Two-Year Follow-Up Of Gait And Postural Control Following Initiation Of Recombinant Human Tripeptidyl Intracerebroventricular Enzyme Replacement Therapy In Two Atypical Cln2 Patients, Rahul Soangra, Marybeth Grant-Beuttler, Harriet Chang, Raymond Y. Wang

Physical Therapy Faculty Articles and Research

Neuronal ceroid lipofuscinosis type 2 (CLN2) is a rapidly progressive neurodegenerative disorder leading to premature mortality. Ambulatory CLN2 patients typically receive standard of care treatment through biweekly intracerebroventricular (ICV) enzyme replacement therapy (ERT) involving recombinant human tripeptidyl peptidase 1, known as cerliponase alfa (Brineura^®, Biomarin Pharmaceuticals). This study longitudinally assessed the impact of ICV cerliponase alfa ERT on gait, and postural control across a two-year span in two siblings diagnosed with atypical CLN2 disease. Both participants, ID01 (18 years and 8 months old at enrollment) and ID02 (13 years and 3 months old at enrollment), exhibited symptomatic characteristics …

Efficacy Of Low-Level Laser Therapy For Osteoarthritis Of The Knee, Emily Drummond

The PA Department Journal of Medical Science

Introduction: Osteoarthritis (OA) is a disease associated with numerous effects on quality of life (QoL) and activities of daily living (ADLs). In recent years, low-level laser therapy (LLLT) has been evaluated as a symptom management option for KOA due to its non-invasive mechanistic properties. The purpose of this paper is to assess the efficacy of LLLT as a modality of treatment to help reduce mild to moderate symptoms associated with KOA.

Methods: A search via PubMed database was made using the keywords “LLLT” AND “osteoarthritis” AND “knee” with additional specifiers resulting in 10 articles for review. Four articles were chosen …

Optimizing Pelvic Health: Evaluating The Efficacy Of Prenatal Strength And Resistance Training Combined With Pelvic Floor Muscle Exercises In Reducing Pelvic Organ Prolapse Risk, Samantha Requilman

Nursing | Senior Theses

While postnatal recovery is focused on the newborn, the mother’s health is equally important – particularly in preventing pelvic organ prolapse (POP), a condition that results in pelvic discomfort, incontinence, and a reduced quality of life. Although clinicians encourage pelvic floor muscle exercises (PFME) throughout pregnancy, POP is still prevalent among women, especially those who deliver vaginally. There are limited research studies on the effectiveness of prenatal resistance training in the prevention of pelvic dysfunctions and this study aims to address the gaps in the literature. So the question to address this study is: Does combining prenatal resistance training with …

Caregiver Perceptions Of Gobabygo Car Usage, Sierra L. Hays, Erin L. Hefner, Richelle Gray, Carrie Smith-Bell

Graduate Student Scholarship

This qualitative study aims to understand caregiver perceptions of their child’s play using a modified ride-on toy car (MROC). Caregivers of children with disabilities participated in a semi-structured interview and a photo-elicitation interview to better understand their beliefs, attitudes, values, and feelings about their children’s play with a MROC. A directed content analysis was used based on constructs of the model for the Process for Establishing Children’s Occupations (PECO; Wiseman et al., 2005). Most constructs of the PECO model, including stages of play and influences on play, were identified within the caregivers’ descriptions of children's play with the MROC. Additional …

Adjusting Your L.E.N.S: Learn And Educate With Neurodiverse Students, Jenna Potter

Entry Level Occupational Therapy Doctoral Capstone Projects Class of 2025

This doctoral capstone project, Adjusting Your L.E.N.S: Learn & Educate with Neurodiverse Students, focused on how occupational therapy (OT) can play a unique role in contributing to an inclusive postsecondary higher education (IPSE) program at a local university. This capstone project focused on supporting faculty, staff, and peer academic coaches, developing a transition camp for high school students, and enhancing the university’s current IPSE program to ensure that students with intellectual disability and autism can access higher education and learn within an inclusive and supportive setting. A faculty, staff, and academic coach training program was implemented to equip participants with …

