Recreational Therapy Commons^™

Play To Win: A Randomized Controlled Trial To Assess The Effects Of Play-Based Training On Upper Extremity Function In Children With Hemiplegia, Vivian London

Honors Scholar Theses

Hemiplegia, or paralysis of one side of the body, is the primary symptom of unilateral cerebral palsy, a subtype of cerebral palsy, the most common movement disorder in children. Standard of care is regular physical and occupational therapy to improve performance in bimanual activities, but conventional therapy can be expensive and draining for caregivers and children, so a need exists for a novel intervention that can take place at home and that is economical for families while being engaging for children. This thesis reports data from a subset of ten children seen as part of a randomized controlled clinical trial …

Embodied Aging: Older Adults’ Gendered Participation In Physical And Recreational Activity In Assisted Living, Gavin Anderson

Self-Designed Majors Honors Papers

This study examines how older adults interpret their experiences with physical and recreational activity in assisted living, and how these interpretations influence how they engage in their everyday social and physical contexts. In the fall of 2025, eleven older adults—nine women and two men—living in an assisted living facility in a coastal city in Southeastern Connecticut participated in in-depth semi-structured interviews. The facility provides both short-term post-acute care and long-term residential care, offering structured opportunities for physical and recreational engagement.

Past research demonstrates that participation in physical and recreational activity provides substantial benefits for older adults; yet, the lived experience …

Energy Flow Differences In Throwing Arm Joints Between Javelin And Weighted Balls In Male Javelin Throwers, Hans-Peter Köhler, Kristof Kipp, Nikola Prvulović, Maren Witt

Exercise Science Faculty Research and Publications

Introduction: To enhance release velocity during competition, javelin throwers incorporate implements of varying mass into their training regimens. Previous research has demonstrated that, although velocity contributes quadratically to the computation of kinetic energy, heavier implements generate substantially greater kinetic energy at the moment of release, despite markedly lower release velocities. The primary objective of the present investigation was to analyze energy transfer within the throwing arm to gain deeper insight into the biomechanical mechanisms underlying the use of implements with different masses.

Methods: The three-dimensional coordinates of 16 reflective markers were recorded for 6 athletes during throws using 6 different …

Mechanisms For The Age-Related Increase In Fatigability Of The Elbow Flexor Muscles In Healthy Adults, Blaine E. Arney, Andrew Kuplic, Mitchell D. Adam, Christopher W. Sundberg, Sandra Hunter

Exercise Science Faculty Research and Publications

The mechanisms for the age-related increase in fatigability of the elbow flexor muscles during dynamic contractions are unknown. The purpose of this study was to determine the contribution of supraspinal and contractile mechanisms for the age-related increase in fatigability of the elbow flexor muscles. Twenty-eight young (23.2 ± 2.6 years; 14 females) and 32 older adults (72.6 ± 5.6 years; 15 females) performed 80 maximal velocity contractions at 20% of maximal isometric strength. Voluntary activation and muscle contractile properties were assessed before and immediately following the fatiguing exercise using transcranial magnetic stimulation (TMS) and electrical stimulation. Fatigability (% reduction in …

Sex-Based Differences In The Representation Of Top Youth Athletes, Jessica J. James, Sandra K. Hunter, Elizabeth P. Bueckers, Michael J. Joyner, Jonathon W. Senefeld

Exercise Science Faculty Research and Publications

Although emerging research demonstrates that male athletes outperform female athletes before puberty, the effect of these sex-related advantages on ordinal ranking of top performances remains unclear.

Objectives

Among overall top performances of youth track and swimming athletes, we aimed to determine 1) the proportional number of male compared with female athletes represented and 2) at what age females are no longer represented.

