Rehabilitation and Therapy Commons^™

Comparative Investigation Of Bacterial Adhesion On Medical Device Thermoplastics, Dev V. Mehta

Honors Theses

This project will focus on determining if differences in bacterial cell wall composition influences adhesiveness to thermoplastic materials used to construct patient orthotic splints. Bacteria with decreased adhesion are unable to remain bonded to orthotic splints, increasing its ability to transfer to a patient’s wound, leading to an infection. Antibiotic resistant bacteria used in this investigation included gram-positive cocci vancomycin-resistant (VRE) Enterococcus faecalis, methicillin-resistant Staphylococcus aureus (MRSA), and gram-negative rods extended-spectrum beta-lactamase (ESBL) Escherichia coli and Pseudomonas aeruginosa. Each test bacterium is a major pathogen causing healthcare-associated infections (HAIs). Saline, artificial perspiration, and ascites fluids were used to determine the …

Development Of Low-Cost Triaxial Force Sensor For Measurement Of Human-Exoskeleton Interaction Forces, Hamdan Khan Sarvathullah

All Theses

Contemporary research suggests that shear force is a major contributor to discomfort and pressure injury. However, the variation of shear forces during human-exoskeleton interaction dynamics is a highly unexplored field. The high cost of commercial triaxial force sensors may be a major factor in the notable lack of research in this field. Therefore, in this paper, we present a low-cost, 3D-printed triaxial force sensor designed specifically to measure the triaxial interaction forces between an exoskeleton and its user. The triaxial force sensor uses Carbon-Black/Silicone Rubber (CB/SR) strings to measure shear forces, whereas the normal force is measured with a Force …

The Scoop On Feeding Therapy: Where Occupational Therapy Fits In, Katherine G. Epperson

Occupational Therapy Doctorate Capstone Posters

This capstone project was completed at Horn and Associates in Rehabilitation in Lexington, Ky. The primary ACOTE areas of focus included education, advocacy, and clinical practice skills. The goals of this project were to identify and fill gaps in knowledge related to the role of occupational therapy in feeding therapy in the pediatric population, support interdisciplinary collaboration, and create educational handouts to advocate and highlight the importance of occupational therapy in the realm of feeding.

A needs assessment was completed prior to completion of this capstone project in order to identify a need. For this needs assessment, I completed a …

Professional Advocacy: Designing And Implementing Resources For The Kota Website, Jaden Johnson

Occupational Therapy Doctorate Capstone Posters

This doctoral capstone project and Applied Leadership Experience (ALE) focused on advocacy, leadership, and virtual program development within the Kentucky Occupational Therapy Association (KOTA). The project addressed a gap, bridging conversations surrounding advocacy to active engagement in professional advocacy through an 'Advocacy' webpage for the KOTA website. The goal of this capstone project is to make advocacy resources more accessible and increase participation in professional organizations for the benefit and unification of occupational therapy and occupational therapy assistant students and practitioners.

Virginia Stoffel's Presidential Address, Engagement, Exploration, and Empowerment (2015), served as the primary framework guiding this project. The framework …

Success In Motion: A Comparative Thematic Analysis Of Patient Success In Inpatient And Outpatient Physical Therapy, William T. Gish

Theses/Capstones/Creative Projects

Physical therapy is practiced across a wide range of clinical settings that differ substantially in patient populations, goals, and care timelines. While standardized outcome measures are commonly used to evaluate treatment effectiveness, little research has examined how physical therapists themselves define successful outcomes  or whether those definitions vary across inpatient and outpatient contexts. This study employed a qualitative mixed-methods design to explore how physical therapists conceptualize success in clinical practice. Ten licensed physical therapists participated in semi-structured interviews, which were analyzed using thematic analysis.

Supplementary quantitative data were collected via an online background survey. Five primary themes emerged: goal-oriented, patient-centered …

Clinical Case Study: The Effects Of Task Dynamics And Saltatory Pneumotactile Stimulation On Cerebral Oxygenation, Cognitive Performance, And Sensorimotor Function In An Adult Following Left Ischemic Mca Stroke, Bridget Slagle

College of Education and Human Sciences: Dissertations, Theses, and Student Research

In the chronic stage of stroke recovery, neuroplasticity is thought to require external influence, and is often considered to be experience-dependent, or “Hebbian,” plasticity. Current studies have been investigating multiple ways to induce plasticity to enhance recovery, including investigating the role of sensory stimulation in cortical priming to enhance the effects of rehabilitation interventions.

