Rehabilitation and Therapy Commons^™

Measures Of Pediatric Function And Physical Activity In Arthritis, Anna E. Greer, Maura D. Iversen

Exercise Science Faculty Publications

Physical function can be assessed through physical examination with the use of performance-based measures and patient-reported outcome measures (PROMs). Each form of assessment provides a unique contribution to the understanding of the impact of rheumatologic conditions on the patient. PROMs of physical function (PF) are an important component of the assessment of children with arthritis and have been included in the recommended core set of measures for childhood arthritis and musculoskeletal conditions. These measures provide the child’s or parent’s perspective of function within the context of daily living. Measures of PF include both generic measures, which are designed for use …

Time-Frequency Analysis Of Muscle Activation Patterns In People With Chronic Ankle Instability During Landing And Cutting Tasks, Hoon Kim, Rianna M. Palmieri-Smith, Kristof Kipp

Exercise Science Faculty Research and Publications

Background

People with chronic ankle instability (CAI) exhibit neuromuscular deficits. Previous studies, however, only investigated magnitudes of muscle activation and not the time-frequency domain.

Research question

Do people with CAI exhibit differences in muscle activation patterns in the time-frequency domain during landing, anticipated cutting, and unanticipated cutting compared to matched controls?

Methods

Eleven people with CAI and eleven healthy matched controls (CON) performed landing, anticipated cutting, and unanticipated cutting as surface EMG of the lateral gastrocnemius, medial gastrocnemius, fibularis longus, soleus, and tibialis anterior were recorded. The time-frequency domain of surface EMG data was analyzed with wavelet transformations and principal …

Greater Fatigue Resistance Of Dorsiflexor Muscles In People With Prediabetes Than Type 2 Diabetes, Jonathon Senefeld, Lynette A. Singh-Peters, Kenji A. Kenno, Sandra K. Hunter, Jennifer M. Jakobi

Exercise Science Faculty Research and Publications

Although exercise can prevent progression to T2D among people with prediabetes, little is known about fatigue during exercise in people with prediabetes compared to T2D. The purpose of the study was to compare the magnitude and mechanisms of fatigability of the ankle dorsiflexor muscles between people with prediabetes and T2D. Ten people with prediabetes (6 females, 51.7 ± 6.9 years) and fourteen with T2D (6 females, 52.6 ± 6.2 years) who were matched for age, body mass index and physical activity performed an intermittent (6 s contraction: 4 s relaxation) fatiguing task at 75% maximal voluntary contraction (MVC) with the …

Exercise And Lifestyle Physical Activity Recommendations For People With Multiple Sclerosis Throughout The Disease Course, Rosalind Kalb, Theodore R. Brown, Susan Coote, Kathleen Costello, Ulrik Dalgas, Eric Garmon, Barbara Geisser, June Halper, Herb Karpatkin, Jennifer Keller, Alexander V. Ng, Lara A. Pilutti, Amanda Rohring, Paul Van Asch, Kathleen Zachowski, Robert W. Motl

Exercise Science Faculty Research and Publications

Objectives:

To provide clinicians who treat multiple sclerosis (MS) patients with evidence-based or expert opinion–based recommendations for promoting exercise and lifestyle physical activity across disability levels.

Methods:

The National MS Society (“Society”) convened clinical and research experts in the fields of MS, exercise, rehabilitation, and physical activity to (1) reach consensus on optimal exercise and lifestyle physical activity recommendations for individuals with MS at disability levels 0–9.0 on the Expanded Disability Status Scale (EDSS) and (2) identify and address barriers/facilitators for participation.

Recommendations:

Based on current evidence and expert opinion, the Society makes the following recommendations, endorsed by the Consortium …

Impaired Firing Behavior Of Individually Tracked Paretic Motor Units During Fatiguing Contractions Of The Dorsiflexors And Functional Implications Post Stroke, Francesco Negro, Kathleen Bathon, Jennifer Nguyen, Cassidy Bannon, Claudio Orizio, Sandra K. Hunter, Allison S. Hyngstrom

Exercise Science Faculty Research and Publications

Introduction: This study quantified stroke-related changes in the following: (1) the averaged discharge rate of motor units (individually tracked and untracked) identified from high-density electromyography (HD-EMG) recordings, (2) global muscle EMG properties of the dorsiflexors during a fatiguing contraction, and the relationship between task endurance and measures of leg function.

Methods: Ten individuals with chronic stroke performed a sustained sub-maximal, isometric, fatiguing dorsiflexion contraction in paretic and non-paretic legs. Motor-unit firing behavior, task duration, maximal voluntary contraction strength (MVC), and clinical measures of leg function were obtained.

