Rehabilitation and Therapy Commons^™

Senescent Fibroblasts In Aging And Pulmonary Fibrosis, Sara B. Palega, Aiwei Y. Borengasser, Yan Y. Sanders

Microbiology & Molecular Cell Biology Faculty Publications

Aging is a major risk factor for many chronic lung diseases, including Idiopathic Pulmonary Fibrosis (IPF), a fatal and incurable disease characterized by progressive fibrotic remodeling. Age-associated structural alterations, impaired regenerative capacity, and dysregulated cellular signaling collectively create a pro-fibrotic microenvironment. A central driver of this pathological shift is the accumulation of senescent cells, which undergo irreversible growth arrest and develop a robust pro-inflammatory senescence-associated secretory phenotype (SASP). Emerging evidence identifies senescent lung fibroblasts as critical mediators of IPF pathogenesis. These cells promote excessive extracellular matrix deposition, myofibroblast differentiation, and tissue stiffening, while simultaneously impairing epithelial regeneration. Together, these effects …

Tools Used To Measure Fear Avoidance Behaviour In The Management Of Mild Traumatic Brain Injury (Concussion), Liam Sherwood

Theses: Doctorates and Masters

Concussion can present challenges with respect to diagnosis and management. Fear avoidance behaviour and beliefs may be perpetuating factors in the clinical course of concussion. Understanding which patients may adopt such behaviours and beliefs can offer important information to allow tailoring of clinical management and implementing strategies to minimise the risk of progression to persisting post-concussion symptoms.

In this thesis, I:

-       systematically reviewed the current measurement tools used to assess fear avoidance behaviours and beliefs associated with concussion;

-       explored the experience of clinicians, researchers and people with lived experience of concussion in relation to fear avoidance behaviours;

- …

Exploring The Role Of Occupational Therapy In A Pediatric Specialty Care Office, Sierra Leigh Hays

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction: The role of OT in primary and specialty care clinics is a rising area of interest in the field. There are also many multidisciplinary clinics that OTs can be or are apart of. This study aims to evaluate the consulting role of OT in primary and specialty care clinics, as well as to evaluate data collected by an OT in a pediatric brachial plexus and peripheral nerve clinic. Methods: The first objective was focused on analyzing functional outcomes, using the Active Movement Scale (AMS), of children following neurosurgery or onabotulinum toxin A injections. This was a retrospective study with …

Caring For The Caregiver: Implementing An Occupational Therapy-Tailored Educational Program To Alleviate Caregiver Burden, Lura Elizabeth Simons

Graduate Theses, Dissertations, and Problem Reports (ETD)

Caregivers of traumatic brain injury (TBI) survivors experience caregiver burden, which is a prevalent issue. The most significant concern is for symptoms of burden affecting mental health and sleep quality. This doctoral capstone project addressed the knowledge gap regarding programs that alleviate these signs and symptoms through evidence-based interventions. The objective was to create an educational program with modules that demonstrated improvement in satisfaction and content understanding through in-person sessions and individualized interviews with staff members. This project aimed to reduce perceived burden by conducting in-person sessions to implement interventions through an occupational therapy (OT) lens and by using educational …

Enhancing Occupational Engagement And Wellness In Middle-Aged And Retired Adults Through Movement And Mindfulness Program Development, Erin J. Harvey

Graduate Theses, Dissertations, and Problem Reports (ETD)

Occupational imbalance and a diminished sense of purpose are common challenges faced during middle age and the transition into retirement. These issues can contribute to increased burnout, decreased participation in meaningful activities, and an overall decline in health and well-being. Occupational therapy is well-equipped to address these concerns through comprehensive and holistic, occupation-based wellness programs that promote healthy routines and engagement in meaningful roles. This doctoral capstone project involved developing and implementing two community-based wellness programs tailored to different populations. The first program included self-paced wellness modules for middle-aged adults, aiming to encourage healthy lifestyle habits, enhance coping skills, and …

Strategic Transition Planning And Post-Graduation Preparedness For Students In Secondary School, Kelsey Renae Armentrout

Graduate Theses, Dissertations, and Problem Reports (ETD)

The transition period between high school and post-graduation life can be a challenging time for many students. Young adults may follow different paths, including going into the workforce or attending post-secondary education, as well as learning how to navigate life skills such as paying bills, buying a house or a car, applying for jobs, obtaining insurance, and occupations within the adult life stage. While young adults may learn about these things throughout their high school career, it is likely that the feelings of unpreparedness are continuously relevant. The purpose of this DCE is to develop and implement learning modules for …

Effectiveness Of Occupational Therapy-Inspired Educational Sessions For Mothers Accessing Women, Infants, And Children (Wic) Services, Samantha Annette Merew

Graduate Theses, Dissertations, and Problem Reports (ETD)