Optimizing Decision-Making In A Cerebral Palsy Model Using Reinforcement Learning, Richard Ampah

Pitzer Senior Theses

This study presents an original interdisciplinary investigation into how reinforcement learning (RL) can model motor and cognitive defects and potentially improve motor and cognitive functions in individuals with cerebral palsy (CP), a non-progressive neurological disorder that impairs movement and adaptability. Integrating computational neuroscience and machine learning, the research applies policy gradient methods and Markov Decision Processes (MDPs) to simulate adaptive learning in agents with and without CP-related constraints.

The central aim is to compare the cumulative rewards of optimal policies, derived from value iteration, and human-like learning policies using the REINFORCE algorithm, both with and without the Bellman baseline. The …

Development And Clinical Validation Of The Sensor-E Exoskeleton For Objective Hand Function Assessment In Stroke Rehabilitation, Madison Bates

Theses and Dissertations--Biomedical Engineering

Hand function is often impaired following neurological trauma or in conditions such as stroke, limiting independence and the ability to perform activities of daily living (ADLs). Current clinical assessments rely heavily on subjective rating scales that lack the resolution to detect subtle changes in motor performance, which can limit access to rehabilitation. Recent advances in wearable technologies highlight the potential for hand-worn devices to provide objective, real-time measures of hand function. However, most systems focus solely on kinematics and rarely capture both movement and exerted force. Moreover, integration into rehabilitation frameworks and brain-computer interface (BCI) protocols remains limited. To address …

The Effectiveness Of Botulinum Toxin Injections In The Management Of Chronic Neck And Shoulder Myofascial Pain: A Nursing Perspective, Jia Zhou

Nursing | Senior Theses

Abstract

Background

Chronic neck and shoulder myofascial pain has long been challenging patients and medical professionals due to its limited response to traditional therapies on top of high recurrence. Physical therapy, oral analgesics, and trigger point injections have only provided partial or short-term relief. As a result, botulinum toxin type A injections have been explored as an alternative treatment. Previous studies have shown promising short-term outcomes, but concerns regarding long-term safety, cost-effectiveness, and potential adverse effects, particularly in older adults, have remained unresolved. These gaps have highlighted the need for comprehensive evaluation from both clinical and nursing perspectives.

Objective

The …

Leveraging Clinical Standards To Improve The Translational Relevance Of Therapies For Experimental Spinal Cord Injury, Aaron L. Silverstein

Theses and Dissertations--Neuroscience

Efforts to improve treatment of spinal cord injury (SCI) often use animals to develop effective therapeutics, intending to improve the survival and the quality of life of persons with SCI. Over half of all SCIs in the United States occur at the cervical level and often cause locomotor deficits and life-threatening breathing dysfunction. Thus, my dissertation is focused on this important patient population.

After beginning with a description of translational research and surveying SCI from a clinical standpoint, I turned to describe experimental models of cervical SCI and more detailed neuroimmunological findings relevant to my work. Then, I conducted a …

Automated Thermo-Mechanical Therapy For Immediate Relief In Chronic Non-Specific Lower Back Pain (Cnslbp): A Randomized Controlled Trial, Kyle V. Donnery

Dissertations and Theses

Objective: Chronic non-specific lower back pain (cNSLBP) is a prevalent and disabling condition, imposing a substantial socioeconomic burden due to high healthcare costs and productivity losses, with limited accessible and effective long-term treatment options. Automated Thermo-mechanical Therapy (ATT) is a promising, non-drug intervention that leverages innovative technical advances to provide multimodal pain relief, offering accessibility and low-cost delivery. This study tested ATT for immediate pain relief in individuals with cNSLBP in a single-session, double-blind, randomized controlled trial.