Methods

Finishing times and sex of the top 10 and top 100 performances of youth runners and swimmers between 5 and 18 yr were abstracted from online U.S.-based databases for four running (100 m–800 m) and six freestyle …

Efficacy Of Single Joystick-Operated Ride-On-Toy Navigation Training Program To Promote Increased Spontaneous Use And Motor Function In The Affected Arm In Children With Unilateral Cerebral Palsy, Neha Samuel

Honors Scholar Theses

The purpose of this study is to assess the adjunctive effects of a home-based single joystick-operated ride-on-toy navigation program to conventional care on affected upper extremity (UE) use and motor function in children with hemiplegia. Wrist-worn accelerometers were worn by children on both their affected and unaffected extremities at baseline (i.e., prior to start of the training program) and during ride-on toy training sessions to measure affected and unaffected arm activity, resulting in measurements of percent duration of time in every session that children engaged in sedentary, light, and moderate-to-vigorous activity (MVPA) using their affected and unaffected arms at baseline …

Supporting Elementary Educators Through A Nervous System Regulation And Social-Emotional Learning Skills Workshop Intervention: An Musc Capstone Project, Lily Morgan

Entry-Level Occupational Therapy Doctorate - Doctoral Capstone Symposium

Teachers have a great influence on developing children’s emotional intelligence, regulatory capacity, and occupational engagement. These professionals also happen to report some of the highest rates of stress, mental health challenges (Agyapong, B. et al, 2022), and burnout (Xie, M., et al, 2022). Providing teachers with education and support on nervous system regulation, social-emotional learning skills, and related topics can improve their ability to manage job stress, enhance modeling and interactions with students, and improve their quality of life. This project aimed to enhance knowledge, provide access to resources, and serve to support elementary educators at an inner-city school in …

Scaling New Heights: A Prospective Survey Of Rock Climbing's Impact On Mental Health, Kathy Chen, Swetha Sundaram, David F Lo, Ahmed Gawash, Charalampos Papachristou, Altamash E Raja

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: Sport climbing, officially added to the 2020 Summer Olympics, has grown rapidly, with U.S. climbing gyms increasing from 310 in 2013 to 591 in 2021. Over the past decade, European research has identified bouldering as a potential psychotherapeutic treatment for anxiety and depression. Randomized controlled trials have compared bouldering psychotherapy (BPT) to cognitive behavioral therapy (CBT), showing that BPT produces comparable results and positively impacts mental health.

PURPOSE: There have been very few studies dedicated to the use of rock climbing as a therapy in the United States; further, there are few surveys that investigate whether American climbers would …

Walking Performance Is Worse In Black Than White People With Multiple Sclerosis, Robert W. Motl, Deborah Backus, Jeffrey R. Hebert, Alexander V. Ng, Kevin K. Mccully, Whitney N. Neal, Hollie Schmidt, Robert Mcburney, Prudence Plummer, Francois Bethoux, John Lowman, Gary R. Cutter

Exercise Science Faculty Research and Publications

Background

There is emerging evidence for poor health outcomes among Black people with MS, and Black people with MS may have worse walking performance than White counterparts.

Purpose

The current study examined if Black participants with MS had slower walking speed (timed 25-foot walk, T25FW) and shorter walking distance (six-minute walk, 6MW) than White participants, and if these differences were accounted for by demographic variables, physical activity, disease/clinical characteristics, and Social Determinants of Health (SDOH).

Method

The analysis included samples of Black (N = 105) and White (N = 246) participants with MS who completed the T25FW and 6MW, underwent …

Isapa 2025: Program Guide, Catherine Carty, Gerard Masdeu Yelamos

Publications

ISAPA 2025 is a landmark international event that brings together global leaders, researchers, practitioners, and advocates in Adapted Physical Activity to ignite systemic change under the unifying theme “Shifting the Dial: From Awareness to Transformation.” Hosted in Kerry, Ireland, under the patronage of UNESCO, the symposium integrates five major events into one dynamic platform.

