Other Rehabilitation and Therapy Commons^™

Variation In Rehabilitation Related Durable Medical Equipment Use And Cost Among Stroke Survivors: A Retrospective Analysis Of Medicare Beneficiaries, Madison Gersper

Entry-Level Occupational Therapy Doctorate - Doctoral Capstone Symposium

Title: Variation in Rehabilitation-Related Durable Medical Equipment Use and Cost Among Stroke Survivors: A Retrospective Analysis of Medicare Beneficiaries.

Purpose: In the US, stroke is a leading cause of disability (Centers for Disease Control and Prevention, 2017). Stroke survivorship is expected to rise significantly in the coming years (Feigin et al., 2024; Martin et al., 2025), resulting in a large number of people with disabilities who rely on Rehabilitation-Related Durable Medical Equipment (RR-DME) for daily living. However, there is limited published research on equipment access and costs.

The overall objective of this study was to identify predictors of access to …

The Differential Effects Of Fast Walking Speed On Muscle Coactivation In The Paretic And Non-Paretic Extremities Post-Stroke, Natalia Sánchez, Andrian Kuch, Samantha N. Jeffcoat, Andrew Hooyman, Aria Haver-Hill, Christina K. Holl, Kristan A. Leech

Physical Therapy Faculty Articles and Research

Background:

Clinical practice guidelines for walking recovery post-stroke recommend high aerobic intensity training, which usually involves walking at fast speeds. However, the acute effect of fast speeds on the neuromuscular control of walking is unclear.

Objectives:

(1) Assess the criterion validity of the Dynamic Motor Control Index (WalkDMC) as a measure of coactivation post-stroke. (2) Assess acute speed-dependent coactivation post-stroke. (3) Assess how clinical characteristics shape the speed-dependent coactivation response. (4) Assess the relationship between heart rate and coactivation post-stroke. We hypothesized that WalkDMC is correlated with function and impairment measures. We also hypothesize that coactivation measured via the WalkDMC …

Twenty Minutes Of Corsi Block Tapping Task Training Does Not Improve Mental Rotation In Adults With Stroke, Sarah A. Kettlety, Giuliet L. Kibler, Andrew Hooyman, Christina K. Holl, Sydney Y. Schaefer, Kristan A. Leech

Physical Therapy Faculty Articles and Research

Background: Visuospatial function is commonly impaired post-stroke and is associated with motor learning and recovery. A single, twenty-minute Corsi Block Tapping Task (CBTT) training session improved visuospatial function in young neurotypical adults; however, it is unclear whether this training would improve visuospatial function in adults with stroke.

Objective: To understand if a single, twenty-minute CBTT training session improved visuospatial function in adults with stroke compared to a no-training control group of adults with stroke.

Methods: Participants post-stroke were assigned to one of two groups. The training group completed twenty minutes of computerized CBTT training. The control group completed a survey …

Identification Of Subtypes Of Post-Stroke And Neurotypical Gait Behaviors Using Neural Network Analysis Of Gait Cycle Kinematics, Andrian Kuch, Nicolas Schweighofer, James M. Finley, Alison Mckenzie, Yuxin Wen, Natalia Sánchez

Physical Therapy Faculty Articles and Research

Gait impairment post-stroke is highly heterogeneous. Prior studies classified heterogeneous gait patterns into subgroups using peak kinematics, kinetics, or spatiotemporal variables. A limitation of this approach is the need to select discrete features in the gait cycle. Using continuous gait cycle data, we accounted for differences in magnitude and timing of kinematics. Here, we propose a machine-learning pipeline combining supervised and unsupervised learning. We first trained a Convolutional Neural Network and a Temporal Convolutional Network to extract features that distinguish impaired from neurotypical gait. Then, we used unsupervised time-series k-means and Gaussian Mixture Models to identify gait clusters. We tested …

A Review Of Key Music Therapy Approaches To Unlocking Recovery From Stroke And Traumatic Brain Injury, Bethany Woolman, Nina Mourao, Joshua K. Elliott, Shizue Mito, Ney Alliey-Rodriguez

