Rehabilitation and Therapy Commons^™

Targeting The Beiging Of Muscle-Associated Adipose Tissue To Promote Muscle Regeneration, Jacob C. Parson

WUSM Theses and Dissertations – All Programs

The expansion of intra-muscular adipose tissue (IMAT) between myofibers and epi-muscular adipose tissue (EMAT) outside of the muscle boundary accompanies numerous pathologies including diabetes, muscular dystrophy, and aging. IMAT and EMAT are anatomically juxtaposed to myofibers. Some evidence supports that IMAT and EMAT impede muscle function. This is potentially due to paracrine factors that are secreted by IMAT/EMAT. Different adipose depots can be classified in numerous ways including where they are located anatomically as well as the factors in which they secrete. Unlike classical white fat, adipose depots classified as brown or beige, noted by the marker uncoupling protein-1 (UCP-1) …

Toward An Understanding Of Loneliness And Social Participation In Serious Mental Illness, Samantha B. Randolph

WUSM Theses and Dissertations – All Programs

Loneliness is an immense challenge facing the majority of Americans with Serious Mental Illness. Loneliness is linked to negative outcomes, including heart disease, reduced quality of life, and early mortality. Current loneliness interventions (e.g., social skills training, social support) do not effectively address all the complex factors that lead to loneliness in this population. More work is needed, therefore, to better understand how to optimally research and prevent loneliness among individuals with Serious Mental Illness, who experience unique barriers to social integration/participation and dwell in complex settings, such as permanent supportive housing. The presented dissertation aims to address current gaps …

Implementation Of Standardized Mobilization Assessment Tools To Promote Patient Ambulation At Medical Surgical Units, Yunxuan Su

Master's Projects and Capstones

The objective is the cardiac medical surgical unit in a hospital in San Francisco not meeting the ambulation goal. This study aims to provide a context for enhancing patients' ambulation levels by using standardized assessment tools Prior Level of Functional (PLOF) and Current Level of Functional (CLOF) in daily practice, thereby strengthening care plans and shortening hospital stay. The methods are microsystem evaluation, SWOT analysis, causal analysis, cost-benefit analysis, Gantt chart, pre & post survey, and flyer education for staff to guide the project implementation. The results are that after the intervention, the compliance of PLOF and CLOF documentation and …

Empowering Nurses, Enhancing Mobility: A Qi Initiative Using Plof And Clof To Promote Patient Ambulation, Kaela Nguyen

Master's Projects and Capstones

The quality improvement project involves the intervention of implemented mobility educational flyers about the mobility tools, Clinician Reported Level of Function (CLOF) and Patient Reported Level of Function (PLOF) and aims to increase patient mobility post surgery. The quality improvement project was conducted in two medical surgical units in a San Francisco hospital. To address unmet mobility goals, during change of shift, in-services on the educational flyers about the mobility tools (CLOF and PLOF), were utilized to provide education about the importance of mobility, how to utilize the mobility tools, and correctly document ambulation. More than twenty flyers were posted …

The Influence Of Intrinsic Foot Muscles In Modulating Foot Shape Relative To Substrate And The Efficacy Of Different Strengthening Approaches, Luke R. Lotsis

Masters Theses, 2020-current

Cross-sloped surfaces create an asymmetrical substrate for foot contact, introducing a slip force within the transverse plane and a gravitational pull within the coronal plane that increases the tendency to topple downslope. To maintain stability, the foot must make structural adjustments across the hindfoot, midfoot, forefoot, and hallux. In chapter 1, I investigated how IFMs respond to varying substrate conditions and balance demands, providing insight into their functional role in maintaining stability and adapting foot structure in static and dynamic locomotor tasks. Twenty-four healthy adults participated in a series of dynamic walking trials on flat, cross-sloped and sandy substrates and …

Unlv Department Of Physical Therapy And The Fine Arts Clinic For Health And Injury Prevention, Madeline Cosgrove, Ashton Johnson, Keith Lopez, Diana Nguyen

