Rehabilitation and Therapy Commons^™

Serious Game-Based Training For Improved Utilization Of A Novel Temporalis Emg Interface For Controlling Powered Wheelchairs, Calvin Macdonald

Honors Undergraduate Theses

Amyotrophic lateral sclerosis (ALS) is a terminal neurodegenerative disease that leads to a lack of independent mobility. One solution uses a unilateral surface EMG (sEMG) interface on the temporalis muscle to provide autonomous control of a powered wheelchair. Limbitless Journey, an EMG-controlled serious game, intends to provide users with a virtual environment to train in before use in a real-world scenario. A recent study analyzed the effect of video game training on the use of sEMG systems on the forearm, showing significant improvement in the usage of the interface but no difference between Free Play and structured play. The study …

How Hormonal Contraceptives Influence Injury In Female Athletes: A Systematic Review, Ashley V. Malvita

Honors Undergraduate Theses

Research indicates that female athletes have a higher risk of musculoskeletal injuries. Hormone fluctuations throughout the different periods of the menstruation cycle impacts the risk of injuries for women. Contraceptive use, most used in the form of an oral contraceptive pill, directly effects hormones and menstrual cycle related symptoms, with evidence of ameliorating some symptoms. Oral contraceptive use is suggested to influence musculoskeletal injuries in female athletes. However, there is little research and data that explores the direct relationship between oral contraceptive use and the injury rates of female athletes. Within this systematic review, five articles investigating this relationship fulfilled …

Activity Levels Across The Intensity Spectrum In Athletes: A Systematic Review Protocol, Jacob J. Capin, Jena Heck Street, Alissa V. Fial, Nicola D. Ridgers, Grant R. Tomkinson

Physical Therapy Faculty Research and Publications

Physical activity (PA) promotes better cardiometabolic health, physical function, brain health and longevity. In contrast, prolonged sedentary behaviour (SB) is a risk factor for many chronic diseases and poor health. Limited research has evaluated or synthesised how competitive sports participation influences PA across the lifespan. Some evidence suggests, ironically, that former competitive athletes may be insufficiently active and current athletes may be highly sedentary away from sport. This study describes the protocol for a systematic review and meta-analysis on activity levels across the intensity spectrum in athletes, addressing the primary research question: is sports participation significantly associated with PA and/or …

I Am A Man: Understanding Black Male Identity And Mental Health Needs, Rommel Johnson

School of Rehabilitation Services & Counseling Faculty Publications

Despite the historical and perpetual trauma, racism, discrimination, socio-economical, and socio-political disparities they have experienced in the United States, Black men have consistently forged ways to demonstrate resilience and assert their own sense of autonomy and masculinity. Nevertheless, their ecological context of living in a country that has historically sought to dehumanize them and eradicate their manhood is cumbersome to their mental wellbeing. Furthermore, the tendency by researchers to pathologize Black males obfuscates the reality of their situation in the United States, minimizing their mental needs. Understanding both the complexity of their ecological context as well as their adaptability and …

Mental Health In College Students: Efficacy Of A Telehealth-Delivered Occupational Therapy Program, Amy Marie Nelson

Dissertations and Theses

The number of college students in the United States struggling with mental health issues has increased tremendously over the past decade. Specifically, undergraduate students report stress and anxiety as significant inhibitors to academic performance. Colleges are investing resources to combat this problem, but increased counseling services are insufficient. Novel approaches beyond traditional college counseling services are recommended. Occupational therapy, not traditionally offered on most college campuses, may be one solution. A few occupational therapy programs exist on college campuses, but there is limited evidence of their efficacy, and most lack solid theoretical underpinnings. More evidence is needed on the effectiveness …

Ergonomics Of Various Modalities For Ear Surgery, Matthew E Lin, Sheng Zhou, Seiji Kakeheta, Tsukasa Ito, Seiji B Shibata

Faculty, Staff and Student Publications

OBJECTIVE: Evaluate ergonomic differences of various modalities for performing middle ear surgery.

STUDY DESIGN: Observational study.

SETTING: Two academic tertiary care centers.

