Rehabilitation and Therapy Commons^™

Ensure Follow-Up For Functional Issues Post Covid-19, Nethra Ankam, Md, Tulasi Gude, Md, Kristofer Feeko, Do, Shannon Ames, Pt, Catherine Piersol, Ot, Tiffany Prince-Kandrakota, Pt, Erica Rao, Pt, Kristen Stout, Pt, Monina Florendo, Pt

Health Equity and Quality Improvement (HEQI) Summit

What's the Problem?

Patients post COVID-19 infection have functional limitations at home related to the multi-system effects of the infection, in addition to elevated risk for post-intensive care syndrome.

Our goals were to ensure patients had the resources they needed to safely mobilize at home, ensure referral to appropriate agencies for home care and therapies, and provide guidance on return to life activities in the setting of the stay-at-home order, need to self-quarantine, and limited outpatient therapy options.

Screening Tool To Ensure Optimal Patient Care And Function Post Covid Diagnosis, Nethra Ankam, Md, Shannon Ames, Pt, Dpt, Mba, Tiffany Prince-Kandrakota, Pt, Dpt, Ocs, Erica Rao, Pt, Dpt, Namrata Grampurohit, Phd, Otr/L, Catherine Piersol, Phd, Otr/L

Health Equity and Quality Improvement (HEQI) Summit

We developed a screening tool of questions to determine which patients would benefit from outpatient PM&R visits after discharge from the hospital/ED that included: four questions looking at function, shortness of breath and cognition. Screening questions were created so a YES response triggers a referral to PM&R to assess functional and cognitive needs for the patient.

Sars-Cov-2 Testing Guidelines For Patients Admitted To Mrh For Inpatient Rehabilitation, Deborah Cassidy, Do, Roger Liu, Do, Malav Shah, Md, Kyle Hummerston, Do, Jeanne Doherty, Md

Health Equity and Quality Improvement (HEQI) Summit

We implemented a clinical algorithmic approach with an emphasis on symptoms and risk to stratify patients into 3 groups:

• Acutely Ill COVID Rule Out/PUI
• Stable COVID Rule Out/PUI
• COVID OBS

Cardiovascular And Stride Frequency Differences During Land And Aquatic Treadmill Walking, Jessica Burton, Sarah Duffey, Amber Hammonds, Anna Leduc, Rachel Shumate, John Coons, Ryan T. Conners

International Journal of Aquatic Research and Education

This study examined heart rate (HR) and stride frequency (SF) values of 30 college-aged males and females during dry-land (DL) and aquatic walking (AW). Aquatic walking trials were completed in an underwater treadmill with the water depth at waist level; the water temperature (31℃ ± 0.1℃) and room temperature (26.6℃ ± 0.1℃) were maintained at thermoneutral levels throughout the study. During each walking condition, HR and SF were recorded at treadmill speeds of 1 mph, 2 mph, and 3 mph. Participants were instructed to walk with their hands at their sides swinging as they would when walking on dry-land unless …

Evaluation Of Repetitive Jumping Intensity On The Digi-Jump Machine, T. Scott Lyons, James W. Navalta, Whitley J. Stone, Scott W. Arnett, Mark A. Schafer, Laura Igaune

Kinesiology and Nutrition Sciences Faculty Research

Cardiorespiratory endurance is an important element of aerobic fitness, particularly in weight management and reducing risk for cardiovascular disease. While there are numerous options for aerobic exercise, rope jumping is often overlooked. In addition to regular exercise and a healthy diet, the American Heart Association strongly recommends rope jumping. The first purpose of this study was to determine the steady state metabolic cost of repetitive jumping on the Digi-Jump machine to evaluate whether exercise on this device is more or less strenuous than similar exercise with a jump rope, as demonstrated in previous literature. A second purpose was to determine …