Results: Compared to the non-paretic leg, the paretic leg task duration was shorter, …

A Discrete-Choice Experiment To Assess Patients’ Preferences For Osteoarthritis Treatment: An Esceo Working Group, Mickael Hiligsmann, Elaine Dennison, Charlotte Beaudart, Gabriel Herrero-Beaumont, Jaime Branco, Olivier Bruyère, Philip G. Conaghan, Cyrus Cooper, Nasser Al-Daghri, Famida Jiwa, Willem Lems, Daniel Pinto, René Rizzoli, Thierry Thomas, Daniel Uebelhart, Nicolas Veronese, Jean-Yves Reginster

Physical Therapy Faculty Research and Publications

Objective

To evaluate the preferences of patients with osteoarthritis for treatment.

Methods

A discrete-choice experiment was conducted among adult OA patients who were presented with 12 choice sets of two treatment options and asked in each to select the treatment they would prefer. Based on literature reviews, expert consultation, patient survey and expert meeting, treatment options were characterized by seven attributes: improvement in pain, improvement in walking, ability to manage domestic activities, ability to manage social activities, improvement in overall energy and well-being, risk of moderate/severe side effects and impact on disease progression. Random parameters logit model was used to …

The Effects Of Meditation In College Students, Katherine Shelton

Student Theses and Dissertations

Research has been conducted on young student age groups (ages 13-18) and the effects that meditation elicits on anxiety, stress and academic performance, but that is where the age is capped (Beauchemin, Hutchins, & Patterson, 2008). The purpose of this study was to investigate the effects of meditation on a previously understudied age category: undergraduate college students ages 18-22. All participants had their age, gender, height, weight, body mass index, systolic blood pressure, diastolic blood pressure, and resting heart rate measured before and after the study, and completed a 19-Item Body-Image Questionnaire (Koleck, Brunchon-Schweitzer, Cousson-Gélie, Gilliard, & Quintard, 2002). Results …

Turning Everyday Activities Into Play: Building Relationships And Fostering Connections For Adopted Children And Children In Foster Care, Marissa E. Siu

Student Capstone Papers

The purpose of this capstone project was to create a program for community members, foster families, and adoptive families. In this project, community members was defined as any professional that works with foster and adoptive families in the community or in their profession. This included school staff, school administrators, therapists, and day care or respite providers.

The goal of this program was to use play to build stronger family bonds and relationships while also supporting the development of children in foster care and adopted children. By providing this program as a tool that can be used by families and community …

Utilization Of A Double Robot To Promote Critical Thinking By Novice Student Physical Therapists, Bonnie L. Rogulj, Mechelle Roy, Megan Dickerson

Physical Therapy Collection

This presentation discusses the clinical significance of the utilization of a double robot during a simulated telehealth session by novice student physical therapists to develop critical thinking skills. We demonstrate how to create a simulated telehealth session utilizing a double robot to promote critical thinking by novice student physical therapists. Finally, the limitations for virtual healthcare simulation are addressed as well as strategies for successful outcomes in the development of critical thinking skills.

Core Neuropsychological Measures For Obesity And Diabetes Trials: Initial Report, Kimberlee D'Ardenne, Cary R. Savage, Dana Small, Uku Vainik, Luke E. Stoeckel

Center for Brain, Biology, and Behavior: Faculty Publications

Obesity and diabetes are known to be related to cognitive abilities. The Core Neuropsychological Measures for Obesity and Diabetes Trials Project aimed to identify the key cognitive and perceptual domains in which performance can influence treatment outcomes, including predicting, mediating, and moderating treatment outcome and to generate neuropsychological batteries comprised of well-validated, easy-to-administer tests that best measure these key domains. The ultimate goal is to facilitate inclusion of neuropsychological measures in clinical studies and trials so that we can gather more information on potential mediators of obesity and diabetes treatment outcomes. We will present the rationale for the project and …

Demystifying Sensory Processing To Promote Effective Interprofessional And Caregiver Collaboration, Janis Leinfuss, Erin O'Hara

Student Journal of Occupational Therapy

Research shows collaboration and coaching with caregivers and educators positively impacts growth in occupational performance. Better understanding of this additional role that occupational therapy practitioners play; when working with children with sensory processing challenges, is vital to properly advocate for strategies and resources to help them reach their personal trajectory.

This article offers insight into the importance of removing professional jargon to facilitate effective interprofessional collaboration. Specific strategies for making coaching and training sessions for sensory processing content relatable and meaningful to educators and caregivers are also provided.