Methods: Forty participants with cNSLBP were randomly assigned to receive either active ATT (n=20) or control ATT (n=20) in a 40-minute session. The …

Clear Speech Intervention In Parkinson’S Disease: A Single Case Design Examining Acoustic And Aerodynamic Outcomes Following A Structured Protocol, Zachariah Jordan Backus

Graduate Theses, Dissertations, and Problem Reports (ETD)

ABSTRACT

Clear Speech Intervention in Parkinson’s Disease: A Single Case Design Examining Acoustic and Aerodynamic Outcomes Following a Structured Protocol

Zachariah Backus

Purpose:

Parkinson Disease (PD) is a neuro-progressive movement disorder that impacts all movement of the body, including speech production. Ninety percent of individuals living with PD will experience hypokinetic dysarthria, a motor speech disorder, during the progression of their disease. Clear speech instruction is a treatment strategy used to increase motor speech outcomes in those with PD. Studies have shown positive changes in articulation, prosody, voice, and listener perception measures in those with PD after clear speech instruction …

Evaluating The Efficacy Of A Progressive Mobility Protocol Among Adult Icu Patients, Clayton Chroust

DNP Projects

Background: Many intensive care unit (ICU) patients are critically ill and require ventilator support, and they often do not receive any progressive mobility interventions until after they are liberated from the ventilator or receive transfer orders out of the ICU. Current literature suggests that patients in the ICU face deconditioning, increased ventilator days, development of deep vein thrombosis, pressure ulcers, pulmonary embolism, muscular atrophy, and increased days in the ICU which can be attributed to a lack of mobility. Current evidence-based research identifies that utilization of a progressive mobility protocol is one way to improve patient outcomes and reduce …

Comparison Of Baumgaertner Reduction Quality Criteria , Chang Criteria And Ap3×Ml3 Classification And Their Ability To Predict Mechanical Complications Of Trochanteric Fractures Fixed With Proximal Femoral Nail, Amr Elhadidy Elhadidy, Ahmed Abdelbadie Ibrahim, Sallam Ibrahim Fawzy, Ehab Youssef Hassanin

Mansoura Medical Journal

Background Trochanteric fractures are common injuries among the elderly. Despite advances in fixation with proximal femoral nails (PFN), Mechanical complication remain significant. Several reduction quality systems have been proposed, but their predictive value and reproducibility remain debated. Aim To evaluate and compare the predictive value and reproducibility of Baumgaertner Reduction Quality Criteria (BRQC), Chang Reduction Quality Criteria (CRQC), and AP3×ML3 classification in patients with AO Foundation/Orthopaedic Trauma Association (AO/OTA) 31-A1 and 31-A2 trochanteric fractures fixed with PFN. Methods A prospective observational study was conducted on 146 patients with 31-A1 and A2 trochanteric fractures treated by PFN. Postoperative radiographs were assessed …

Occupational Therapy Using Cbt To Improve Work Productivity In Schizophrenia: A Case Study, Artha Nisa Thohiroh Triyantari, Reza Nur Arsyi, Muhammad Luthfi, Ayleen Alicia K, Hermito Gideon, Zulfa Khoirunisah, Putri Dirgantara, Purnama Betty R. Sitorus

Jurnal Fisioterapi Terapan Indonesia

Schizophrenia is a chronic mental disorder that often impairs an individual's social and occupational functioning, including productivity-related activities. Patients with schizophrenia frequently face challenges in maintaining employment or running an independent business due to cognitive and emotional disturbances affecting their adaptive skills. This single-case study integrates Cognitive Behavioral Therapy (CBT) into occupational therapy to enhance productivity in a schizophrenia patient through an entrepreneurial activity—independently opening a coffee shop. The study subject is a 50-year-old male diagnosed with schizophrenia undergoing psychosocial rehabilitation at RSJ Dr. Soeharto Heerdjan. The CBT-based intervention was designed to develop adaptive thinking patterns and occupational skills through …