Research Symposium

Background: Strokes and traumatic brain injuries are neuronal injuries that can impact the motor, sensory, and cognitive abilities of an affected individual, and may necessitate therapy of multiple forms to regain back total or partial functionality and independence in their daily lives. Music assists in stimulating multiple brain regions, and when incorporated into rehabilitation, it has the potential to impact stroke and traumatic brain injury recovery. This literature review focuses on the efficacy of two novel music therapy approaches, melodic intonation therapy (MIT) and rhythmic auditory stimulation (RAS), on recovery from aphasia and restoration of gait, respectively, to assess whether …

Effectiveness Of Using Soft Exosuit In Stroke Case To Improve Walking Speed And Endurance, Aditya Denny Pratama, Rakha Shidqi Widyadhana

Jurnal Fisioterapi Terapan Indonesia

Stroke is a clinically defined syndrome of acute, focal nerve discharge caused by vascular injury (infarction, hemorrhage) of the central nervous system. Punches can cause damage to the brain and affect a person's ability to walk, balance and coordinate movements. Impaired gait is common in stroke cases, often resulting in poor recovery of mobility and inability to carry out daily activities without assistance. One of the interventions that can be used is a soft exosuit. This method can help overcome walking problems in stroke patients where soft exosuits are used to increase walking speed and walking endurance. The purpose of …

Occupational Therapy In Stroke: A Case Study Using The Bobath Frame Of Reference And Task Oriented Approach, Reza Nur Arsyi, Afifah Fadhilah Nursyam, Muhammad Luthfi, Hermito Gidion, Ayleen Alicia Kosasi, Erna Faryza Mohd Poot, Rosilah Wahab, Nur Atiqah Azman

Jurnal Fisioterapi Terapan Indonesia

Stroke is a sudden neurological disorder caused by vascular injury to the brain, leading to significant functional limitations. This case study examines the use of occupational therapy interventions, specifically the Bobath and Task Oriented approaches, for a 43-year-old male with left hemiparesis to enhance independence in motorcycling. The patient experienced various limitations, including vestibular function, range of motion, muscle tone and strength, postural control, and fine motor skills. Using the Ashworth scale and the Canadian Occupational Performance Measure (COPM) for assessment, occupational therapy interventions showed progress in several aspects, although the primary goal has not yet been fully achieved. This …

A Single-Center, Assessor-Blinded, Randomized Controlled Clinical Trial To Test The Safety And Efficacy Of A Novel Brain-Computer Interface Controlled Functional Electrical Stimulation (Bci-Fes) Intervention For Gait Rehabilitation In The Chronic Stroke Population, Piyashi Biswas, Lucy Dodakian, Po T. Wang, Christopher A. Johnson, Jill See, Vicky Chan, Cathy Chou, Wendy Lazouras, Alison L. Mckenzie, David J. Reinkensmeyer, Danh V. Nguyen, Steven C. Cramer, An H. Do, Zoran Nenadic

Physical Therapy Faculty Articles and Research

Background

In the United States, there are over seven million stroke survivors, with many facing gait impairments due to foot drop. This restricts their community ambulation and hinders functional independence, leading to several long-term health complications. Despite the best available physical therapy, gait function is incompletely recovered, and this occurs mainly during the acute phase post-stroke. Therapeutic options are limited currently. Novel therapies based on neurobiological principles have the potential to lead to long-term functional improvements. The Brain-Computer Interface (BCI) controlled Functional Electrical Stimulation (FES) system is one such strategy. It is based on Hebbian principles and has shown promise …

Multi-Site Identification And Generalization Of Clusters Of Walking Behaviors In Individuals With Chronic Stroke And Neurotypical Controls, Natalia Sánchez, Nicolas Schweighofer, Sara J. Mulroy, Ryan T. Roemmich, Trisha M. Keshar, Gelsy Torres-Oviedo, Beth E. Fisher, James M. Finley, Carolee J. Winstein