This case study of an 80-year-old female with aphasia after L-MCA ischemic stroke included 18 neurotherapeutic sessions over 10 weeks. Each session included pneumotactile somatosensory stimulation to the glabrous hand and perioral face, delivered to both the left and right side via the GALILEO, as well …

The Impact Of Palm Cooling On The Physiological And Cognitive Function Of Aerobically Trained Individuals, Katherine L. Tibbs

Honors Theses

Background: Cooling strategies have been shown to combat the harmful effects that an increase in body temperature can potentially cause, and palm cooling in particular has been adopted due to its effectiveness in mitigating muscle fatigue during exercise. While there is clear support that this improves muscular strength and endurance, there is a lack of research on the impact palm cooling has on the mental aspect of physical activity. The purpose of this study was to investigate the cognitive and physiological effects of palm cooling on aerobic exercise performance. Methods: Ten aerobically trained participants between the ages of 18-35 were …

A Comparative Analysis Of Two Play-Based Upper Extremity Training Programs In Improving Arm Motor Function In Children With Hemiplegia, Kara Borkowski

Honors Scholar Theses

Cerebral Palsy is one of the most common causes of childhood motor disability. Children with cerebral palsy often experience impaired movement, posture, and balance (Vitrikas et al., 2020). A key factor in the success of upper extremity training for children with cerebral palsy is the frequency and intensity of therapy sessions (Jackman et al., 2020). However, these sessions can be expensive, time consuming, and often difficult to fit into home routines. These limitations have led to an increasing exploration of the effects of caregiver-led programs, bridging many of the gaps these barriers create. The efficacy of a play-based training program …

Clinical Impact Of Prior Versus De Novo Selective Serotonin Reuptake Inhibitors Use On Motor Recovery After Ischemic Stroke, Jonathan Xi, Alexandre Mazar, Michelle Jankkowski, Jose Mendez, P Tyler Roskos

Conference Presentation Abstracts

Background: Cerebrovascular Accident (CVA), or stroke, is the fourth highest cause of death and the leading cause of disability in the United States. Although used typically as antidepressants, Selective Serotonin Reuptake Inhibitors (SSRIs) have been linked to positive outcomes in stroke recovery. This retrospective chart review evaluated differences in motor recovery with prior versus de novo Selective Serotonin Reuptake Inhibitor use in the inpatient rehabilitation setting. Methods: Participant data were obtained using a convenience sample of adult (aged 18 or older) ischemic stroke patients admitted to the inpatient rehabilitation unit at a suburban inpatient rehabilitation unit from January 1, 2016, …

Applying Evidence-Based Practice To Guide Occupational Therapy In The Nicu And Outpatient-Based Early Intervention Settings, Brooke A. Wilson

Occupational Therapy Capstone Presentations

Infants admitted to the neonatal intensive care unit (NICU) are at increased risk for feeding difficulties, developmental delays, and sensory processing challenges due to prematurity and complex medical needs. These effects often persist into the first years of a child’s life, and many receive early intervention or outpatient therapies. Occupational therapy plays a critical role in addressing these concerns while supporting caregivers in building knowledge and confidence. The purpose of this capstone project was to develop in-depth clinical skills in the NICU and outpatient early intervention settings, educate caregivers, and complete continuing education courses related to neonatal and pediatric therapeutic …

Addressing The Motor And Non-Motor Symptoms Of Parkinson’S Disease Through Integration Of Clinical Skills And Community Educational Resources, Alison C. Lee

Occupational Therapy Capstone Presentations

Individuals with Parkinson’s Disease (PD) face many challenges to their daily life including various motor and non-motor symptoms that affects their participation in meaningful occupations. Non-motor symptoms like decreased social participation, sleep disturbances, fatigue, and decline in cognition often go unnoticed and undertreated. Limited resources are available to clinicians and individuals with PD regarding tangible ways to address these concerns. Occupational therapy (OT) has a unique role in addressing both motor and non-motor symptoms through evidence-based resources, education, and general awareness. This project bridged this gap in care regarding non-motor symptoms of PD through the creation of easily accessible handouts, …

Improving Occupational Performance In Vision Neurorehabilitation, Catherine Lentsch

Occupational Therapy Capstone Presentations

Visual dysfunction affects up to 90% of individuals with traumatic brain injuries and up to half of stroke survivors, significantly impacting independence in daily occupations. This capstone project, conducted at Nebraska Methodist Hospital, aimed to improve clients’ occupational performance and enhance occupational therapy vision neurorehabilitation through advanced clinical skill development and the development of resources. The project involved the evaluation and treatment of eleven neurological patients across inpatient and outpatient settings. Guided by Warren’s Hierarchy of Visual Perceptual Skills and Toglia’s Dynamic Interactional Approach, the project emphasized stabilizing foundational visual skills before progressing to higher‑level visual-perceptual tasks and used near …

