in a 68-year-old male, with unilateral involvement of the MTJ. Symptoms developed three months after resuming resistance training following left acromioclavicular dislocation surgery. Ultrasound revealed a full-thickness insertional tear on the left and a partial MTJ tear on the right. Conservative treatment led to symptom resolution without surgery. This case highlights the diagnostic value of dynamic ultrasound for subtle rotator cuff and MTJ lesions in elderly …

Safety In Dry Needling: The Role And Contributions Of The International Dry Needling Education & Training Advisory Group (Idnetag), W Mahmoud, J. Dommerholt

Rehabilitation Practice and Science

Dry needling is an intervention that physical therapists use to address various neuromusculoskeletal pain syndromes, primarily through targeting myofascial trigger points (TrPs) in muscle tissue. This technique involves inserting thin filiform needles into specific areas to relieve pain and improve movement. Despite its therapeutic potential, concerns regarding adverse events (AEs) necessitate stringent safety protocols and guidelines. In response, the International Dry Needling Education & Training Advisory Group (IDNETAG) was established in 2023 with members from diverse professions across eight countries. IDNETAG's mission is to enhance global standards of practice, focusing on safety, education, and consistency in treatment protocols. Research indicates …

Assessing How Patients With Spinal Cord Injury Are Affected By Climate Change And Extreme Weather: A Scoping Review, Lien-Chieh Lin, Hung-Chou Chen, Tsan-Hon Liou

Rehabilitation Practice and Science

Climate change and the rising frequency of extreme weather events (EWEs) pose significant challenges to vulnerable populations, particularly individuals with spinal cord injury (SCI). These patients are at greater risk due to impaired thermoregulation, limited mobility, poor sensation, and dependence on caregivers or adaptive equipment, increasing their exposure to climate-related hazards and disrupting healthcare access during disasters. Although climate change impacts on the general population are well-documented, research on specific disability groups like SCI patients remains limited. This scoping review investigates how SCI patients perceive and experience health risks from climate change and EWEs, as well as factors influencing their …

The Effects Of 10-Ml Versus 40-Ml Capsular Dilatation Under Ultrasound Guidance In Patients With Adhesive Capsulitis: A Randomized Controlled Trial, Kollatee Buranarach, Rawipa Khunnarong, Chanasak Hathaiareerug

Rehabilitation Practice and Science

Background: Adhesive capsulitis causes pain and limited mobility. Hydrodilatation is an effective, minimally invasive treatment, but the optimal volume is unclear. This study compares the pain and function improvement from large-volume (40 mL) versus small-volume (10 mL) ultrasound-guided hydrodilatation in patients with adhesive capsulitis.

Methods: This study was conducted at Phramongkutklao Hospital in Bangkok, Thailand, with Thai adults aged 20 and older who had adhesive capsulitis. Participants had a pain score of 4 or higher on the Visual Analogue Scale (VAS) and limited movement in at least two directions. They were divided into two groups. One group received ultrasound-guided hydrodilatation …

Long-Term Benefits Of An Integrative Scoliosis-Specific Rehabilitation Program For High-Risk Adolescent Idiopathic Scoliosis: A Retrospective Cohort Study, Yu-Shan Fu, Lin-Fen Hsieh, Julian Wang, Wei-Chen Chang, Ya-Fang Liu, Hsuan-Han Lin

Rehabilitation Practice and Science

Background/Purpose: Adolescent idiopathic scoliosis (AIS) is a common spinal deformity in adolescents, but the optimal combination therapy remains to be established. Therefore, our purpose is to investigate the long-term benefits of a scoliosis-specific rehabilitation program integrating pattern-specific manual therapy, Schroth Best Practice exercises, and Gensingen brace application for patients with AIS.