Physical Therapy Faculty Articles and Research

Background

Objectives

Methods

Multi-Site Identification And Generalization Of Clusters Of Walking Behaviors In Individuals With Chronic Stroke And Neurotypical Controls, Natalia Sanchez, Nicolas Schweighofer, Sara J. Mulroy, Ryan T. Roemmich, Tricia M. Kesar, Gelsy Torres-Oviedo, Beth E. Fisher, James M. Finley, Carolee J. Winstein

Physical Therapy Faculty Articles and Research

Background

Objectives

Methods

The Level Of Functionality Of The Affected Upper Limb In Stroke Patients Depends On The Type Of Therapy Used And The Lateralization Of The Subjects' Body - A Randomized Observational Study., Anna Olczak, Marcin Dornowski

Baltic Journal of Health and Physical Activity

Introduction: Impairment of the functions of the upper limb and hand is a major problem in stroke patients. The aim of the study was to evaluate various therapies in terms of their influence on changes in the activity of the affected, dominant, and non-dominant upper limb in patients after ischemic stroke. Material/Methods: This is a randomized, double-blinded study. The research was carried out in a rehabilitation clinic on a group of 60 stroke patients who were randomly assigned to groups differing in the rehabilitation program. The study group had physiotherapy based on the NDT Bobath concept and the control group …

Examining The Use Of Expressive Arts Therapies In Neurorehabilitation Treatment Planning, Rebecca J. Horner

Expressive Therapies Capstone Theses

Those undergoing neurorehabilitation after stroke and traumatic brain injury report a diminished sense of overall wellness. This paper examines the conceivable benefits of introducing expressive arts therapies, which is the therapeutic use and combination of the visual arts, movement, drama, music, writing and other intermodal creative processes, into physical therapy and neurorehabilitation treatment planning. Expressive arts therapies have the capacity to engage with an individual’s physical, emotional, social and spiritual states concurrently. They simultaneously offer the ability to promote an increased sense of well-being, address mind-body disconnects, and process trauma non-verbally.

The sections of this narrative literature review focus on …

The Effectiveness And Outcomes Of Oculomotor And Visual Field Deficit Rehabilitation Secondary To Ischemic Cerebrovascular Accident: A Literature Review, Maanas Chiplunkar

Rowan-Virtua Research Day

Visual field loss and oculomotor dysfunctions are two common vision deficits caused by cerebrovascular accidents. Oftentimes these deficits can result in a loss of independence for patients and depression. Neurovisual rehabilitation is a frequently overlooked aspect of stroke rehabilitation, so investigating the current rehab approaches and the factors that play a role in the effectiveness of these methods is crucial so that clinicians can provide more direct and focused treatment for their patients. This literature review research process used PubMed, NCBI, and EbscoHost as primary databases. Preliminary results showed that restitutive and compensatory rehabilitation approaches are effective for treating visual …

Characterizing Pediatric Unilateral Brain Damage: Unilateral Spatial Neglect, Balance, And More, Emerson Hart

MUSC Theses and Dissertations

Pediatric unilateral brain damage is a costly, impactful condition. There are many subsequent impairments that children experience after pediatric unilateral brain damage, two of which are unilateral spatial neglect (USN) and balance impairments. This project aims to compile the existing literature regarding USN in children, analyze insurance billing data to characterize the population, and evaluate balance and USN in a small case-control cohort of children with and without unilateral brain damage. The literature search elucidated the scant literature available addressing USN, including a lack of quality assessments to definitively identify USN. Insurance billing analyses showed an incredibly heterogeneous group, very …

Barriers To Exercise And Physical Activity - Insight From The Rural Practitioner, Erin G. Tillery

Honors College Theses

Sedentary lifestyles are a growing public health concern. Furthermore, many rural Americans lack adequate access to healthcare resources. When healthcare is sought, the patient-practitioner interactions may serve to influence the patient’s lifestyle choices. The practitioners' exercise and physical activity habits may shape the effectiveness of the patient-practitioners interaction. Here, we explored the potential barriers to exercise and physical activity (PA) in licensed physical and occupational therapists. In addition, we aimed to describe barriers to exercise and PA in individuals with a history of stroke from the perspective of the practitioner. Lastly, how current exercise and physical activity habits influence their …

Quantifying Intra- And Interlimb Use During Unimanual And Bimanual Tasks In Persons With Hemiparesis Post-Stroke, Susan V. Duff, Aaron Miller, Lori Quinn, Gregory Youdan Jr., Lauri Bishop, Heather Ruthrauff, Eric Wade

Physical Therapy Faculty Articles and Research

Background

Individuals with hemiparesis post-stroke often have difficulty with tasks requiring upper extremity (UE) intra- and interlimb use, yet methods to quantify both are limited.

