Rehabilitation and Therapy Commons^™

Kienböck's Disease In A Patient With Hemiparetic Stroke: A Casereport, Pao-Sheng Wu, Yen-Ting Cho

Rehabilitation Practice and Science

Kienböck's disease of the wrist is a multifactorial, progressive osteonecrosis of the lunate bone. Patients with this disease often complain of dorsal wrist pain and other wrist dysfunctions. Image studies are usually required for definite diagnosis; however, careful history taking and physical examination are also necessary. Treatment varies according to the stage of the disease; although surgery is needed in most of the cases, rehabilitation after the surgery seems helpful as well. Kienböck's disease is rarely seen in our daily practice, and even though we do recognize the disease, diagnosing it correctly in patients with comorbidities such as stroke is …

Evaluation Of Clinical Morbidities And Their Influence On Quality Of Life In Patients With Oral Cavity Cancer After Radiotherapy, Hao-Wei Tang, Tung-Hao Chang, Kuan-Lin Chen, Kuo-Yang Tsai, Su-Fen Liao, Wei-Te Wang

Rehabilitation Practice and Science

Background: Oral cavity cancer is the most common cancer in middle-aged men in Taiwan. Radiation fibrosis syndrome and lymphedema are the leading side effects in patients with oral cavity cancer, and can deteriorate their quality of life (QOL). The aim of this study was to prospectively evaluate common morbidities and their influences on QOL in patients with oral cavity cancer. Methods: 27 patients with oral cavity cancer who received surgery and radiotherapy (RT) were recruited. Clinical evaluations of each patient included the VAS pain scale, the lymphedema scale, facial distance measurement for lymphedema, maximal interincisal distance (MID), range of motion …

In-Season Rehabilitation Program Using Blood Flow Restriction With Therapy For Two Decathletes With Patellar Tendinopathy: A Case Report, Tyler Cuddeford, Jason Brumitt

Faculty Publications - College of Physical Therapy

Background and Purpose: Patellar tendinopathy is an overuse injury experienced primarily by athletes; especially athletes who participate in sports that involve frequent jumping. Therapeutic exercise is the primary conservative treatment for patients with this condition. However, some patients with patellar tendinopathy may be unable to tolerate the loading that occurs during exercise. The use of blood flow restriction (BFR) therapy for patients with patellar tendinopathy may allow the athlete to exercise with a lower load while still experiencing the physiological benefits associated with training at a higher intensity. The purpose of this case report was to detail the outcomes from …

Gains Across Who Dimensions Of Function After Robot-Based Therapy In Stroke Subjects, Jennifer Wu, Lucy Dodakian, Jill See, Erin Burke Quinlan, Lisa Meng, Jeby Abraham, Ellen C. Wong, Vu Le, Alison Mckenzie, Steven C. Cramer

Physical Therapy Faculty Articles and Research

Background

Studies examining the effects of therapeutic interventions after stroke often focus on changes in loss of body function/structure (impairment). However, improvements in activities limitations and participation restriction are often higher patient priorities, and the relationship that these measures have with loss of body function/structure is unclear.

Objective

This study measured gains across WHO International Classification of Function (ICF) dimensions and examined their interrelationships.

Methods

Subjects were recruited 11 to 26 weeks after hemiparetic stroke. Over a 3-week period, subjects received 12 sessions of intensive robot-based therapy targeting the distal arm. Each subject was assessed at baseline and at 1 …

Post-Stroke Cognitive Impairments And Responsiveness To Motor Rehabilitation: A Review, Jennapher Lingo Vangilder, Andrew Hooyman, Daniel S. Peterson, Sydney Y. Schaefer

Physical Therapy Faculty Articles and Research

Purpose of Review
This review discusses the prevalence of cognitive deficits following stroke and their impact on responsiveness to therapeutic intervention within a motor learning context.

Recent Findings
Clinical and experimental studies have established that post-stroke cognitive and motor deficits may impede ambulation, augment fall risk, and influence the efficacy of interventions. Recent research suggests the presence of cognitive deficits may play a larger role in motor recovery than previously understood.

