Rehabilitation and Therapy Commons^™

The Use Of Nature As A Treatment Modality In Occupational Therapy, Lauren Koch

Honors Theses

Nature is inherently therapeutic. Applying the principles of occupational therapy within the natural environment integrates the physical, mental, and socio-emotional health benefits afforded by nature into therapeutic intervention practices. The nature centered context of the outdoors addresses performance skills and patterns, highlighting its use as a therapeutic modality. As such, nature may be used as an effective treatment modality in the practice of occupational therapy due to the benefits that it affords. The incorporation of nature into therapeutic intervention may be based upon the environmental factors, available resources, and function of the natural environment. The goal of this literature review …

Fracture Of A Heterotopic Ossification Of The Syndesmosis In A Collegiate Football Player: A Case Report., Stephen A. Cage, Brandon J. Warner, Diana M. Gallegos

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

Objective: Present a clinical case detailing the assessment and management of a collegiate football player suffering from the fracturing of a heterotopic ossification of the syndesmosis. Background: Heterotopic ossifications are not uncommon following surgical fixation of the tibiofibular syndesmosis. Typically, properly healed fibular fractures do not result in further complications associated with heterotopic ossification. Treatment: A 21-year-old collegiate football player (1.8 m, 77.1 kg) reported to the athletic training staff complaining of acute lateral ankle pain following a plant and twist mechanism while running receiving routes. Initial evaluation led to a diagnosis of a syndesmotic ankle sprain, with a …

Efficacy Of High-Performance Vision Training On Improving The Reaction Time Of Collegiate Softball Athletes: A Randomized Trial, Diana R. Feldhacker, Whitney Lucas Molitor, Ashley Athmann, Molly Boell, Angela Kaiser, Ashley Musch, Logan Willhite

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

Purpose. A well-developed visual system is integral to the dynamic nature of sport performance among collegiate athletes. Occupational therapists play an important role in addressing an athlete’s visual skills through incorporating meaningful occupation, in this case sport, into interventions while addressing specific client factors. The aim of the study was to examine the efficacy of occupational therapist led high-performance visual training in improving the reaction time of collegiate softball athletes. Method. A mixed method approach was used to collect both qualitative and quantitative data. Qualitative data were collected to assess athlete perceptions of sport, and quantitative data were collected using …

Current Athletic Training Educational Preparation For Dry Needling, Brian V. Hortz, Sue Falsone, Duncan Tulimieri

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

Purpose: Dry needling is an advanced practice skill that many athletic trainers are being trained to perform. The purpose of this study is to determine the degree to which the current athletic training educational competencies and standards prepare practitioners for the performance of dry needling tasks. Methods: An expert panel review was used to verify which of the dry needling tasks are currently taught through entry-level athletic education as defined by the 5^th edition competencies and 2020 standards. Results: Results demonstrated that 11% of the tasks were dry needling specific and these were regarded as not provided through entry-level …

Commentary: The Use Of Case-Based Learning And Concept Mapping To Teach Students Clinical Reasoning, Jeremy R. Hawkins, Michael Reeder, Michael Olson, Amy Bronson

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

Introduction: Teaching students as inexperienced clinicians the process of evaluating athletic injuries and medical conditions is often challenging. Utilizing case-based learning and concept mapping as educational tools can facilitate growth in the clinical and diagnostic decision making process. Discussion: Experienced clinicians regularly employ case pattern recognition and hypothetico-deductive reasoning in clinical settings. Each type of reasoning is prone to anchoring and confirmation bias, devaluing relevant information, and framing effect if not utilized correctly. Classroom instructors and preceptors can use case-based learning and concept mapping to help students as inexperienced clinicians organize their thinking and more effectively apply their …

The Effects Of Deep Oscillation Therapy For Individuals With Lower-Leg Pain, Mccall E. Christian, Riley C. Koenig, Zachary K. Winkelmann, Kenneth E. Games