The program reflects IFAPA’s mission to advance inclusion, research, professional excellence, and international cooperation, while also contributing meaningfully to the implementation of global frameworks such as the UN Convention on the Rights of Persons with Disabilities (CRPD), the Sustainable Development Goals (SDGs), the Paris 2024 Call …

Prediction Of Snatch And Clean And Jerk Performance From Physical Performance Measures In Elite Male Weightlifters, Ingo Sandau, Kristof Kipp

Exercise Science Faculty Research and Publications

This study aimed to build a valid model to predict maximal weightlifting competition performance using ordinary least squares linear regression (OLR) and penalized (Ridge) linear regression (penLR) in 29 elite male weightlifters. One repetition maximum (1RM) or 3RM test results of assistant exercises were used as predictors. Maximal performance data of competition and assistant exercises were collected during a macrocycle in preparation for a competition. One repetition maximum snatch pull, 3RM back squat, 1RM overhead press, and body mass were used to predict the 1RM snatch; and 1RM clean pull, 3RM front squat, 1RM overhead press, and body mass were …

Effect Of Trauma Type And Trauma Burden On Self-Efficacy For Physical Exercise In Military Veterans, Kaley E. Davis, Meghan M. Bennett, Cecilia J. Hillard, Jeffrey Whittle, Zeno Franco, Rachel E. Bollaert, Jacklynn M. Fitzgerald

Exercise Science Faculty Research and Publications

Introduction

United States (U.S.) military veterans experience significant physical health problems. Lifestyle modifications, such as increasing daily physical activity, are often considered the first course of action in treatment for the general public. However, veterans report low levels of physical activity, often due to perceived barriers to engaging in exercise. Trauma exposure type and cumulative trauma burden may be differentially associated with exercise attitudes and behaviors.

Methods

We surveyed U.S. military veterans on perceived self-efficacy to overcome barriers to engaging in exercise and physical activity levels. Additionally, we explored the relationship between the type of traumatic event exposure and cumulative …

Relative Muscular Effort In The Older Adults During The Sit-To-Stand Task: Monitoring Neuromuscular Reserve And Movement Limitations, Nayun Ahn, Michael H. Haischer, Cara L. Lewis, Kristof Kipp

Exercise Science Faculty Research and Publications

Background

Due to lower maximum strength, older adults purportedly need to exert greater muscular effort to stand up from a chair. This study investigated joint-specific muscular effort during a sit-to-stand by calculating relative-muscular-effort and investigating differences between healthy older and young adults.

Methods

Fifteen older (age: 69.9 ± 3.5 years) and 15 young (age: 22.2 ± 2.6 years) adults performed five self-paced sit-to-stand trials. Kinematic and kinetic data were collected and used to calculate inverse dynamics net joint moment. Peak isometric knee and hip extensor torques were measured and used as inputs to regression models that predicted angle- and velocity-dependent …

Proceedings Of The 2022 “Lifestyle Intervention For Epilepsy (Life)” Symposium Hosted By Cleveland Clinic, Martha Sajatovic

Faculty Scholarship

Lifestyle interventions are strategies used to self-manage medical conditions, such as epilepsy, and often complement traditional pharmacologic and surgical therapies. The need for integrating evidence-based lifestyle interventions into mainstream medicine for the treatment of epilepsy is evident given that despite the availability of a multitude of treatments with medications and surgical techniques, a significant proportion of patients have refractory seizures, and even those who are seizure-free report significant adverse effects with current treatments. Although the evidence base for complementary medicine is less robust than it is for traditional forms of medicine, the evidence to date suggests that several forms of …

Performance Of Artificial Neural Network Compared To Multi-Linear Regression In Prediction Of Countermovement Jump Height, Amirhossein Emamian, Alireza Hashemi Oskouei, Kristof Kipp, Rasoul Azreh