Enhancement Of Functional Ability In Supraspinatus Tendinitis Using Ultrasound And Isotonic Exercise: Case Study, Tu Lidya Ike Putri, Christabelle Aurelia

Jurnal Fisioterapi Terapan Indonesia

Supraspinatus tendinitis is an inflammation of the supraspinatus tendon caused by the supraspinatus muscle tendon overlapping with the caput longus bicep tendon so that friction and repetitive pressure occur over a long period of time and result in damage to the supraspinatus muscle tendon and supraspinatus tendinitis occurs. Characterized by complaints of pain around the shoulder followed by limitation of motion in the shoulder joint. The clinical question arises "can the application of ultrasound and isotonic exercise reduce pain and functional ability improvement?". To be able to answer this question, an evidence search was conducted on 3 data bases, namely …

Perbandingan Konservatif Fisioterapi Dengan Core Stability Exercise Pada Kasus Nyeri Punggung Bawah, Angria Pradita, Nurul Halimah

Jurnal Fisioterapi Terapan Indonesia

ABSTRACT: Low back pain is a major complaint caused by multifactorial conditions. The most common factors of low back pain complaints are due to age, occupation and gender. This study aims to compare the differences in therapeutic effects of conservative physiotherapy with the provision of electrotherapy, namely; microwave diathermy combined with transcutaneous electrical nerve stimulation (TENS), core stability exercise techniques and a combination of electrotherapy with core stability exercise (CSE). This type of research is quasi experimental with a pre-post test design in a population of 90 low back pain patients who seek treatment at the Physiotherapy clinic. By using …

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 …

A Survey On Attitudes Of Rehabilitation Professionals On The Use Of Immersive Gamification Technology Systems In Therapy, Anna Mae U. Consing, Maria Eliza R. Aguila

Philippine Journal of Physical Therapy

Introduction. Immersive gamification technology systems (ImGTS) are used among patients with physical impairments in different practice settings. Studies have shown moderate evidence for the effectiveness of ImGTS in improving functional outcomes. However, studies are scarce on the use of ImGTS by rehabilitation professionals in clinical practice. Thus, this study aimed to determine attitudes of rehabilitation professionals in using ImGTS in rehabilitation.

Methods. This cross-sectional descriptive survey utilized a self-administered online questionnaire, the modified Unified Theory of Acceptance and Use of Technology (UTAUT) Questionnaire, to determine perceptions on performance expectancy, effort expectancy, social influence, and facilitating conditions on using ImGTS for …

Navigating Life After The Nicu: A Developmental Guide For Preterm And High-Risk Infants And Toddlers, Reagan Lachaussee, Mary Jan Greer Phd, Otr, Theresa Mensi

Fall 2024 OTD Capstone Symposium

Premature and medically fragile infants are at high risk for developmental delays and benefit from ongoing support. Parents often feel overwhelmed and uncertain about how to support their child’s development at home. This project addressed gaps in caregiver education and support by developing the PEARLS Program (Promoting Early Achievements, Resilience, and Life Skills), a practical resource tailored to the needs of families and healthcare providers.

A needs assessment and provider feedback guided the program’s development, identifying challenges such as information overload, confusion around corrected age, and feeding difficulties. The PEARLS Program empowers families with digestible, actionable resources, including …

Multimodal Assessment Battery And Heart Rate Variability Enhance Clinical Utility Of Buffalo Concussion Treadmill Test, Daniel Miner, Michael Shiraishi, Pamela Gibbons, Rahul Soangra, Brent Harper

Physical Therapy Faculty Articles and Research

Context: The Buffalo Concussion Treadmill Test (BCTT) for exercise intolerance following concussion may highlight underlying autonomic dysfunction. Autonomic function at rest and with exertion may be predictive of neurocognitive performance for individuals with sports-related concussion. The purpose of this study is to explore the feasibility and utility of combining multimodal assessments with heart rate variability (HRV) measures during the BCTT for individuals with a remote history of concussion. Design: Prospective cohort study design, pretest/posttest. Methods: Participants included 5 males and 5 females (N = 10, age: 25.2 [3.3] y old, height: 173.2 [11.2] cm, mass: 73.4 [13.7] …