Longitudinal Evaluation Of The Effects Of Illness Perceptions And Beliefs About Cardiac Rehabilitation On Quality Of Life Of Patients With Coronary Artery Disease And Their Caregivers, Patricia Thomson, Neil J. Angus, Federico Andreis, Gordon F. Rushworth, Andrea R. Mohan, Misook L. Chung, Stephen J. Leslie

Nursing Faculty Publications

Background

Patients’ negative illness perceptions and beliefs about cardiac rehabilitation (CR) can influence uptake and adherence to CR. Little is known about the interpartner influence of these antecedent variables on quality of life of patients with coronary artery disease (CAD) and their family caregivers. The aims of the study were: 1) to assess differences in illness perceptions, beliefs about CR and quality of life between patients with CAD and their family caregivers upon entry to a CR programme and at 6 months follow-up; and 2) to examine whether patients’ and caregivers’ perceptions of the patient’s illness and beliefs about CR …

Features Of Acceleration And Angular Velocity Using Thigh Imus During Walking In Water, Koichi Kaneda, Yuji Ohgi, Mark Mckean, Brendan Burkett

International Journal of Aquatic Research and Education

Ten participants were assessed while walking in water and on land with wearable inertial measurement units (IMUs) attached to the right thigh. Longitudinal acceleration, anterior-posterior acceleration, and frontal axis angular velocity were measured at 100 Hz, matched with video analysis sampled at 25 Hz during the walking trials. The longitudinal acceleration showed almost 1 g from initial heel contact to 70% of one cycle, and the anterior-posterior acceleration showed a sinusoidal pattern, synchronizing the approximate posture of the thigh in water. The frontal axis angular velocity fluctuated less while walking in water compared with on land, because thigh motion speed …

The Ocean Lifeguard Intervention Continuum: A Cognitive Aid For Surf Lifeguard Education, William A. Koon, Ryan M. Gates, Shane Scoggins, Paul Andrus, Jack A. Futoran

International Journal of Aquatic Research and Education

Ocean lifeguards are constantly engaged in beach risk analysis, required to efficiently evaluate a variety of environmental and other factors quickly in order to triage and prioritize who needs help. Teaching these skills is a challenge for introductory training programs. We sought to improve new lifeguards’ understanding of the interaction of various risk components in the beach environment and aid decision-making related to when a lifeguard should intervene in a situation. We developed a two-part cognitive aid for introductory ocean lifeguard education depicting individual and interacting elements of a beach goer’s risk of drowning or injury and the process by …

Effectiveness Of Splinting In Adults With Radial Nerve Palsy, Laurel Jeanette Pitman, Logan Buckner, Logan Stem, Sarah Grace Rogers, Emylee Williams

Master of Occupational Therapy Student Critically Appraised Topics

The final portfolio contains 5 research articles from national and international journals. The study designs included in this portfolio are one small-scale RTC, one retrospective pretest posttest design, and three case studies. The studies included help answer our PICO question and help draw conclusions about how to care for adults with radial nerve palsy in regards to splinting. Three of the articles compared static splinting and dynamic splinting in regards to improvements in hand function. Two of the articles focused on dynamic splinting as a means of treatment for adults with radial nerve palsy.

Infant Massage And Bonding, Aly Blumenberg, Samantha Davis, Ali Graham, Rachel Medina, Emily Rayder

Master of Occupational Therapy Student Critically Appraised Topics

This project aims to appraise evidence of the effectiveness of infant massage for increasing social-emotional bonding. In our research, we focused on two studies considered Level I evidence and three studies considered Level II evidence. Study designs include quasi-experimental and randomized controlled trials. Strong evidence supports that infant massage increases social-emotional bonding and attachment. Based on the evidence, implementation varied from once per day for 10 minutes to 2-3 times per day for 15 minutes. It is recommended to use infant massage in an acute care setting and in the home to increase social-emotional bonding and attachment.