UNLV Theses, Dissertations, Professional Papers, and Capstones

At the collegiate of performing arts, those who participate in classes and performances will often be at risk for musculoskeletal injury due to repetition and specific patterns of their movements. The establishment of a pro-bono physical therapy clinic for students enrolled in undergraduate and graduate-level fine arts programs may improve healthcare access for this often underserved community. The goals of this service learning project were to provide injury-prevention screenings to dancers and administer specialized physical therapy (PT) services in the form of evaluations and treatments to all students in the UNLV (University of Las Vegas, Nevada) College of Fine Arts …

The Effect Of Amputation And Prosthesis Use On The Ability To Differentiate Between Surfaces Underfoot, Allen Paul F. Aquino, Bradley C. Belasco, Kara D. Hlebak, Amanda B. Lewin

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background/ Purpose: There is limited understanding of how the sensory deficits associated with lower limb amputation (LLA) impact mobility during daily life. As a first step to developing this understanding, the aim of this study was to determine to what extent people with LLA can identify differences in commonly encountered walking surfaces beneath their feet. We hypothesized that people with LLA would demonstrate a poorer ability to discriminate between different surfaces than people without an amputation, and that discrimination ability would be surface characteristic-specific; discrimination would be poor for roughness discrimination due to the lack of plantar sensation in the …

Feasibility And Acceptability Of Tap Dance As A Therapeutic Intervention For Adults With Lower Limb Amputation: A Pilot Study, Julianne Roser, Allison Strande, Bailey Taggart

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objectives: This study aimed to evaluate the feasibility, acceptability, and potential efficacy of an 8-week adapted tap dance program as a therapeutic intervention for individuals with lower limb amputation (LLA).

Methods

Three participants with LLA (two with unilateral transfemoral amputation and one with bilateral transtibial amputations) attended weekly 1-hour tap dance classes, with movements adapted for their needs and mobility aids and dance barres available as needed. The Physical Activity Enjoyment Scale (PACES) and participant feedback assessed acceptability. Functional mobility, balance and quality of life were measured using the Activities-Specific Balance Confidence (ABC) scale, Timed Up-and-Go (TUG), Berg Balance Scale …

Effects Of Altered Somatosensory Input On Gait Kinetics And Kinematics Via Different Footwear In Individuals With Chronic Post-Stroke Hemiparesis, Daniela Casillas, Lesley Ruiz

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis: Individuals with post-stroke hemiparesis walk with significant asymmetries, leading to slow, effortful walking, and a high risk of falls. One contributing factor is altered sensation on the plantar surface. Studies examining altered somatosensory input via insoles, vibration and other tactile stimuli observed improvements in hemiparesis gait. This study investigates whether altering somatosensory input through different footwear can affect kinetics, kinematics and muscle activity during walking post-stroke. We hypothesized the barefoot conditions would have increased dorsiflexion (heel-strike, swing), increased plantarflexion during toe-off, increased muscle activity and kinetics, compared to memory foam conditions.

Participants: 13 individuals with chronic post-stroke hemiparesis (4F/9M, …

Empowering Educators To Improve Social Emotional Behaviors Among K-8 Students: Quality Improvement Project, Paige Yael Bister

UNLV Theses, Dissertations, Professional Papers, and Capstones

Social and emotional learning (SEL) encompasses essential skills for effectively managing and expressing emotions. Studies have shown that SEL strengthens early education while supporting students' lifelong success by fostering positive behaviors within and beyond the classroom. In school settings, occupational therapists (OTs) aim to empower children to thrive as students and as social beings through targeted interventions and educational support for parents and teachers. In private school settings, limited access to occupational therapy services may impact teachers' ability to implement SEL strategies effectively.This capstone project addressed gaps in teachers' knowledge and confidence in applying the Zones of Regulation SEL curriculum …