Exercise Science Faculty Research and Publications

Previous research has used primarily linear regression models to predict jump height and establish contributors of performance. The purpose of this study was to compare the performance of artificial neural network (ANN) and multi-linear regression (MLR) in prediction of countermovement jump (CMJ) height and investigating the contribution of kinematic variables to CMJ performance. Thirty-four healthy young male athletes performed a total of 204 CMJ while eight kinematic variables (the hip, knee, and ankle angles at the begging of the concentric phase of CMJ, the hip and knee take-off angles, and the shoulder, hip, and knee maximum angular velocities) were used …

Effects Of Photobiomodulation Therapy On Muscle Function In Individuals With Multiple Sclerosis, Mitra Rouhani, Miguel Tolentino, Jeri-Anne Lyons, Alexander V. Ng

Exercise Science Faculty Research and Publications

Background

In people with multiple sclerosis (pwMS), muscle fatigue and weakness are common issues that can interfere with daily activities. Photobiomodulation therapy (PBMT), comprising light in a 600–1100 nm bandwidth, is a low-level laser therapy thought to improve muscle performance in non-disease populations, in part, by improving mitochondrial function and thus, might be beneficial in pwMS. Given this potential, we aimed to investigate the effects of PBMT on muscle performance in pwMS, both in the short-term and over an extended period.

Methods

This study consisted of two parts with a randomized double-blind crossover design. In study I, muscle function was …

Increasing Social Inclusion And Engagement Of Exercise For Individuals With Spinal Cord Injuries: A Universal Resource Development For Wellness Facilities, Alexa Hall

Entry-Level Occupational Therapy Doctorate - Doctoral Capstone Symposium

Individuals with spinal cord injuries (SCIs) are 1.5 times more likely to disengage in exercise one-year post-injury despite 80% of these individuals agreeing that exercise is critical to their overall health and quality of life (Baehr. Et al., 2022). A needs assessment was conducted on why the lack of engagement in exercise exists for individuals with SCIs within fitness facilities to identify barriers preventing participation. A quality improvement program called the Spinal Cord Injury Wellness Toolkit was created based off these findings and implemented at the MUSC Wellness Center. 14 individuals with SCIs participated at wellness center; REDCap surveys were …

Middle-Range Scores From The Patient Determined Disease Steps Scale Reflect Varying Levels Of Walking Dysfunction In Multiple Sclerosis, Robert W. Motl, Whitney Neal, Deborah Backus, Jeffrey Hebert, Kevin K. Mccully, Francois Bethoux, Prudence Plummer, Alexander V. Ng, John Lowman, Hollie Schmidt, Robert Mcburney, Gary R. Cutter

Exercise Science Faculty Research and Publications

Background

Multiple sclerosis (MS) is a leading cause of neurological disability among young and middle-aged adults worldwide, and disability is measured using a variety of approaches, including patient reported outcome measures (PROMs) such as the Patient Determined Disease Steps (PDDS) scale. There is limited evidence for the validity of inferences from the middle-range of scores on the PDDS (i.e., 3 “gait disability” – 6 “bilateral support”), but that range of scores seemingly represents moderate disability characterized by varying levels of walking dysfunction.

Purpose

The current study examined whether the middle-range of scores from the PDDS reflect varying levels of walking …

Muscle-Specific Contributions To Vertical Ground Reaction Force Profiles During Countermovement Jumps: Case Studies In College Basketball Players, Kristof Kipp, Hoon Kim

Exercise Science Faculty Research and Publications

The purpose of this study was to determine muscle-specific contributions to various types of vertical ground reaction force (vGRF) profiles in collegiate basketball players. Players from a men's (n = 5; height: 1.84 ± 0.14 m; mass: 92.8 ± 11.4 kg) and a women's (n = 5; 1.71 ± 0.09 m; mass: 80.1 ± 17.6 kg) basketball team completed 3–5 countermovement jumps (CMJ) while motion capture and force plate data were recorded. Muscle-specific contributions to vGRF were calculated through vGRF decomposition analysis. Profiles of vGRF were analyzed based on the presence of unimodal or bimodal peaks during the …

Running To The Beat: Does Listening To Music Affect Running Cadence And Lower Extremity Biomechanics?, Carolyn Meinerz, Jessica M. Fritz, Janelle A. Cross, Cody C. Dziuk, Kristof Kipp, Carole Vetter

Exercise Science Faculty Research and Publications

Background

Gait retraining can be effective in altering lower extremity biomechanics and reducing risk of injury. In attempts to alter running gait, previous studies used metronomes to manipulate cadence.