Objective

To develop a quantitative yet sensitive method to identify distinct features of UE intra- and interlimb use during task performance.

Methods

Twenty adults post-stroke and 20 controls wore five inertial sensors (wrists, upper arms, sternum) during 12 seated UE tasks. Three sensor modalities (acceleration, angular rate of change, orientation) were examined for three metrics (peak to peak amplitude, time, and frequency). To allow for comparison between sensor data, the resultant values were combined into …

Visualization-Driven Time-Series Extraction From Wearable Systems Can Facilitate Differentiation Of Passive Adl Characteristics Among Stroke And Healthy Older Adults, Joby John, Rahul Soangra

Physical Therapy Faculty Articles and Research

Wearable technologies allow the measurement of unhindered activities of daily living (ADL) among patients who had a stroke in their natural settings. However, methods to extract meaningful information from large multi-day datasets are limited. This study investigated new visualization-driven time-series extraction methods for distinguishing activities from stroke and healthy adults. Fourteen stroke and fourteen healthy adults wore a wearable sensor at the L5/S1 position for three consecutive days and collected accelerometer data passively in the participant’s naturalistic environment. Data from visualization facilitated selecting information-rich time series, which resulted in classification accuracy of 97.3% using recurrent neural networks (RNNs). Individuals with …

Kinematic Analysis Of 360° Turning In Stroke Survivors Using Wearable Motion Sensors, Masoud Abdollahi, Pranav Madhav Kuber, Michael Shiraishi, Rahul Soangra, Ehsan Rashedi

Physical Therapy Faculty Articles and Research

Background: A stroke often bequeaths surviving patients with impaired neuromusculoskeletal systems subjecting them to increased risk of injury (e.g., due to falls) even during activities of daily living. The risk of injuries to such individuals can be related to alterations in their movement. Using inertial sensors to record the digital biomarkers during turning could reveal the relevant turning alterations. Objectives: In this study, movement alterations in stroke survivors (SS) were studied and compared to healthy individuals (HI) in the entire turning task due to its requirement of synergistic application of multiple bodily systems. Methods: The motion of 28 participants (14 …

The Experience Of Meditation, And Its Effects On Attention, For Adults With Stroke Or Attention Deficit Hyperactivity Disorder: A Three-Part Dissertation With Qualitative And Quantitative Evidence, Cheryl Carrico

Theses and Dissertations--Rehabilitation Sciences

Impairment of attention is common after stroke; is a defining characteristic of attention deficit hyperactivity disorder (ADHD); and has been shown to correlate significantly with difficulties in daily life for individuals with these conditions. More research is needed to establish effective interventions addressing impaired attention in such cases. Meditation is not a standard-of-care intervention for this purpose but may have therapeutic potential. Meditation has been broadly defined as an activity which has self-regulation of attention as its main aim. In other words, it can be considered a training of attention. To shed light on the therapeutic potential of meditation, including …

Evaluating The Microbiome To Boost Recovery From Stroke: The Embrs Study, Tyler Hammond

Theses and Dissertations--Neuroscience

Accumulating evidence suggests that gut microbes modulate brain plasticity via the bidirectional gut-brain axis and may play a role in stroke rehabilitation. A severely imbalanced microbial community has been shown to occur following stroke, causing a systemic flood of neuro- and immunomodulatory substances due to increased gut permeability and decreased gut motility. Here we measure post-stroke increased gut dysbiosis and how it correlates with gut permeability and subsequent cognitive impairment.