Fragile Patients, Intentional Care: Nonpharmacological Pain Management Treatment Approaches In The Neonatal Intensive Care Unit (Nicu), Kristie A. Moeller

Occupational Therapy Capstone Presentations

The aim of this project was to increase clinical skills in a level III neonatal intensive care unit (NICU) and explore how nonpharmacological occupational therapy (OT) interventions impact pain management in the NICU for a variety of patients. Due to the increasing rates of admissions to the NICU and the impact that pain has on child development there was a clear need to gain skills to create interventions that would minimize the effect on infant development (Martin & Osterman, 2025; Pineda et al., 2025). The needs assessment revealed the need for occupational therapists (OTs) role in nonpharmacological pain management to …

Diagnostic Ability Of Rate Of Torque Development For Patellofemoral Pain, Arun Loganathan, Neal R. Glaviano Phd, Sungwan Kim Phd

Honors Scholar Theses

Context: Patellofemoral pain (PFP) is a highly prevalent condition (22.7% in general population) that significantly impacts the quality of life of those who suffer from it. However, there is no gold standard test to diagnose it yet, leading to inconsistencies with treatment as well as delayed intervention. Rate of torque development (RTD) is a neuromuscular measure that has shown strong connections to PFP.

Objective: The purpose of this study is to determine the diagnostic ability of RTD for PFP.

Design: Cross-sectional.

Setting: Laboratory.

Participants: Thirty-five individuals with PFP (24 males and 11 females, 22.7 ± 3.7 years, 1.67 ± 0.1 …

Play To Win: A Randomized Controlled Trial To Assess The Effects Of Play-Based Training On Upper Extremity Function In Children With Hemiplegia, Vivian London

Honors Scholar Theses

Hemiplegia, or paralysis of one side of the body, is the primary symptom of unilateral cerebral palsy, a subtype of cerebral palsy, the most common movement disorder in children. Standard of care is regular physical and occupational therapy to improve performance in bimanual activities, but conventional therapy can be expensive and draining for caregivers and children, so a need exists for a novel intervention that can take place at home and that is economical for families while being engaging for children. This thesis reports data from a subset of ten children seen as part of a randomized controlled clinical trial …

Beyond The First Bout: Adaptations To Repeated Injuries Across Physiological And Pathological Conditions, Cory W. Baumann, Christopher P. Ingalls, Kazunori Nosaka, Jarrod A. Call

Research outputs 2022 to 2026

Skeletal muscle exhibits remarkable plasticity following injury, yet most research has focused on responses to a single bout of eccentric contractions. This review addresses adaptations to repeated eccentric contraction–induced injuries across physiological and pathological conditions, with emphasis on insights from preclinical rodent models. In healthy muscle, the repeated bout effect (RBE) reduces strength loss and accelerates recovery after subsequent bouts. However, these adaptations are highly condition dependent. Aging can attenuate the RBE, while dystrophic muscle remains vulnerable to repeated injury despite compensatory remodeling. Other factors, including but not limited to, chronic alcohol intake and malignant hyperthermia can influence these responses, …

Role Of Allied Health Professions In Falls Prevention For Community-Dwelling Older Adults: A Scoping Review, Amy Lawton, Nicholas Tripodi, Rebecca Wospil, Breanna M. Wright, Hylton B. Menz, Suzanne Martin, Daniel R. Bonanno, Corey Linton, Andisheh Bastani, Andrew Ross, Rees Thomas, Daniel Corcoran, Timothy Mcnamara, Danielle Baxter, Brett Vaughan, Rebecca Lane, Jack Feehan

Research outputs 2022 to 2026

Objective: Falls among community-dwelling older adults are prevalent and have serious individual, societal and economic consequences. Allied health professionals provide key falls prevention interventions yet their representation in current clinical practice guidelines is inconsistent. Increased recognition of allied health roles and delivering context-specific guidelines for falls care could help to address workforce gaps and optimise care approaches. This scoping review explored the roles of the allied health professions in falls prevention screening, assessment and intervention for community-dwelling older adults. Design: Scoping review, using the Joanna Briggs Institute methodology for scoping reviews. Data sources: PubMed, CINAHL, Scopus, Cochrane, Web of Science …

Identifying The Role Of Occupational Therapy In Suicide Prevention, Grey Buchheit