Summary
Considering that cognitive impairments affect motor relearning, post-stroke motor rehabilitation therapies may benefit from formal neuropsychological testing. For example, early work suggests that in neurotypical adults, cognitive function …

Mediolateral Damping Of An Overhead Body Weight Support System Assists Stability During Treadmill Walking, M. Bannwart, S. L. Bayer, Niklas König Ignasiak, M. Bolliger, G. Rauter, C. A. Easthope

Physical Therapy Faculty Articles and Research

Background

Body weight support systems with three or more degrees of freedom (3-DoF) are permissive and safe environments that provide unloading and allow unrestricted movement in any direction. This enables training of walking and balance control at an early stage in rehabilitation. Transparent systems generate a support force vector that is near vertical at all positions in the workspace to only minimally interfere with natural movement patterns. Patients with impaired balance, however, may benefit from additional mediolateral support that can be adjusted according to their capacity. An elegant solution for providing balance support might be by rendering viscous damping along …

Return To School 1 Year After Traumatic Brain Injury: A Study Using The Traumatic Brain Injury Model Systems National Database, Kathryn Tarnai

Masters Theses, 2020-current

For many individuals, recovery from moderate to severe brain injuries involves returning to a level of pre-injury productivity. Specifically, previous research has focused extensively on factors predicting return to employment, where students are inconsistently categorized with those in competitive employment. Moreover, research dedicated to return to school for students in secondary and tertiary education is largely qualitative; very few studies have utilized predictive modeling on a sample composed solely of students. For this study, a model including days of post-traumatic amnesia (PTA), length of stay (LOS), rehabilitation discharge Disability Rating Scale (DRS) scores, and educational level was used to predict …

Bundling Payment Initiatives For Total Hip And Knee Arthroplasties: Perspectives Of Health Care Professionals, Katherine Lally, Melinda Schultze, Hannah Ehresman, Helene L. Lohman, Vanessa D. Jewell

The Open Journal of Occupational Therapy

Background: A broad qualitative research study explored the perceptions of rehabilitation health care professionals and administrative leadership on coordination of care for rehabilitation patients who received hip or knee arthroplasties under the bundling initiative.

Method: Data was collected through the conduction of a focus group, email communication, and individual phone interviews. Researchers analyzed data collected from five administrative personnel and eight rehabilitation health care professionals who work in a facility that participates in a bundling initiative payment model.

Results: Four major themes were identified: importance of care coordination, increased efficiency and effectiveness, establishing protocols, and challenges of …

Effectiveness Of Home-Based Rehabilitation Program In Minimizing Disability And Secondary Falls After A Hip Fracture: Protocol For A Randomized Controlled Trial, Anum Sadruddin Pidani, Saniya Sabzwari, Khabir Ahmad, Ata Khan, Shahryar Noordin

Department of Surgery Docs

Introduction: Hip fractures are a major health problem globally and are associated with increased morbidity, mortality, and substantial economic costs. Successful operative treatment of hip fracture patients is necessary for the optimization of post-op mobility and functional recovery of the patient. Rehabilitation after surgical stabilization of a hip fracture is crucial in order to restore pre-fracture function and to avoid long-term institutionalization. In particular ongoing exercise which targets balance can prevent up to 40% of falls. Therefore, we have designed a post-discharge home-based physical rehabilitation intervention program to minimize disability and falls in this high-risk elderly population.
Methods and analysis: …

Athletic Trainers Provide A Positive Outlet To Athletes'' Injuries And Mental State During Summer Travel Baseball Season, Jeffrey Clydesdale, J. Brett Massie, Erika Smith-Goodwin

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

Please enjoy Volume 6, Issue 1 of the JSMAHS. In this issue, you will find Professional, Graduate, and Undergraduate research abstracts, and case reports.

Thank you for viewing this 6^th Annual OATA Special Edition.