Targeted Engagement Of The Action Selection Network During Task-Oriented Arm Training After Stroke, Jill Campbell Stewart Pt,Phd, Kaci Handlery, Jessica F. Baird, Erika L. Blanck, Geetanjali Pathak, Stacy L. Fritz

Faculty Publications

Action selection (AS), or selection of an action from a set of alternatives, is an important movement preparation process that engages a frontal-parietal network. The addition of AS demands to arm training after stroke could be used to engage this motor planning process and the neural network that supports it. The purpose of this case series is to describe the feasibility and outcomes associated with task-oriented arm training aimed at engaging the AS behavioral process and the related neural network in three individuals with chronic stroke. Three participants with mild to moderate motor deficits completed 13 to 15 sessions of …

An Analysis Of A New Shoe Technology In The Gait Patterns Of A Child With A Neurological Disability, Emma Madonna, Jeff Bauer

The SUNY Journal of the Scholarship of Engagement: JoSE

This study focused on the application of a unique technology originally designed to supply biofeedback to dancers, but in this case was used to assist a child learning to walk while battling the effects of Cerebral Palsy. The musical shoes, called Electroskip^TM, utilize a biofeedback system that generates variable sounds/beats/songs when an individual is walking and placing pressure on their heel or toe. The study lasted six weeks with two sessions per week. Each session started with shoes fitted with Electroskip^TM technology placed on the child’s feet. When instructed by the researcher the child would proceed to …

Supporting Coordination Of Children With Asd Using Neurological Music Therapy: A Pilot Randomized Control Trial Comparing An Elastic Touch-Display With Tambourines, Franceli L. Cibrian, Melisa Madrigal, Marina Avelais, Monica Tentori

Engineering Faculty Articles and Research

Aim

To evaluate the efficacy of Neurologic Music Therapy (NMT) using a traditional and a technological intervention (elastic touch-display) in improving the coordination of children with Autism Spectrum Disorder (ASD), as a primary outcome, and the timing and strength control of their movements as secondary outcomes.

Methods

Twenty-two children with ASD completed 8 NMT sessions, as a part of a 2-month intervention. Participants were randomly assigned to either use an elastic touch-display (experimental group) or tambourines (control group). We conducted pre- and post- assessment evaluations, including the Developmental Coordination Disorder Questionnaire (DCDQ) and motor assessments related to the control of …

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

Physical Therapy Faculty Articles and Research

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

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

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

Recovery From Covid-19 And Acute Respiratory Distress Syndrome: The Potential Role Of An Intensive Care Unit Recovery Clinic: A Case Report, Kirby P. Mayer, Jamie L. Sturgill, Anna G. Kalema, Melissa K. Soper, Sherif M. Seif, Evan P. Cassity, Jimmi Hatton Kolpek, Esther E. Dupont-Versteegden, Ashley A. Montgomery-Yates, Peter E. Morris

Physical Therapy Faculty Publications

Background

In this case report, we describe the trajectory of recovery of a young, healthy patient diagnosed with coronavirus disease 2019 who developed acute respiratory distress syndrome. The purpose of this case report is to highlight the potential role of intensive care unit recovery or follow-up clinics for patients surviving acute hospitalization for coronavirus disease 2019.

Case Presentation

Our patient was a 27-year-old Caucasian woman with a past medical history of asthma transferred from a community hospital to our medical intensive care unit for acute hypoxic respiratory failure due to bilateral pneumonia requiring mechanical ventilation (ratio of arterial oxygen partial …

Applying The Who Icf Framework To The Outcome Measures Used In The Evaluation Of Long-Term Clinical Outcomes In Coronavirus Outbreaks, Kajal Patel, Sofia Straudi, Ng Yee Sien, Nora Fayed, John L. Melvin, Manoj Sivan

Department of Rehabilitation Medicine Faculty Papers

(1) Objective: The World Health Organization's (WHO) International Classification of Functioning, Disability and Health (ICF) classification is a unified framework for the description of health and health-related states. This study aimed to use the ICF framework to classify outcome measures used in follow-up studies of coronavirus outbreaks and make recommendations for future studies. (2) Methods: EMBASE, MEDLINE, CINAHL and PsycINFO were systematically searched for original studies assessing clinical outcomes in adult survivors of severe acute respiratory distress syndrome (SARS), middle east respiratory syndrome (MERS) and coronavirus disease-19 (COVID-19) after hospital discharge. Individual items of the identified outcome measures were linked …

The Association Between Medication Use And Gait In Adults With Intellectual Disabilities, S. Maas, D. A.M. Festen, Thessa I.M. Hilgenkamp, A. Oppewal

