Rehabilitation and Therapy Commons^™

Task Effects On Functional Connectivity Measures After Stroke, Kaleb Vinehout, Sheila M. Schindler-Ivens, Jeffrey R. Binder, Brian D. Schmit

Physical Therapy Faculty Research and Publications

Understanding the effect of task compared to rest on detecting stroke-related network abnormalities will inform efforts to optimize detection of such abnormalities. The goal of this work was to determine whether connectivity measures obtained during an overt task are more effective than connectivity obtained during a “resting” state for detecting stroke-related changes in network function of the brain. This study examined working memory, discrete pedaling, continuous pedaling and language tasks. Functional magnetic resonance imaging was used to examine regional and inter-regional brain network function in 14 stroke and 16 control participants. Independent component analysis was used to identify 149 regions …

Disparities In The Allocation Of Inpatient Physical And Occupational Therapy Services For Patients With Covid-19, Sarah Jolley, Amy Nordon-Craft, Melissa P. Wilson, Kyle Ridgeway, Michelle R. Rauzi, Jacob J. Capin, Lauren M. Heery, Jennifer Stevens-Lapsley, Kristine M. Erlandson

Physical Therapy Faculty Research and Publications

Background

Survivors of the novel coronavirus (COVID-19) experience significant morbidity with reduced physical function and impairments in activities of daily living. The use of in-hospital rehabilitation therapy may reduce long-term impairments.

Objective

To determine the frequency of therapy referral and treatment amongst hospitalized COVID-19 patients, assess for disparities in referral and receipt of therapy, and identify potentially modifiable factors contributing to disparities in therapy allocation.

Design, Setting and Participants

Retrospective cohort study using data collected from the University of Colorado Health Data Compass data warehouse assessing therapy referral rates and estimated delivery based on available administrative billing.

Measurements

Multivariable logistic …

Developing Peri-Operative Rehabilitation In Degenerative Cervical Myelopathy [Ao Spine Recode-Dcm Research Priority Number 6]: An Unexplored Opportunity?, Timothy F. Boerger, Allison S. Hyngstrom, Julio C. Furlan, Sukhvinder Klasi-Ryan, Armin Curt, Brian K. Kwon, Shekar N. Kurpad, Michael G. Fehlings, James S. Harrop, Bizhan Aarabi, Vafa Rahimi-Movaghar, James D. Guest, Jefferson R. Wilson, Benjamin M. Davies, Mark R. N. Kotter, Paul A. Koljonen

Physical Therapy Faculty Research and Publications

Study Design

Narrative review.

Objective

Degenerative cervical myelopathy is one of the most frequent impairments of the spinal cord encountered internationally in adults. Currently, surgical decompression is the recommended treatment for people with DCM (PwCM) presenting with moderate to severe symptoms or neurological deficits. However, despite surgical intervention, not all patients make a complete recovery due to the irreversible tissue damage within the spinal cord. The objective of this review is to describe the state and gaps in the current literature on rehabilitation for PwCM and possible innovative rehabilitation strategies.

Methods

Literature search.

Results

In other neurological disorders such as …

Blood Flow Restriction Training After Patellar Instability (Brains Trial), Benjamin D. Brightwell, Austin V. Stone, Xiaojuan Li, Peter A. Hardy, Katherine L. Thompson, Brian W. Noehren, Cale A. Jacobs

Orthopaedic Surgery and Sports Medicine Faculty Publications

Background

Patellar instability is a common and understudied condition that disproportionally affects athletes and military personnel. The rate of post-traumatic osteoarthritis that develops following a patellar dislocation can be up to 50% of individuals 5–15 years after injury. Conservative treatment is the standard of care for patellar instability however, there are no evidence-informed rehabilitation guidelines in the scientific literature. The purpose of this study is to assess the effectiveness of blood-flow restriction training (BFRT) for patellar instability. Our hypotheses are that this strategy will improve patient-reported outcomes and accelerate restoration of symmetric strength and knee biomechanics necessary to safely return …

Long-Lasting Impairments In Quadriceps Mitochondrial Health, Muscle Size, And Phenotypic Composition Are Present After Non-Invasive Anterior Cruciate Ligament Injury, Steven M. Davi, Ahram Ahn, Mckenzie S. White, Timothy A. Butterfield, Kate Kosmac, Oh Sung Kwon, Lindsey K. Lepley