Supporting Leisure Exploration And Participation For Older Adults To Improve Occupational Performance, Jack Fong, Karen Park, Jazminne Orozco Arteaga

Fall 2024 OTD Capstone Symposium

This capstone project aimed to develop a program advocating for leisure exploration and participation among older adults to address functional decline and improve quality of life. The program utilized a comprehensive needs assessment, including interviews, interest screening, and observations, to identify participants' preferences and barriers to participation. Through education and advocacy, the program encouraged engagement in meaningful leisure activities tailored to individual interests and abilities. Participants reported satisfaction with their leisure participation, emphasizing the importance of socialization and maintaining physical and cognitive health. Modifications, such as activity adjustments, enabled participation despite health-related challenges. This project highlights the value of responsive …

An Educational Video Guide To Aging In Place, Cecilia Ramos, Steven Gerardi Phd, Otd, Mss, Otr, Elizabeth Deluca-Berg Otd, Otr, Caps

Fall 2024 OTD Capstone Symposium

The growing population of older adults in the U.S. faces numerous challenges in maintaining independence while aging in place. Key findings from the needs assessment and literature review underscore the importance of accessible resources, health promotion, and health literacy in fostering autonomy and well-being among older adults. Occupational therapy addresses individual needs, educates on resource availability, and promotes interventions to enhance older adults' independence and safety. The purpose of this project was to create an educational video guide aimed at empowering older adults and their families with the knowledge and tools to overcome barriers to aging in place. This project …

Effects Of Simultaneous Smartphone Texting And Auditory Stimulation On Gait, Sebastian Herrera Vargas

Student Scholar Symposium Abstracts and Posters

More often than not, pedestrians around busy college campuses, business parks, and shopping malls are seen walking while using their phones and listening to music or having earphones in. Activities on pedestrians’ phones that captivate them more and require higher cognitive processing demonstrated a higher detriment to their gait kinematics than less cognitively complicated activities (Brennan and Preloff, 2021). This study aims to establish whether or not gait parameters are affected by walking while engaging in cognitively demanding activities such as texting and listening to green noise. Green noise is a deviation from white noise, which amplifies the mid-range frequencies …

Clinical Utility Of Opencap Motion Analysis In Lower Limb Prosthesis Users, Sarahi Fernandez Leon

Honors Program Theses and Research Projects

The use of prosthetics has gradually increased due to various diseases, and it is estimated that 35-40 million people are prosthetic/orthotic users, with the number estimated to increase to two billion by 2050. Mobility has been determined to be a strong predictor of quality of life. There are various ways to measure mobility and predict outcomes in lower-limb amputees (LLA), such as self-report and performance-based measures. However, these come with many limitations, showcasing the need for quantitative measures of gait parameters to allow for better development of prosthetic components. Motion analysis tools are expensive and time consuming, but an inexpensive, …

A Comparison Of Vestibular Function In Young Adult Musicians And Non-Musician Peers, Alexandria W. Greene, Ashley G. Flagge, Nicholas S. Stanley

Ashley Flagge Publications

Purpose: The majority of college-level musicians exceed the daily recommended noise dose level during instrumental practices and performances, although less than one-third report wearing hearing protection while playing their instruments. Although the hazardous effects of music on the auditory system have been established, even in young adult musicians still early in their musical careers, the effects of music on the vestibular system are still unclear. The purpose of the present study was to examine vestibular/balance differences between young adult musicians and non-musicians to determine the effects of music exposure on the vestibular system.