Efficacy Of Dorsal Application Of Kt For Carpal Tunnel Syndrome In Esport Gamers: A Randomized Clinical Trial, Anthony Foreman

UNLV Theses, Dissertations, Professional Papers, and Capstones

This doctoral study investigated the impact of the dorsal application of kinesiotape on carpal tunnel syndrome (CTS) symptoms and performance among Esport gamers. The study was conducted in controlled environments at the UNLV Esports Lounge, Black Fire Innovation, and the Musculoskeletal Lab using a randomized two-group pretest-posttest design. To maintain ecological validity, participants were permitted to use personally owned gaming peripherals (e.g., computer mouse), and all received brief instruction on proper body mechanics to promote consistency during testing. Participants (n = 11) were systematically assigned by order of registration to either an intervention group receiving dorsal application of kinesiotape on …

Enhancing Motor Function In Individuals With Lower Limb Amputation Through Peerbased Learning Of Balance And Fall Recovery Skills, Zoe Castle, Jer Ja Chuang, Jewel Granados, Danna Shaw

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: Lower limb amputation (LLA) is a devastating condition that is becoming more prevalent in the United States. We examined the effects of peer-based action observation learning on the brain activation and the eyetracking pattern in individuals with LLA.

Methods: Fourteen individuals with LLA (51.9±12.6 years, 4 females, 9 with transfemoral amputations) were asked to learn a balance task through observing the movements demonstrated by individuals with LLA or persons with intact limbs. Electroencephalogram (EEG) signals, visual attention time, and peak saccade velocity were recorded when participants watched the demonstration videos. Power spectral density (PSD) was used to analyze the …

Developing An Evidence-Based Continuing Education Program For Physical Therapists Working With Individuals With Down Syndrome, Luis Azpeitia, Chantel Montayre, Rebecca Peterson, Alyssa Pociernicki

UNLV Theses, Dissertations, Professional Papers, and Capstones

Despite the abundance of resources available for physical therapists (PTs) treating children with Ds, the resources are limited for PTs working with teens and adults. This suggests that this population is underserved within the healthcare community. This project aimed to bridge this knowledge gap by developing a comprehensive continuing education program for physical therapists, focused on the treatment and care of teens and adults with Ds. This education program will give physical therapists a resource for treating teens and adults with Ds, an under-resourced population. Two modules focusing on musculoskeletal (MSK)/gait and communication strategies were developed, and then pilot tested …

Fostering Intergenerational Connection Through The Implementation Of Bingocize: A Community-Based Fall-Prevention Program, Dejeigh Herrera, Shelby Humphreys, Kayla Lee, Danielle Platt

UNLV Theses, Dissertations, Professional Papers, and Capstones

Falling is an experience that can be traumatic and detrimental to the overall health of those aged 65 and older. As this portion of the population in the United States continues to grow, so does the importance of understanding the general health concerns of these individuals and the way they contribute to their risk of falling and impact their ability to live independently. One program to help address these risks is Bingocize, an evidence-based program designed by Jason Crandall, a professor of exercise science at Western Kentucky University in 2011. Bingocize is a 10-week fall prevention program designed to educate …

Effects Of Different Cannabis Compounds On Balance, Freezing Of Gait, And Bradykinesia In Parkinson’S Disease: Cross-Sectional Analysis Of Self-Report Data From The Fox Insight Study, Alexandria Dockery, Adan Hernandez, Cody Miyashiro

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: To explore the effects of delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD)) on self-reported balance problems, freezing of gait (FOG), and bradykinesia in Parkinson’s disease (PD).

Background: Recent research has indicated that a high proportion of people with PD are interested in using cannabis for symptom management. Given the known intoxicating and motor impairing properties of THC, it may negatively affect postural instability and increase fall risk in people with PD.