METHODS: Attending physicians and residents performing middle ear surgery were photographed intraoperatively. Intraoperative photographs were analyzed using the validated Rapid Upper Limb Assessment (RULA) tool to measure musculoskeletal disease (MSD) risk. Descriptive statistics and significance testing were used to characterize and compare ergonomic differences between surgical modalities. Multivariable ordinal regression was performed to assess factors associated with increased MSD risk, as determined by the final RULA score.

RESULTS: Most of our 110 intraoperative photos featured attendings (82.7%) performing …

High Doses Of Caffeine-Induced Cerebral Infarction Leading To Partial Locked-In Syndrome In A Young Adult: A Novel Association?, Vijay Sinha, Loc Lam, Michael V Nguyen

Faculty, Staff and Student Publications

INTRODUCTION: This is a case of a 30-year-old male with no prior medical conditions presented to the emergency department for presumed seizures after ingesting 900 mg of caffeine via pre-workout drinks and pills.

CASE PRESENTATION: The patient was described as having nearly 15 min of generalized seizure activity observed by emergency medical service, requiring midazolam. A head computerized tomography (CT) demonstrated a possible thrombus, and further, CT angiography and CT perfusion confirmed a basilar artery occlusion. He was treated with tissue plasminogen activator and underwent thrombectomy achieving TICI grade 3 in the left posterior cerebral artery and TICI grade 2b …

How Can We Treat If We Do Not Measure: A Systematic Review Of Neurogenic Bowel Objective Measures, Argy Stampas, Amisha Patel, Komal Luthra, Madeline Dicks, Radha Korupolu, Leila Neshatian, George Triadafilopoulos

Faculty, Staff and Student Publications

Background: Guidelines fail to recommend objective measures to assist with treatment of neurogenic bowel dysfunction (NBD) in spinal cord injury (SCI).

Objectives: The main objective was to review the literature to identify the objective measures used in all NBD populations and to present their results and any correlations performed to validated subjective measures.

Methods: A systematic review of the literature was performed in accordance with PRISMA (2020) guidelines, including all records from January 2012 to May 2023 with MeSH terms like "neurogenic bowel" indexed in the following databases: PubMed, EMBASE, CINAHL, Cochrane Central Trials Register, and ClinicalTrials.gov. Abstracts were excluded …

Multimodal Therapy And Use Of Adjunctive Therapies To Bont-A In Spasticity Management: Defining Terminology To Help Enhance Spasticity Treatment, Rajiv Reebye, Luis Jorge Jacinto, Alexander Balbert, Bo Biering-Sørensen, Stefano Carda, Nathalie Draulans, Franco Molteni, Michael W O'Dell, Alessandro Picelli, Andrea Santamato, Monica Verduzco-Gutierrez, Heather Walker, Joerg Wissel, Gerard E Francisco

Faculty, Staff and Student Publications

Spasticity management should be provided within the context of a comprehensive person-centered rehabilitation program. Furthermore, active goal setting for specific spasticity interventions is also important, with a well-established "more is better" approach. It is critical to consider adjunctive therapy and multimodal approaches if patients are not attaining their treatment goals. Often used interchangeably, there may be confusion between the terms adjunctive and multimodal therapy. Yet it is imperative to understand the differences between these approaches to achieve treatment goals in spasticity management. Addition of a secondary pharmacologic or non-pharmacologic treatment to optimize the efficacy of the initial modality, such as …

Safety And Feasibility Of Paired Vagus Nerve Stimulation With Rehabilitation For Improving Upper Extremity Function In People With Cervical Spinal Cord Injury: Study Protocol For A Pilot Randomized Controlled Trial, Nuray Yozbatiran, Gerard E Francisco, Radha Korupolu

Faculty, Staff and Student Publications

Introduction: Pairing vagus nerve stimulation with traditional rehabilitation therapies results in improved motor recovery in people with stroke. However, this approach has not yet been studied in people with spinal cord injury (SCI). Motor recovery continues to be challenging after SCI, and there is a need for innovative research strategies to enhance motor recovery after SCI. Hence, this pilot randomized controlled trial aims to evaluate the safety, feasibility, and potential efficacy of pairing vagus nerve stimulation (VNS) with rehabilitation therapy to restore the motor function of the paretic upper limbs in people with cervical SCI.