Method: Young adult participants aged 18-27 years …

Short-Term And One-Week Follow-Up Of Dry Needling Effects On Shoulder Range Of Motion And Strength With Asymptomatic Individuals, Mark Hecimovich

Master of Science in Kinesiology

Dry needling, a subcutaneous treatment intervention using fine filiform needles, is growing in popularity amongst manual therapists and is used in treating myofascial trigger points, pain, range of motion, and strength, albeit with limited research. This research aimed to measure the effect of dry needling on the shoulder, its impact on external rotation, and abduction range of motion and strength with an asymptomatic cohort of individuals. It is hypothesized that dry needling on a cohort of healthy individuals will not influence both range of motion and strength.

This study consisted of a convenience sample of 20 university students aged 20 …

The Dual Timescales Of Gait Adaptation: Initial Stability Adjustments Followed By Subsequent Energetic Cost Adjustments, Sasha A. Brinkerhoff, Natalia Sánchez, Meral N. Culver, William M. Murrah, Austin T. Robinson, J. Danielle Mccullough, Matthew W. Miller, Jaimie A. Roper

Physical Therapy Faculty Articles and Research

Gait adaptation during bipedal walking allows people to adjust their walking patterns to maintain balance, avoid obstacles and avoid injury. Adaptation involves complex processes that function to maintain stability and reduce energy expenditure. However, the processes that influence walking patterns during different points in the adaptation period remain to be investigated. We assessed split-belt adaptation in 17 young adults aged 19–35. We also assessed individual aerobic capacity to understand how aerobic capacity influences adaptation. We analyzed step lengths, step length asymmetry (SLA), mediolateral margins of stability, positive, negative and net mechanical work rates, as well as metabolic rate during adaptation. …

Advance Care Planning In Rehabilitation: Training Nurses And Social Workers To Facilitate Discussions, Celeste Christiansen

Student Scholarly Projects

Practice Problem: Patients and healthcare workers fail to hold advance care planning (ACP) discussions. Social workers perceive a lack of time and feel unprepared to hold ACP conversations.

PICOT: The PICOT question that guided this project was: Do patients in acute inpatient rehabilitation (P) who receive education and resources about ACP from trained nurses and social workers (I) accept and participate in ACP (O) compared to prior standards of care (C) while on the rehabilitation unit (T)?

Evidence: The public and healthcare workers have limited knowledge of ACPs and their role in these discussions. People are more likely to hold …

Evaluating The Superiority Of Multimodal Analgesia Over Opioid-Based Analgesia In Postoperative Pain Management For Total Knee Arthroplasty: A Comprehensive Integrative Review, Janna Smith, Mahdi Mofazali, Nya-Qien Smith

Master's Projects

With total knee arthroplasty (TKA), postoperative pain management is so important for optimal recovery and patient outcomes. This integrative review evaluates the effectiveness of multimodal analgesia (MMA) compared to traditional opioid-based analgesia in reducing pain and opioid consumption post-TKA. Research shows that MMA is very effective at providing adequate pain relief, reducing side effects, and also decreasing opioid use. MMA also addresses both the specific needs of individual patients and the broader public health issue of opioid dependence. However, a significant barrier to widespread adoption is the absence of standardized protocols. This review sets forth the importance of coming up …

Consumers', Family Members', And Health Practitioners' Perspectives On Increasing Activity Engagement Of Older Patients Admitted To Geriatric Hospital Units, Yvonne Y.K. Mak-Yuen, Farnaz Khoshmanesh, Tamara Tse

Patient Experience Journal

The aim of this study was to explore the perspective of consumers, family members, and health practitioners on increasing patient activity engagement in a Geriatric Evaluation and Management (GEM) Unit. This study followed a qualitative phenomenology approach. Semi-structured interviews were conducted, audio-recorded and transcribed verbatim with consenting patients (n = 12), family members (n = 3), and health practitioners (n = 5) admitted to the GEM Unit of a tertiary metropolitan hospital in Melbourne, Victoria, Australia between August 2017 and March 2018. Data were analysed using spiral content analysis. From the 20 interviews, three themes emerged: 1. What can I …