Rehabilitation and Therapy Commons^™

Objective Biomarker Development For Parameter Optimization In Neuromodulation Using High-Density Emg Temporal And Spatial Features, Shirin Madarshahian, Nikoo Javadpour, Michael Trakhtorchuck, Tatiana Guerrero-David, Kristin Gustafson, James Harrop, Caio Matias, M. J. Mulcahey, Alessandro Naopli, Alex R. Vaccaro, Mijail Serruya

Farber Institute for Neuroscience Faculty Papers

Transcutaneous spinal cord stimulation (tSCS) is a promising neuromodulation approach for motor recovery after spinal cord injury (SCI), yet clinical programming remains largely dependent on subjective parameter selection. This study evaluated high-density surface EMG (HD-sEMG)–derived spatial and temporal features as objective biomarkers for tSCS optimization in three adults with chronic cervical SCI. A 64-channel electrode array recorded stimulation-evoked responses across five cervical stimulation levels, four pulse widths, and graded amplitudes. Features describing activation magnitude, spatial distribution, cluster morphology, and temporal dynamics were extracted from epoch-based activation maps. Of the three enrolled participants, two demonstrated measurable stimulation-evoked responses and contributed to …

The Necessity Of Adaptive Sports: Addressing Financial Barriers To Participation In Children With Spinal Cord Injuries, Megan G. Wells

Student Capstone Papers

 Children with spinal cord injuries (SCIs) experience numerous barriers to participation in adaptive sports despite the well-established physical, psychosocial, and developmental benefits of physical activity. Financial constraints, limited awareness of funding opportunities, and the complexity of grant application processes often prevent families from accessing adaptive sports programs and specialized equipment. The purpose of this doctoral capstone project was to develop a comprehensive financial guidebook for families of children with SCIs to address financial barriers to adaptive sports participation, promote physical activity, and improve overall quality of life. Guided by the Person-Environment-Occupation-Performance (PEOP) model, this doctoral capstone project addressed financial accessibility …

Advancing Health Equity In Women With Sci Through Ob/Gyn Provider Education, Nethra S. Ankam, Md, Amanda Parezo, Otd, Otr/L, Beth I. Schwartz, Md, Trisha Hicks, Lsw, Med

Department of Rehabilitation Medicine Training Videos and Materials

Background

Individuals with spinal cord injury (SCI) experience persistent disparities in reproductive healthcare access. OB-GYN providers often report limited training and discomfort in addressing these needs. These gaps contribute to inequitable care, reduced patient satisfaction, and missed opportunities for patient-centered care.

Purpose

To develop, implement, and disseminate an evidence-informed educational module aimed at improving OB-GYN provider knowledge, confidence, and clinical competence in delivering accessible, inclusive, and patient-centered reproductive healthcare for individuals with SCI.

Methods

• Community Advisory Board (CAB) engagement 
• Needs assessment survey (SCI population)
• Iterative module development
• Articulate Rise module creation
• Implementation across interdisciplinary providers

Results/Outcomes

Reach & Implementation

• 18 …

Exploring Outcomes For Patients With Spinal Cord Injuries Participating In A Day Treatment Program, Christina Kane, Alexa Chappell, Kristen Frack, Sarah Salluom, Brittany Meurs

Occupational Therapy Annual Research Colloquium

Purpose: This study explored program outcomes of the Brooks Spinal Cord Injury & Related Disorders Day Treatment Program in Jacksonville, Florida. By examining secondary data, using both the Self-Reported Functional Measure (SRFM) and the Spinal Cord Independence Measure–III (SCIM-III), researchers determined the change between admission and discharge scores in both patient- and therapist-reported outcomes of self-care skills. This study also studied if a correlation existed between the SRFM (patient-reported) and SCIM-III (therapist-reported) outcomes.

Participants: Data from 49 participant records were collected in 2022-2023, with 42 participants data qualifying for this study.