We recruited 12 participants with acute stroke, 12 healthy control participants, and 18 participants who had risk factors for stroke, but had not had a stroke. We measured the gut …

Comparison Of 360° Turn Cycles Among Individuals After Stroke And Healthy Older Adults, Rahul Soangra, Vennila Krishnan, Joby John, Ehsan Rashedi, Alison Mckenzie

Physical Therapy Faculty Articles and Research

Stroke survivors are at high risk of falling during turning. The kinematics of performing a 360° turn have not been fully analyzed among individuals after stroke. Quantitative differences in the parameters of turning between healthy older adults and those after stroke could provide detailed information on turning ability among these groups. The purpose of the current study was to characterize differences between healthy older adults and adults after stroke in 360° turn kinematics. Fourteen individuals with chronic stroke (mean age: 69 ± 8.4 years) and 14 healthy older adults (mean age: 74 ± 8.7 years) performed three trials of 360° …

A Feasibility Study Of Expanded Home-Based Telerehabilitation After Stroke, Steven C. Cramer, Lucy Dodakian, Vu Le, Alison Mckenzie, Jill See, Renee Augsburger, Robert J. Zhou, Sophia M. Raefsky, Thalia Nguyen, Benjamin Vanderschelden, Gene Wong, Daniel Bandak, Laila Nazarzai, Amar Dhand, Walt Scacchi, Jutta Heckhausen

Physical Therapy Faculty Articles and Research

Introduction: High doses of activity-based rehabilitation therapy improve outcomes after stroke, but many patients do not receive this for various reasons such as poor access, transportation difficulties, and low compliance. Home-based telerehabilitation (TR) can address these issues. The current study evaluated the feasibility of an expanded TR program.

Methods: Under the supervision of a licensed therapist, adults with stroke and limb weakness received home-based TR (1 h/day, 6 days/week) delivered using games and exercises. New features examined include extending therapy to 12 weeks duration, treating both arm and leg motor deficits, patient assessments performed with no therapist supervision, adding sensors …

Social Network Structure Is Related To Functional Improvement From Home-Based Telerehabilitation After Stroke, Archana Podury, Sophia M. Raefsky, Lucy Dodakian, Liam Mccafferty, Vu Le, Alison Mckenzie, Jill See, Robert J. Zhou, Thalia Nguyen, Benjamin Vanderschelden, Gene Wong, Laila Nazarzai, Jutta Heckhausen, Steven C. Cramer, Amar Dhand

Physical Therapy Faculty Articles and Research

Objective: Telerehabilitation (TR) is now, in the context of COVID-19, more clinically relevant than ever as a major source of outpatient care. The social network of a patient is a critical yet understudied factor in the success of TR that may influence both engagement in therapy programs and post-stroke outcomes. We designed a 12-week home-based TR program for stroke patients and evaluated which social factors might be related to motor gains and reduced depressive symptoms.

Methods: Stroke patients (n = 13) with arm motor deficits underwent supervised home-based TR for 12 weeks with routine assessments of motor function and …

Gains Across Who Dimensions Of Function After Robot-Based Therapy In Stroke Subjects, Jennifer Wu, Lucy Dodakian, Jill See, Erin Burke Quinlan, Lisa Meng, Jeby Abraham, Ellen C. Wong, Vu Le, Alison Mckenzie, Steven C. Cramer

Physical Therapy Faculty Articles and Research

Background

Studies examining the effects of therapeutic interventions after stroke often focus on changes in loss of body function/structure (impairment). However, improvements in activities limitations and participation restriction are often higher patient priorities, and the relationship that these measures have with loss of body function/structure is unclear.

Objective

This study measured gains across WHO International Classification of Function (ICF) dimensions and examined their interrelationships.