Research question

The aim of this study was to determine if manipulating running cadence via music could alter lower extremity biomechanics.

Methods

Eighteen runners ran at a self-selected speed (SS) and ran to music where the beats per minute (bpm) of the songs was increased by 5% (+5%) and 10% (+10%). Kinematic and kinetic data were collected with a motion capture system and a triaxial accelerometer. A one-way repeated measures analysis …

Pne - Lots Of Talk, Superficial Results, Aidan Keller, Michael Ray, Taylor Baugher

ASPIRE 2023

A narrative review (NR) of meta-analyses (MA) and systematic reviews (SR) that assess the effectiveness or efficacy of pain neuroscience education (PNE) on various outcome measures in individuals with chronic musculoskeletal (MSK) pain. Systematic searches were conducted on 4 databases. Study selection included MAs and SRs that assessed the effectiveness or efficacy of PNE on CP populations. Quantitative eligibility criteria included randomized controlled trials (RCTs), adults (18+ years of age), English or Spanish speaking individuals, and reporting of chronic pain (persistent or recurrent pain lasting ≥ 3 months). Qualitative eligibility criteria included individuals reporting chronic pain and experienced a PNE …

Community Facing Athletic Trainer, Eric Post

2022 Fall Reports (Marshall, IL)

In an initial planning meeting with Marshall Mayor John Hasten, the mayor identified the potential need for an athletic trainer to serve as a community-facing health professional within the Marshall community in order to provide access to highquality injury prevention, evaluation, and care. The agreed-upon objectives for this project were to: ● Perform a needs assessment to determine the potential costs and resources necessary to provide a community-facing athletic trainer within the Marshall community. ● Share perspectives on how athletic trainers can provide services to serve the health needs in the Marshall community. ● Determine the best strategies for providing …

“It’S About Being Healthy”; A Novel Approach To The Socio-Ecological Model Using Family Perspectives Within The Latinx Community, Bethany Korom, Meghan Malloy, Caroline Remmers, Mari Cevilla, Kelly Dione, Paula E. Papanek, Jeffrey Condit, David Nelson

Exercise Science Faculty Research and Publications

Background

The Latinx community is at risk for obesity, type 2 diabetes, and other chronic illnesses. Culturally appropriate, community facing physical activity (P.A.) and nutrition programs may provide the basis for families to improve their health status. Our objectives are as follows: 1. To investigate synergistic factors within this type of program that play a role in creating an environment for participants to learn and practice healthy behaviors. 2. To apply factors into a novel model of components that support health and wellness. 3. To design an intervention for future implementation and evaluation.

Methods

A two-year P.A. and nutrition program, …

Pne – Lots Of Talk, Superficial Results, Aidan Keller, Michael Ray, Taylor Baugher

Honors Projects

Objective: A narrative review (NR) of meta-analyses (MA) and systematic reviews (SR) that assess the effectiveness or efficacy of pain neuroscience education (PNE) on various outcome measures in individuals with chronic musculoskeletal (MSK) pain. Methods: This was a mixed methodology review involving systematic searches across 4 databases (PubMed, ScienceDirect, CENTRAL (Cochrane), and Google Scholar). Inclusion criteria stipulated MAs and SRs that assessed the effectiveness or efficacy of PNE on CP population. Quantitative eligibility criteria included randomized controlled trials (RCTs), adults (18+ years of age), English or Spanish speaking individuals, and reporting of chronic pain (persistent or recurrent pain lasting ≥ …