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

Purpose: Lower extremity (LE) pain accounts for 13-20% of injuries in the active population. LE pain has been contributed to inflexibility and fascial restrictions. Deep oscillation therapy (DOT) has been proposed to improve range of motion and reduce pain following musculoskeletal injuries. Therefore, our objective was to determine the effectiveness of DOT on ankle dorsiflexion range of motion (ROM) and pain in individuals with and without lower-leg pain. Methods: We used a single blind, pre-post experimental study in a research laboratory. Thirty-two active participants completed this study. Sixteen individuals reporting lower-leg pain and sixteen non-painful individuals completed the study. Participants …

Perceptual And Contextual Sources Of Athletic Training Confidence: The Transition To Professional Entry Level Master’S Programs, Craig E. Pfeifer, Erin Moore, Brian Seiler, Caroline Thomason, Eva V. Monsma

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

Introduction: The shift of athletic training education from undergraduate degrees to professional master’s degrees and the prominence of computer-based credentialing may impact the hands-on experiences beneficial for developing confidence in athletic training competency domains. Health care provider confidence is critical for clinical skill development, performance and enhancing patient care. Purpose: To examine domain specific efficacy, its sources, learning contexts (i.e., classroom, laboratory, clinical settings) and clinical characteristics by program types. Method: Descriptive, cross-sectional design where 178 Athletic Trainers (AT; age 24.25 + 3.76, n = 72 male, n = 106 female) participated in the study (Master’s Program (MP) = 38; …

Physicians’ Knowledge And Beliefs Regarding Athletic Trainers, Joseph H. Vogler, Lindsey E. Eberman, Zachary K. Winkelmann, M. Seth Smith, James L. Turner, Kenneth E. Games

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

Purpose: The relationship between athletic trainers (ATs) and physicians is a legal obligation and collaboration to improve patient outcomes. The objective of this study was to examine the knowledge of physicians regarding the educational preparation, legal obligations, and scope of practice for ATs and how it relates to previous experiences with ATs. Additionally physicians’ perceptions of Interprofessional Collaboration (IPC) were studied. Methods: 169 physicians medical doctors (MD)=133/169, 78.7%, doctor of osteopathy (DO)=36/169, 21%) completed a 36-question web-based survey, which included a validated IPC scale. Results: Respondents with experience working with an AT scored significantly higher (P < 0.01) on the knowledge assessment, where physicians currently working with an AT scored higher (5.4/8) than those who previously worked with an AT (4.2/8) and those who had never worked with an AT (3.3/8). Additionally, physicians with previous exposure to an AT as an athlete had significantly higher knowledge scores than those without exposure (P < 0.01). Two areas of weakness in IPC from the physician’s perspective included sharing of important information (2.48/4) and importance of work as compared to others on the team (2.38/4). Conclusions: Physicians who have a current working relationship with an AT and those that had access to an AT as an athlete demonstrated significantly higher knowledge about an AT’s academic preparation, legal obligations, and scope of practice. Moreover, physicians currently working with an AT report positive interprofessional collaborations.

Biomechanical Characteristics Of Lumbar Manipulation Performed By Expert, Resident, And Student Physical Therapists, Joseph M. Derian, Jo Armour Smith, Yue Wang, Wilson Lam, Kornelia Kulig

Physical Therapy Faculty Articles and Research

Background

Lumbar manipulation is a commonly used treatment for low back pain, but little research evidence exists regarding practitioner biomechanics during manipulation. Most existing evidence describes rate of force production through the hands into instrumented manikins and it is unclear how the practitioner moves their body and legs to generate this force.

Objectives

To identify and characterize important kinetic and kinematic factors in practitioners of varying experience performing lumbar manipulation in order to identify which factors distinguish experts from less experienced practitioners.

Study design

This was a cohort observational laboratory study.