Methods: Data from the Fox Insight online clinical study were analyzed in February 2024. The analysis only included participants with PD who answered questions about cannabis use (n=2754). Responses were …

Does Student Interest In Rural Or Underserved Practice Change Following Exposure To A Full Time Rural Or Underserved Clinical Experience?, Hans D. Capistrano, Maxwell D. Giedlin, Kayla A. Houston

UNLV Theses, Dissertations, Professional Papers, and Capstones

Access to healthcare in rural areas remains a significant challenge, with rural communities facing unique barriers such as limited healthcare providers, increased travel distances, and lower insurance coverage rates. Nevada exemplifies this issue, ranking 45th in the United States in access to physical therapy services, with particularly low provider availability in its rural regions. Research suggests that clinical education experiences in rural and underserved areas may encourage healthcare professionals to practice in these communities post-graduation. This study examined the relationship between clinical experiences in rural and underserved settings amongst University of Nevada, Las Vegas Physical Therapy (UNLVPT) students’ interest in …

Unlv Admissions: Effect Of The In-Person Interview On The Holistic Admissions Of Minority Applicants Into The University Of Nevada, Las Vegas Doctor Of Physical Therapy Program, Jonathan Madamba, Walker Riley, Isaiah Taylor

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Methods: The goal of this study is to analyze the effect of an in-person interview on the admission of minority applicants into the Doctor of Physical Therapy (DPT) program at the University of Nevada, Las Vegas (UNLV). Using data from the 2014-2022 admissions cycles we assessed inter-rater reliability of the interviewer’s, differences in average in-person interview score between racial groups, and compared the difference in pre-interview scores between racial groups.

Results: We found that students identifying as Black scored higher on interviews than their White counterparts. However, a smaller proportion of them matriculated into the program due to the difference …

Correlation Between Atnr Retention And Sensory Processing Difficulties In A Pediatric Occupational Therapy Population, Cassaundra H. Abernathy

UNLV Theses, Dissertations, Professional Papers, and Capstones

This study aimed to examine the correlation between retained Asymmetric Tonic Neck Reflex (ATNR) and sensory processing difficulties in children. A review of the literature available contributed to understanding the relationship between these; however, the limited research indicated a need for further examination to provide practitioners with evidence-based research for comprehensive care and improved occupational performance in children. A small correlational study was conducted using the snowball method with convenience sampling. The study yielded six participants from an occupational therapy outpatient clinic, A Clubhouse for Kids. Caregivers completed the Sensory Profile 2 in hard copy to assess their child's sensory …

Bridging The Gap: A Quality Improvement Initiative To Enhance Interoception Resources For Pediatric Oncology Ots, Dana Louise Lomotan Doolittle

UNLV Theses, Dissertations, Professional Papers, and Capstones

Chemotherapy administered to children and youth diagnosed with pediatric cancers may induce side effects such as pain, fatigue, anxiety, and other distressing symptoms that could impact the ability to meet occupational needs and desires in daily functioning. The occupational therapy discipline incorporates mindfulness strategies to target these symptoms for increased body awareness in children with cancer, though interoception’s role within the pediatric oncology population is obscure. Furthermore, there are implicated demands described in the literature for more established pediatric oncology rehabilitation programs to attend to the specific needs of the population and to advocate for occupational therapy’s role in the …

Plagiocephaly In Premature Infants: Enhancing Nicu Caregiver Education, Hailee Efferson

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: To improve NICU nurses’ confidence in preventing and managing plagiocephaly in premature infants through a one-on-one educational session.Design: One-group post-test design for a quality improvement initiative. Setting: Neonatal Intensive Care Unit (NICU) at Summerlin Hospital Medical Center. Participants: 20 NICU Nurses. Measures: Post-session questionnaire including close-ended Likert scale and open-ended questions. Results: Mean scores ranged from 3.5 to 4.0, with the highest rating for the helpfulness of the session format (mean = 4.0) and the lowest for confidence in alternating infant positioning (mean = 3.5). Standard deviations ranged from 0 to 0.59, indicating strong agreement regarding the session format …