Methods and analysis: In this …

Proportional Sway-Based Electrotactile Feedback Improves Lateral Standing Balance, V S Raghav Hari Krishna, Jeonghee Kim, Shuo-Hsiu Chang, Yoonsuck Choe, Hangue Park

Faculty, Staff and Student Publications

INTRODUCTION: Plantar cutaneous augmentation is a promising approach in balance rehabilitation by enhancing motion-dependent sensory feedback. The effect of plantar cutaneous augmentation on balance has been mainly investigated in its passive form (e.g., textured insole) or on lower-limb amputees. In this study, we tested the effect of plantar cutaneous augmentation on balance in its active form (i.e., electrical stimulation) for individuals with intact limbs.

METHODS: Ten healthy subjects participated in the study and were instructed to maintain their balance as long as possible on the balance board, with or without electrotactile feedback evoked on the medial side of the heel, …

Occupational Therapy Interventions For Visual Impairments Among Adolescents With Mild Traumatic Brain Injury, Olivia Vander Haar, Molly Whitlow, Sarah Fellman

Student Systematized Reviews: Occupational Therapy

PUPROSE: The purpose of this systematic review was to synthesize the evidence of occupational therapy (OT) interventions for adolescents who have sustained a mTBI and experience visual dysfunction.

DESIGN AND METHOD: A systematic review of peer-reviewed literature was conducted. Articles were included if participants were eight to nineteen years of age and diagnosed with an mTBI. Titles and abstracts of 506 articles from three databases were screened. The full text of 26 articles was reviewed. Seven met inclusion criteria. The U.S. Preventive Services Task Force levels of certainty and grade definitions described the strength of evidence.

RESULTS: Physical conditioning, vision …

Occupational Therapy Interventions For School-Aged Children To Improve Handwriting Outcomes: A Systematized Review, Cassidy P. Johnson, Carley E. Leners, Ashley N. Stanton, Nicole A. Wiese, Danielle Westmark, Stacy Smallfield, Molly Whitlow

Student Systematized Reviews: Occupational Therapy

Importance: The development of handwriting skills builds a child’s confidence, self-esteem, fine motor skills, ability to communicate effectively and overall academic success (Feder & Majnemer, 2007).

Objective: The purpose of this systematized review was to determine which occupational therapy interventions are most effective for improving handwriting outcomes for prekindergarten through 3rd grade students.

Data sources: Searches were performed by a medical librarian in PubMed, CINAHL and ERIC including articles from 2014 to 2024.

Design: Studies were included if they were English-language articles with a level of evidence of I, II, or III that focused on occupational therapy interventions with an …

Ot Interventions For Post-Stroke Depression: A Systematized Review, Jack Cosgrove, Austin Fernau, Christian Kwambamba, Claire Vanderbeek, Danielle Westmark, Stacy Smallfield, Molly Whitlow

Student Systematized Reviews: Occupational Therapy

Importance: Strokes are a leading cause of disability. 35-50% of stroke survivors develop depression, which is the most common physiological impairment post-stroke and associated with less functional independence with activities of daily living (ADLs) (Ezema et al., 2019; Hildebrand, 2014; Wijeratne & Sales, 2021).

Objective: This systematized review addressed interventions within the scope of occupational therapy that are effective for reducing depressive symptoms for adults post-stroke.

Data sources: A medical librarian searched the databases Medline, PsycINFO, and CINAHL. Quantitative studies, systematic reviews, meta-analyses, and randomized controlled trials published in English within the last ten years were included.

Study selection and …

Evidence-Based Interventions For Postpartum Women With Pelvic Floor Dysfunction: A Systematized Review​, Kelsey Novak, Jaycee Wallace, Emma Rutt, Lydia Delkamiller, Danielle Westmark, Stacy Smallfield, Molly Whitlow

Student Systematized Reviews: Occupational Therapy

Importance: Pelvic floor disorders affect an estimated 86% of pregnancies, leading to decreased quality of life and negative health outcomes for postpartum women (Palmieri et al., 2022; Dasikan et al., 2020). Functional challenges including urinary incontinence, and difficulty with sexual activity and exercise are also frequently reported (Burkhart et al., 2020).

Objective: The objective of this review is to provide occupational therapists with evidence-based interventions for postpartum women with pelvic floor dysfunction.