Methods: Using secondary de-identified data, statistical analyses were conducted …

Post Spinal Cord Injury (Sci) Related Depression And Anxiety, Felecia Marshall

Lynchburg Journal of Medical Science

This article aims to examine the prevalence, significant factors, and clinical significance of depression and anxiety in individuals with spinal cord injury (SCI). Depression and anxiety are common after an SCI. These problems are difficult to recover from and, as such, can have a negative impact on a patient’s quality of life. This article stresses the need for early diagnosis and treatment with both cognitive behavioral therapy and pharmacological treatments for those with SCI. Mental health can be improved through this method. A comprehensive search of studies in PubMed was conducted. In 10 peer-reviewed articles, researchers uncovered findings concerning the …

Evaluating Virtual Group Coaching’S Impact On Self-Determination In Spinal Cord Injury, Alana Scalzo, Ms, Otr/L

Post-Professional Occupational Therapy Doctorate Culminating Presentations

Introduction: Spinal cord injury (SCI) is a lifelong condition that requires effort and adjustment for managing physical, psychological, and social well-being to have the ability to engage in meaningful activities. As people living with SCI have higher rates of isolation and social disconnect, it is important to study group level approaches for addressing mental health.

Objectives: To determine the impact of virtual group coaching to enhance occupational performance, satisfaction, self-efficacy and relationship closeness in people living with SCI.

Methods: A quasi-experimental single-group pre/post-test design was used. Adults with SCI were recruited through online flyers, social media, newsletters, support groups, clinics, …

A Guide To Sexual Intimacy Following Spinal Cord Injury, Jillian M. Olenick

Entry Level Occupational Therapy Doctoral Capstone Projects Class of 2025

A Guide to Sexual Intimacy Following Spinal Cord Injury is a two-part manual that was created to increase the knowledge related to how sex can be impacted following a spinal cord injury. The first manual was created as a guide for individuals with spinal cord injuries and their partners to enhance their knowledge on how their spinal cord injury may impact their sexual functioning. The second manual was created as a guide for occupational therapy practitioners to use as a resource when addressing sex with their clients following a spinal cord injury. Each manual provides information related to sexual intimacy, …

Brivaracetam For Spinal Cord Injury-Related Neuropathic Pain: Results Of A Pilot Double-Blinded, Randomized, Placebo-Controlled Clinical Trial, Leslie R. Morse, Ricardo A. Battaglino, Nguyen Nguyen, Brian Devries, Abigail Welch, Ana Lucia Battaglino, Clas Linnman, Michael Stillman, Robert Wudlick, Joda Glossner, Grant Anderton, Richard Goldstein, Scott P. Falci

Department of Medicine Faculty Papers

OBJECTIVE: Assess feasibility, safety, and tolerability of 3 months of oral brivaracetam for severe (9-10/10) spinal cord injury-related neuropathic pain.

METHODS: We conducted a multisite pilot study where adults were randomized to 3 months of brivaracetam (100 mg BID) or placebo. Pain was assessed via the Brief Pain Inventory, the International Spinal Cord Injury Pain Basic Dataset (version 2.0), and a daily pain diary.

RESULTS: We enrolled 24 participants across 2 sites and 14 participants were included in the final analysis (n = 8 placebo, n = 6 brivaracetam). The drug was tolerated with expected, nonserious side effects (nausea if …

Educational Program For Individuals With Spinal Cord Injuries Over Bowel And Bladder Management, Hannah H. Bacino, Rebecca King, Leah Holderbaum

Spring 2025 OTD Capstone Symposium

A spinal cord injury (SCI) is a life-altering event that impacts many domains of an individual's life. Individuals may experience a decreased ability to participate in meaningful activities and a loss of voluntary body functions. The most common symptom following an SCI is loss of voluntary bowel and bladder control. Literature highlights the importance of education on bowel and bladder management following a SCI. However, there is a lack of accessible and comprehensive education on this topic for individuals affected by an SCI. To address this problem, an educational resource was created. The purpose of the educational resource was to …

The Role Of Occupational Therapy In Bladder And Bowel Management For Individuals With Spinal Cord Injuries: An Educational Video Series, Julia Ryan

Student Capstone Papers

Occupational therapy (OT) practitioners are uniquely positioned to support individuals with spinal cord injury (SCI) in developing effective bowel and bladder management (BBM) routines. However, most existing literature approaches BBM from a medical perspective, offering limited guidance on how to translate occupation-based strategies into OT practice. This lack of discipline-specific resources contributes to reduced confidence among generalist practitioners and hinders the consistent implementation of BBM interventions across inpatient and community settings. To address this gap, a nine-part educational video series was developed to enhance OT practitioners’ knowledge, clinical reasoning, and confidence in delivering BBM interventions for clients with SCI. The …

The Role Of Occupational Therapy In Bladder And Bowel Management For Individuals With Spinal Cord Injuries: An Educational Video Series, Julia Ryan, Steven Gerardi, Heather Rennerfeldt