Center for Muscle Biology Faculty Publications

Introduction: Despite rigorous rehabilitation aimed at restoring muscle health, anterior cruciate ligament (ACL) injury is often hallmarked by significant long-term quadriceps muscle weakness. Derangements in mitochondrial function are a common feature of various atrophying conditions, yet it is unclear to what extent mitochondria are involved in the detrimental sequela of quadriceps dysfunction after ACL injury. Using a preclinical, non-invasive ACL injury rodent model, our objective was to explore the direct effect of an isolated ACL injury on mitochondrial function, muscle atrophy, and muscle phenotypic transitions.

Methods: A total of 40 male and female, Long Evans rats (16-week-old) were exposed to …

Laterality Of The Activation Of The Vastus Lateralis Muscle In Females With Parkinson's Disease During The Medication State Compared With Healthy Controls, Yuichi Nishikawa, Kohei Watanabe, Tetsuya Takahashi, Noriaki Maeda, Hirofumi Maruyama, Shinobu Tanaka, Allison S. Hyngstrom

Physical Therapy Faculty Research and Publications

This study quantified the laterality of motor unit activation properties in females with Parkinson’s disease during force production (low to high-intensity contraction) using high-density surface electromyography. Sixteen females with Parkinson’s disease (age = ± 7.6 years, disease duration = 4.9 ± 5.1 years) and 14 healthy female subjects (age = 68.6 ± 3.6 years) performed submaximal ramp-up contractions during isometric knee extension. High-density surface electromyography signals were recorded from both vastus lateralis muscles. The level of heterogeneity was calculated in the spatial distribution patterns of the high-density surface electromyography signals to determine the modified entropy, coefficient of variation of the …

Trait Energy And Fatigue May Be Connected To Gut Bacteria Among Young Physically Active Adults: An Exploratory Study, Ali Boolani, Karyn M. Gallivan, Kristin S. Ondrak, Courtney J. Christopher, Hector F. Castro, Shawn R. Campagna, Christopher M. Taylor, Meng Luo, Scot E. Dowd, Matthew Lee Smith, Lauri O. Byerley

School of Medicine Faculty Publications

Recent scientific evidence suggests that traits energy and fatigue are two unique unipolar moods with distinct mental and physical components. This exploratory study investigated the correlation between mental energy (ME), mental fatigue (MF), physical energy (PE), physical fatigue (PF), and the gut microbiome. The four moods were assessed by survey, and the gut microbiome and metabolome were determined from 16 S rRNA analysis and untargeted metabolomics analysis, respectively. Twenty subjects who were 31 ± 5 y, physically active, and not obese (26.4 ± 4.4 kg/m2) participated. Bacteroidetes (45%), the most prominent phyla, was only negatively correlated with PF. The second …

A Muscle Cell-Macrophage Axis Involving Matrix Metalloproteinase 14 Facilitates Extracellular Matrix Remodeling With Mechanical Loading, Bailey D. Peck, Kevin A. Murach, R. Grace Walton, Alexander J. Simmons, Douglas E. Long, Kate Kosmac, Cory M. Dungan, Philip A. Kern, Marcas M. Bamman, Charlotte A. Peterson

Center for Muscle Biology Faculty Publications

The extracellular matrix (ECM) in skeletal muscle plays an integral role in tissue development, structural support, and force transmission. For successful adaptation to mechanical loading, remodeling processes must occur. In a large cohort of older adults, transcriptomics revealed that genes involved in ECM remodeling, including matrix metalloproteinase 14 (MMP14), were the most upregulated following 14 weeks of progressive resistance exercise training (PRT). Using single-cell RNA-seq, we identified macrophages as a source of Mmp14 in muscle following a hypertrophic exercise stimulus in mice. In vitro contractile activity in myotubes revealed that the gene encoding cytokine leukemia inhibitory factor ( …

Patient Satisfaction With Care Is Associated With Better Outcomes In Function And Pain 1 Year After Lumbar Spine Surgery, Björn Knutsson, Bakir Kadum, Ted Eneqvist, Sebastian Mukka, Arkan S. Sayed-Noor

Journal of Patient-Centered Research and Reviews

Purpose: There has been increasing interest in patient-reported experience measures (PREMs) to evaluate the patient experience and satisfaction with care. We conducted a prospective multicenter cohort study to determine any association between patients’ satisfaction of care and their outcomes 1 year after lumbar spine surgery.