This doctoral capstone project examined the effectiveness of occupational therapy (OT)-inspired group and one-on-one educational sessions designed to support the emotional, mental, and social well-being of pregnant and postpartum mothers accessing Women, Infants, and Children (WIC) services in Onslow County, North Carolina. Grounded in the Model of Human Occupation and Cognitive Behavioral Frame of Reference, the program aimed to address gaps in holistic maternal health support, particularly among low-income and at-risk populations. Eight structured group sessions and five one-on-one sessions were developed, implemented, and evaluated, focusing on topics such as stress management, emotional regulation, self-care, role transition, and self-advocacy. A …

Bridging The Sensory Gap With Occupational Therapy: Program Development For Sensory Integration In Inpatient Rehabilitation For Adults With Central Nervous System Injuries, Callie Marie Honaker

Graduate Theses, Dissertations, and Problem Reports (ETD)

Objectives: This project aimed to identify sensory processing deficits in adults with central nervous system injuries and to inform the development of sensory-informed program components in an inpatient rehabilitation setting. Participants: A total of 76 adults admitted with diagnoses including cerebrovascular accident, brain injury, and spinal cord injury were included. Methods: A structured sensory screening and mental health questionnaire were administered and compared to prescreening admission documentation and PHQ-9 scores. Descriptive statistics and inferential analyses were conducted. Results: Sensory impairments were highly prevalent, with participants demonstrating an average of three impairments across the sensory domains. Proprioceptive, tactile, and visual deficits …

Association Of Alcohol Use With Helmet Use In Cyclists: Analysis Of The National Trauma Data Bank, Daniel C Brock, Gaibo Yan, Chad T Wilson, Emanuel Narcis Husu

Faculty, Staff and Students Publications

Background: Helmet use significantly reduces the risk of traumatic brain injury among cyclists; however, the influence of alcohol use on helmet-wearing adherence remains understudied in large national data sets. The goal of this study was to investigate the relationship between alcohol use and helmet use in injured cyclists.

Methods: This study is a retrospective cross-sectional analysis of 155 766 cyclists with traumatic injuries from the National Trauma Data Bank spanning 8 years (2017-2023). Cyclists were categorized by blood alcohol concentration (BAC) as follows: not screened, sober (BAC < 0.02), impaired (BAC 0.02-0.08), intoxicated (BAC ≥0.08), and multidrug intoxicated (BAC ≥0.08 plus ≥1 positive drug screen). The primary outcome was helmet usage. Secondary outcomes included mortality, hospital and intensive care unit length of stay, Injury Severity Score, and adverse events. Comorbid substance use disorders were considered as covariates.

Results: Alcohol use was associated with a dose-response decrease in helmet use. Helmet …

Fall Prevention Interventions In Community-Dwelling Older People With Cognitive Impairment: A Systematic Review, Sumattana Glangkarn, Pelden Chejor, Rujira Nonsa-Ard, Kasama Wongprachum, Sirapat Khodseewong, Chaiwut Bourneow, Davina Porock

Research outputs 2022 to 2026

Introduction: Falls are a major health concern for older adults, particularly those with cognitive impairment. Many factors contribute to the risk of falls, making it a complex issue to manage. Aim: This systematic review aimed to identify and describe the implementation strategies used for fall prevention in community-dwelling older people with cognitive impairment. Eligibility criteria: The review included studies on fall prevention interventions for community-dwelling adults aged > 50 years with cognitive impairment. Eligible studies were primary research, including experimental, quasi-experimental, qualitative, and mixed methods designs, with detailed implementation strategies. Systematic reviews, protocols, editorials, opinions, commentaries, and conference papers were excluded. …

Neuromotor Function Following Lower-Limb Muscle Or Tendon Injury: Systematic Review And Meta-Analysis, Jack Andringa-Bate, Moath Almusallam, Molly Coventry, Myles C. Murphy, Ebonie Rio, Tania Pizzari

Research outputs 2022 to 2026

Purpose: Alterations in neuromotor function occur following lower-limb injuries and might be a factor in recurrent injury. We evaluated if adults with previous lower-limb muscle or tendon injury demonstrate differences in neuromotor function compared with uninjured or control limbs. Methods: A systematic search of health databases MEDLINE, EMBASE, CINAHL, and SPORTDiscus was conducted from inception until the end of April 2024. Studies evaluating neuromotor function of adults with a history of lower-limb muscle or tendon injury compared to an uninjured contralateral or control limb were included. Inverse variance, random effects meta-analyses were used to generate effect estimates for neuromotor outcomes. …

Addressing Professional Tensions Through Intellectual Candour And Stewardship, Thoughtful Dialoguing As A Duoethnographic Collaborative Exploration, Sarah Barradell, Narelle Lemon