Resilience Among Older Adults With Multiple Sclerosis: Pattern And Correlates, Dena Sadeghi-Bahmani, Ariel Kidwell, Rachel E. Bollaert, Robert W. Motl

Exercise Science Faculty Research and Publications

Background

There is an increasing number of older adults with multiple sclerosis (MS) who present with significant challenges associated with aging in conjunction with a chronic, disabling disease. Resilience has been associated with healthy aging in the general population, yet there is limited research on resilience and its correlates among older adults with MS. The current study investigated the difference in resilience between older adults with MS and demographically matched healthy controls. We then examined the associations between resilience and functional, symptomatic, socio-behavioral, and QOL outcomes, along with demographic and clinical characteristics, among only older adults with MS. Method: The …

Equine Assisted Therapy For Veterans, Nicole M. Krum

IPS/BAS 495 Undergraduate Capstone Projects

Equine-assisted activities and therapy have been proven to be highly effective in assisting veterans with mental health conditions. This project aimed to provide information and resources about these services to Treasure Valley veterans. In order to do this, an in-person open-house was hosted, to connect veterans to equine therapy. By completing this project, it can be asserted that there is a general lack of accessible and affordable services.

Muscle Force Contributions To Ankle Joint Contact Forces During An Unanticipated Cutting Task In People With Chronic Ankle Instability, Hoon Kim, Rianna M. Palmieri-Smith, Kristof Kipp

Exercise Science Faculty Research and Publications

The purpose of this study was to compare muscle force contributions to ankle joint compression and anteroposterior shear forces between people with chronic ankle instability (CAI) and healthy controls (CON) during an unanticipated cutting task. Eleven people with CAI and 11 CON performed an unanticipated cutting task as three-dimensional motion capture, ground reaction force (GRF), and muscle activation data were collected. A musculoskeletal modeling was used to calculate talocrural joint compression and anteroposterior shear forces and parse out the contributions to these forces from ankle-spanning muscles and from GRF. Independent t-tests were used for statistical analysis. People with CAI exhibited …

Navigator Role For Promoting Adaptive Sports And Recreation Participation In Individuals With Disabilities, Moriah Iverson, Alexander V. Ng, Alice F. Yan, Kimberley Zvara, Michael Bonk, Deb Falk-Palec, Cherri Sylla, Maurine Strickland, Rachel Preston, Diane W. Braza

Exercise Science Faculty Research and Publications

Objective

The aims of the study were to gain a better understanding of the resources, barriers, and facilitators of participation in adaptive sport and recreational activities as a means of achieving physical activity recommendations in individuals with disability and to understand preferences for a patient navigator service to help mitigate the barriers.

Design

Clinical, academic, and community stakeholders applied a community-engaged research approach to develop online surveys and focus group questions for adults with a disability or parents of a child with a disability to meet study objectives.

Results

One hundred ninety-eight adults and 146 parents completed the online surveys. …

Sex Differences In Fatigability Following Exercise Normalised To The Power–Duration Relationship, Paul Ansdell, Jacob Skarabot, Elliott Atkinson, Sarah Corden, Amber Tygart, Kristy M. Hicks, Kevin Thomas, Sandra K. Hunter, Glyn Howatson, Stuart Goodall

Exercise Science Faculty Research and Publications

Due to morphological differences, females demonstrate greater fatigue resistance of locomotor muscle during single-limb and whole-body exercise modalities. Whilst females sustain a greater relative intensity of single-limb, isometric exercise than males, limited investigation has been performed during whole-body exercise. Accordingly, this study established the power–duration relationship during cycling in 18 trained participants (eight females). Subsequently, constant-load exercise was performed at critical power (CP)-matched intensities within the heavy and severe domains, with the mechanisms of fatigability assessed via non-invasive neurostimulation, near-infrared spectroscopy and pulmonary gas exchange during and following exercise. Relative CP (72 ± 5 vs. 74 ± 2% P …

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

Exercise Science Faculty Research and Publications

Background

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

Research question

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

Methods

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