Methods: The retrospective cohort study was conducted in an outpatient clinic, including 54 patients with AIS at a high risk of progression who participated in the aforementioned program. The primary outcomes were the angle of trunk rotation (ATR) and Cobb angle, whereas the secondary outcome was the lateral …

Hemiplegic Shoulder Pain: A Narrative Review, Yeh-Kai Liao, Chueh-Hung Wu, Levent Özçakar

Rehabilitation Practice and Science

Hemiplegic shoulder pain is a common post-stroke complication that negatively affects functional recovery. It is caused by both mechanical and neurological factors. Prevention focuses on proper positioning, patient education, and maintenance of motion. Treatment remains largely conservative; with increasing research surrounding injection therapies, including intra-articular corticosteroid injection, subacromial hyaluronic acid injection, suprascapular nerve blocks, and botulinum toxin injection, all of which have demonstrated improved pain control. Functional electrical stimulation appears to be beneficial, and adjunct therapies such as supportive devices and robotic training may further enhance conventional treatment. Herewith, evidence regarding medications and acupuncture remains limited. Emerging treatments including high-intensity …

Unveiling The Role Of The Suprascapular Nerve In Painful Shoulder: A Narrative Review With A Focus On Ultrasound-Guided Diagnosis And Intervention, Hong Hong, Wei-Ting Wu, Ke-Vin Chang

Rehabilitation Practice and Science

Suprascapular nerve disorders are a significant yet often underdiagnosed cause of shoulder pain and dysfunction, stemming from the nerve's critical role in shoulder stability and mobility through its innervation of the supraspinatus and infraspinatus muscles. This review explores the anatomy and clinical relevance of the suprascapular nerve, highlighting the need for accurate diagnosis in cases of pain, weakness, or functional impairment that mimic other shoulder conditions. Among diagnostic modalities, ultrasound has become a vital tool, providing real-time imaging to precisely assess nerve compression or damage. Its utility extends to therapy, with recent advancements in ultrasound-guided interventions—such as nerve blocks, corticosteroid …

Late-Onset Sciatic Nerve Compression Due To Distal Femoral Osteochondroma, I-Fan Hsieh, Tian-Shin Yeh

Rehabilitation Practice and Science

Osteochondroma is one of the most common benign bone tumors, typically asymptomatic, and rarely causes nerve compression. Previous case reports documented nerve compression by osteochondroma arising from the proximal fibula, pelvic bone, and spine. We report a rare case of osteochondroma at the distal femur causing sciatic nerve compression with symptom onset at 42 years old. This case highlights that osteochondroma can develop at any skeletal location, and even though these lesions typically cease to grow after skeletal maturity. Individuals with a history of osteochondroma should consider it as a differential diagnosis for new symptoms even in older age to …

Multidisciplinary Approach To Managing Hypotonia And Developmental Delays Due To A Novel Gtpbp3 Mutation, Fan Mei, Ru-Lan Hsieh

Rehabilitation Practice and Science

Introduction: Hypotonia in early life is often challenging to diagnose due to its diverse etiologies, with genetic disorders accounting for about one-third of cases. A precise diagnosis using a comprehensive, multidisciplinary approach is crucial for determining prognosis, guiding treatment, and providing genetic counseling.

Case Presentation: We report the first case in Taiwan involving compound heterozygous mutations in the GTPBP3 gene. A 13-month-old girl presented with developmental delays and hypotonia despite normal prenatal screenings and a year of rehabilitation therapy. Next-generation sequencing revealed two novel mutations: c.785A>C (p.Gln262Pro), a missense mutation in Exon 5, and c.1175_1181dup (p.Ser395GlufsTer4) …

Effectiveness Of Fu's Subcutaneous Needling In Pain Management And Rehabilitation: A Narrative Review, Po-En Chiu, Chun-Chang Wu, De-Jian Lu, Zhonghua Fu, Li-Wei Chou

