Rehabilitation and Therapy Commons^™

Evolution Of Occupational Therapy Practice: Life History Of Marsha Waind, Otr/L, Patrick Finnegan, Jared Skoog

Oral History Posters

This project, one of 29 life history interviews which are a part of a larger project, is titled Life Histories of Individuals Who Have Been Influential in Developing Occupational Therapy (OT) in North Dakota and Wyoming. The purpose of the project is to gather information about the history and evolution of occupational therapy (OT) practice in North Dakota and Wyoming through life histories of individuals who have been influential in developing OT in these two states. It is anticipated that the life history process will be a powerful way to gather this information. This study is intended to provide current …

Complex Regional Pain Syndrome Type I Treated With Active Release Technique, Kathleen Hughes, James M. Mckivigan

College of Health & Human Services (TUN) Publications and Research

This report describes the examination, intervention, and outcome for a patient with CRPS type I treated with ART®. The patient was diagnosed with CRPS following a grade II ATFL sprain. For two months, treatment consisted of weekly 45-minute sessions including ART® in combination with self-massage, desensitization, joint mobilization, gait training, therapeutic exercise, and patient education. A brief reexamination was performed weekly. A clinically significant increase of 13 points on the LEFS was measured after eight weeks of treatment, as were improvements in quality of gait and gait distance. In addition, the patient experienced the return of ankle range of motion …

Efficacy Of Yoga Therapy In Treating Low Back Pain, James M. Mckivigan

College of Health & Human Services (TUN) Publications and Research

Background: Non-specific low back pain is a frequent condition that is often treated using non-pharmaceutical interventions such as exercise therapy. Yoga is one popular form of mind-body workout that can be applied to treat nonspecific low back pain.

Objective: To evaluate the impact yoga as a treatment therapy for chronic non-specific low back pain has on pain and functional ability in comparison to no exercise or the prescription of medication.

Search Methods: A review of existing studies that described randomized control trials that focused on the treatment of chronic low back pain with yoga and were published …

Occupational Therapy Students’ Self-Efficacy, Experience Of Supervision, And Perception Of Meaningfulness Of Level Ii Fieldwork, Lynne Andonian

Faculty Publications

Background: This study explored the relationship of perceived self-efficacy to demographic and fieldwork variables for occupational therapy (OT) students. Self-efficacy is related to student and employee success and competency.Methods: OT students (n = 306) from 42 OT programs in the United States completed the Student Confidence Questionnaire and the Demographic Questionnaire and Survey addressing demographics, practice setting, students’ experience of supervision, and perceptions of the fieldwork’s personal meaning during Level II fieldwork. Correlational and regression methods examined the relationships among the variables. Analysis of variance methods tested differences between higher and lower self-efficacy student groups.Results: The degree of self-efficacy was …

Data Note: Time From Vr Application To Closure In Employment For Adults With Intellectual Disabilities, Alberto Migliore, Uchenna Nwangwu, John Butterworth, Thinkwork! At The Institute For Community Inclusion At Umass Boston

Data Note Series, Institute for Community Inclusion

Getting a job as soon as possible after applying for vocational rehabilitation (VR) services is important for job seekers with intellectual disabilities. This DataNote describes how long it takes for job seekers with intellectual disabilities to go through the steps from application for VR services to determination of eligibility, completion of an individual employment plan, and closure into integrated employment.

Data Note: Reasons For Exiting Vr Services Without Employment, Alberto Migliore, Cady Landa, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

Only 23% of adults with intellectual disabilities work, compared to 73% of people without disabilities (statedata.info). To bridge this gap, the vocational rehabilitation (VR) program offers valuable services including assessment, job search assistance, and counseling. In FY 2014, over 46,000 adults with intellectual disabilities exited the national VR program. About 38% of them reported an employment outcome. However, a large proportion of them exited without employment, and were reported as either having lost interest in receiving services (29%), or unable to be located by VR staff (17%). These two reasons combined represented 46% of the total number of case closures …

Upper Limb Prosthesis: A Functional Replacement For The Biological Limb?, Ari Schacter

The Science Journal of the Lander College of Arts and Sciences

The 21st century continues to produce major advancements in prosthetic limb technology. Specifically, improvements to the myo-electric prosthesis have helped numerous upper limb amputees, especially transhumeral patients. Targeted muscle reinnervation surgery has allowed for more seamless control of the prosthetic device by creating new control centers for the unused nerves of the residual arm. Additionally, improvements in pattern recognition technology have enabled transhumeral amputees to gain more natural control of the prosthesis and consequently better imitate a biological limb. Another important development is in regards to the configuration and placement of electromyography electrodes on the amputee’s body. Using high-density electrodes …

