Occupational Therapy Commons^™

Development Of A Training Program To Increase Student Clinician Competency When Communicating With People With Aphasia, Meghan Doherty, Chevie Lay

Journal of Occupational Therapy Education

The Washington University in St. Louis Stroke Clinic is a student-run free clinic (SRSC) designed to enhance student learning and provide the community with no-cost evidence-based occupational therapy services. Aphasia is a common communication impairment after stroke that affects the ability to access services and give and get information, and impacts life participation and satisfaction. Conversation partner training is an evidence-based treatment approach to improve communication with people with aphasia (PWA). The purpose of this project was to develop and evaluate the effectiveness of student clinician training about communicating with PWA using conversation partner training in the SRSC. This study …

Selection Of Post-Acute Care For Stroke Patients, Kathryn M. Gulfo, Glen Gillen, Lauri Bishop, Clare C. Bassile, Randy B. Kolodny, Joel Stein

The Open Journal of Occupational Therapy

Background: Significant variation exists in post-acute care for stroke survivors. This study examines referral practices of occupational and physical therapists for patients after acute stroke.

Method: Occupational therapists (OTs) and physical therapists (PTs) were surveyed either electronically or in person at a national conference. The respondents selected the most appropriate referral for each of five case vignettes. The referral choices included Inpatient Rehabilitation Facility (IRF), Skilled Nursing Facility (SNF), Long-Term Acute Care Hospital (LTACH), home with home services, or home with outpatient services. Demographic data included practice location, setting, and duration. The respondents were also asked to rate …

Puzzleart Therapy: Connecting The Pieces In Search Of Answers, Jennifer Fortuna

Open Journal of Occupational Therapy: Occupation and the Artist

Alli Berman has been an artist, educator, author, and lecturer for more than 25 years. Her art can be found in private, corporate, and nonprofit collections around the world. Berman is the creator of PuzzleArt, a series of small abstract paintings that combine to form a modular puzzle. When a stroke impacted Berman’s quality of life, she turned to art for answers. Engagement in a meaningful activity, such as painting, provided her motivation and strength for continued physical and psychological healing. The PuzzleArt concept evolved from a simple exercise that helped Berman to fit all of the missing pieces back …

Puzzleart Therapy: Connecting The Pieces In Search Of Answers, Jennifer Fortuna

The Open Journal of Occupational Therapy

Alli Berman, a New York based artist, provided the cover art for the Fall 2016 issue of The Open Journal of Occupational Therapy (OJOT). “Sunlight Underwater” is a 12 piece PuzzleArt painting made from acrylic on American maple that measures 22x30. The PuzzleArt concept began as a simple exercise that evolved into a therapeutic modality. When a sudden stroke impacted Berman’s well-being and quality of life, it was art that helped her to make connections during recovery.

Effectiveness Of The Bridge/Adapt Program On Functional Skill Generalization After Acquired Brain Injury, Janice S. Li, Diana Lopez, Eugene Cheung, Angela Talamantez

Dissertations, Masters Theses, Capstones, and Culminating Projects

This study explored the effectiveness of the Bridge/Adapt program for generalizing increased cognition to functional skills. Three participants, identified as having significant cognitive impairments as measured by the Cognistat assessment, participated in the Bridge/Adapt program, an eight-week program that includes both remedial and compensatory components. The remedial component used was a computer-based cognitive rehabilitation program called Parrot Software. Past studies have proven computer-based cognitive rehabilitation to be effective in increasing overall cognition. The Bridge/Adapt module is the compensatory component that utilized a variety of strategies and everyday tasks to facilitate the generalization of improved cognition to functional performance. A homework …

Use Of Occupational Performance Coaching For Stroke Survivors (Opc-Stroke) In Late Rehabilitation: A Descriptive Case Study, Danika Belliveau, Isabelle Belliveau, Aniane Camire-Raymond, Dorothy Kessler, Mary Egan

The Open Journal of Occupational Therapy

Background: Stroke is a leading cause of disability in adults. Following stroke, 60% of people report needing help with everyday activities, and 80% report having very few meaningful activities. These restrictions often continue for years. This study explored the efficacy of Occupational Performance Coaching for stroke survivors (OPC-Stroke) on the participation level of adults in the later stage of stroke rehabilitation.

