Recreational Therapy Commons^™

Proceedings Of The 25th International Symposium On Adapted Physical Activity, Catherine Carty, Gerard Masdeu Yelamos

Publications

This volume presents the Proceedings of the 25th International Symposium of Adapted Physical Activity (ISAPA 2025), hosted by Munster Technological University under the Patronage of UNESCO. It is intended as a permanent scholarly record of the symposium, its themes, and its contributions across research, practice, policy, culture, and inclusion in line with CoARA principles.

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 …

Unraveling The Impact Of Spider Cage Therapy On Static And Dynamic Standing Balance In Children With Spastic Diplegic Cerebral Palsy: A Randomized Clinical Trial, Varsha Anbu, Senthil Kumar Natarajan, Jagatheesan Alagesan, Akshaya Venkat, Rekha Chitrada

Internet Journal of Allied Health Sciences and Practice

Purpose: The intent of this study was to ascertain the efficacy of spider cage therapy for static and dynamic standing balance in children with spastic diplegic cerebral palsy using Pediatric Balance Scale (PBS) and Gross Motor Function Measure (GMFM). Cerebral palsy described as a group of disorders with uneven posture and movement were spastic diplegia is the most prevalent type. Method: This study was a randomized controlled trial that used random sampling and blinded evaluators. Children with diplegic CP aged between 5 and 10 years, with GMFCS levels II-IV, were assigned to spider cage therapy group and conventional …

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 …

Introducing Patient-Centered Outcomes To Preceptors In Caate-Approved Athletic Training Programs, K. Judge

Clinical Practice in Athletic Training

The 2020 standards set by the Commission on Accreditation of Athletic Training Education (CAATE) now require the incorporation of the International Classification of Function and Patient-Centered Outcomes into professional practice. These standards can be introduced initially through simulation, but to develop a competent and culturally aware professional, outcome measures should be completed during clinical experiences under the guidance of approved preceptors. As this is a relatively new standard, many preceptors did not receive this as part of their education and may be uncomfortable integrating outcomes into their practice. This lack of integration can negatively affect the learning opportunities of athletic …

Incorporating Balance Training Into Ankle Sprain Injury Prevention Programs: An Evidence-To-Practice Review, David Tomchuk, Jacob Meyer, Kyle Schneider, Ben Fox

Clinical Practice in Athletic Training

Ankle sprains are among the most common injuries in sports and non-sporting activities. For patients, ankle sprains can result in multiple short and long-term hardships, such as financial burdens of evaluation and treatment, absenteeism from sport and physical activity, and diminished ankle and lower extremity function. However, athletic trainers and other stakeholders are also impacted by administrative and time burdens in caring for ankle sprains and how ankle sprains affect team dynamics and performance. The 2022 guiding systematic review evaluated the effectiveness of incorporating preventive balance training exercises on the incidence of ankle sprains in soccer athletes. The search performed …

Psychological And Psychosocial Effects Of Contemplative Practices In The Athletic Population: A Systematic Review, Victoria Baker, Emily Duckett, Alison Gardiner-Shires, Lindsey Keenan

Clinical Practice in Athletic Training

Mental health concerns in athletes are becoming a primary focus for institutions, companies, coaches, and more. An athlete carries an abundant load of stressors due to their lifestyle. The stressors can negatively impact an athlete by producing anxiety, depression, insomnia, and other mental health concerns. Previous studies have found a connection between the use of contemplative practices on psychological and psychosocial effects in athletes, creating an opportunity to evaluate the research of contemplative practices in the athletic population. 5, 7, 8, 13-16 A systematic review was conducted using nine electronic databases. Seven studies were included in this review, each assessing …

Use Of An Electronic Dynamometer Following Pitching To Identify Fatigue In Softball Pitchers, Bethany L. Hansberger, Peter Lisman

Clinical Practice in Athletic Training

This study used a case-series design to collect in-game fatigue measures for collegiate softball pitchers immediately after pitching during the competitive season. Five softball pitchers (age = 19.8 ± 1.5 years; height = 169.9±6.1 cm; body mass = 79.1±22.6 kg) from one Division I program were recruited. Isometric internal and external rotation, scaption, and grip strength measures were collected using an electronic dynamometer at the beginning and conclusion of the fall non-traditional season, and at the beginning of preseason in January. Strength measures were also obtained during the competitive season at the conclusion of pitching in a game and compared …