Chronic Ankle Instability And Aging, Kyle B. Kosik

Theses and Dissertations--Rehabilitation Sciences

Lateral ankle sprains are the most common musculoskeletal injury among the general population and U.S. military personnel. Despite the common perception of being a minor injury, at least 1 out of 3 individuals with a previous ankle sprain will develop chronic ankle instability (CAI). This clinical phenomenon creates a significant barrier for patients to return to their prior level of physical function. Specifically, CAI is associated with reductions in physical activity level, leading to decreases in lower health-related quality of life and increase risk of developing of post-traumatic ankle osteoarthritis. Current evidence has largely focused on characterizing the mechanical and …

The Effect Of One-On-One Intervention In Athletes With Multiple Risk Factors For Injury, Kathryn Schwartzkopf-Phifer

Theses and Dissertations--Rehabilitation Sciences

Background: Lower extremity (LE) musculoskeletal injuries in soccer players are extremely common. These injuries can result in many days of lost time in competition, severely impacting players and their respective teams. Implementation of group injury prevention programs has gained popularity due to time and cost-effectiveness. Though participation in group injury prevention programs has been successful at reducing injuries, programs often target a single injury and all players do not benefit from participation. Players with a greater number of risk factors are most likely to sustain an injury, and unfortunately, less likely to benefit from a group injury prevention program. …

Social Participation In Schools: Developing The Role Of Occupational Therapy Practitioners, Kelly L. Leigers

Theses and Dissertations--Rehabilitation Sciences

The aim of this dissertation is to build the repertoire of occupational therapy practitioners so that they are better prepared in the provision of services addressing social participation of students with disabilities in the general education classroom. Students with disabilities in general education classrooms tend to have greater difficulty establishing and maintaining friendships (Wight & Chapparo, 2008), have fewer reciprocated friendships (Kemp & Carter, 2002), and lower stability in relationships than peers without disabilities. Furthermore, studies indicate that students with disabilities are less social accepted (Ekornas, Heimann, Tjus, Heyerdahl, & Lundervold, 2011) and are more isolated (Nadeau & Tessier, 2006). …

Prediction Of Acute And Recurrent Ankle Sprains In Athletes, Ryan S. Mccann

Theses and Dissertations--Rehabilitation Sciences

Ankle sprains are not only among the most common sport-related injuries, but also associated with a high rate of recurrence. While prevention is a favorable approach to reducing the incidence of index and recurrent ankle sprains, identifying individuals at greater risk may improve allocation of preventative resources. This dissertation aimed to accomplish the following through three aims: 1) determine the ability of baseline clinical tests to predict acute lateral ankle sprain (LAS) in an understudied athletic population, 2) describe the degree of residual impairments and activity limitations in athletes returning to play from a LAS, and 3) determine the ability …

A Study Exploring Parents’ And Occupational Therapists Views On Facilitating Social And Emotional Development, Salena C. Neuwar

Honors College Theses

This study examined how parents of a child with a disability and the child's occupational therapist each facilitate social and emotional development among children who have or are currently receiving occupational therapy services. This study first served to identify, through interviews, what social and emotional skills are important individually to the parent and the occupational therapist that the child gains. Through interviews, the researcher investigated the perceptions of how parents and occupational therapists facilitate social and emotional skills. The location of the therapy session was found to be a vital component among parent and occupational therapist interaction. Finally, this research …

Alternative Therapies For People With Special Needs: An Emphasis On Animal-Assisted Therapies, Emily Hamilton

Undergraduate Honors Theses

This paper contains research examining the effectiveness of alternative therapies - play therapy, art therapy, music therapy, horticulture therapy, and animal-assisted therapies – in helping various special needs populations. The focus of this research was on animal-assisted therapies that utilized therapy dogs or horses. These therapies provide a plethora of benefits physically, mentally, and psychologically. 11 interviews were conducted with counselors, psychologists, therapy dog owners, and an equine therapy director to further examine the effectiveness of these alternative therapy programs. Each interview presented unique evidence of the positive impact these therapies are having on various populations. All research into these …

What Does A Promis T-Score Mean For Physical Function?, Jeff Houck, Zane Wise, Amanda Tamanaha, Judith Baumhauer, Luke Skerjanec, Alexandra Wegner, Chris Dasilva, Michael Bass