Research outputs 2022 to 2026

Using duoethnography, we explore our experiences of physiotherapy practice and education and argue that the profession’s desire for credibility is at the expense of vulnerability, risk and intellectual candour–of imagining the profession and education of its graduates differently. We identified key themes around: alignment/misalignment, reflection/reflexivity and professional scope. This methodology models risk and questioning through the juxtaposition of different perspectives. Through our contrasting narratives, we remain open to new forms of learning, modelling what intellectual candour demands from us: facing the problems of the past so that we might learn from our history and change our future. This can be …

Aerobic Exercise Increases Brain-Derived Neurotrophic Factor (Bdnf) In Sub-Acute Stroke: A Randomized Controlled Trial, Christopher P. Mackay, Suzanne Kuys, Mia Schaumberg, Li Ann Leow, Sandy Brauer

Research outputs 2022 to 2026

Background: Brain-derived neurotrophic factor (BDNF) is a key neurotrophin due to its role in neuron process outgrowth, plasticity, and neuronal survival. Aerobic exercise can induce BDNF release and may ultimately maximize post-stroke recovery. Objectives: This study aimed to determine if a program of moderate-to-high-intensity aerobic exercise increased concentrations of BDNF in subacute stroke survivors compared to usual care. Methods: A parallel-group, RCT was undertaken in people with subacute stroke undergoing rehabilitation. Participants were randomly allocated to usual care (control group) or usual care plus an 8-week program of moderate-high intensity treadmill walking (3 x 30 min sessions per week) (experimental …

Developing Consumer Consensus On Remote Assessment And Management Of Physical Function In Older Adults (Ramp): International Modified Delphi Process, Elsa Dent, Christopher Hurst, Jack Dalla Via, Jackson J. Fyfe, Paul Jansons, Eleanor J. Hayes, Gary Skinner, Marc Sim, Mylene Aubertin-Leheudre, Sabine Britting, Fanny Buckinx, Gavin Connolly, Lora Giangregorio, Jennifer R.A. Jones, Pauline Kelly, Robert Kob, Suzanne N. Morin, Girish Nandakumar, Lucas B.R. Orssatto, Maria Pearson, Daniel Pinto, Esmee M. Reijnierse, Catherine M. Said, Mohamed Salem, Vina P.S. Tan, Rosanna Tran

Research outputs 2022 to 2026

Background: Remote health care delivery, including the use of digital health interventions, is emerging as a tool for assessing and managing physical function, but its design and implementation often overlook the needs and preferences of older adult end users. Objective: The primary aim of this modified Delphi process was to develop consumer consensus on preferences for remote assessment and management of physical function in older adults. Methods: Research and consumer experts of the Remote Assessment and Management of Physical Function in Older Adults (RAMP) Working Group co-developed the Round 1 Delphi survey, which was advertised to consumers (adults aged ≥60 …

Do Combined Resistance And Aerobic Exercise Programs Cause An Interference Effect In Women With Breast Cancer? A Systematic Review And Network Meta-Analysis, Pedro Lopez, Anderson Rech, Maria Petropoulou, Caroline B. Silveira, Talita Molinari, Cindranne Torres Muller, Priscila Casara, Francesco Bettariga, Favil Singh, Régis Radaelli

Research outputs 2022 to 2026

Background: Exercise medicine has gained significant recognition owing to its demonstrated benefits throughout the breast cancer treatment continuum. While resistance exercise (RE) promotes improvements in lean mass and muscle strength, aerobic exercise (AE) enhances cardiorespiratory fitness, with several studies investigating both exercise modes in patients with breast cancer. However, because of an effect often referred to as interference effect, it is hypothesised that combining resistance and aerobic exercise (COMB) may compromise gains in lean mass and muscle strength and other outcomes in cancer populations. Objective: This study aims to investigate the presence of an interference effect from prescribing COMB compared …

Efficacy And Safety Of Tai Chi For Chronic Musculoskeletal Pain: A Systematic Review And Meta-Analysis, Shun Chen, Weiting Liu, Qinwei Fu, Mingyu Huang, Weilan Lin, Yanting Ding, Ming Li

Research outputs 2022 to 2026

Objectives: Tai Chi, a form of complementary intervention emphasizing breathing and mind-body connection, is increasingly recognized for its potential in pain management. This review aims to synthesize current evidence on the efficacy and safety of Tai Chi for chronic musculoskeletal pain management in adults. Design: Systematic review and meta-analysis. Data sources: AMED, EMBASE, MEDLINE, WoS, CBM, CNKI, VIP, Wanfang Databases, CENTRAL, and WHO ICTRP were searched from database inception through May 2025, with an additional supplementary search conducted in January 2026. Eligibility criteria for selecting studies: We included randomized controlled trials (RCTs) comparing Tai Chi with other interventions for chronic …