Methods

43 male physical therapists (PT) and PT students …

Functional Swallow-Related Outcomes Following Transoral Robotic Surgery For Base Of Tongue Carcinoma: A Pilot Study, Kelly Salmon, Slpd, Ccc-Slp, Bcs-S, Clt-Lana, Cesar Ruiz, Slpd, Ccc-Slp, Bcs-S

Department of Rehabilitation Medicine Posters

In an era where the incidence of oropharyngeal cancer has been growing steadily, there is a limited amount of research exploring functional outcomes for individuals whose definitive cancer management approach includes transoral robotic surgical (TORS) resection with or without adjuvant treatment.

This study was designed to examine functional outcome measures related to tongue strength, swallow function, oral intake, and quality of life in individuals newly diagnosed with base of tongue (BOT) cancer whose treatment plan included surgical resection via TORS, with or without a plan for subsequent adjuvant treatment in the form of radiation or chemoradiation. Data was collected preoperatively …

Transspinal Stimulation Increases Motoneuron Output Of Multiple Segments In Human Spinal Cord Injury, Lynda M. Murray, Maria Knikou

Publications and Research

Targeted neuromodulation strategies that strengthen neuronal activity are in great need for restoring sensorimotor function after chronic spinal cord injury (SCI). In this study, we established changes in the motoneuron output of individuals with and without SCI after repeated noninvasive transspinal stimulation at rest over the thoracolumbar enlargement, the spinal location of leg motor circuits. Cases of motor incomplete and complete SCI were included to delineate potential differences when corticospinal motor drive is minimal. All 10 SCI and 10 healthy control subjects received daily monophasic transspinal stimuli of 1-ms duration at 0.2 Hz at right soleus transspinal evoked potential (TEP) …

Table Of A Second Chance, Jean P. Belizaire Mr.

National Youth Advocacy & Resilience Conference

i will present on the continous dilemma on the opiate crisis and the best practices based on 5 years experience in the field in helping to stabilize and rehabilitate those held in the grips of addictions and various related symptoms of addictions.

The Effect Of Sensory Input On The Temporal Structure Of Center Of Pressure In Stroke Survivors, Samantha Chong

UNO Student Research and Creative Activity Fair

Stroke is the leading cause of disability that affects 17 million people worldwide. Patients post stroke suffer from maintaining balance because the brain may not be able to receive or process visual, vestibular and proprioceptive sensory information: all of which contribute towards maintaining stability. Information provided by vision is important for spatial orientation, as it develops an environmental perspective. Proprioception is detected through the stretching of tendonsand surrounding tissue, and is able to help the brain determine spatial location. The vestibular system provides the sense of balance detecting rotations and linear accelerations through the vestibulo-ocular reflex. The vestibular system is …

Developing And Testing Of An Upper Limb Exoskeleton For Stroke Patients, Drew Dudley, David Salazar

UNO Student Research and Creative Activity Fair

Objective: The main objective of this study was to determine functional and neuromuscular outcomes of stroke patients using their non-preferred hand with and without a 3D printed passive exoskeleton compared to controls using their non-preferred hand with and without the passive exoskeleton. Methods: Adults at least six months post stroke (Stroke, n = 5) and age- and sex- matched healthy controls (Control, n = 5) performed nine trials of a gross motor task while having their brain activity measured. The Fugl-Meyer and “Box and Block” test was used to measure the gross dexterity of the subjects with and without the …

Efficacy Of Assistive Devices Produced With Additive Manufacturing, James Pierce

UNO Student Research and Creative Activity Fair

Despite the frequency of musculoskeletal injuries such as sprains, broken bones and torn ligaments¹, treatment options are often costly, time-consuming and ill-fitted.^2,3 Additive manufacturing (“3D-printing) allows for the production of highly-customized and inexpensive assistive devices⁴, which suggests potential efficacy in the prescription of splints and casts for musculoskeletal injury.³ In the present study, a parametric, customizable splint/cast was created using a computer-aided design (CAD) package (Fusion 360, Autodesk, San Rafael, CA, USA) and produced with low-cost, desktop 3D printing (Ultimaker 2+ Extended, Ultimaker, Geldermalsen, Netherlands). Fitting of the devices was performed on five healthy …