Faculty Publications - College of Physical Therapy

Introduction/Purpose: The use of patient-reported outcomes (PRO) continues to expand beyond research to involve standard of care assessments. Although the PROMIS physical function (PF) is normalized to a T-score it is unclear how to interpret and apply this information in the daily care of patients. The T-score is abstract and unanchored to patient abilities impairing its clinical utility when shared with the patient. Patient questions are concrete such as “when will I be able to run again after this procedure?” The purpose of this research was to link PROMIS PF T-scores with physical function activities and provide a visual map …

Reading The Future: Predicting Who Will Benefit From Bunion Surgery, Ashlee Macdonald, Jeff Houck, Judith Baumhauer

Faculty Publications - College of Physical Therapy

Introduction/Purpose: Hallux valgus is a common condition of the foot with 4.4 million patients seeking care yearly for this condition. A previous study suggested specific pre-operative cut-off scores based on Patient Reported Outcomes Measurement Information System (PROMIS) physical function (PF), pain interference (PI), and depression (D) values could predict post-operative outcomes in foot and ankle surgery. Though hallux valgus correction, among other procedures, were identified as one of the most common surgeries in the previous study, specific conditions were not considered separately. The purpose of this study was to evaluate the validity of applying a published comprehensive pre-surgical PROMIS profile …

Comparison Of Patient Reported Outcomes Using Promis In Patients With Shoulder Pain, Benjamin Strong, Raymond James Kennedy, Joseph Christopher Schaffer, Jon Hedgecock, Jeff Houck, Michael D. Maloney, Ilya Voloshin

Faculty Publications - College of Physical Therapy

Objectives: Compare a disease specific questionnaire (American Shoulder and Elbow Surgeons [ASES]) and a multidimensional global health scale (Patient reported outcome measurement system [PROMIS]) across a variety of shoulder conditions

Generalizability And Validation Of Promis Scores To Predict Surgical Success In Foot And Ankle Patients: A Tale Of Two Academic Centers, Judith Baumhauer, Michael Anderson, Charles Saltzman, Man Hung, Florian Nickisch, Alexej Barg, Timothy Beals, Jeff Houck

Faculty Publications - College of Physical Therapy

Introduction/Purpose: Patient-reported outcomes are advancing clinical care by improving patient satisfaction and engagement. A recent publication reported preoperative PROMIS scores to be highly predictive in selecting patients who would and would not benefit from foot and ankle (F/A) surgery. Although this publication used the data from 5 fellowship trained foot and ankle surgeons at one institution, the generalizability to other patient populations and geographic areas is unknown. This validation study assesses the pre-operative PROMIS physical function (PF) and pain interference (PI) t-scores as a predictor of post-operative success from a separate geographic area.

Can Foot Exercises Alter Foot Posture, Strength, And Walking Foot Pressure Patterns In People With Severe Flat Foot?, Jeff Houck, Lacey Seidl, Austin Montgomery, Joshua Keefer, Miranda Walker

Faculty Publications - College of Physical Therapy

Introduction/Purpose: Muscle training muscle control for barefoot running (i.e. doming seated[DS] and standing[DSt]) and post foot and ankle injury (i.e. seated plantar flexion and inversion[SPFI]) are common. Although studies demonstrated improvement in foot posture (validated foot posture index [FPI]) immediately following a 4-week exercise program this was not assessed in people with flatfoot. Also, more rigorous assessment of foot function is lacking (i.e. foot posture, strength, and plantar pressure during walking). There is clearly a need for more rigorous clinical data on the effect of foot exercises. The purpose of this pilot study was to assess the immediate effect of …

Clinical Utilization Of Patient Reported Outcome (Promis) Scores For Surgical Reconstruction Of Posterior Tibialis Tendon Dysfunction, Michael Anderson, Jeff Houck, Adolph Flemister, Judith Baumhauer, John Ketz, Benedict Digiovanni, David Ciufo, Irvin Oh

Faculty Publications - College of Physical Therapy

Introduction/Purpose: Previous studies have demonstrated that preoperative Patient Reported Outcome Instrumentation System (PROMIS) scores effectively predict improvement in foot and ankle surgery. Adult acquired flatfoot deformity (AAFD) and Posterior Tibialis Tendon Dysfunction (PTTD) are a common surgical problem, but it is unclear if the specific thresholds for the physical function (PF), pain interference (PI) and depression published previously for all foot and ankle surgeries apply to a specific diagnosis. Furthermore, the interplay of PROMIS scores and clinical variables has not been evaluated. The purpose of this study was: 1) to investigate the change in PROMIS scales and radiographic measurements from …