The Effects Of Dual-Tasking On Fall Risks In Adults With Brain Injury, Kaley Campbell, Anayston Casey, Madison Culpepper, Elizabeth Denton, Katie Morgan

Master of Occupational Therapy Student Critically Appraised Topics

Clinical Scenario: Dual-tasking combines both physical and cognitive components into one therapeutic intervention. There has been limited research on the benefits of dual tasking in relation to fall risks in adults with brain injury. Currently, it is common for various therapy interventions to spend the majority of time targeting physical or cognitive components, but not both at once. After appraisal, a total of five articles were used. These included two level I studies involving a high-quality randomized control trial and a meta-analysis, two level II studies that were both small-scale randomized control trials, and one level IV study that was …

Effects Of Occupational Therapy Intervention In Low Vision, Zach Harrington, Juliana Crossett, Carlie Carter, Baleigh Gooch, Liberty Harris

Master of Occupational Therapy Student Critically Appraised Topics

The purpose of this CAT is to investigate therapeutic intervention and its effects for improving independence in occupational performance, overall health, quality of life, and mental health in adults over 40 with acquired low vision. This CAT contains nine peer-reviewed research articles from national journals. Study designs include one randomized controlled trial, seven systematic reviews, and one non-randomized controlled trial. All studies relate directly to the components of our evidence-based practice question and will be used to support further research on the optometry and occupational therapy collaboration. All of the articles specifically describe various interventions used in the low vision …

Group Therapy Versus Individual Therapy For Older Adults With A Cerebrovascular Accident, Montana R. Bawcum, Jessica Sorrell, Kaleigh Stevens, Caitlyn Strietelmeier, Madeline Young

Master of Occupational Therapy Student Critically Appraised Topics

The purpose of our critically appraised topic is to synthesize the best current evidence regarding the feasibility of group occupational therapy and outcomes related to ADL performance. The final portfolio contains a total of five research articles. Study designs include two pre-post single group designs, two case studies, and one non randomized pilot trial with a control group. All studies related directly to the PICO question and were used to determine best evidence for the feasibility of group therapy of the older adult population in a rehabilitation setting.

Moving Through Depression: Development Of A Dance/Movement Therapy Method In Psychiatric Inpatient Care, Melissa Olmedo

Expressive Therapies Capstone Theses

Short-term psychiatric hospitalization is a challenging health care model due to its short duration of care, treating the highest risk psychiatric population. Priority care within a short-term psychiatric hospitalization involves monitoring a patient’s safety for stabilization by decreasing acute mental health symptoms. Holistic psychotherapy treatment options are needed to meet the severity of patients’ symptoms for effective stabilization within a short-term model of care. This paper investigates the first implementation of a dance/movement therapy (DMT) method within two short-term units in a notable Boston hospital. The DMT group called Mindful Movement was facilitated weekly as single sessions to adults ranging …

Long-Term Functional Effects Of Medulloblastoma Treatments, Serena Khiantani, Pamela Ponce, Bailey Diprima, Sarika Maymoundok, Leah Murray

Master of Occupational Therapy Student Critically Appraised Topics

All studies relate directly to components of the evidence-based practice question and were used to understand the possible long-term effects of treatment for clients diagnosed with medulloblastoma cancer. This Critically Appraised Topic (CAT) contains 6 research articles from both national and international journals. Study designs include two cohort studies with a control group, 1 cross sectional study with a control group, 1 retrospective cohort study without a control group, 1 descriptive report on a Randomized Control Trial (RCT), and 1 descriptive study. Through these studies, we found that radiation treatment is associated with impaired IQ and academic achievement and that …

Implementing The Hodgson Red Yellow Green Mobilization Consensus Recommendation In A Medical And Surgical Icu: A Retrospective Study Exploring The Effectiveness Of An Early Mobilization Decision Protocol In Icu, Swati Patel

Seton Hall University Dissertations and Theses (ETDs)