Expanding Anatomy Academy In The Las Vegas Metropolitan Area: A Service Learning Project To Improve Childhood Health Through Supplemental Educational Sessions, Alekzander Hall, Brandon Paige, Marlee Parkin, David Sanchez

UNLV Theses, Dissertations, Professional Papers, and Capstones

Childhood obesity is a growing epidemic in the United States, with approximately 18.5% of US children presenting with obesity. High levels of obesity are less common in higher income communities, but increasingly more prevalent in lower income communities. Currently in Clark County, Nevada, more specifically in lower socioeconomic communities and Title I schools within the Las Vegas area, there is an opportunity to educate students about the components of a healthier lifestyle to provide children with the tools to improve their health. Anatomy Academy (AA) is an eight-week health education program that was created to teach fourth and fifth grade …

Enhancing Therapeutic Use Of Self: The Value Of Unfolding Case Studies In Occupational Therapy Education, Janel Marie Gozum

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: This capstone project evaluated the effectiveness of using unfolding case studies (UCS) as a supplemental instructional method to enhance occupational therapy (OT) students’ self-efficacy (SE) in applying therapeutic use of self (TUOS), a core competency in OT education.Methods: Four workshop modules were delivered to and completed by OT students (n=3) enrolled in the occupational therapy doctorate program at the University of Nevada, Las Vegas. The sessions included instructional content, guided discussions, unfolding case study activities, and a TUOS competency. The Self-Efficacy for Therapeutic Use of Self (SETUS) Questionnaire was administered at four points throughout to monitor perceived self-efficacy over …

Acquired Brain Injury Education: Utilizing Unfolding Case Studies To Improve Critical Thinking Skills In Occupational Therapy Students, Katherine Hathaway

UNLV Theses, Dissertations, Professional Papers, and Capstones

Acquired brain injuries (ABI), including traumatic brain injury, stroke, and anoxia, affect millions worldwide, and often result in long-term impairments in daily functioning. Despite the need for specialized, ongoing care, many individuals with ABI lack access to adequate long-term rehabilitation services, and families report substantial caregiver burden due to limited resources and poor care coordination. Occupational therapy plays a critical role in meeting the needs of this population; however, many entry-level practitioners feel underprepared to manage the complex challenges associated with ABI, largely due to limited training and exposure. This capstone project aimed to address this educational gap by implementing …

Ethnoracial Characterization Of Cognitive Function And Activities Of Daily Living In Neurodegenerative Diseases, Justine A. Bachmann

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: Neurodegenerative diseases, such as Alzheimer's disease (AD), lead to progressive cognitive and functional decline, which significantly affects individuals’ ability to perform their everyday Activities of Daily Living (ADLs). Occupational Therapist (OTs) assess cognitive impairments and their impact on daily function by utilizing tools like the Montreal Cognitive Assessment (MoCA) to guide intervention planning. However, research on the MoCA’s effectiveness across ethnoracial groups is limited, raising potential biases in the accuracy of cognitive assessments. This study examines the relationship between cognitive function, measured by the MoCA, and functional impairment, assessed using the Functional Activities Questionnaire (FAQ), among ethnoracial older adults …

The Effectiveness Of Occupational Therapy Objective Structured Clinical Exam & Student Self-Efficacy In Preparation For Fieldwork Rotation, Angela Kay

UNLV Theses, Dissertations, Professional Papers, and Capstones

This capstone project focuses on exploring the effectiveness of the University of Nevada, Las Vegas Department of Occupational Therapy’s Objective Structured Clinical Exam (OSCE) on students’ perceived self-efficacy in preparation for and throughout fieldwork rotation. This retrospective study analyzed repeated measures of the New General Self-Efficacy (NGSE) Likert Scale collected from a sample of 49 occupational therapy students across five time points. Findings indicated a statistically significant increase in self-efficacy over time (p< .001). These results suggest that the OSCE may play a meaningful role in enhancing students’ self-efficacy in their clinical hands-on skills, supporting its continued use in occupational therapy academics.