The Road To Recovery For Bunion Surgery: Data Analytic Plots To Target Patient Progress, Ashlee Macdonald, Jeff Houck, Judith Baumhauer

Faculty Publications - College of Physical Therapy

Introduction/Purpose: Patient reported outcomes (PROs) can provide information on individual patient’s progress throughout a treatment course and additionally, with common surgeries, powerful numbers can be generated to provide data analytic curves to provide a recovery road map for patients and surgeons. Those who deviate negatively from the predicted path may have a complication and early intervention can be initiated. Those who deviate positively have the potential to need less physical therapy, early return to sports or work. Hallux valgus (HV) is a common condition of the foot with 4.4 million patients seeking care yearly and surgery is equally common. The …

Changes In Postural Sway Behavior Across The Life Span, Maria M B N R Santos

Graduate Student Theses, Dissertations, & Professional Papers

The present study aimed to investigate human balance control by assessing postural sway on three groups representing three stages of life (6-12, 19-40 and 65-74 years old). There were 14 individuals in each group and they were tested during upright bipedal stance with either eyes open or closed. Focus was given to multiple sway indices representing multi-dimensional features of postural sway in quiet stance and included: the center of pressure area, amplitude, root mean square (RMS), velocity, jerkiness, and sample entropy. Results confirmed that children and seniors swayed more (p<.004), faster (p<.001) and their body sway was shakier (p<.001) than young adults. Seniors also presented faster (p<.006) and shakier (p<.001) sway than children and a more unpredictable pattern of body sway in time (p<.002) than children and young adults. In addition, children presented a more random anterior-posterior sway (p<.034) and a more regular medio-lateral sway (p<.043) than young adults, and a higher synchronization between anterior-posterior and medio-lateral body sway (p<.012) than young adults and seniors. We also observed that postural control of children and young adults becomes relatively more challenged in experimental situations when eyes were closed for most postural indices. In conclusion, this study suggests that multi-dimension posturography is sensitive to detect subtle age-related changes in the postural behavior and each stage of life may have their own signature patterns of postural behavior. Therefore, we expect that quantifications of this nature may be used to assess not only postural instability and fall risk but also to aid the testing of the efficacy of balance interventional protocols.

Autologous Blood And Platelet-Rich Plasma Injections In The Treatment Of Achilles Tendinopathy: A Critically Appraised Topic, Cori Sinnott, Hayley M. White, Jennifer W. Cuchna, Bonnie L. Van Lunen

Rehabilitation Sciences Faculty Publications

Clinical Scenario: Achilles tendinopathy is a painful condition commonly affecting the general and athletic population. It presents with localized pain, stiffness, and swelling in the midportion of the Achilles tendon. The physical stress placed on the tendon results in microtrauma, which leads to subsequent inflammation and degeneration. While it is not surprising that this condition affects the physically active, nearly one-third of Achilles tendinopathy cases occur in sedentary individuals. Etiology for this condition stems from a change in loading patterns and/or overuse of the tendon, resulting in microscopic tearing and degenerative changes. There are numerous causes contributing to the …

Examination Of The Rehabilitation Protocol Of Traumatic Transfemoral Amputees And How To Prevent Bone Mineral Density Loss, Emily R. Jenkinson

Honors Undergraduate Theses

The purpose of this literature review was to identify any adaptations that could be made to the rehabilitation process for Traumatic Transfemoral Amputees. Traumatic Transfemoral Amputation is particularly debilitating with the amputees encountering many obstacles throughout the rehabilitation process. These obstacles can prevent the return to pre-morbid functioning. With an ever-increasing number of amputees within the United States, it is imperative the rehabilitation process be addressed. This literature review addresses possible adjustments in the initial stages of rehabilitation examining the post-operative, pre-prosthetic, and prosthetic rehabilitation stage to enhance the physical functioning for the amputee. This comprehensive literature review encompassing 63 …

Self-Reported Adherence To Physical Activity For Cancer Survivors: An Update From The 2015 Nhis Database, Andrew Jackson Shearer

Theses and Dissertations--Kinesiology and Health Promotion

Cancer is the second leading cause of death in America. It’s been suggested that regular physical activity (PA) can improve health outcomes in cancer survivors. An estimate from BRFSS data (2009) suggested that 47% of all cancer survivors met recommended guidelines and that this estimate was not different from the population at large (48%). Several factors were examined from these BRFSS data to determine whether subgroups of survivors existed who might benefit from interventions aimed at improving their PA status. The purpose of this investigation was to obtain more recent estimates of adherence to established PA guidelines for cancer survivors. …

Age-Related Differences In The Lumbopelvic Kinematics During The Trunk Motions In The Anatomical Planes, Milad Vazirian

Theses and Dissertations--Biomedical Engineering

Management and control of the low back pain as an important health problem in the industrial societies necessitates to investigate how the risk of this disease is affected by aging. Since the abnormalities of the lumbopelvic kinematics are related to the existence or risk of low back injuries, the objective of this dissertation was set to find the age-related differences in lumbopelvic kinematics when performing basic trunk motions reaching to range of motion in different anatomical planes.