Efficacy And Effectiveness Of Melatonin For The Management Of Musculoskeletal Pain: A Systematic Review And Meta-Analysis Of Placebo And Active Controlled Trials, Kangchao Wu, Ting Him Ho, Paula R. Beckenkamp, Michelle Hall, Hanzhi Zhang, James Puterflam, Karin Due Bruun, Jianhua Lin, Christopher Gordon, Ron Grunstein, Manuela L. Ferreira, Paulo Ferreira

Research outputs 2022 to 2026

Melatonin may provide benefits for managing musculoskeletal (MSK) pain, and this review evaluated its efficacy and effectiveness on pain intensity and sleep quality. We searched 6 databases from inception to April 2025 and included randomized controlled trials in people with chronic or postoperative MSK pain reporting pain or sleep outcomes. Comparators included placebo or active controls (eg, analgesics). Random-effects meta-analyses were performed using mean differences with 95% confidence intervals. Subgroup analyses were conducted by comparator type. Sensitivity analyses included only low-risk studies. Certainty of evidence was assessed using GRADE. Twenty-three studies (2028 participants) were included. For people with chronic MSK …

Rock On Technology: Perspectives Of People With Neurological Conditions On Robot-Assisted Lower Limb And Gait Neurorehabilitation, Rachel G. Buckingham, Saran Chamberlain, Amanda Timler, Matthew K. Bagg, Nikki E. Bakhtazad, Taya Hamilton, Patricia Martinet, Bianca Haagman, Stuart I. Hodgetts, Barbara Singer, Ann Maree Vallence, Jodie Marquez, Eric Gaitho, Emma Gee, Jessica Nolan

Research outputs 2022 to 2026

Purpose: Explore perspectives of people living with neurological conditions in Western Australia (WA) on robot-assisted lower limb neurorehabilitation (RALLR), and implementation requirements. Materials and methods: This co-designed, qualitative descriptive study included people living with neurological conditions. In-person semi-structured focus groups (FGs) were facilitated by a person with lived experience of stroke. FGs were recorded, data were transcribed, and thematically analysed using a reflexive approach. Results: Five FGs included 24 participants (54.2% women, median age 50 years). Of these, thirteen participants had RALLR experience. Primary neurological conditions represented among participants comprised spinal cord injury (n = 11), stroke (n = 3), …

Effects Of Exercise Interventions On Motor Coordination In Children With Developmental Coordination Disorder (Dcd): A Systematic Review And Meta-Analysis, Changhui Peng, Jinrong He, Kai Xu, Xueping Wu, Dandan Wang, Lei Zhang

Research outputs 2022 to 2026

Background Exercise interventions are recognized as an established therapeutic approach for children with DCD. This review aims to quantify the effectiveness of exercise interventions and examine the influence of potential moderating factors on outcomes. Methods We systematically searched PubMed, Web of Science, Embase, the Cochrane Library, and EBSCO from inception to November 1, 2025. All studies were rigorously screened based on predefined eligibility criteria. Risk of bias was assessed using ROB 2 and ROBINS-I. Effect sizes were calculated as Hedges’ g (g) and pooled under a random-effects model, and potential moderators were examined through subgroup and regression analyses. Results A …

Clinician-Led, Single-Blind, Randomised Controlled Trial Evaluating The Efficacy Of A High-Intensity Resistance And Impact Training Intervention For Improving Health-Related Quality Of Life In People With Multiple Sclerosis: Protocol For Strong-Ms, Lisa Grech, Beck, David Scott, Marc Sim, Jakub Mesinovic, Paul Jansons, Fernanda Rodrigues Fonseca, Julie Abimanyi-Ochom, Michelle Allan, Stefan Blum, Ernest Butler, William Carroll, Nigel Caswell, Peter Ebeling, Vanessa Gan, Alan Herschtal, Nevin John, Allan Kermode, Linh Le-Kavanagh, Shalika Bohingamu Mudiyanselage, Lynne Elizabeth Ohman, Mia Poposka, Alison Reece, Phoebe Sansom, Charlotte Scroggie, Christopher Todaro

Research outputs 2022 to 2026

Introduction: People with multiple sclerosis (MS) engage in less physical activity and experience higher rates of osteoporosis, falls and fractures than the general population, contributing to reduced health-related quality of life (HRQoL) and increased healthcare costs. High-intensity resistance and impact training (HiRIT) has beneficial effects on bone, muscle and physical function in other populations, but its effectiveness in people with MS is unclear. Methods and analysis: STRONG-MS is a codesigned, clinician-led, single-blind, randomised controlled trial evaluating the effect of a HiRIT programme, ONERO, on HRQoL for people with MS. Secondary aims include assessing changes in bone mineral density, body composition, …