Capstone Projects

Occupational therapists are uniquely positioned to identify and support individuals experiencing suicidal ideation; however, suicide prevention education remains limited within occupational therapy curricula despite its relevance across diverse practice settings. This doctoral capstone experience sought to address this educational gap by developing evidence-based suicide prevention resources for Western Michigan University's Doctor of Occupational Therapy Program while promoting student wellness and burnout prevention as complementary components of suicide prevention. Guided by a literature review, SWOT analysis, faculty interviews, and a needs assessment that included a survey of Level I fieldwork educators, this project identified opportunities to strengthen occupational therapy education related …

Supporting Neurodiversity-Affirming Practice For Young Adults: Resource Development For A Level I Occupational Therapy Fieldwork Clinic, Grace Campbell

Capstone Projects

Neurodiversity-affirming and strengths-based practices are a growing area of focus within occupational therapy, viewing neurological differences as natural variations of human diversity rather than deficits to be corrected. This Doctoral Capstone Experience (DCE) focused on applying these perspectives within the Work-to-Work Clinic, a Level I occupational therapy fieldwork clinic that serves young adults with neurodevelopmental conditions such as Autism, ADHD, and intellectual disability. Commonly-used assessments and treatment materials at the clinic were outdated, deficit-focused, and poorly suited to this population’s developmental stage, leaving many clients with unmet needs. Additionally, Level I fieldwork students are still developing clinical reasoning skills and …

Co-Location Of Substance Use Disorder Treatment And Hospital Emergency Departments, Leila Hasan

Honors College Theses

Patients with substance use disorder (SUD) rely heavily on the hospital emergency department (ED) for acute care and are often discharged from the ED without access to long-term recovery resources. This project explores the impact of co-located addiction treatment programs with hospital EDs on recovery outcomes of patients with SUD. A systematic literature review conducted on relevant studies indicates that co-located programs can be effective in increasing treatment initiation and maintenance, reducing ED revisits, and reducing repeated overdose in SUD patients. Programs that were most effective included three key elements: fast linkage of SUD patients to program staff in the …

Exploring Clinical Reasoning In Occupational Therapy Students Using Think Aloud During Computerized Patient Simulation, Candra Selene Talylor

Graduate Theses and Dissertations (2019 - present)

The objective of this research was to explore the effects of the think aloud (TA) method on the development of clinical reasoning in occupational therapy students completing an online simulation assignment. The study aimed to determine if thinking aloud develops clinical reasoning in occupational therapy students as evidenced by a change in clinical reasoning skill scores and investigates the relationship between students' overall clinical simulation competency scores.

This study used a mixed methods design, combining quantitative and qualitative data to explore and measure the use of the TA strategy on the development of clinical reasoning skills. The sample from this …

Stance And Gait Analysis Of Apollo Astronauts On The Moon, Faye Y Chiou-Tan, Conrad Li, Jason P Caffrey, Millard Reschke, Timothy R Macaulay

Faculty, Staff and Students Publications

Introduction/aim: As humans return to the Moon, safe efficient ambulation and fall prevention on the lunar surface are key concerns. The analysis of gait from archived Apollo mission video footage is now possible with pose estimation video analysis software. Thus, this study aims to retrospectively quantify parameters of Apollo astronauts' stance and gait on the Moon.

Methods: Publicly available National Aeronautics and Space Administration (NASA) footage of astronauts ambulating on the Lunar surface was examined using body pose analysis software. Goniometric lower limb joint/torso angles and width of base of stance and gait were derived. Gait cycle stance phase, swing …

The Intersection Of Occupational Therapy And Optometry In The Treatment Of Visual Impairments: Addressing An Unmet Need, Grace Bannon

Capstone Projects

The prevalence of visual impairments in the United States is substantial and anticipated to increase in severity over the coming decades. These impairments have wide-reaching consequences on an individual’s occupational performance in daily living. While both occupational therapists and optometrists focus on the relationship between visual function and engagement in meaningful and purposeful occupations across the lifespan, only a limited number of optometrists offer specialized vision therapy services. This gap emphasizes a growing demand for vision services to manage the needs of individuals with visual deficits. Therefore, this Doctoral Capstone Experience (DCE) sought to bridge this gap by exploring the …

The Role Of Occupational Therapy In Community-Based Nonprofit Durable Medical Equipment Programs, Coral Mcfern

Capstone Projects

This 14 week doctoral capstone project focused on improving education within a nonprofit durable medical equipment program, Renew Mobility, to enhance safety and independence for individuals using mobility devices. This work is relevant to occupational therapy as it applies OT principles of client-centered care, health literacy, and adaptive equipment training in a community-based setting. A key gap in the literature was identified as the lack of structured educational resources, leading to inconsistent training and reliance on verbal instructions.