Concurrent Acl And Medial/Lateral Meniscal Repair In A Collegiate Soccer Player: Disablement Model Case Study, Rebecca L. Perry, Angelica Alicea, Jeanette Welch, Carl White, Emily E. Hildebrand, Peter Lisman

Clinical Practice in Athletic Training

This case examines a 19-year-old female Division I collegiate soccer player who underwent anterior cruciate ligament (ACL) reconstruction with medial and lateral meniscal repairs. Though meniscal tears often occur in conjunction with ACL injury, incidence of concurrent medial and lateral tears with presence of a displaced bucket-handle lesion is rare. This patient attempted to tackle an oncoming opponent in which contact caused forceful trunk rotation away from her planted right foot. Sideline evaluation revealed medial and posterior knee pain with active knee range of motion deficits. Further evaluation revealed apprehension and muscle guarding during Lachman’s, anterior drawer, and valgus stress …

Suturing Education For Athletic Trainers: An Evidence-To-Practice Review, Morgan K. Webb, Brett T. Heim, Allyson E. Ritchey, Kenya Moore, Zachary K. Winkelmann

Clinical Practice in Athletic Training

Teaching suturing skills to medical students is a critical component of their education. Implementing suturing into a comprehensive framework is developed from how professors teach the skill. Suturing is a required skill by the General Medical Council that all medical students must have, and how it is being introduced to new students is changing. This review aimed to summarize different educational interventions and determine the most efficient and cost-effective way to teach future suturing skills. The original systematic review included 25 articles in the final data synthesis. Fourteen studies were randomized control trials, six were quasi-experimental, and five were observational. …

Impact Of A Focused Best Practice Workshop On Athletic Trainer Confidence, Jaclyn B. Arduini, Jennifer L. Volberding, Zachary A. Murray

Clinical Practice in Athletic Training

Athletic trainers are required to be proficient in emergency management skills, without review these skills may decay creating a potentially dangerous knowledge gap. Confidence measures of emergency management skills were taken before and after a workshop to determine if they changed due to the review of material. All 11 confidence measures increased post workshop, seven significantly, including rectal temperature, hemostatic agents, external hemostatic modalities, in-line stabilization, measurement and application of a cervical collar, football and other equipment removal. ATs should aim to incorporate emergency management review into continuing education choices.

Neuromuscular Deficits Following An Isolated Pcl Tear In A Collegiate Lacrosse Player: A Case Study, Mckenna G. Witlin, Erin R. Mcmullan, Courtney M. Meyer, Amy L. Fraley

Clinical Practice in Athletic Training

This disablement model case study outlines a 21-year-old female collegiate lacrosse player attending a United States service academy who presented with a unique neuromuscular deficit following a conservative grade II PCL tear rehabilitation. Nearing the end of her rehabilitation protocol, she noticed difficulty with toe-off while running; however, she did not report to the athletic trainer due to the institution’s holiday break proximity. An unexpected transfer of care occurred when the patient returned after the holidays, and she was cleared for full participation upon return. Several days after the patient was cleared, she reported her ankle feeling “stuck.” Upon evaluation, …

Improving The Discussion Of Suicide Prevention: A Quality Improvement Project, Chelsea Reynolds, Alyssa Zeitouni, Kathryn Stephenson

Clinical Practice in Athletic Training

Suicide is currently the second leading cause of death among adolescents in the United States and the third leading cause of death in this age group worldwide.1,2 Suicide prevention is understandably a growing focus in pediatrics. Currently, at the Children’s Hospital Outpatient Clinic, that is staffed by pediatric resident physicians, suicidal ideation is screened for using a PHQ-9 screen. However, at the time this study was initiated and completed, the TEEN screen was utilized. After the screening is performed, regardless of type, it is up to the provider to address these findings in a safe and effective manner. The goal …

Examining Burnout Among Athletic Trainers Employed In The College And Secondary School Settings, Stephanie M. Singe, Dayna Liu, Alexandrya Cairns