Controlled Observation: The Challenges Of Therapy For The Mentally Ill Incarcerated Population, Esther Tingué

Dissertations, Theses, and Capstone Projects

Popular perception and objective of incarceration is confinement, brutality and in some cases inhumane conditions. But what about the incarcerated population who suffer from the additional burden of mental illness? How does confinement affect mentally ill inmates? This capstone project asks: (1) how do individuals/organizations provide rehabilitative services in this evolved culture of crime and punishment? And (2) how is therapy provided in a restricted environment? I examine these questions from the perspective of the therapist, the person who (in a restricted environment) takes on the responsibility of treating and managing the effects of mental illness for this population.

Association Between Patient Ability In Activities Of Daily Living At Hospital Admission And Key Indicators, Stephanie Rosen, Amber Steele

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Illness and inactivity in the hospital frequently leads to disability that can reduce quality of life and increase costs. Early identification of people with limitations in activities of daily living (ADL) who are at risk for poor outcomes such as increased length of stay (LOS), hospital acquired conditions (i.e., falls and pressure injuries (PIs)), and discharge away from home can facilitate appropriate intervention. The Activity Measure for Post-Acute Care Inpatient Activity Short Form (AM-PAC IASF), a reliable and valid tool to measure ADL limitations, is scored at admission for all patients in our hospital. The purpose of this study …

Physical Therapy After Amputation In Community Dwelling Older Adults: A Quantitative And Qualitative Interview Study, Amanda Ferraro, Jennifer Gorton, Lindsey Horn, Michaela Kubo

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis: To investigate participation in physical therapy in older adults after lower extremity limb loss. The secondary objective was to examine the associations between physical therapy attendance, fear of falling avoidance behavior, self-perceived prosthetic mobility, and mental well-being. Number of Subjects: 64 Materials and Methods: Community-dwelling older adults with amputation were recruited and individually interviewed. The data collection consisted of four surveys (Physical Therapy after Amputation Patient Perception Survey, Short-Form Health Survey [SF-36v2], Prosthetic Evaluation Questionnaire [PEQ, mobility group], and Fear of Falling Avoidance Behavior Questionnaire [FFABQ]). Participants' demographic characteristics were analyzed using descriptive statistics. Participant comments were qualitatively categorized. …

Are All Instrumental Activities Of Daily Living Equal? A Pilot Study On The Performances Of Adults With Acquired Brain Injury, Crystal Lee, Samantha Schauer, Amy Tam, Yareli Vargas

Occupational Therapy | MSOT Capstone Projects

Aim: To determine if a relationship exists among performances of different instrumental activities of daily living (IADLs) in adults with acquired brain injury (ABI).

Methods: A two-group correlational design was used to examine the relationship among performances in cooking, medication management, and financial management in nine adults with ABI who returned to driving and nine adults with ABI who did not return to driving. The Executive Function Performance Test (EFPT) measured initiation, organization, sequencing, judgment and safety, and completion.

The Effects Of Bilingualism In Post-Stroke Aphasia Patients: Clinical Implications Within The United States, Kristen Bennett

Undergraduate Honors Theses

The consistent increase of cultural diversity and immigration within the United States over the last fifty years has contributed to a societal shift towards a growing bilingual population. The growth of this population has generated a need to evaluate current assessment and treatment plans for bilingual post-stroke aphasia patients within the United States to ensure that these individuals are receiving effective healthcare. This study aims to investigate the current knowledge gap surrounding appropriate methods of assessing and treating bilingual post-stroke aphasia patients within the United States and suggest potential approaches based on existing research. In order to synthesize information regarding …

The Effectiveness Of Lsvt-Big And Pwr! Programs On A Patient With Parkinson’S Disease: A Case Report, Naureen Imam, Jennifer Dannenbring

San Marcos, Spring 2020

Background: The prevalence of Parkinson’s Disease (PD) drives the search for effective interventions. While LSVT-BIG and high-intensity training improve gait speed and balance deficits, only limited research exists on the impact of the Parkinson's Wellness Recovery (PWR!) program on PD symptoms. Thus, LSVT-BIG and PWR! should be explored in tandem as standardized treatment for patients with PD.

