Rehabilitation and Therapy Commons^™

Facilitating Engagement In Meaningful Occupations Through Nature-Based Experiences, Sydney Johnson

Occupational Therapy Capstones

Background: Many children, especially those living in urban areas, are spending less time in nature than ever before which is decreasing their engagement in meaningful occupations such as sleep, play, education, social participation, and activities of daily living. Interacting with nature can improve children’s emotional regulation, development, attention span, mental health, and overall well-being. It is important that children have access to nature and its benefits to ensure they are reaching their full potential in life. One method to improve children’s access to nature is providing them with nature-based activities that can be modified or adapted for those living in …

Effect Of Walking With An Active Ankle Exoskeleton On The Biomechanical Responses Of The Lumbar Spine, Jose E. Rubio, Junfei Tong, Aravind Sundaramurthy, Anup Pant, Sridevi Nagaraja, Meredith K. Owen, Michael A. Samaan, Brian W. Noehren, Jaques Reifman

Physical Therapy Faculty Publications

Objective: Musculoskeletal injuries pose a health threat to U.S. Service members. In particular, the physical demands of walking and running with load carriage contribute to a high incidence of musculoskeletal injuries of the lower back. Active ankle exoskeleton devices are promising technologies that may help mitigate the impact of load carriage on the incidence of these injuries. However, the safe extended use of these devices requires an understanding of their beneficial or detrimental effects on the lumbar spine. In this pilot study, we investigated the impact of walking with an ankle exoskeleton device on lumbar biomechanical responses.

Methods: We collected …

The Role Of Advocacy And Occupational Justice In Increasing The Accessibility Of Parks For Parents With Disabilities, Nathan Burke-Tan

Doctoral Projects

The purpose of this doctoral capstone project was to address ongoing accessibility barriers experienced by adults with disabilities, particularly those in caregiving roles, in public parks and playgrounds in the greater San Diego region. Although many parks meet the minimum requirements of the Americans with Disabilities Act (1990), research shows that caregivers with disabilities continue to encounter obstacles that limit safe, meaningful participation in community spaces (Dalpra, 2022; Fernelius, 2017; Firkin et al., 2024; Movahed et al., 2023; Ogletree et al., 2020; Prellwitz & Skar, 2007). These persistent gaps indicate a need for stronger advocacy and clearer public awareness of …

Grounded In Experience: A Collaborative Approach To Resource Development For Adults With Ehlers-Danlos Syndrome, Morgan Kam

Doctoral Projects

Background: Ehlers-Danlos syndrome (EDS) is a complex connective tissue disorder that significantly affects daily occupations, participation, and quality of life, yet early support for individuals pursuing or newly receiving a diagnosis remains limited. Occupational therapy (OT) is uniquely positioned to address these challenges through interventions that promote self-management and functional engagement.

Purpose: This project aimed to develop an experience- and evidence-informed educational resource for individuals undergoing or newly receiving an EDS diagnosis, while increasing awareness of OT’s role in managing this chronic, multisystemic condition.

Methods: A mixed-methods approach integrated qualitative insights from interviews, online support groups, and practitioner feedback. A …

Family-Level Impacts Of Equine-Assisted Occupational Therapy For Children With Disabilities: An Exploratory Mixed-Methods Pilot Study, Emily Canigiula

Doctoral Projects

Equine-assisted occupational therapy (EAOT) has been shown to enhance functional, social, and quality-of-life outcomes for children with disabilities (McDaniel Peters & Wood, 2017; Prieto et al., 2022). While child-focused outcomes are well documented, significantly less is known about how EAOT participation may influence caregivers and the broader family unit, as existing research largely prioritizes individual outcomes over family experiences (Peters et al., 2017; Tan & Simmonds, 2018; Trzmiel et al., 2019; Xiao et al., 2023). Emerging qualitative studies suggest potential family-level impacts including family engagement, reduced parental stress, and enhanced feelings of pride, empowerment, and connection (Kalmback et al., 2020; …

Bridging Gaps With Occupational Therapy: The Unique Role Of Occupational Therapy In Women’S Day Shelters, Alex Sato

Doctoral Projects

Homelessness is a multifaceted, complex issue that we face as a society. Mainstream services provided to homeless or vulnerable populations tend to focus on housing and basic services. While these are essential and meaningful, literature suggests there is a lack in trauma and self-care support (Marzana et al., 2023; Milaney et al., 2020). Looking through an Occupational Therapy (OT) lens, there are a multitude of ways the profession can provide holistic care. Current OT service provision within this population most commonly focuses on obtaining and maintaining housing and addressing the survival occupations these individuals may be engaging in (Cunningham & …

Applying Occupational Empowerment Principles In A Life Skills Program For Unhoused Transitional-Aged Youth: Feasibility And Early Outcomes, Eriza Navarro

Doctoral Projects

The purpose of this occupational therapy doctoral capstone project was to address a gap in community-based services for unhoused transitional-aged youth (TAY) by promoting life skill acquisition and supporting participation in meaningful activities in order to enhance self-efficacy. This project aimed to design, implement, and evaluate a structured occupation-based life skills program that builds upon existing services at a local drop-in center. The program incorporated life skill education and activity-based, experiential interventions tailored to meet the needs and learning styles of the population. Methods included conducting a needs assessment, developing the program curriculum, and piloting the 6-week program consisting of …