The Impact Of Psychosocial Factors On Occupational Therapy Doctoral Students’ Communication With Fieldwork Educators: A Retrospective Analysis, Melissa Montes

UNLV Theses, Dissertations, Professional Papers, and Capstones

This capstone project investigates the impact of adverse psychosocial factors, such as depression, anxiety, and stress, on effective communication of occupational therapy doctoral (OTD) students with their fieldwork educators (FWEds) during level II fieldwork experiences at the University of Nevada, Las Vegas (UNLV). Using a convergent parallel mixed methods design and retrospective analysis, the study integrates quantitative data from the Depression, Anxiety, and Stress Scale (DASS-21) and qualitative data from the Fieldwork Experience Assessment Tool (FEAT) to explore how these factors affect communication and the management of the adverse psychosocial factors OTD students experience. This study involved 36 OTD students …

Exploring The Occupation Of Parenting With A Cognitive Disability, Alysa Polley

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: To investigate how parents with cognitive disabilities perform child-rearing tasks and barriers associated with their disability, to determine their needs and self-efficacy to improve the role of occupational therapy in supporting child-rearing for parents with cognitive disability.Design: Qualitative Case-study, Phenomenology Setting: Gigi's Playhouse Participant(s): Inclusion criteria: parents or expecting parents, individuals with a cognitive disability resulting from an autism spectrum disorder diagnosis, English speaking, 18+, and autonomy to consent participation. Exclusion criteria: non-English speaking, individuals without a cognitive disability resulting from an autism spectrum disorder diagnosis, and under 18. Measure(s): Semi-Structured Interview and Tool for Measuring Parental Self-efficacy. Results: …

Maximizing Functional Independence And Well-Being: The Impact Of Sensory Impairments On Iadls And Functional Mobility Skills, Jessica L. Ryan

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: Sensory impairments involving vision and hearing among the adult population are predicted to double by 2030 (Gutherie et al., 2018). Individuals with experiences of sensory impairments like low vision are at risk of decreased functional participation in their homes and communities, which often leads to mental health concerns due to social withdrawal, experiences with environmental barriers, and limited occupational engagement (Bezyak et al., 2017; Gerami et al., 2015; Pfeiffer et al., 2020; Vreeken et al., 2020). This doctoral capstone focused on program evaluation to support adults with low vision and blindness in transferring learned skills from a simulated environment …

Gaming Participation: An Occupational Therapy Approach To Esports Ergonomics, Althea Rivera-Millare

UNLV Theses, Dissertations, Professional Papers, and Capstones

Competitive e-sport gamers are increasingly at risk for repetitive strain injuries (RSIs) due to the prolonged and repetitive nature of their gaming demands. Current healthcare protocols often overlook the unique ergonomic needs of this population, potentially leading to decreased occupational performance and dysfunction. This study aims to develop and evaluate an evidence-based ergonomic protocol tailored specifically to e-sport gamers who primarily use a mouse and keyboard, with the goal of reducing the risk of musculoskeletal injuries and enhancing gaming performance. Grounded in the principles of occupational therapy, the study emphasizes occupation-based interventions that address the specific occupational demands of e-sport …

Comparison Of Gluteal Muscle Central Activation In Individuals With And Without Patellofemoral Pain, Michael Carpio, John S. Donohue, Jacob P. Kissman

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis: Individuals with patellofemoral pain (PFP) often present with knee valgus during weight-bearing activities. Weakness in the gluteal muscles is thought to contribute to this condition, but recent studies suggest that hip weakness might be a secondary problem in this population. Central nervous system adaptations have been noted in persons with PFP, which can lead to altered muscle function, faulty movement patterns, and poor function. Experimentally, central activation can be quantified by a central activation ratio (CAR) via superimposed burst (SIB) during a maximum voluntary isometric contraction (MVIC) where the ratio of volitionally activated motor units to total motor units …