A cross-sectional study was designed where sixty asymptomatic individuals between 20–70 years old with no confounding health condition, no current or previous highly …

A Theory Of Veteran Identity, Travis L. Martin

Theses and Dissertations--English

More than 2.6 million troops have deployed in support of the wars in Iraq and Afghanistan. Still, surveys reveal that more than half feel “disconnected” from their civilian counterparts, and this feeling persists despite ongoing efforts, in the academy and elsewhere, to help returning veterans overcome physical and mental wounds, seek an education, and find meaningful ways to contribute to society after taking off the uniform. This dissertation argues that Iraq and Afghanistan War veterans struggle with reassimilation because they lack healthy, complete models of veteran identity to draw upon in their postwar lives, a problem they’re working through collectively …

Longitudinal Adaptations In Muscle Strength, Functional Performance, Gait Biomechanics, And Patient-Reported Function After Unilateral Total Knee Arthroplasty, Paul W. Kline

Theses and Dissertations--Rehabilitation Sciences

Objective: The aims of this research were to identify gaps in the literature related to impairments after total knee arthroplasty (TKA) (Aim 1) and define recovery between 3 and 6 months after TKA across four domains: 1) hip and knee muscle performance, 2) functional performance, 3) patient-reported function, and 4) biomechanics of walking and stair descent (Aim 2). Additionally, this project sought to explore the relationships between each domain (Aim 3) and establish predictive models to allow clinicians to use clinical measures to predict future gait biomechanics in patients after TKA (Aim 4). Ultimately, the results of this research would …

Effect Of A 12-Week Home-Based Neuromuscular Electrical Stimulation Treatment On Clinical Outcomes Following Articular Cartilage Knee Surgery, Caitlin E. Whale Conley

Theses and Dissertations--Rehabilitation Sciences

Articular cartilage defects in the knee are common, and can result in pain, decreased function and decreased quality of life. Untreated defects are considered to be a risk factor for developing osteoarthritis, a progressive degenerative joint disease with minimal treatment options. To address these issues, various surgical procedures are available to treat articular cartilage defects in the knee. While these procedures overall have positive results, after surgery patients experience large and persistent deficits in quadriceps strength. A contributing factor to this post-surgical weakness is believed to be the extended post-operative non-weight bearing period, with full weight bearing not initiated until …

A Grounded Theory Study Of Maternal Engagement Of Low Income, Young Rural Mothers In Home-Based, Early Intervention Services, Elaine K. Fehringer

Theses and Dissertations--Rehabilitation Sciences

Home-based, early intervention programs as a preferred delivery model are widely endorsed, heavily funded and highly utilized as prevention and remediation initiatives for families with young children (Eckenrode, et al., 2010; Karoly, Killion, & Cannon, 2005). Of concern, is that while an estimated 40 billion dollars are spent annually between federally funded programs and private foundations, a significant number of families disengage from services before the end of a child’s eligibility period (Stevens, Ammerman, Putnam, Gannon, & van Ginkel, 2005). Several meta-analyses indicate only modest effectiveness of home-based services (Tandon, et al., 2008). It is estimated that well over 500,000 …

The Relationship Between Selective Attention And Global Coherence In Narrative Discourse Following Right Hemisphere Stroke, Katherine Mccomas Maddy

Theses and Dissertations--Rehabilitation Sciences

Stroke is the leading cause of serious, long-term disability and nearly half of older stroke survivors experience moderate to severe disability. A common impairment following stroke is impaired discourse production. Functional outcome studies have proposed that the recovery of discourse abilities is critical to achieving a good quality of life. Communication impairments often persist into the chronic stages of recovery and can cause individuals to withdraw from social situations. Discourse production deficits may not be apparent in basic communication interactions, but become more obvious during complex conversations following non-aphasic brain injury (NABI) or right hemisphere stroke (RHD). The purpose of …