Method: A descriptive case study design was used. One participant in the later stages of rehabilitation was recruited. Outcome measures for participation, goal performance and satisfaction, and emotional well-being were administered pre and postintervention to observe for direction of …

The Lived Experience Of Informal Caregivers Of Chronic Stroke Patients, Ann Snider Wigginton

Online Theses and Dissertations

The purpose of this phenomenological study is to contribute to the literature surrounding stroke-survivor caregivers and to understand the caregivers’ perspective on leisure participation and quality of life. Four caregivers of clients with chronic stroke were recruited for the study via convenience sampling. Participants were audio-recorded during a semi-structured interview lasting 60-80 minutes. The interview guide was consistent across participants and included open-ended questions about the caregiver’s leisure participation and quality of life. Recorded data was transcribed and in-vivo coding was completed. Eight categories were developed from the identified codes and narrowed into primary meaning units: role shift, loss of …

The Experience Of Adults With Chronic Stroke Who Have Participated In Occupation-Based Or Modified Constraint Induced Interventions As A Part Of A Research Study, Ariel Wilson

Online Theses and Dissertations

There is a lack of qualitative research about the client perspective of specific chronic stroke interventions for motor recovery. The purpose of this phenomenological study was to understand the experiences of adults with chronic stroke who have participated in occupation-based (OBP) or modified constraint-induced (MCIT) interventions as a part of a research study. Four participants were recruited through convenience sampling and interviewed about their participation in research. Interviews were audio recorded, transcribed, and analyzed until themes emerged. Results showed participants engaged in the research interventions because of a desire to achieve a lost sense of ‘normalcy’ and perceptions of their …

Bridge/Adapt: Transfer From Computer Remediation To Functional Skill, Eugene Cheung, Janice S. Li, Diana Lopez, Angela Talamantez

Student Research Posters

This study explored the effectiveness of the Bridge/Adapt program for generalizing increased cognition to functional skills. Three participants, identified as having significant cognitive impairments as measured by the Cognistat assessment, participated in the Bridge/Adapt program, an eight-week program that includes both remedial and compensatory components. The remedial component used was a computer-based cognitive rehabilitation program called Parrot Software. Past studies have proven computer-based cognitive rehabilitation to be effective in increasing overall cognition. The Bridge/Adapt module is the compensatory component that utilized a variety of strategies and everyday tasks to facilitate the generalization of improved cognition to functional performance. A homework …

Concise Arm And Hand Rehabilitation Approach In Stroke (Caras): A Practical And Evidence-Based Framework For Clinical Rehabilitation Management, Johan A. Franck, Jos Halfens, Rob Smeets, Henk Seelen

The Open Journal of Occupational Therapy

The volume of information on new treatment techniques supporting the restoration of arm-hand function (AHF) and arm-hand skill performance (ASHP) in stroke survivors overwhelms therapists in everyday clinical practice when choosing the appropriate therapy. The Concise Arm and Hand Rehabilitation Approach in Stroke (CARAS) is designed for paramedical staff to structure and implement training of AHF and AHSP in stroke survivors. The CARAS is based on four constructs: (a) stratification according to the severity of arm–hand impairment (using the Utrecht Arm/Hand -Test [UAT]), (b) the individual’s rehabilitation goals and concomitant potential rehabilitation outcomes, (c) principles of self-efficacy, and (d) possibilities …

Does Generalization Occur Following Computer-Based Cognitive Retraining?—An Exploratory Study, Kitsum Li, Jonathan Alonso, Nisha Chadha, Jennifer Pulido

Collected Faculty Scholarship

Computer-based cognitive retraining (CBCR) intervention has gained great popularity in recent years. This study aimed to investigate the occurrence of skill generalization to daily living task for individuals with acquired brain injury (ABI) after completion of eight modules of a commercially available CBCR program, the Parrot Software. The study investigated changes in individuals’ global cognition as measured by the Montreal Cognitive Assessment, and changes in individuals’ performance during a medication-box sorting task, a novel instrumental activity of daily living. The medication-box sorting task resembled real life medication management with daily prescribed and over-the-counter medications. Twelve individuals with ABI from a …

Fret: Validity Of A Fall Risk Evaluation Tool For Individuals With Acquired Brain Injuries, Desiree Shaver, Colon Mikaela, Irene Leung, Melanie Shea

Dissertations, Masters Theses, Capstones, and Culminating Projects

Objective: The purpose of this study is to evaluate the predictive validity of the Fall Risk Evaluation Tool (FRET) for individuals with acquired brain injuries (ABIs).

Methods: Ten participants were included for the study. Inclusion criteria for participants included: age 18 and older, English speaking, 6-months post ABI, ambulatory with or without an assistive device, and uses a wheelchair less than 25% of the day. Exclusion criteria for participants included: global confusion and degenerative neurological conditions. Following the administration of the FRET, participants recorded falls that occurred over the following 3-month study period.

Results: Data was analyzed using the Pearson’s …

Relieving Post-Stroke Fatigue Using A Group-Based Educational Training Approach, Catherine E. Emery

Theses and Dissertations

Post-stroke fatigue is a common problem that may limit participation in everyday activities. Emerging evidence suggests that group-based training in fatigue management may be an efficient means of reducing the effects of post-stroke fatigue. This mixed methods, quasi-experimental study proposed to determine whether a group-based educational program could be successful in relieving post-stroke fatigue and improving participation in daily activities. A convenience sample of stroke survivors (n=20) from retirement communities in southeastern PA were invited to participate in the research. Participants were screened for depression, motor and cognitive recovery, and sleep quality. Fatigue was measured using the Fatigue Severity Scale …

Home-Based Constraint Induced Movement Therapy Poststroke, Stephen Isbel, Christine Chapparo, David Mcconnell, Judy Ranka

The Open Journal of Occupational Therapy

Background: This study examined the efficacy of a home-based Constraint Induced Movement Therapy (CI Therapy) protocol with eight poststroke survivors.