Promoting Participation And Self-Efficacy Among Youth With Disabilities In Community-Based Vocational Education, Allison Hollender

Doctoral Projects

Occupational therapy, with its focus on participation, contextual adaptation, and strength-based practice, is uniquely suited to support the growth and inclusion of youth in transition (Angell et al., 2018; Cahill et al., 2020; Carroll et al., 2025). Research indicates that transitional-aged youth (TAY) with disabilities, ages 14-24, are less likely to graduate from high school, pursue postsecondary education, or live independently (BLS, 2024; Cheng & Shaewitz, 2022; Cook et al., 2015). These disparities are compounded by occupational deprivation, or limited opportunities for meaningful participation, which can negatively impact long-term self-efficacy and belonging (Arbesman & Logsdon, 2011; Cahill et al., 2020). …

From Silos To Synergies: How To Enhance Interdisciplinary Collaboration Among Graduate Students, Jennifer Jimenez

Doctoral Projects

Interprofessional education (IPE) is essential for preparing collaborative healthcare practitioners, yet opportunities at San José State University (SJSU) have been limited, inconsistent, and largely dependent on individual faculty initiative. This capstone project aimed to strengthen IPE at SJSU by assessing institutional capacity and developing feasible, sustainable strategies to enhance exposure and participation across health-related programs. Guided by the Person–Environment–Occupation–Performance (PEOP) model and adult learning theory, the project combined a needs assessment, literature review, and partnership with the Healthy Development Community Clinic (HDCC) to create an instructor implementation guide and student introductory modules for HDCC service-learning onboarding. An IRB-approved mixed-methods faculty …

A Guide To Falls In A Skilled Nursing Facility, Sarah Ghione

Doctoral Projects

Approximately one in four older adults experiences a fall each year in the United States (Centers for Disease Control and Prevention [CDC], 2024b; Kakara et al., 2023). Among those residing in nursing homes for either short-term rehabilitation or long-term care, the risk of falls is doubled (Acker & Janssen, 2017; Shao et al., 2023). The purpose of this doctoral capstone project was to develop an educational resource aimed at enhancing staff education and fall prevention efforts within a single nursing home, supporting the facility’s goal of reducing fall rates. Methods included a needs assessment, observational experiences, resource development, and the …

Psychological Techniques For Athletes With Orthopedic Musculoskeletal Injuries: A Systematic Review, Nicole L. Williams

Antioch University Dissertations & Theses

Musculoskeletal injuries and recovery from them play a vital role in both the physical and psychological wellbeing of the public. Existing research has been conducted primarily within the athlete population with rehabilitation from these injuries having a profound impact on the physical and mental health. One of the most frequent psychological responses related to sports injuries is a trauma response, which has been shown to hinder the rehabilitation process and to increase the likelihood for reinjury upon return to play. Embedded within the many inputs to trauma responses to these injuries are psychological distress reactions, in particular fear connected to …

The Impact Of Social Participation Through Adaptive Sports On Quality Of Life In Individuals With Spinal Cord Injury, Mikayla Martin, Zeida Gutierrez

Spring 2025 OTD Capstone Symposium

This project researched and explored how socialization through adaptive sports in this case impacts the perception of quality of life among individuals who have sustained a spinal cord injury.

Physical Activity For Anxiety For Autistic People: A Systematic Review, Kathryn Riis, Brittany Samulski, Kristina A. Neely, Patricia Laverdure

Rehabilitation Sciences Faculty Publications

Clinical anxiety is a common comorbidity in autistic people. Due to the prevalence of anxiety in the autism population and the adverse effects it causes, there is a critical need to develop effective interventions which address anxiety symptoms for autistic people. Therefore, the purpose of this systematic review was to examine the effectiveness of the use of physical activity as an intervention to reduce anxiety in autistic people. Three databases PubMed, PsychInfo, and Cochrane RCTs, were searched utilizing key terms. PRISMA systematic search procedures identified 44 studies meeting predetermined inclusion criteria. Participant characteristics, the type of physical activity performed, the …

Newly Credentialed Athletic Trainers' Onboarding Process During The Transition To Practice, Ashley B. Thrasher, Stacy E. Walker, Julie M. Cavallario

Rehabilitation Sciences Faculty Publications

Context: As new athletic trainers (ATs) transition into their roles, some employers provide orientation and onboarding to assist with the transition to practice. Research in which authors outline the ideal onboarding process for new ATs transitioning to practice is lacking.

Objective: To examine the onboarding process for new ATs.

Design: Grounded theory.

Setting: College or university, secondary school, and hospital or clinic.