Physical Therapy Faculty Research

Background: Adults with intellectual disabilities (ID) often have polypharmacy and often use antipsychotics. Both polypharmacy and antipsychotics have a negative effect on gait in the general population, but this has not been studied in adults with ID. These negative effects may add to pre‐existing gait disturbances in adults with ID and increase the risk for adverse health outcomes in this population. Therefore, the aim of this study is to investigate the difference in gait parameters between adults with ID with and without polypharmacy and between adults with ID using and not using antipsychotics. Method: The gait parameters of 31 participants …

Differential Rates Of Intravascular Uptake And Pain Perception During Lumbosacral Epidural Injection Among Adults Using A 22-Gauge Needle Versus 25-Gauge Needle: A Randomized Clinical Trial, Robin Raju, Michael Mehnert, David Stolzenberg, Jeremy Simon, Theodore Conliffe, Jeffrey Gehret

Department of Rehabilitation Medicine Faculty Papers

BACKGROUND: Inadvertent intravascular injection has been suggested as the most probable mechanism behind serious neurological complications during transforaminal epidural steroid injections. Authors believe a smaller gauge needle may lead to less intravascular uptake and less pain. Theoretically, there is less chance for a smaller gauge needle to encounter a blood vessel during an injection compared to a larger gauge needle. Studies have also shown smaller gauge needle to cause less pain. The aim of the study was to quantify the difference between a 22-gauge needle and 25-gauge needle during lumbosacral transforaminal epidural steroid injection in regards to intravascular uptake and …

Promoting Interprofessional Collaboration Through Education In The Inpatient Rehabilitation Setting, Emma Murphy

OTD Capstone Projects

As part of a 14-week occupational therapy doctoral capstone project, the author partnered with Vanderbilt Stallworth Rehabilitation Hospital to research and address interprofessional collaboration in the inpatient rehabilitation setting. The project sought to attain a comprehensive assessment of the current interdisciplinary collaboration environment at VSRH, improve communication between the therapy and nursing departments, provide rehabilitation education for nurses on staff-identified topics, and promote interprofessional collaboration as a whole.

Flexible Coordinator And Switcher Hubs For Adaptive Task Control, Carrisa V. Cocuzza, Takuya Ito, Douglas H. Schultz, Dabielle D. Bassett, Michael W. Cole

Center for Brain, Biology, and Behavior: Faculty Publications

Functional connectivity (FC) studies have identified at least two large-scale neural systems that constitute cognitive control networks, the frontoparietal network (FPN) and cingulo-opercular network (CON). Control networks are thought to support goal-directed cognition and behavior. It was previously shown that the FPN flexibly shifts its global connectivity pattern according to task goal, consistent with a “flexible hub” mechanism for cognitive control. Our aim was to build on this finding to develop a functional cartography (a multimetric profile) of control networks in terms of dynamic network properties. We quantified network properties in (male and female) humans using a high-control-demand cognitive paradigm …

Doing Nonbinary Gender: The Occupational Experience Of Nonbinary Persons In The Environment, Karen Mccarthy, Meghan Ballog, Maria Mayela Carranza, Katherine Lee

Occupational Therapy | Faculty Scholarship

Understanding the effect of the environment is fundamental to grasping the occupational experiences of nonbinary individuals. Current research in occupational science addresses the occupations of the transgender population but often fails to distinguish between the binary and nonbinary experience. There is an absence of occupational science research that solely focuses on the nonbinary experience. This study focuses on nonbinary individuals and aims to illuminate the environmental factors that support or hinder occupational engagement for nonbinary individuals. Using a descriptive qualitative research design, we conducted two interviews per participant and photo-elicitation. Data analysis resulted in three themes: binary environments and safe …

Strategies For Hybrid Teaching, Julia Bilotta

OTD Capstone Projects

This project aimed to work alongside the occupational therapy department at Belmont University to research, develop, and disseminate strategies for hybrid teaching. As the early days of the COVID-19 pandemic required universities to rapidly switch to online teaching, the need for strategies to complete this effectively arose. Moving months ahead to present day, Belmont University has adapted a hybrid model for teaching, which includes both online and in-person learning. With that being said, the department of occupational therapy expressed the need for lab experiences and clinical skill competencies that follow the ACOTE standards, that can be delivered through a virtual …

Understanding The Impact Of Social Distancing On Older Adults And Senior Centers To Better Adapt Towards A New Normal, Salina Jivan