Rehabilitation Practice and Science

Fu’s Subcutaneous Needling (FSN) is a modern needling technique distinct from traditional acupuncture, primarily used for musculoskeletal pain, neuropathic conditions, and emerging applications in rehabilitation. FSN is also designated as a kind of dry needling focusing on deactivating myofascial trigger points. This review categorizes FSN-related studies into case reports, clinical trials, and animal studies, evaluating its therapeutic efficacy, safety, and mechanisms. Case reports suggest that FSN provides rapid pain relief and functional improvement, while clinical trials, including randomized controlled trials (RCTs), support its role in reducing pain and enhancing neuromuscular function despite limitations in sample size and protocol consistency. Animal …

Ambulation Challenges Post High-Voltage Electrical Burn Involving Three Extremities, Complicated With Osteomyelitis: A Case Report, Chiang-Hui Huang, Katie Pei-Hsuan Wu

Rehabilitation Practice and Science

High-voltage electrical burns in occupational settings can leave detrimental injuries with immediate impact and long-term sequel. Despite extensive literature on the injury mechanism, comprehensive long-term rehabilitation descriptions for such devastating cases remain scarce. This report presents a significant traumatized high-voltage electrical injury involved three out of four extremities. A late complication with extensive tibial osteomyelitis affecting two-thirds of the bone severely compromised the patient’s ambulation potential, emphasizing the importance of segmental rehabilitation with progressive tolerance in ambulatory weight-bearing. We evaluated the patient’s physical, mental, and social component using Barthel Index, Veterans RAND 12-Item Health Survey (VR-12), and Patient-Reported Outcomes Measurement …

Principles And Practices Of Selecting Screening Tools For Oropharyngeal Dysphagia: A Narrative Review, Yu-Hsuan Lai, Tyng-Guey Wang, Nai-Hsin Meng

Rehabilitation Practice and Science

Oropharyngeal dysphagia is a potentially life-threatening condition, particularly affecting individuals with neurological diseases, head and neck cancers, and age-related issues. Its prevalence in the general population ranges from 2.3% to 16%, with much higher rates among patients with stroke, Parkinson’s disease, and traumatic brain injury. Dysphagia is prevalent in geriatric and long-term care settings, where over 50% of elderly residents may experience swallowing difficulties. Given its high prevalence and serious consequences, early detection through dysphagia screening in at-risk populations is essential. Since the 1990s, numerous screening tools for dysphagia have been developed, with over 160 non-instrumental tools identified in review …

Clinical Application Of Intraoperative Neurophysiological Monitoring During Detethering Surgery Of A Newborn: A Case Report, Mu-Yun Lin, Hsin-Hung Chen, Tsui-Fen Yang

Rehabilitation Practice and Science

Background:

Tethered cord syndrome (TCS) is a rare congenital condition that causes abnormal tension on the spinal cord and often requires early surgical intervention to prevent progressive neurological and orthopedic deficits. However, performing detethering surgery in neonates presents unique challenges due to their immature neural pathways, which complicate intraoperative neuromonitoring (IONM).

Case Description:

We report the case of a 13-day-old neonate with TCS who underwent successful detethering surgery under advanced IONM. Double-train stimulation with a linked quadripolar montage was employed to elicit motor evoked potentials (MEPs), overcoming the challenge of monitoring immature corticospinal tracts. Additionally, subdural strip electrodes were used …

Dysphagia In Becker Muscular Dystrophy: A Case Report And Literature Review, Chien-Ping Chen, Hung-Jui Chuang, Yi-Chi Li, Ming-Yen Hsiao, Tyng-Guey Wang

Rehabilitation Practice and Science

Dysphagia is a recognized complication in patients with muscular dystrophies, but its characteristics in Becker muscular dystrophy (BMD) remain underexplored. This case report describes a man with BMD who developed dysphagia, initially presenting with mild symptoms but later experiencing aspiration pneumonia with respiratory failure. He regained safe oral intake after swallowing training. Three years later, he suffered worsening dysphagia following a severe coronavirus disease-2019 (COVID-19) infection, ultimately losing the ability to resume oral feeding despite months of rehabilitation. Literature on swallowing disorder in BMD reported poor mastication, reduced laryngeal elevation, and increased pharyngeal residue; however, silent aspiration, as observed in …

Influence Of Local Application Of Lidocaine Patch On Peripheral Nerve Conduction – A Pilot Study, Thanh-Nhan Doan, Fang-Yin Liao, Yueh-Ling Hsieh, Li-Wei Chou

Rehabilitation Practice and Science

Background: This study aimed to investigate the effects of a lidocaine patch on peripheral nerve conduction.