Purpose: The primary purpose of this case report is to determine the effects of LSVT-BIG and PWR! programs on gait impairments, balance deficits, and participation restrictions in a patient with PD.

Case Description: A 74-year old male with PD attended PT …

Aota Continuing Education: Occupational Therapy’S Role In Addressing Sexuality And Intimacy, Tiffany E. Lee, Jacqueline M. Marquez

OTD Capstone Projects

The purpose of this capstone project was to create a continuing education course for the American Occupational Therapy Association (AOTA) on the topic of OT’s role in addressing sexuality and intimacy. The topic of sexuality and intimacy is often under-addressed by healthcare professionals, despite its importance to clients. According to the Occupational Therapy Practice Framework, engagement in sexual activity is not only an ADL, but can be a key aspect of social participation in the context of familial and peer/ friend roles. Therefore, it is well within OT’s scope of practice to address sexuality and intimacy with clients. However, there …

Walking Kinematics In Young Children With Limb Loss Using Early Versus Traditional Prosthetic Knee Prescription Protocols, Mark Daniel Geil, Zahra Safaeepour, Brian Giavedoni, Colleen Coulter

Faculty Articles

The traditional treatment protocol for young children with congenital or acquired amputations at or proximal to the knee prescribes a prosthesis without a working knee joint, based in part on the assumption that a child learning to walk cannot properly utilize a passively flexing prosthetic knee component. An alternative to this Traditional Knee (TK) protocol is an “Early Knee” (EK) protocol, which prescribes an articulating prosthetic knee in the child’s first prosthesis, during development of crawling and transitioning into and out of upright positions. To date, no study has compared samples of children with limb loss at or proximal to …

Effects Of A Rehabilitation Program For Individuals With Chronic Spinal Cord Injury In Shanghai, China, Fengshui Chang, Qi Zhang, Haixia Xie, Yuhui Yang, Mei Sun, Airong Wu, Jinghua Wu, Gang Chen, Feng Shen, Chengyue Li, Jun Lu

Community & Environmental Health Faculty Publications

Background: Specialized Institution-Based Rehabilitation (SIBR) is the cornerstone of care and treatment for individuals with spinal cord injury, but most people with chronic spinal cord injury (CSCI) living in China have no SIBR experience after acute care hospital discharge. In 2009, an SIBR facility was set up in Shanghai (China) to fill this important gap in care. The purpose of the study was to evaluate the effectiveness of an integrated rehabilitation training program among individuals with CSCI living in Shanghai.

Methods: A within-subject pre-posttest design was used to evaluate the SIBR. The sample included 455 individuals ≥1 year post-SCI, who …

Comparison Of Pre- And Post-Operative Shoulder Muscle Emg Profiles In Reverse Total Shoulder Arthroplasty Patients, Emily Lau, Sreten Franovic, Noah Kuhlmann, Eric C. Makhni Md, Stephanie Muh Md

Medical Student Research Symposium

Background: Deltoid muscle function is central in reverse total shoulder arthroplasty (RTSA) function; however, there is limited information available regarding changes in deltoid activity before and after surgery. Few tests exist to evaluate specific muscle metrics pre and post operatively. Surface Electromyographic (EMG) is non-invasive and allows for observation of motions with multifaceted analysis of movement with minimal patient demand. Understanding the changes in shoulder muscle activation, namely in the deltoid, in patients pre and post-RTSA can further advance understanding of the procedure and rehabilitation efforts.