Student Capstone Papers

COVID-19 brought about social distancing mandates that posed as a new barrier to meaningful social participation in the community. The purpose of this project was to understand the impact of social distancing on older adults and senior organizations to better inform the role of OT in helping seniors adapt towards a new normal within the community. A qualitative study and needs assessment were performed through phone interviews with seniors and organizations that support them from around the United States. Themes highlighted seniors desire for social contact and cautious return to the community once mandates are lifted. Both seniors and organizations …

An Examination Of Acute Cross-Over Effects Following Unilateral Low Intensity Concentric And Eccentric Exercise, William Miller, Sunggun Jeon, Xin Ye

Faculty and Student Publications

We compared the effects of low intensity concentric (CON) and eccentric (ECC) exercise on the force and neural responses of the dominant (exercised) elbow flexors (EFs), and studied if these conditions could induce cross-over effects to the contralateral (non-exercised) EFs. Fifteen subjects (8 males) completed all conditions (CON and ECC: 6 sets of low intensity exercise to failure; control: rest) in separate visits with a randomized order. Maximal isometric force and electromyography (EMG) of the dominant and contralateral EFs were assessed at pre, immediate-, 24-, and 48-h-post. Two-factor (condition and time) linear mixed-model analyses were performed to examine the force …

Occupational Therapy And Accessibility In The Outdoors And Summer Camps, David M. Lewis

Student Capstone Papers

Opportunities for positive youth development (PYD) are promoted through both outdoor and camp experiences. The experiences provided by the outdoors and camps are ideal for developing physically, cognitively, socially, emotionally, and spiritually. These areas of PYD are further generalizable to several aspects of occupational performance and participation, while continuing to have benefits throughout the lifespan. While the outdoors and camps provide these valuable opportunities for development, the environments and contexts of these opportunities are often limiting factors for individuals with disabilities. Utilizing an occupational therapy approach allows for further understanding of how to promote inclusion and accessibility practices in these …

The Effects Of Human Visual Sensory Stimuli On N1b Amplitude: An Eeg Study, Damien Moore, Toshikazu Ikuta, Paul D. Loprinzi

Faculty and Student Publications

Sensory systems are widely known to exhibit adaptive mechanisms. Vision is no exception to input dependent changes in its sensitivity. Recent animal work demonstrates enhanced connectivity between neurons in the visual cortex. The purpose of the present experiment was to evaluate a human model that noninvasively alters the amplitude of the N1b component in the visual cortex of humans by means of rapid visual stimulation. Nineteen participants (Mage = 24 years; 52.6% male) completed a rapid visual stimulation paradigm involving black and white reversal checkerboards presented bilaterally in the visual field. EEG data was collected during the visual stimulation paradigm, …

Transition In Occupations Of Refugees During Resettlement, Karen Mccarthy, Jacqueline-Elizabeth Cantrell, Jennifer Daine, Kimberley K. Banuelos, Adam Chan

Occupational Therapy | Faculty Scholarship

Background: Human displacement is a social problem that has occupational implications. There is a significant gap in the research focusing on the refugee experience and the impact of this experience on their occupations as they transition to living in the US. This study seeks to capture the experience of refugees and the impact of this transition to the US on a broad array of occupations.

Method: This research is a qualitative study. Data was collected through semi-structured interviews with two participants who have legal status as refugees living in the US.

Results: Thematic analysis generated three themes: …

Validating Tackle Mechanics In American Football: Improving Safety And Performance, Arthur C. Maerlender, Caitlin J. Masterson, Rex Norris, Adam Hinthorne

Center for Brain, Biology, and Behavior: Faculty Publications

Research has helped to understand the risks of injuries of tackling in American football and rugby; however, approaches to teaching and analysis are not well-documented. Shoulder-led tackling has been proposed as a safer approach to tackling even though data on the effectiveness for safety and defensive performance is limited. Additionally, some have argued that safety and effectiveness are incompatible. The purpose of the study was to validate a specific sequence of tackling actions as a tool for teaching safer and more effective tackling skills. Results suggested tackle scores help predict presence of head contact, and that higher tackle scores were …

Middle Cerebral Artery Occlusion And The Effects Of Physical Therapy In The Skilled Nursing Facility: A Case Study, Delany Faiman

Physical Therapy Scholarly Projects

Background and Purpose: Stroke is the leading cause of disability and fifth leading cause of death among adults in the Unites States. This case study evaluates the effectiveness of inpatient physical therapy following a right middle cerebral artery occlusion and the outcomes throughout the weeks of treatment.

Case Description: The patient was an 80-year-old male who received physical therapy within the hospital for six days before he was referred to a skilled nursing facility. The patient completed four total weeks of skilled physical therapy in the nursing home prior to discharge.

Intervention: The therapy provided to the …