Spring 2025 OTD Capstone Symposium

Occupational therapy (OT) practitioners are uniquely positioned to support individuals with spinal cord injury (SCI) in developing effective bowel and bladder management (BBM) routines. However, most existing literature approaches BBM from a medical perspective, offering limited guidance on how to translate occupation-based strategies into OT practice. This lack of discipline-specific resources contributes to reduced confidence among generalist practitioners and hinders the consistent implementation of BBM interventions across inpatient and community settings. To address this gap, a nine-part educational video series was developed to enhance OT practitioners’ knowledge, clinical reasoning, and confidence in delivering BBM interventions for clients with SCI. The …

Leveraging Clinical Standards To Improve The Translational Relevance Of Therapies For Experimental Spinal Cord Injury, Aaron L. Silverstein

Theses and Dissertations--Neuroscience

Efforts to improve treatment of spinal cord injury (SCI) often use animals to develop effective therapeutics, intending to improve the survival and the quality of life of persons with SCI. Over half of all SCIs in the United States occur at the cervical level and often cause locomotor deficits and life-threatening breathing dysfunction. Thus, my dissertation is focused on this important patient population.

After beginning with a description of translational research and surveying SCI from a clinical standpoint, I turned to describe experimental models of cervical SCI and more detailed neuroimmunological findings relevant to my work. Then, I conducted a …

The Impact Of Social Participation Through Adaptive Sports On Quality Of Life In Individuals With Spinal Cord Injury, Mikayla Martin, Zeida Gutierrez

Spring 2025 OTD Capstone Symposium

This project researched and explored how socialization through adaptive sports in this case impacts the perception of quality of life among individuals who have sustained a spinal cord injury.

Remote Functional Assessment: Experiences Of People Living With Spinal Cord Injury, Adrian David, Mot, Otr/L

Post-Professional Occupational Therapy Doctorate Culminating Presentations

Background: As telerehabilitation gains traction in occupational therapy, validating functional measures is crucial. Understanding clients' views on telehealth is essential, yet literature on spinal cord injury (SCI) in this context is sparse.

Objective: This study aims to describe the experiences of people living with SCI regarding remote and in-person functional testing.

Methods: A qualitative design was used, involving participants from a previous study validating the GRASSP, SCIM, and SCI-MovIN for remote use. Semi-structured interviews explored experiences, and transcripts were coded for thematic analysis. Twenty-five individuals with SCI, aged 18-80 and at least nine months post-injury, were included.

Results: Four themes …

Defining The Peripheral Plasticity Of Nociceptive Afferents Following Spinal Cord Injury And Physical Therapy Intervention., Morgan Julianna Forston

Electronic Theses and Dissertations

The focus of this dissertation is to explore the peripheral plasticity of nociceptive afferents following spinal cord injury (SCI) and whether it is exacerbated or induced when physical therapy-based muscle stretching, a therapy we have shown to be detrimental to locomotor recovery in rodents, is implemented post-SCI. Chapter I provides a brief introduction on sensory afferents with particular emphasis on nociceptive afferents and their multifaceted role within the peripheral and central nervous systems. Chapter II describes SCI epidemiology and common sensory related complications that occur in patients as well and pharmaco- and physical therapies that are employed post-SCI. Chapter III …

Response: Use Of The Wisci-Ii Score In Assessing Outcome Of Intensive Robot-Assisted Gait Training In Spinal Cord Injury, Dylan J. Edwards, A. Jayaraman

Research outputs 2022 to 2026

No abstract provided.

Outdoor Recreation For People With Spinal Cord Injuries: An Educational Video Series, Siarra Walker

Student Capstone Papers

More than 15 million people globally are living with spinal cord injury (SCI). Only half of people with SCI engage in leisure activities and approximately 71% of the population reports dissatisfaction in their leisure participation. There are numerous intrinsic and extrinsic barriers that lead to these significant declines in leisure exploration and participation, including lack of knowledge and inaccurate accessible online information. In correlation with these barriers, occupational therapy practitioners underutilize leisure participation during the rehabilitation process for people with SCI and this is an underreported topic in the literature. Occupational therapy practitioners and people with SCI lack knowledge of …

Disaster Planning For People With Spinal Cord Injury: An Educational Video Series, Kayla Webre, Steven M. Gerardi Phd, Otd, Mss, Otr, Eric Hicks Phd, Ms, Otr