Methods: Nine individuals were recruited for this study: all patients underwent RTSA by a …

A Randomized Feasibility Trial Of A Novel, Integrative, And Intensive Virtual Rehabilitation Program For Service Members Post-Acquired Brain Injury., Kiara H Buccellato, Michelle Nordstrom, Justin M Murphy, Grigore C Burdea, Kevin Polistico, Gregory House, Nam Kim, Namrata Grampurohit, Jeff Sorensen, Brad M Isaacson, Paul F Pasquina

Department of Occupational Therapy Faculty Papers

INTRODUCTION: Acquired Brain Injury, whether resulting from Traumatic brain injury (TBI) or Cerebral Vascular Accident (CVA), represent major health concerns for the Department of Defense and the nation. TBI has been referred to as the "signature" injury of recent U.S. military conflicts in Iraq and Afghanistan - affecting approximately 380,000 service members from 2000 to 2017; whereas CVA has been estimated to effect 795,000 individuals each year in the United States. TBI and CVA often present with similar motor, cognitive, and emotional deficits; therefore the treatment interventions for both often overlap. The Defense Health Agency and Veterans Health Administration would …

Strategic Planning For A Psychosocial Occupational Therapy Program: A Swot Analysis, Kellie Roy

OT Student Capstones

PURPOSE

To examine and evaluate the Northern Arizona Veterans Affairs Healthcare System (NAVAHCS) psychosocial occupational therapy (OT) program using a SWOT analysis to inform solution-oriented strategies for future directions of the program.

Pilot Evaluation Of The Usability And Utility Of A Wearable Technology To Monitor And Evaluate Health Condition, Drew Nielsen, David Shipon, Md, Facc, Facp

Phase 1

Introduction: Cardiac rehabilitation programs have particularly poor attrition and rehospitalization from cardiac-related events is a large burden on the medical system, as 8.9% of patients who have acute MI are rehospitalized within one year. External barriers may exist that prevent patients from adequately completing in-house cardiac rehabilitation, which makes them strong candidates for a home-based rehab program (HBCR). Previous randomized trials have generated evidence that HBCR can achieve similar cardiac improvements in 3- 12-month clinical outcomes. With the large-scale adoption of wearable technologies, with an estimated 8.2 million devices owned by individuals over 55, we have an opportunity to incorporate …

The Effect Of Intermittent Theta Burst Stimulation On Biceps Corticomotor Excitability In Non-Impaired Individuals And Individuals With Tetraplegia, Blaize Majdic

Theses and Dissertations

Neuromodulation of the primary motor cortex (M1) in pair with physical therapy may be a promising method for improving motor outcomes after spinal cord injury (SCI). Increased excitability of the corticospinal motor pathways (i.e. corticomotor excitability) has shown to be associated with improved motor learning and skill acquisition. Intermittent theta burst stimulation (iTBS) is a form of non-invasive brain stimulation which can increase corticomotor excitability, as measured by an increase in the amplitude of motor evoked potentials (MEPs). However, the ability for iTBS to increase the corticomotor excitability of proximal muscles such as the biceps, and muscles affected by spinal …

Determinants Of Stroke Inpatient Charge In Chronic Rehabilitation Wards Of A Community Hospital In Taiwan, Allen C.L. Hsu, Miao-Ming Chen, Chih-Kuang Chen

Rehabilitation Practice and Science

Stroke is a disease with severe consequences which impose a considerable socio-economic burden on patients and society. In developed countries, stroke patients alone generate about 3-4% of the direct costs within the healthcare system. The costs of rehabilitation and long-term care of disabled stroke survivors are expected to rise even further because of the increasing number of the aging population and declining stroke case-fatality rates. The aims of the paper are to evaluate the factors that may influence costs of stroke patients in chronic rehabilitation wards for better management of medical resources. This study was conducted at a local general …

Effectiveness Of Post-Acute Rehabilitation On Functional Outcome After Hip Fracture, Yen-Ju Wang, Pei-Hsin Lin, Li-Ning Peng, Mu-Jung Kao, Serena Y.C Lin, Kuan-Hua Huang, Yen-Fang Chen, Miao-Ru Liang