Background: More than 4 million people are admitted annually to intensive care units (ICUs). Due to immobility, many ICU survivors experience significant cognitive, psychological, and physically disabling side effects regardless of admitting diagnosis. Multiple studies and quality improvement projects have shown the safety, feasibility, and benefits of early mobilization in the ICU setting. Hodgson et al (2014) published consensus recommendations for safe active mobilization of mechanically ventilated critically ill adults. To date, there is no standardized and simple triage protocol for identifying patients for early mobilization. No study so far has described operationalizing and implementing the Red-Yellow-Green system described …

Correlations Of Calf Muscle Macrophage Content With Muscle Properties And Walking Performance In Peripheral Artery Disease, Kate Kosmac, Marta Gonzalez-Freire, Mary M. Mcdermott, Sarah H. White, R. Grace Walton, Robert L. Sufit, Lu Tian, Lingyu Li, Melina R. Kibbe, Michael H Criqui, Jack M. Guralnik, Tamar S. Polonsky, Christiaan Leeuwenburgh, Luigi Ferrucci, Charlotte A. Peterson

Physical Therapy Faculty Publications

Background

Peripheral artery disease (PAD) is a manifestation of atherosclerosis characterized by reduced blood flow to the lower extremities and mobility loss. Preliminary evidence suggests PAD damages skeletal muscle, resulting in muscle impairments that contribute to functional decline. We sought to determine whether PAD is associated with an altered macrophage profile in gastrocnemius muscles and whether muscle macrophage populations are associated with impaired muscle phenotype and walking performance in patients with PAD.

Methods and Results

Macrophages, satellite cells, and extracellular matrix in gastrocnemius muscles from 25 patients with PAD and 7 patients without PAD were quantified using immunohistochemistry. Among patients …

Association Between Patient Ability In Activities Of Daily Living At Hospital Admission And Key Indicators, Stephanie Rosen, Amber Steele

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Illness and inactivity in the hospital frequently leads to disability that can reduce quality of life and increase costs. Early identification of people with limitations in activities of daily living (ADL) who are at risk for poor outcomes such as increased length of stay (LOS), hospital acquired conditions (i.e., falls and pressure injuries (PIs)), and discharge away from home can facilitate appropriate intervention. The Activity Measure for Post-Acute Care Inpatient Activity Short Form (AM-PAC IASF), a reliable and valid tool to measure ADL limitations, is scored at admission for all patients in our hospital. The purpose of this study …

Mental Associations And Music Therapy: Including The History Of Associationism And The Neurology Of Associations, Dianna Rose

Expressive Therapies Capstone Theses

Associations are formed in our minds based upon three elements: sensory experience, emotions, and memories. These associations, unique to each individual, dictate thoughts, beliefs, behaviors, and actions. Some are necessary and supportive, while others can be maladaptive. Established associations can be changed, and new associations can be formed, to align with a client’s goals. The literature presents a strong history of associationism, as well as a body of research that demonstrates the neurological processes of how mental associations are formed. There are also studies showing how music activates the brain. However, there is a lack of research which draws direct …

Reliability Of The Lateral Reach Test In People With Unilateral Transfemoral Amputations, Stephen Hill, Samantha Leonard, Elizabeth Vianey Trujillo

UNLV Theses, Dissertations, Professional Papers, and Capstones

Lateral reach testing has been established as useful in quantifying stability and fall-risk for older populations without limb loss,1 and has potential for providing useful information about fall-risk, recovery, and rehabilitation of individuals after unilateral trans-femoral amputation. Investigators sought to determine the feasibility and reliability of the Lateral Reach Test (LRT) in people with unilateral trans-femoral amputations. Nine individuals, aged 20-68, with a unilateral trans-femoral amputation were recruited for this study. Two females and seven males participated, and the average height and weight for the group was 167cm and 76kg, respectively. Three participants had right trans-femoral amputations while six had …