Methods: Fifteen healthy volunteers with no symptoms or signs of neuropathy in either upper limb were recruited for this double-blind, placebo-controlled study over a 10-month period. A lidocaine patch or a placebo patch was applied to the volar aspect of the wrist during sleep. The treatment procedure was repeated for 14 consecutive nights. Nerve conduction studies were performed and analyzed at each assessment point. All participants were re-evaluated, with electrophysiological studies of the median and ulnar nerves repeated at 1 week and 2 weeks …

Optimizing Decision-Making In A Cerebral Palsy Model Using Reinforcement Learning, Richard Ampah

Pitzer Senior Theses

This study presents an original interdisciplinary investigation into how reinforcement learning (RL) can model motor and cognitive defects and potentially improve motor and cognitive functions in individuals with cerebral palsy (CP), a non-progressive neurological disorder that impairs movement and adaptability. Integrating computational neuroscience and machine learning, the research applies policy gradient methods and Markov Decision Processes (MDPs) to simulate adaptive learning in agents with and without CP-related constraints.

The central aim is to compare the cumulative rewards of optimal policies, derived from value iteration, and human-like learning policies using the REINFORCE algorithm, both with and without the Bellman baseline. The …

Mind The Gap, Klaire Perry

OTD 721: Cultural Responsiveness & Occupation

I went in to OT to make the world more accessible. I love how OT views people as their hopes, dreams, values, strengths, and facilitators...NOT as an injury or disease. At this point, every room I enter becomes a personal case study of accessibility. I can't help but wonder how many spaces have hung huge signs that say "YOU ARE NOT WELCOME" that are only visible to some. I'm thankful for my love ones who agreed to help me with this project. While I can never fully understand their experience, I can listen.

Klaire Perry, Class of 2027

Summer School: The Experience Of An Occupational Therapy Student Exploring Culture In Spokane!, Lulu Brady

OTD 721: Cultural Responsiveness & Occupation

This zine illustrates my experience in this OTD 721 Cultural Responsiveness class, led by Dr. Kirkpatrick. The class took place in the summer of 2025. It was absolutely inspiring, and I wanted to be able to share my takeaways and learnings from my experiences in this class. Culture is so relevant to the field of occupational therapy (OT) because occupations are often shaped by culture, OT cannot be truly client-centered without respective culture. Not only did this class help me grow as a future occupational therapist practitioner, but it also helped me grow as a person. It showed me the …

Welcomed In: A Love Letter To Okinawa, Taylor Fernandez

OTD 721: Cultural Responsiveness & Occupation

This zine is a personal, reflective project exploring Okinawan culture through my lens as a long-term guest -- first as a military child, then as an adult returning "home" to visit the island where my parents still live. While I am not Okinawan, the culture has deeply influenced my values, worldview, and understanding of community, aging, and wellness.

Through this project, I have sought to honor the richness of Okinawan traditions -- not as an authority, but a someone shaped by the grace of being welcomed in. The pages blend scholarly knowledge, lived experience, and cultural observation to explore how …

Occupational Apartheid, Kimberly Dewey

OTD 721: Cultural Responsiveness & Occupation

Occupational apartheid is a term that is often misunderstood. I wanted to bring more awareness and understanding to a very real concept that happens every day. I hope to have provided education and examples that make it easy to follow along and see how apartheid shows up on a daily basis. Let's work together as future OT professionals to expand our knowledge and practice to decrease experiences of occupational apartheid.

Kimberly Dewey, Class of 2027