Study Selection and Data Collection: Inclusion criteria were as follows: published in English within the last 10 years, postpartum women, RCTs, systematic reviews and meta-analysis.

Data Sources: The …

Interventions To Promote Social Participation In Children With Autism: A Systematized Review, Noah Farho, Bailey Hein, Holly Manalili, Danielle Westmark, Stacy Smallfield, Molly Whitlow

Student Systematized Reviews: Occupational Therapy

Importance: Roughly 1 in 36 children have autism spectrum disorder (ASD) (CDC, 2024). Children with ASD frequently experience difficulties with social participation (SP), which is essential for positive development and quality of life (Smith et al., 2023).

Objective: This systematized review examines the effectiveness of Occupational Therapy (OT) interventions for improving SP among children with ASD.

Data sources: A search of PubMed, CINAHL, and PsycINFO from 2014 to 2024 was conducted by a medical librarian.

Study Collection and Data Collection: English-language articles were included if they were within the scope of OT, level 1-5 evidence, and related to promoting SP. …

An Overview Of Systematic Reviews Investigating Clinical Features For Diagnosing Neck Pain And Its Associated Disorders, Ryan C. Mcconnell

Funded Scholarship

Background: Neck pain is a common condition that is often difficult to diagnose. Previous literature has investigated diagnostic accuracy of examination measures, but the strength and clinical applicability are limited. This overview of systematic reviews aimed to investigate clinical features for diagnosing neck pain and its associated disorders.

Methods: An overview of systematic reviews was conducted searching four electronic databases for systematic reviews evaluating diagnostic criteria for neck pain. Quality and risk of bias were assessed using the AMSTAR 2 and ROBIS. Clinical features for neck pain were investigated for diagnostic utility.

Results: Twenty-seven systematic reviews were included. Hand radiculopathy …

Completeness Of Dry Needling Intervention Reporting In Musculoskeletal Conditions Using The Standards For Reporting Interventions In Clinical Trials Of Acupuncture And Template For Intervention Description And Replication Checklists: A Systematic Review, Ryan C. Mcconnell

Funded Scholarship

OBJECTIVE: The purpose of this study was to determine the completeness of reporting of dry needling (DN) as a primary intervention, using the Template for Intervention Description and Replication (TIDieR) and Standards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA) checklists.

DESIGN: This study is a systematic review of methodological reporting.

LITERATURE SEARCH: Electronic databases (Ovid MEDLINE ALL, Cumulative Index to Nursing and Allied Health Literature, Cochrane Central Register for Controlled Trials, Embase, and SPORTDiscus) were searched from inception to April 2024.

STUDY SELECTION CRITERIA: Clinical trials addressing the effects of DN on pain, function, and/or musculoskeletal impairments in …

Navigating The Layers Of Concern For Safe Dry Needling Of The Rectus Abdominis: A Cadaveric Study, Ryan C. Mcconnell, Christi L. Williams

Funded Scholarship

Objectives: To assess needle placement accuracy in the rectus abdominis (RA) muscle during dry needling (DN) without entering the peritoneum.

Methods: Two physical therapists performed DN on a cadaver, making 10 attempts each to needle the RA without entering the peritoneum. Techniques followed two common DN approaches. Ultrasound verified needle depth and safety.

Results: Seventy percent of attempts were recorded as safe needle placement, while 30% were unsafe. Accurate RA needle placement without peritoneal entry occurred in 55% of attempts.

Discussion/Conclusion: Inadvertent peritoneal needle placement during RA DN poses risks regardless of experience. Ultrasound guidance may enhance safety and precision …

Addressing Sexual Health Concerns Across Settings, Abigail Jeske

Graduate Student Scholarship

Sexuality can affect many areas of people’s lives; not addressing it in therapy is a disservice to patients. There is a clear need for occupational therapy intervention in this domain, and it is well within occupational therapy’s scope of practice. Yet, many occupational therapy practitioners (OTPs) exclude addressing sexuality and sexual health in everyday practice. This study aimed to understand better the reasons for not addressing this topic with patients. The mixed methods approach consisted of an online questionnaire and semi-structured interviews. Respondents were OTPs currently practicing in various practice settings. The questionnaire was completed by 31 OTPs and the …