Methods

Subjects were recruited 11 to 26 weeks after hemiparetic stroke. Over a 3-week period, subjects received 12 sessions of intensive robot-based therapy targeting the distal arm. Each subject was assessed at baseline and at 1 …

The Effects Of Bilingualism In Post-Stroke Aphasia Patients: Clinical Implications Within The United States, Kristen Bennett

Undergraduate Honors Theses

The consistent increase of cultural diversity and immigration within the United States over the last fifty years has contributed to a societal shift towards a growing bilingual population. The growth of this population has generated a need to evaluate current assessment and treatment plans for bilingual post-stroke aphasia patients within the United States to ensure that these individuals are receiving effective healthcare. This study aims to investigate the current knowledge gap surrounding appropriate methods of assessing and treating bilingual post-stroke aphasia patients within the United States and suggest potential approaches based on existing research. In order to synthesize information regarding …

Are All Instrumental Activities Of Daily Living Equal? A Pilot Study On The Performances Of Adults With Acquired Brain Injury, Crystal Lee, Samantha Schauer, Amy Tam, Yareli Vargas

Occupational Therapy | MSOT Capstone Projects

Aim: To determine if a relationship exists among performances of different instrumental activities of daily living (IADLs) in adults with acquired brain injury (ABI).

Methods: A two-group correlational design was used to examine the relationship among performances in cooking, medication management, and financial management in nine adults with ABI who returned to driving and nine adults with ABI who did not return to driving. The Executive Function Performance Test (EFPT) measured initiation, organization, sequencing, judgment and safety, and completion.

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 …

The Impact Of Depression On Treatment Outcomes For Patients With Aphasia Who Participate In An Intensive Comprehensive Aphasia Program (Icap), Harley B. Kincheloe

Undergraduate Theses, Professional Papers, and Capstone Artifacts

Abstract

Background: Aphasia is a multi-modal impairment resulting from left-hemisphere stroke. Aphasia is often accompanied by post-stroke depression. Acquiring aphasia and depression is seen to hinder quality of life and rehabilitative outcomes. Traditional stroke therapy often does not monitor or treat psychological difficulties such as depression. Such psychological difficulties hinder progress in recovery and may need to be addressed in therapy to ensure the best possible outcomes.

Aims: In response to the lack of psychological support for persons with aphasia, this literature review aims to explore the impact of depression on functional outcomes. Furthermore, this literature review will explore how …

Predicting Gains With Visuospatial Training After Stroke Using An Eeg Measure Of Frontoparietal Circuit Function, Robert J. Zhou, Hossein M. Hondori, Maryam Khademi, Jessica M. Cassidy, Katherine M. Wu, Derek Z. Yang, Nikhita Kathuria, Fareshte R. Erani, Lucy Dodakian, Alison Mckenzie, Cristina V. Lopes, Walt Scacchi, Ramesh Srinivasan, Steven C. Cramer

Physical Therapy Faculty Articles and Research

The heterogeneity of stroke prompts the need for predictors of individual treatment response to rehabilitation therapies. We previously studied healthy subjects with EEG and identified a frontoparietal circuit in which activity predicted training-related gains in visuomotor tracking. Here we asked whether activity in this same frontoparietal circuit also predicts training-related gains in visuomotor tracking in patients with chronic hemiparetic stroke. Subjects (n = 12) underwent dense-array EEG recording at rest, then received 8 sessions of visuomotor tracking training delivered via home-based telehealth methods. Subjects showed significant training-related gains in the primary behavioral endpoint, Success Rate score on a standardized test …

In-Home Delivery Of Constraint-Induced Movement Therapy Via Virtual Reality Gaming, Alexandra L. Borstad, Roger Crawfis, Kala Phillips, Linda Pax Lowes, David Maung, Ryan Mcpherson, Amelia Siles, Lise Worthen-Chaudhari, Lynne V. Gauthier

Journal of Patient-Centered Research and Reviews

Purpose: People with chronic hemiparesis are frequently dissatisfied with the recovery of their hand and arm, yet many lack access to effective treatments. Constraint-induced movement therapy (CI therapy) effectively increases arm function and spontaneous use in persons with chronic hemiparesis. The purpose of this study was to determine the feasibility and measure safety and outcomes of an in-home model of delivering CI therapy using a custom, avatar-based virtual reality game.

Methods: Seventeen individuals with chronic hemiparesis participated in this pretest/posttest quasi-experimental design study. The 10-day intervention had three components: 1) high-repetition motor practice using virtual reality gaming; 2) constraint of …