The objective of this project was to develop accessible educational materials to support proper equipment use and safety. This resulted in a …

Interprofessional Palliative Care: Implementation Of What Matters Most, Nicole Moran, Madeleine A. Keppel, Madison E. Markey, Alicia Naccarato, Kristen Cumming, Lori Boright

Oncology Rehabilitation in Practice

Palliative care (PC) is defined as specialized care plans for people with serious, life-limiting illnesses, emphasizing comfort care and management of complex symptoms. Rehabilitation professionals such as physical and occupational therapists have unique skills and perspectives towards managing and contributing to this population though are often under-represented on interprofessional palliative care teams. The Guide to What Matters (The Guide) was created upon recognition of the need for an increased presence of rehabilitation services in PC.

Severe Chemotherapy-Induced Peripheral Neuropathy Presenting With Paraplegic Symptoms: A Rehabilitation Case Report, Cecilia Hammond, Elizabeth Campione

Oncology Rehabilitation in Practice

Background: Chemotherapy-induced peripheral neuropathy (CIPN) is characterized by sensory and/or motor symptoms in distal extremities starting within 24 hours of receiving chemotherapy and can potentially last for years. Management of CIPN may include medication (i.e. Duloxetine) and physical therapy (PT). The purpose of this case report is to describe the rehabilitation process and adjustments to the plan of care for a patient with severe CIPN. This case underscores the importance of a proper diagnosis and the need for research to develop evidence-based guidelines for PT interventions for non-ambulatory patients with severe CIPN.

Case description: The patient was a 53-year-old female …

Clinical Management Of A Patient With Lipo-Lymphedema Using Adjustable Compression Wraps: A Case Report, Candace Alexander, Claire Davies, Martha Monroe

Oncology Rehabilitation in Practice

Background: Lipo-lymphedema indicates the presence of lipedema and lymphedema. Compression is used to achieve volume reduction and assist with long-term management. Adjustable compression wraps (ACWs) have been used in lymphedema care to replace traditional compression bandaging and facilitate patient self-care.

Case Description: This patient reported issues with bilateral leg edema for more than 35 years. She reported poor experiences with compression garments and had tried self-management with a compression pump only. She was referred for lymphedema care when her malfunctioning compression pump enabled her edema to worsen.

Assessment and Treatment: Lipedema may have been present for many years …

Recurring Axillary Web Syndrome (Aws) Following A Strenuous Increase In Upper Extremity Strengthening Exercise: A Case Report, David Locke, Linda Koehler

Oncology Rehabilitation in Practice

Background: Axillary web syndrome (AWS) refers to cords presenting in the axilla, upper extremity, and lateral chest wall after breast cancer surgery with axillary lymph node dissection. This unique case demonstrates the onset of AWS 2 weeks post-operatively with recurrence at 4 and 21 months, following rapid progression in upper extremity strengthening exercise.

Case Description: A 33-year-old athletic woman with invasive ductal carcinoma underwent a left mastectomy with sentinel node biopsy (6 nodes removed). Cord development occurred at 2 weeks after surgery. She sought physiotherapy consisting of AWS education, myofascial pin-and-stretch techniques applied to the cord in end-range abduction, a …

Physical Therapy Management Of An Adult Patient Diagnosed With Spindle Cell Rhabdomyosarcoma: A Case Report, Jennifer Carrano

Oncology Rehabilitation in Practice

Background: Rhabdomyosarcoma (RMS) is a rare soft tissue sarcoma that primarily affects children and adolescents. Adult RMS is uncommon and associated with poorer prognosis and limited evidence to guide rehabilitation.

Case Description: A 29-year-old male presented with right facial pain, hearing loss, tinnitus, and right facial and tongue paresthesia. Imaging and biopsy revealed spindle cell RMS of the right masticator space. He had no cancer-related family history, did not smoke, and used alcohol occasionally. Treatment included neoadjuvant chemotherapy, major oncologic resection with scapular free flap reconstruction, and adjuvant radiation. He was referred to outpatient physical therapy with trismus, restricted …

Navigating Care In Cancer: Aligning Rehabilitation And Exercise To Support Patients, Christopher M. Wilson

Oncology Rehabilitation in Practice

The growing evidence base supporting both exercise oncology and cancer rehabilitation highlights their complementary roles across the cancer continuum. Research consistently demonstrates that physical activity improves physical function, fatigue, quality of life, and survival, while rehabilitation addresses impairments and restores participation in meaningful activities. Despite these advances, current care models often lack coordination, resulting in fragmented services, inappropriate referrals, and missed opportunities for optimal patient outcomes. Some individuals are directed to exercise programs without adequate screening for underlying impairments, while others may receive rehabilitation services when supervised, independent or community-based activity would suffice.

To address these gaps, there is a …