Temporal Step Coordination While Walking With A Single-Point Cane, Monica Barajas

UNO Student Research and Creative Activity Fair

TEMPORAL STEP COORDINATION WHILE WALKING WITH A SINGLE-POINT CANE

Monica Barajas, Russel Buffum, Tyler Hamer, Brian A. Knarr

University of Nebraska at Omaha, Omaha, NE

Stroke is the primary cause of long-term adult disability in the United States. Some physical limitations that a stroke survivor may encounter are foot drop, unilateral muscle weakness, limited coordination and muscle movement, among other effects that may directly affect gait. To address weakness and poor coordination post-stroke, a cane is commonly used. While a cane can help with balance, coordinating steps with an additional device can prove difficult to learn and may alter natural …

The Effect Of Arm Swing On Countermovement Vertical Jump Performance, Arash Mohammadzadeh Gonabadi

UNO Student Research and Creative Activity Fair

Vertical jumping is one of the popular ways to evaluate ankle-knee efficiency in athletic population. Arm swing can play a crucial role in enhancing vertical jump performance. This study aimed to address the differences in kinetic and kinematic parameters during countermovement jump motion with arm swing (AS) and no arm swing (NAS). We used OpenSim to examine the efficacy of AS in reducing the impulse applied to the body and changes in range of lower limb joint angles at landing instant. We calculated the maximum vertical peak of the ground reaction force and impulse generated at landing in two different …

Estimating Variations In Metabolic Cost Within The Stride Cycle During Level And Uphill Walking, Arash Mohammadzadeh Gonabadi

UNO Student Research and Creative Activity Fair

Indirect calorimetry provides the average cost of a stride cycle and prevents from identifying which part of the gait cycle causes increased metabolic cost in patients, however, recent simulation methods allow estimating the time profile of metabolic cost within the stride cycle. In this study, we compare the estimations of the time profile of the metabolic cost of two simulation methods for level and uphill walking. We used kinematic, kinetic and electromyography data from level and uphill walking (one participant) to estimate the time profiles of metabolic cost using the muscle-level metabolic model of Umberger using electromyography and kinematic data …

3d Prosthetics Effects On Standing Posture In Unilateral Upper Limb Deficient Children, Keaton Young

UNO Student Research and Creative Activity Fair

3D Prosthetics Effects on Standing Posture in Unilateral Upper Limb Deficient Children

Keaton Young

Department of Biomechanics, University of Nebraska at Omaha

Introduction

Upper Limb Reduction Deficiency (ULD) is a congenital disability that affects the upper limb, which the Center for Disease Control and Prevention estimates that nearly 1,500 babies are born with ULD in the United States yearly ^1,2. Prior research has focused on functional treatment of the upper limbs but has lacked observance of the effects that prosthetics and limb loss incur to the trunk. Therefore, the purpose of this study is to examine the acute effects …

Left Achilles Tendon Rupture In A Male Collegiate Soccer Player, Benjamin Welch

UNO Student Research and Creative Activity Fair

ABSTRACT

Objective: To present the case of an Achilles tendon rupture including surgical repair and rehabilitation in a National Collegiate Athletic Association Division I, male, soccer athlete.

Background: While attempting to perform a backflip following a match victory, the athlete jumped up and experienced a gunshot sound and feeling on his posterior, distal, left leg. On-field evaluation included a positive Thompson Test for Achilles tendon (AT) rupture. Post injury imaging revealed a coinciding diagnosis.

Differential Diagnosis: AT strain, calcaneal fracture, fibula fracture, Shepard’s fracture

Treatment: Open surgery technique to repair the tear followed by rehabilitation protocol beginning with rest and …