Clinical Practice in Athletic Training

Burnout continues to be an important concern for athletic trainers working traditional employment settings. The purpose of this study was to compare the secondary school and collegiate settings in relation to burnout. Both secondary school and collegiate athletic trainers participated in a self-reported, online cross-sectional design (Qualtrics) to collect data on their experiences with burnout. Data collection occurred during the second week of October 2023 and ceased during the early weeks of November. Collegiate athletic trainers reported moderate burnout overall (54.56 ±15.89) on the CBI whereas secondary school athletic trainers reported low burnout overall (46.67 ±16.57). On the personal-related burnout …

Conservative Management Of Athletic Pubalgia In A Collegiate Beach Volleyball Athlete: A Case Study, Sydney F. Hendrick, Amy L. Fraley, Madison V. Kefferstan, Zachary K. Winkelmann

Clinical Practice in Athletic Training

A 24-year-old female collegiate beach volleyball athlete experienced sharp pain in the pubis symphysis region after turning and running to reach a ball hit over her right shoulder. The patient was unable to move her lower extremities without extreme pain and required help off the court. She was referred to the student health center, where no initial imaging was performed. Differential diagnoses included osteitis pubis, abdominal strain, and athletic pubalgia. Magnetic resonance imaging (MRI) showed a small partial sports hernia with the shearing of the aponeurotic plate. The team physician recommended conservative management. The patient requested a consultation with a …

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 …

Unbridled Healing: Identifying The Barriers Of Equine-Assisted Therapy, Sally A. Hamm

Human Development and Family Sciences Undergraduate Honors Theses

Despite the documented benefits of equine-assisted therapy (EAT) for mental health conditions, this complementary approach remains underutilized. This qualitative study investigated barriers preventing wider EAT implementation by examining challenges faced by clients, facilities, and volunteers. Data collected through open-ended surveys from 33 participants and the researcher's autoethnographic observations revealed eight common barriers: Accessibility (48 mentions), Money (43), Time (30), Awareness (23), Physical Factors (13), Relationships (13), Risk (13), and Weather (7). Clients identified financial constraints as their primary barrier, particularly insurance limitations. Facilitators struggled most with accessibility challenges, including lack of resources, trained staff, suitable horses, and appropriate facilities. Volunteers …

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 …

An Examination Of The Role Of Recreational Therapy In Forensic And Correctional Settings, Sarah R. Fischer

All Dissertations

The estimated prevalence of adults, age 18 and older, with serious mental illness (SMI) in the United States is approximately 6% (NIMH, 2022a). Having a mental illness places individuals at higher risk for arrest and incarceration (NAMI, n.d.b) where they receive treatment, including recreational therapy (RT) in state hospitals, jails or prisons. The purpose of this multi-method study was to gain a better understanding of the role of RT in treating adults with SMI in forensic and correctional settings. A non-standardized 122-item cross-sectional survey (n=49) was used to identify what interventions recreational therapists are using, for what intended outcomes; and …

Optimizing The Well-Being Of Residents Diagnosed With Dementia: An Activities Calendar And Guide For Cognitive And Physical Engagement, Kaylex L. Monteagudo Parra

Undergraduate Theses

This thesis explores the critical role of structured activities in enhancing the cognitive, emotional, and physical well-being of individuals with dementia. Drawing on evidence-based research and practical experience as an Activities Assistant, it emphasizes how engaging, person-centered activities can mitigate symptoms, improve quality of life, and promote social interaction across the stages of disease progression. The research culminates in the development of an ideal activities calendar tailored to patients with dementia, accompanied by a comprehensive guide detailing activity benefits, implementation strategies, and required resources. This framework addresses the unique challenges of dementia care, offering practical tools for caregivers to adapt …

Moomoo Care Program, Shelby Knoble

Research & Creative Achievement Day

Set on a family farm, the Moo-Moo Care Program is a hands-on, multi-day recreational program designed to teach youth about dairy cattle care. As part of my RTTR 203 final project, I created a daily schedule, goals and objectives, a Gantt chart for task organization, marketing materials, and an evaluation form.