Method: Eight ABA, single case experiments were conducted in the homes of poststroke survivors. The intervention comprised restraint of the intact upper limb in a mitt for 21 days combined with a home-based and self-directed daily activity regime. Motor changes were measured using The Wolf Motor Function Test (WMFT) and the Motor Activity Log (MAL).

Results: Grouped results showed statistically and clinically significant differences on the WMFT (WMFT [timed items]): Mean 7.28 seconds, SEM 1.41, 95% CI 4.40 – 10.18, …

“I Think Relax, Relax And It Flows A Lot Easier”: Exploring Client-Generated Relax Strategies, Dianne Cirone, Sara E. Mcewen

The Open Journal of Occupational Therapy

Background. Some adult stroke survivors participating in Cognitive Orientation to daily Occupational Performance (CO-OP) treatment programs self-generated relax strategies that have not been explored in previous CO-OP publications. The objective of this study was to describe the process by which adults with stroke used relax strategies and to explore the outcomes associated with their use.

Methods. Secondary analysis of transcripts of intervention sessions from five participants was conducted.

Results. All five participants applied relax strategies after initially observing a breakdown in performance that was attributed to increased fatigue or tension. The relax strategies used by the participants during their occupations …

Computer-Based Cognitive Retraining For Adults With Chronic Acquired Brain Injury: A Pilot Study, Kitsum Li, Julie Robertson, Joshua Ramos, Stephanie Gella

Collected Faculty Scholarship

This study evaluated the effectiveness of a computer-based cognitive retraining (CBCR) program on improving memory and attention deficits in individuals with a chronic acquired brain injury (ABI). Twelve adults with a chronic ABI demonstrating deficits in memory and attention were recruited from a convenience sample from the community. Using a quasi-experimental one-group pretest–posttest design, a significant improvement was found in both memory and attention scores postintervention using the cognitive screening tool. This study supported the effectiveness of CBCR programs in improving cognitive deficits in memory and attention in individuals with chronic ABI. Further research is recommended to validate these findings …

Usefulness Of The Mms And S5 For Assessing Medication Management Capacity For Clients Post-Stroke, Jessica Jean Bolduc

Occupational Therapy Program Student Theses, Dissertations and Capstones

Occupational therapists need a means to efficiently and accurately screen a client’s medication management capacity, especially for clients post-stroke. Most therapists are not aware of, nor do they utilize specific assessments for medication management capacity, partly due to lack of thorough assessments. The purpose of this study was to compare the scores of the ManageMed Screen (MMS), the Screening for Self-Medication Safety Post Stroke (S5), and the Montreal Assessment of Cognition (MoCA) on a population of rehabilitation clients post-stroke to evaluate consistency of scores and determine their usefulness in clinical practice. All screens were designed for use in occupational therapy; …

Ability And Skill Retraining With Task-Oriented Intervention To Improve Functional Independence In Persons With Stroke, Trista Thacker

Online Theses and Dissertations

The purpose of the study was to examine the difference that ability and skill retraining used with task-oriented intervention can make on functional independence (as measured by FIM subscales) in persons with stroke. The findings of this study can contribute to the body of literature to support occupational therapy. Review of related literature includes background support for the use of FIM with the stroke population through analysis of the psychometric properties of the instrument. Also, the review of related literature provides support for the use of ability and skill retraining and task-oriented interventions with the stroke population. This supports the …

Observation Of Amounts Of Movement Practice Provided During Stroke Rehabilitation, Catherine E. Lang, Jillian R. Macdonald, Darcy S. Reisman, Lara Boyd, Teresa Jacobson Kimberley, Sheila M. Schindler-Ivens, T. George Hornby, Sandy A. Ross, Patricia L. Scheets

Physical Therapy Faculty Research and Publications

Objective

To investigate how much movement practice occurred during stroke rehabilitation, and what factors might influence doses of practice provided.

Design

Observational survey of stroke therapy sessions.

Setting

Seven inpatient and outpatient rehabilitation sites.

Participants

We observed a convenience sample of 312 physical and occupational therapy sessions for people with stroke.

Interventions

Not applicable.

Main Outcome Measures

We recorded numbers of repetitions in specific movement categories and data on potential modifying factors (patient age, side affected, time since stroke, FIM item scores, years of therapist experience). Descriptive statistics were used to characterize amounts of practice. Correlation and regression analyses were …