Patients or other participants: Seventeen newly credentialed, employed ATs who recently graduated from professional masters' programs (11 female, 6 male; 25.6 ± 2.2 years) and 12 employers (6 female, 6 male; years in role supervising new ATs: 8.5 …

Clinician Perspectives On Virtual Reality Use In Physical Therapy Practice In The United States, Danielle T. Felsberg, Jared T. Mcguirt, Scott E. Ross, Louisa D. Raisbeck, Charlend K. Howard, Christopher K. Rhea

Rehabilitation Sciences Faculty Publications

The primary goal of physical rehabilitation is to assess movement impairments and restore function to improve overall quality of life. Virtual reality (VR) may provide the optimal environment to promote these goals due to its motivating and modifiable nature which can be difficult to accomplish through traditional real-world therapeutic methods. Current research of VR for rehabilitation has demonstrated that VR interventions can produce clinically meaningful change in motor outcomes. Despite this, adoption and usage of VR by physical therapy professionals is unclear due to the limited research in this area. Thus, the purpose of this study was to identify the …

Case Report: Multifactorial Intervention For Safe Aging In Place, Ashwini Kulkarni

Rehabilitation Sciences Faculty Publications

Background/Objectives: Falls are a leading cause of morbidity in older adults, particularly those with multiple comorbidities. A multidisciplinary approach addressing physical, psychological, and environmental factors is essential for reducing fall risk and supporting aging in place. This report evaluates the effectiveness of a multidisciplinary, multifactorial approach in managing high fall risk in an older adult with diabetes, hypertension, and osteoporosis. Methods: A 72-year-old woman with a recurrent history of falls participated in an 8-week intervention as part of the American Physical Therapy Association (APTA) balance and falls prevention credential program. This study was conducted in Virginia Beach, USA, at the …

The Landscape Of Virtual Reality Use In Mobility Rehabilitation From 2010-2023: A Scoping Review, Danielle T. Felsberg, Reza Pousti, Charlend K. Howard, Scott E. Ross, Louisa D. Raisbeck, Jared T. Mcguirt, Christopher K. Rhea

Rehabilitation Sciences Faculty Publications

Significant advancements in virtual reality (VR) technology have occurred in the past decade, allowing clinical researchers to take advantage of these reduced barriers to explore the use of VR in patient populations. This scoping review on VR interventions to improve mobility in adults and children focuses on the literature from 2010-2023. A total of 2736 articles were screened and 126 articles met the inclusion criteria. Most of the studies were conducted in inpatient clinical settings (n = 41) and investigated VR interventions to improve balance (n = 118). Less immersive (n = 108) products such as Nintendo Wii or Xbox …

Comparing Immersive And Nonimmersive Clinical Experiences In Athletic Training Education: Effects On Student Engagement And Confidence, Julie M. Cavallario, Shana Pribesh, S. E. Walker

Rehabilitation Sciences Faculty Publications

Context

With the shift to a graduate-level professional degree in athletic training, it was hypothesized that immersive clinical experiences (ICEs) would be more effectively integrated into curricula than non-ICEs (N-ICEs) and better prepare students for practice.

Objective

To longitudinally compare clinical engagement opportunities in ICEs versus N-ICEs and assess if these opportunities are associated with changes in student confidence in performing related tasks.

Design

Prospective, longitudinal, time-diary study using a Web-based survey. Patients or Other Participants: Fifty-three first-year, master’s-level athletic training students from 21 programs.

Main Outcome Measure(s)

Participants reported their type of clinical experience (ICE, N-ICE, or none), the …

How Many Trials Are Needed For Consistent Clinical Gait Assessment?, Charlend K. Howard, Christopher K. Rhea, Jacquelyn R. Moxey, Kyle Langerhans, Paphawee Prupetkaew, Brittany S. Samulski

Rehabilitation Sciences Faculty Publications

Background: Clinical assessment of gait typically consists of patients walking a few trials at various speeds while the clinician assesses performance. Unfortunately, there is no clear guidance on how gait changes across trials, leaving clinicians uncertain about the optimal number of trials needed to observe consistent (non-variable) performance. To address this issue, we examined gait performance from a large dataset of older adults who participated in a community-based comprehensive fall risk assessment. Methods: Community-dwelling, older adults (n = 340; 70.8 ± 7.4 years; 120 men, 220 women) performed gait trials under two conditions: preferred and maximum walking speed. …

Emergency Action Plan Adoption Across Athletic Training Practice Settings, Samantha E. Scarneo-Miller, Rebecca L. Stearns, Christianne M. Eason, Alicia M. Pike Lacy, Rebecca M. Lopez, Zachary K. Winkelmann, Rebecca M. Hirschhorn, Susan W. Yeargin

Rehabilitation Sciences Faculty Publications

Context:

The 2024 NATA Position Statement provides updated recommendations for EAP adoption. Past research on the 2002 statement showed limited adoption by ATs. Assessing current adoption across practice settings offers a clearer picture of the EAP implementation landscape.

Objectives:

To examine ATs' adoption of new EAP best-practice recommendations across practice settings.

Design:

Cross-Sectional study.

Setting:

Online questionnaire.

Patients or Other Participants:

Clinically active ATs (n=614) working in any practice setting (Youth, Secondary School, Division 1 Power 4, Collegiate athletics – Not Power 4, Non-Major Professional Sports, Professional Sports, Non-Sideline).

Main Outcome Measures:

Prevalence of an EAP, adoption of recommendations, and …