Summer 2024 OTD Capstone Symposium

A spinal cord injury is classified as an impairment of the nerves that compose the spinal cord. A spinal cord injury can affect the motor and sensory pathways below the level of the injury. As a result, people with spinal cord injury experience physical, emotional, and environmental barriers. Furthermore, they experience an increase in health-related issues such as autonomic dysreflexia, changes in the bowel and bladder system, pressure wounds, and difficulty regulating body temperature. However, these comorbidities are often exacerbated during a natural disaster. Additionally, the physical and environmental barriers continue to influence this population in times of disaster. The …

Outdoor Recreation For People With Spinal Cord Injuries: An Educational Video Series, Siarra N. Walker, Steven M. Gerardi, Heather Rennerfeldt

Summer 2024 OTD Capstone Symposium

More than 15 million people globally are living with spinal cord injury (SCI). Only half of people with SCI engage in leisure activities and approximately 71% of the population reports dissatisfaction in their leisure participation. There are numerous intrinsic and extrinsic barriers that lead to these significant declines in leisure exploration and participation, including lack of knowledge and inaccurate accessible online information. In correlation with these barriers, occupational therapy practitioners underutilize leisure participation during the rehabilitation process for people with SCI and this is an underreported topic in the literature. Occupational therapy practitioners and people with SCI lack knowledge of …

Occupational Therapy's Role For Individuals With Long-Term Neurological Conditions, Courtney Ahle

Department of Occupational Therapy Entry-Level Capstone Projects

No abstract provided.

Sex Differences In Spontaneous Respiratory Recovery In Chronic Hemisection, Taylor C. Holmes, Nicole M. Popp, Carley F. Hintz, Isabell Dobrzycki, Carolyn J. Schmitz, Kaylyn A. Schwichtenberg, Elisa J. Gonzalez-Rothi, Christopher W. Sundberg, Kristi A. Streeter

Physical Therapy Faculty Research and Publications

Respiratory deficits after C2 hemisection (C2Hx) have been well documented through single-sex investigations. Although ovarian sex hormones enable enhanced respiratory recovery observed in females 2 wk post-C2Hx, it remains unknown if sex impacts spontaneous respiratory recovery at chronic time points. We conducted a longitudinal study to provide a comprehensive sex-based characterization of respiratory neuromuscular recovery for 8 wk after C2Hx. We recorded ventilation and chronic diaphragm electromyography (EMG) output in awake, behaving animals, phrenic motor output in anesthetized animals, and performed diaphragm muscle histology in chronically injured male and female rodents. Our results show that females expressed a greater recovery …

Reliability Of The International Spinal Cord Injury Physical Therapy-Occupational Therapy Basic Data Set, Edelle C. Field-Fote, Kim D. Anderson, Maclain Capron, Ruediger Rupp, Linda Jones, M. Schmidt-Read, Vanessa K. Noonan, Anne Bryden, Sara Mulroy, Walter Weiss, Mario Widmer, Henrik Hagen Poder, Vivien Jørgensen, Eimear Smith, Mariel Purcell, Fin Biering-Sørensen

Department of Rehabilitation Medicine Faculty Papers

In interventional clinical trials for persons with spinal cord injury (SCI), the influence of experimental biological, pharmacological, or device-related interventions must be differentiated from that of physical and occupational therapy interventions, as rehabilitation influences motor-related outcomes. The International Spinal Cord Injury (ISCI) Physical Therapy–Occupational Therapy Basic Data Set (PT-OT BDS) was developed with the intent to track the content and time of rehabilitation interventions that are delivered concurrently with experimental interventions. We assessed the reliability of the PT-OT BDS based on agreement between users. Following an online training session, physical therapists (PTs) and occupational therapists (OTs) from 10 SCI clinical …

Neurorehabilitation With Vagus Nerve Stimulation: A Systematic Review, Radha Korupolu, Alyssa Miller, Andrew Park, Nuray Yozbatiran

Faculty, Staff and Student Publications

OBJECTIVE: To systematically review vagus nerve stimulation (VNS) studies to present data on the safety and efficacy on motor recovery following stroke, traumatic brain injury (TBI), and spinal cord injury (SCI).

METHODS: Data sources: PubMed, EMBASE, SCOPUS, and Cochrane.

STUDY SELECTION: Clinical trials of VNS in animal models and humans with TBI and SCI were included to evaluate the effects of pairing VNS with rehabilitation therapy on motor recovery.

DATA EXTRACTION: Two reviewers independently assessed articles according to the evaluation criteria and extracted relevant data electronically.