Within this program, participants will engage in at least six hours of structured farm activities each day. Through interactive lessons and hands-on demonstrations, participants will learn key aspects of dairy cattle care, including feeding, milking, and how to maintain a clean environment. Participants will practice proper calf grooming skills …

The Amazing Race: Accessibility Edition, Amber Bailey, Anna Rauch

2025 Student Academic Showcase

Inspired by the reality TV show The Amazing Race, here at Lindenwood participants got to engage in a fun interactive and educational competition. This event’s purpose was to raise awareness about recreational therapy. As recreational therapy students we are always ready to adapt. Many people think that just because you have a disability you can't do stuff, which is wrong. Which is why The Amazing Race was able to show the participants that you can adapt to do activities. We had groups of four to five people that all had different disabilities to compete in four different challenges around campus. …

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 …

84 - Effect Of Organized Sport Interventions On Motor Outcomes Of Children With Autism Spectrum Disorder - A Systematic Review., Maeren Hill, Kailash Ram, Caitlyn Warnock, Kaitlin Hardy, Sonia Khurana, Pt, Ph.D.

Undergraduate Research Symposium

Aim:

The aim of this systematic review was to synthesize randomized clinical trials to evaluate the effectiveness of sports-based interventions on motor outcomes in children with autism spectrum disorder (ASD).

Methods:

A comprehensive literature search was conducted on the following five databases from inception to November 2024: PubMed, Web of Science, CINAHL, Cochrane Library, and Clinical Trials. Gray literature was sourced from Google Scholar and ProQuest Dissertations and Theses.

Articles were eligible for inclusion if they met the following criteria: (1) published in English; (2) participants were under the age of 18 with a diagnosis of ASD; (3) interventions consisted …

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 …

Reducing Burnout Among Physiatry Trainees During The Pandemic: Instituting A Wellness Retreat, Edwin Amirianfar, Oliver Acosta, Eduard Tiozzo, Joslyn Gober, Monica Verduzco-Gutierrez

Journal of Wellness

Introduction: Burnout has been described as “a state of mental and physical exhaustion related to work or caregiving activities.” Among resident physicians, burnout is a serious concern that can lead to medical errors and negative patient outcomes. To combat burnout among physiatry trainees during the COVID-19 pandemic, an innovative wellness retreat was created and implemented at the University of Miami’s Physical Medicine and Rehabilitation (PM&R) Residency Program in March 2021 and February 2022.

Methods: The retreat curriculum was designed by the PM&R Residency Wellness Committee and supported by departmental funding. The retreat(s) consisted of three strategies: education and discussion on …

Using Ai-Generated Scenarios To Enhance Learning Of The Emergency Assessment Process, D Cobble, L Schroeder, J Vaughn, S Ford

Clinical Practice in Athletic Training

Introduction: Rigorous accreditation standards require students to demonstrate competency in various clinical proficiencies through clinical practice or simulation-based educational activities. Therefore, simulation has become an integral component of athletic training education, as scenarios can provide realistic and reproducible experiences for all students. To that end, our study had two primary objectives: investigate the ability of artificial intelligence (AI) to generate accurate and realistic athletic training simulation scenarios and evaluate AI's effectiveness in teaching and reinforcing the emergency assessment process through student-created scenarios. Methods: Phase one, AI developed three different scenarios for patients experiencing (1) an ovarian cyst, (2) a hypoglycemic …

Prevalence, Perceptions, And Attitudes Of Accommodation For Students With Disabilities In Athletic Training Education Programs, T J. Babcock, L E. Eberman

Clinical Practice in Athletic Training

Introduction: Disability accommodation has been widely researched in healthcare education programs, including medical doctor (MD), doctor of osteopathy (DO), and physical therapy (PT). However, little research has been conducted on classroom and clinical education accommodation in athletic training education. The purpose of this study was to explore these settings and gain an understanding of student experiences with accommodation in athletic training education programs. This project was deemed exempt by Indiana State University’s Institutional Review Board. Methods: A cross-sectional 24-question survey was developed and adapted from prior qualitative research on accommodation in physical therapy education. Emails containing a link to the …

Clinat: In Service To Athletic Training Scholarship, Lindsey Eberman, Matthew J. Rivera

Clinical Practice in Athletic Training

To be of service to others means to help others without expecting anything in return. The ClinAT, or Clinical Practice in Athletic Training journal, is an online, open-access outlet for the dissemination of practice-based research in health care, and a donation of time, effort, and energy to the profession of athletic training. In 2018, when Indiana State University created its first issue of ClinAT, we were a faculty of 3 with 5 PhD students supporting the journal, one of whom was wholly dedicated to the effort. As the higher education landscape has changed, and the roles and responsibilities of our …