Brain Volumes And Dual-Task Performance Correlates Among Individuals With Cognitive Impairment: A Retrospective Analysis, Jon Basterrechea, Daniel Krist, Caitlin Moreland, Morgan Wise

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Cognitive impairment (CI) is a prevalent condition characterized by loss of brain volume and changes in cognition, motor function, and dual-tasking ability. Objective: To examine associations between brain volumes, dual task performance, and gait and balance in those with CI to elucidate the mechanisms underlying loss of function. Methods: We performed a retrospective analysis of medical records of patients with CI and compared brain volumes, dual task performance, and measures of gait and balance. Results: Greater cognitive function and combined dual task effect (DTE) is associated with smaller brain volumes. In contrast, greater motor DTE is associated with larger …

Comparisons Of Patellar Bone Mineral Density Between Individuals With And Without Patellofemoral Pain, Chris Khuu, Allina Cummins, Steven Shepherd

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Although bone stress injuries have been reported in individuals with patellofemoral pain (PFP), especially within the lateral patella, it remains unclear whether persons with PFP exhibit altered patellar regional bone mineral density (BMD). The primary purpose of this study was to compare BMD of the patella (lateral, medial, and total regions) between individuals with and without PFP using quantitative computed tomography (QCT). The secondary aim was to examine the associations between patellar regional BMD and patellofemoral joint (PFJ) alignment. Methods: Ten individuals with retropatellar pain and 10 sex, age, weight, height, and activity matched pain-free controls underwent a QCT …

Dosage, Mode, And Timing Of Acute Care Physical Therapy: A Scoping Review, Brendan Acosta, Bradley Goins

UNLV Theses, Dissertations, Professional Papers, and Capstones

Aims and Objectives: 1) To synthesize available evidence for mode, dosage, and timing of physical therapy in the acute care hospital setting. 2) To report the evidence about the effects of mode, dosage, and timing of physical therapy in the acute care hospital setting on LOS, associated costs, and PT-related outcomes. Background: Hospital based physical therapy quality depends on providing evidence-based interventions, however, the research regarding dosage, mode, and timing of physical therapy in the acute care hospital setting has not been synthesized for patient populations except for total joint arthroplasties or patients in the ICU. Design: A systematic search …

Partnering With The Nevada Physical Therapy Association To Improve Pt/Pta Engagement, Rachel Cooklin, Joshua Cooper, Madison Luna

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: The American Physical Therapy Association (APTA) is the professional organization that represents Physical Therapy and exists to promote the needs of society by advocating access and availability of all Physical Therapy services. The Nevada Physical Therapy Association (NVPTA) is a chapter of the APTA that represents the Physical Therapy profession in Nevada. In 2017, only 38.9% of licensed Physical Therapists (PTs) and 7.9% of licensed Physical Therapy Assistants (PTAs) practicing in Nevada were members of the NVPTA. Objective: The purpose of this service-learning project was to explore membership trends in the NVPTA, explore why membership amongst PTAs is low, …

Physical Therapy After Amputation In Community Dwelling Older Adults: A Quantitative And Qualitative Interview Study, Amanda Ferraro, Jennifer Gorton, Lindsey Horn, Michaela Kubo

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis: To investigate participation in physical therapy in older adults after lower extremity limb loss. The secondary objective was to examine the associations between physical therapy attendance, fear of falling avoidance behavior, self-perceived prosthetic mobility, and mental well-being. Number of Subjects: 64 Materials and Methods: Community-dwelling older adults with amputation were recruited and individually interviewed. The data collection consisted of four surveys (Physical Therapy after Amputation Patient Perception Survey, Short-Form Health Survey [SF-36v2], Prosthetic Evaluation Questionnaire [PEQ, mobility group], and Fear of Falling Avoidance Behavior Questionnaire [FFABQ]). Participants' demographic characteristics were analyzed using descriptive statistics. Participant comments were qualitatively categorized. …

Fall Prevention Service-Learning Project, Alexis Mansoor, Kendra Morrison, Jeremy Nordfelt, Cheng Yang Tu