DATA SYNTHESIS: Twenty-nine studies were included; 11 were animal models of stroke, TBI, and …

Restoring Meaning Through Leisure: Exploring The Benefits Of Leisure-Focused Occupational Therapy For Individuals With Neurological Diagnoses, Elizabeth Rose Stoutland

Occupational Therapy Capstone Presentations

There are limited findings in occupational therapy literature on leisure, despite being a highly meaningful area of occupation that has implications for both physical and mental health. This poster describes an occupational therapy Capstone experience in adaptive sports and inpatient rehabilitation at a Veterans Affairs Medical Center related to leisure restoration. The student investigated the role of occupational therapy in restoring leisure and recreation for individuals with neurological conditions and achieved the following main goals: (Goal 1) to gain skills in adaptive recreation for individuals with neurological conditions, and (Goal 2) to determine how leisure exploration can be implemented in …

Enhancing Rehabilitative Services For The Spinal Cord Injury Population In Northeast Arkansas, Emily Nichols

Occupational Therapy Doctoral Capstones

The student promoted occupational justice by enhancing the spinal cord injury population’s access to quality care services in an inpatient rehabilitation facility.

Treatments Perceived To Be Helpful For Neuropathic Pain After Traumatic Spinal Cord Injury: A Multicenter Cross-Sectional Survey Study, Thomas N Bryce, Chung-Ying Tsai, Andrew D Delgado, Sara J Mulroy, Abigail Welch, Diana D Cardenas, Heather B Taylor, Elizabeth R Felix

Faculty, Staff and Student Publications

DESIGN: Cross-sectional survey.

OBJECTIVE: To evaluate the perceived helpfulness of pharmacological and non-pharmacological interventions and their combinations for neuropathic pain (NeuP) and subcategories of NeuP after spinal cord injury (SCI).

SETTING: Six Spinal Cord Injury Model System Centers.

METHODS: Three hundred ninety one individuals at least one year post traumatic SCI were enrolled. A telephone survey was conducted to determine the pharmacologic and non-pharmacologic treatments used in the last 12 months for each participant's three worst pains, whether these treatments were "helpful", and if currently used, each treatments' effectiveness.

RESULTS: Two hundred twenty participants (56%) reported 354 distinct NeuPs. Pharmacological …

Increasing Social Inclusion And Engagement Of Exercise For Individuals With Spinal Cord Injuries: A Universal Resource Development For Wellness Facilities, Alexa Hall

Entry-Level Occupational Therapy Doctorate - Doctoral Capstone Symposium

Individuals with spinal cord injuries (SCIs) are 1.5 times more likely to disengage in exercise one-year post-injury despite 80% of these individuals agreeing that exercise is critical to their overall health and quality of life (Baehr. Et al., 2022). A needs assessment was conducted on why the lack of engagement in exercise exists for individuals with SCIs within fitness facilities to identify barriers preventing participation. A quality improvement program called the Spinal Cord Injury Wellness Toolkit was created based off these findings and implemented at the MUSC Wellness Center. 14 individuals with SCIs participated at wellness center; REDCap surveys were …

Arm And Hand Functional Priorities Of Individuals With Tetraplegia, Ashley Giffen

Occupational Therapy Doctoral Student Capstone Posters

This research-based capstone conducted at MetroHealth Rehabilitation Institute determined specific functional arm and hand priorities among individuals with tetraplegia. The identification of these client values will inform the development of future rehabilitation processes and technological advancements to improve overall quality of life.

Occupational Therapy Practitioners’ Perspectives On Pain Management Following Spinal Cord Injury, Helen Saul

Occupational Therapy Doctoral Student Capstone Posters

This capstone was done in collaboration with MetroHealth Rehabilitation Institute and Cleveland State University. This qualitative study explored the role of occupational therapy in pain management for individuals with spinal cord injuries. The specific strengths, weaknesses, opportunities, and threats of the profession were evaluated to enhance service delivery.

Addressing Burnout Among Caregivers Of People With Spinal Cord Injury, Rachael Vance

Occupational Therapy Doctoral Student Capstone Posters

This capstone, completed at Louis Stokes Cleveland Veterans Affairs Medical Center, involved the implementation of a 6-week occupational therapy program to address the mental health needs of veterans with spinal cord injury. As part of this program, a needs assessment was conducted to explore the mental health needs of their caregivers. Findings of the program and needs assessment were presented to an interdisciplinary team.