Methods: Satisfaction with care was recorded through telephone interviews and a standardized questionnaire. Baseline data collection (300 patients) and 1-year follow-up (209 patients) were conducted through The Swedish National Register for Spine Surgery (Swespine). Exposures were patient experiences, health care professional (HCP) attitudes, shared decision-making, and overall satisfaction with care. Associations were evaluated using adjusted …

A Physical Therapy Mobility Checkup For Older Adults: Feasibility And Participant Preferences From A Discrete Choice Experiment, Dalerie Lieberz, Hannah Borgeson, Steven Dobson, Lindsey Ewings, Karen Johnson, Kori Klaysmat, Abby Schultz, Rachel Tasson, Alexandra L. Borstad

Journal of Patient-Centered Research and Reviews

Purpose: Physical performance measures, like walking speed, identify and predict preclinical mobility disability but are rarely used in routine medical care. A preventive model of care called Mobility Checkup is being designed to reduce mobility disability in older adults. This study had two purposes: 1) determine feasibility and outcomes of the Mobility Checkup, and 2) identify preferences of older adults regarding this model of care using a discrete choice experiment.

Methods: Adults over 55 years of age were recruited from the community. In the study’s first phase, participants completed a Mobility Checkup, with feasibility evaluated using 6 criteria. In the …

Using Creative Making To Redesign Life After Stroke, Jennifer K. Fortuna

The Open Journal of Occupational Therapy

Kate Davies, a knitwear designer and author based in Scotland, provided the cover art for the Winter 2022 edition of the Open Journal of Occupational Therapy. “Balance for Better” is a blanket made from wool and mohair. The blanket consists of 30 individual squares designed and knitted by KDD & Co. employees. The colors and pattern of each square reflect the work, achievements, and legacy of the inspirational women celebrated in the blanket. At age 36, Kate suffered a near-fatal stroke that left her paralyzed on the left side of her body. Forced to give up her career as …

Racially Informed Care: A Treatment Approach And Exploration Of The Implications Of Race Related Barriers In The United States, Charae Mcconnell

The Open Journal of Occupational Therapy

Social factors surrounding race and ethnicity often create barriers to meaningful occupation and keep people of color from achieving a greater quality of life (Pooremamali et al., 2016). These barriers often result in occupational deprivation and feelings of alienation in society. Research has shown that these barriers created by systematic racism exist for individuals across different environments and persist over their lifetime (Pooremamali et al., 2016). Because of these barriers and the prolonged stress responses caused by racism, people of color, especially black and brown, have significantly higher rates of chronic illness than White Americans. People of color, specifically African …

Occupational Therapy’S Role In The Foster Care System, Melanie N. Smith

The Open Journal of Occupational Therapy

Children and youth who spend time in the foster care system face a variety of obstacles perpetuated by childhood trauma and limitations in service provision. Literature regarding this population demonstrates challenges, including the inability to form attachments and productive peer relationships, deficits in cognition and educational performance, and unpreparedness upon transitioning from the system. In addition, literature demonstrates the significantly increased prevalence of mental health challenges among those in foster care. Parents of foster children report inadequate services and supports to address the ongoing ramifications of a child raised in a constant state of traumatic stress. Following a depiction of …

Considerations For Occupational Therapists In Developing Community-Level Interventions For Youth With High Adverse Childhood Experiences (Aces), Victoria G. Wilburn, Megan E. Huber, Denise Senter, Hannah B. Stoll

The Open Journal of Occupational Therapy

Drug misuse likely contributes to the over 30,000 children in foster care and to the 24.2% of children who have experienced two or more adverse childhood experiences (ACEs). Twenty-five percent of children are living in poverty, with nearly half of those living in single-parent households. Among the national guidelines to preventing ACEs are connecting youth with positive activities and providing family relationship enhancement opportunities. We believe the profession of occupational therapy can help contribute to the mental and behavioral health care workforce in a greater capacity than is currently used. Many children are not afforded the opportunity to engage in …

Sleep In The Intensive Care Unit (Icu): An Overlooked Opportunity For Occupational Therapists To Fill A Gap In Health Care Service, Mckenzie C. Bolin, Melissa M. Sweetman