Rehabilitation Practice and Science

Objective: We investigated the effectiveness of functional recovery after 2-week post-acute rehabilitation in elderly people with hip fractures. Design: We divided the patients (N = 129) into 2 groups: the post-acute care (PAC) group (N = 90) that received 2-week in-hospital rehabilitation and the control group (N =39) that were discharged immediately. Outcomes were measured according to the Barthel Index (BI) score. Results: The BI scores at 2 weeks, 3 months, and 6 months were higher in the PAC group than those in the control group, especially for transfer and mobility. Males, aged less than 80 years old, or who …

Factors Influencing The Use Of Inpatient Rehabilitation Services Among Amputees In Acute Hospitals: An Observational Study, Ya-Ling Huang, Ming-Chung Yang, Chun-Chieh Wu, Tung-Chou Li

Rehabilitation Practice and Science

Objective: To examine rates of inpatient rehabilitation (IR) use in a nationwide amputee and determine factors associated with receiving rehabilitation services during acute admission. Methods: This research is a retrospective observational study. We sampled data from a nationally representative sample of 1,000,000 enrollees of the single-payer government-based National Health Insurance (NHI) program in Taiwan from 1996 to 2013. Claims data for rehabilitation during index admission after amputation were analyzed, and factors associated with IR use were identified. Multivariable logistic regression was performed with adjustment for clustering to identify which factors were independently associated with acute IR referral. Results: Among the …

Impact Of Motor Therapy With Dynamic Body-Weight Support On Functional Independence Measures In Traumatic Brain Injury: An Exploratory Study, Emily F. Anggelis, Elizabeth Salmon Powell, Philip M. Westgate, Amanda C. Glueck, Lumy Sawaki

Physical Medicine and Rehabilitation Faculty Publications

BACKGROUND: Contemporary goals of rehabilitation after traumatic brain injury (TBI) aim to improve cognitive and motor function by applying concepts of neuroplasticity. This can be challenging to carry out in TBI patients with motor, balance, and cognitive impairments.

OBJECTIVE: To determine whether use of dynamic body-weight support (DBWS) would allow safe administration of intensive motor therapy during inpatient rehabilitation and whether its use would yield greater improvement in functional recovery than standard-of-care (SOC) therapy in adults with TBI.

METHODS: Data in this retrospective cohort study was collected from patients with TBI who receive inpatient rehabilitation incorporating DBWS (n = …

Réadaptation Au Travail Chez Les 45 Ans Et Plus Dans Le Secteur De La Santé Et Des Services Sociaux, Carl-Ardy Dubois, Kathleen Bentein, Alain Marchand

Rapports de recherche scientifique

Au Québec, les 45 ans et plus représentent une part croissante de la main-d'œuvre du secteur de la santé et des services sociaux. Pour assurer l’équilibre nécessaire entre la demande croissante de services de santé et l’offre de main-d’œuvre dans ce contexte de changement sociodémographique, les organisations du secteur font face au défi d’optimiser la participation au travail des plus âgés. Cela exige non seulement la prise en charge efficace des situations incapacitantes au travail chez les 45 ans et plus, mais aussi la prévention de ce type de lésions et le maintien ou la réinsertion en emploi de ceux …

Muscle Activation Patterns During Movement Attempts In Children With Acquired Spinal Cord Injury: Neurophysiological Assessment Of Residual Motor Function Below The Level Of Lesion., Darryn A Atkinson, Laura Mendez, Natalie Goodrich, Sevda C Aslan, Beatrice Ugiliweneza, Andrea L Behrman

Physical Therapy Collection

Introduction: Characterization of residual neuromotor capacity after spinal cord injury (SCI) is challenging. The current gold standard for measurement of sensorimotor function after SCI, the International Society for Neurological Classification of Spinal Cord Injury (ISNCSCI) exam, seeks to determine isolated intentional muscle activation, however many individuals with SCI exhibit intentional movements and muscle activation patterns which are not confined to specific joint or muscle. Further, isolated muscle activation is a feature of the neuromuscular system that emerges during development, and thus may not be an appropriate measurement standard for children younger than 6.

Methods: We utilized neurophysiological assessment …