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction: The purpose of this service-learning project was to: 1) reduce falls in the Las Vegas, Nevada community by implementing the Stepping On fall prevention program and 2) to investigate the effect of planning and implementing a service learning project (SLP) on physical therapy (PT) students’ education and professional development. Description: Under the supervision of our advisor, we planned and organized this SLP, became certified leaders of Stepping On, recruited and screened older adults using the STEADI fall risk screening tool, and facilitated the program at a local community hospital. We facilitated group discussion and instructed the exercises outlined in …

Patient, Student, And Faculty Perceptions Of A Student Led Pro-Bono Education And Treatment Based Back School For Uninsured Nevadans, James Tingey, Daniel Tiano, Rebecca Templeton, Meagan Duncan

UNLV Theses, Dissertations, Professional Papers, and Capstones

Importance: To determine feasibility and benefits of student led back school in an underserved population. Perceptions were positive support benefits for all participants. Objective: To evaluate perceived benefits for uninsured participants, students, and faculty with implementation of an evidence based, student led back school. Design: Eight DPT students created curriculum delivered over two days of two-hour classes, one week apart including screening and abbreviated evaluation of LBP, group education, specific exercise selection, and home exercise program assignment. Following first session, analysis performed to improve subsequent sessions. Setting: Cooperative effort between the pro bono clinic, Volunteers in Medicine of Southern Nevada, …

Effects Of Transcranial Direct Current Stimulation On Gait And Balance Post-Stroke, Leonard Ubalde, Jordon Jacklin, Peyton Hobson, Sara Wright-Avila

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Non-invasive brain stimulation is effective in combination with traditional physical therapy to facilitate motor performance in patients who recently survived a stroke. Current literature has focused on transcranial direct current stimulation and transcranial magnetic stimulation efficacy for improving the completion of fine motor tasks in the upper extremities. However, there is a lack of current evidence regarding the efficacy of this therapy in the lower extremities. Objective: To measure the effects of transcranial direct current stimulation on lower extremity clinical outcomes in patients who had a stroke including gait speed, functional reach, and balance. Methods: Randomized control trial in …

The Effectiveness Of Implementing A Collegiate Dance Clinic At The University Of Nevada, Las Vegas, Quinn Williams, Kristin Allman, Matthew Mcarthur, Ryan Yim

UNLV Theses, Dissertations, Professional Papers, and Capstones

Screenings are commonly employed in athletics to identify deficits in performance with the goal of providing interventions to decrease injury risk; however, their utilization is uncommon in collegiate dance programs. Therefore, the purpose of this service learning project was to address the needs of the University of Nevada, Las Vegas (UNLV) dance program through implementation of an injury screening and prevention clinic for collegiate-level dancers. Four second year Doctor of Physical Therapy students (SPTs) supervised by a clinical faculty member with dance medicine expertise researched, developed, and provided screenings to identify increased risk for dance-specific injuries, and education to decrease …

Patient And Facility Perceptions On The Feasibility Of A Student-Run Pro-Bono Back-School For Uninsured Patients With Low Back Pain, Javier Ascanio-Pellon, Sofia Cruz, Lauren Liebert, Trevor Pacuk

UNLV Theses, Dissertations, Professional Papers, and Capstones

A. Background of Knowledge: Nevada ranks 8th highest in uninsured population in the United States. People who are uninsured may be more affected by low back pain (LBP) than their insured counterparts. Volunteers in Medicine of Southern Nevada (VMSN), a non-profit organization, serves uninsured people in Nevada. VMSN partnered with UNLV Physical Therapy (UNLVPT) to provide a back-school for patients. UNLVPT proposed a service-learning model to provide both education and treatment for VMSN patients with LBP. B. Purpose: The purpose of this community-based research project is to create and implement a student-run pro-bono back-school for uninsured individuals with LBP in …