The Open Journal of Occupational Therapy

Sleep hygiene is well-established in the scope of occupational therapy practice; however, this occupation is rarely addressed in the intensive care unit (ICU). The majority of health care practitioners believe patients experience reduced sleep quality in the ICU, which can negatively impact patient outcomes. Through a review of the literature, this paper identifies common factors that negatively influence sleep quality and duration and proposes evidence-based interventions to improve patients’ sleep. Factors that influence sleep and fall in the domain of occupational therapy practice include the environment, psychosocial elements, and patient care. Occupational therapists can use interventions, such as orienting patients …

Guidelines For Medication Education For Occupational Therapists, Jaclyn K. Schwartz

The Open Journal of Occupational Therapy

Taking medications is a vital health management activity for people with chronic health conditions. These individuals must take their medications as prescribed to receive the intended benefits and minimize negative effects. Many people with chronic health conditions do not know essential information about their medications, which limits their ability to take their medications as prescribed. Occupational therapists regularly engage in client education to enhance performance of health management. When addressing medications, however, additional considerations are needed because of the highly regulated, interdisciplinary, and complex nature of this occupation. The purpose of this practice guideline is to describe the integration of …

Caring For The Caregiver: A Feasibility Study Of An Online Program That Addresses Compassion Fatigue, Burnout, And Secondary Trauma, Emily C. Koller, Regina A. Abel, Lauren E. Milton

The Open Journal of Occupational Therapy

Background: Informal caregivers are susceptible to compassion fatigue in vicarious response to another’s suffering. The purpose of the study was to determine the feasibility of an online program that addresses compassion fatigue, burnout, and secondary traumatic stress in informal caregivers.

Method: The study used a pre-post repeated measures feasibility design. Eighty-six participants were initially recruited. The intervention consisted of a 70-min online program. The participants completed surveys before and after program completion. The number of participants that completed each study phase was recorded to determine feasibility outcomes of acceptability, implementation, and demand. A Wilcoxon signed-rank test was employed to analyze …

Occupational Therapists’ Perspectives On Caregiver Education Of Stroke Survivors, Elinor Pastore, Daniel Ryan, Lisa J. Knecht-Sabres

The Open Journal of Occupational Therapy

Introduction: The objective of this research study was to gather a greater understanding of how occupational therapists provide education to caregivers of stroke survivors and how they address the needs of caregivers throughout the rehabilitation process.

Methods: The researchers used a convergent mixed methods design. RedCap electronic surveys containing both open-ended and closed-ended questions were completed by 90 participants from multiple states. A focus group (n = 8) and a one-on-one interview (n = 1) were conducted to gather qualitative information regarding occupational therapists’ perspectives related to their experiences on educating caregivers in the acute rehabilitation setting. Descriptive …

Ecospirituality In Forensic Mental Health: A Preliminary Outcome Study, Clark Patrick Heard, Jared Scott, Stephen Yeo

The Open Journal of Occupational Therapy

Background: In this study, the personal experience of spirituality in nature (the concept of ecospirituality) was supported by occupational therapy and spiritual care staff enabling a community-based group for persons affiliated with a forensic mental health system in Ontario, Canada. Spirituality is a key, though debated, tenet in occupational therapy practice. At the same time, immersive participation in nature has been linked to positive health outcomes.

Methods: A qualitative method consistent with Interpretative Phenomenological Analysis was employed. Data was collected via the completion of semi-structured interviews (n = 9). Collected data was transcribed verbatim and then coded for …

An Occupation-Based Clinic Makeover: Perceptions And Experiences Of Occupational Therapists, Wendy B. Stav, Alison Herman

The Open Journal of Occupational Therapy

Background: Researchers sought to discover the experiences of occupational therapists transitioning from existing clinical practice to exclusively occupation-based approaches.

Method: This phenomenological study captured the experiences of clinicians as exercise-based equipment was temporarily removed from the rehabilitation gym and replaced with occupation-based kits. The therapists used the new occupation-based materials with all clients for 4 months and participated in interviews and a focus group.

Results: The study yielded a greater understanding therapists’ process and experiences through the themes: (a) challenges to occupation-based practice and (b) occupation-based metamorphosis.

Conclusions: The personal and contextual obstacles associated with implementing …