Rehabilitation and Therapy Commons^™

Shall We Dance: A Parkinson’S Dance-Based Program, Rebecca Zawodny, Anne H. Boddy

St. Augustine, Fall 2018

This poster presents the implementation of a community-based dance program for individuals diagnosed with Parkinson’s disease.

Dance interventions for individuals with PD are shown to be superior to exercise for improving balance and mobility^5,6,7 thus, effectively addressing both motor as well non-motor symptoms such as depression, fear, anxiety, and declined self-efficacy.^8,9,10 Further positive effects include improved flexibility and coordination7^,11 and forced-use of the senses of sight, sound, and touch to assist with movement and balance.¹² The use of choreography further allows for the rehearsal of movement sequences, new motor skill learning, and improved cognitive functions.^{13 …}

Effects Of Weight Shifting And Heel Lift On Gait, Posture, And Balance In An Elderly Female With Backward Disequilibrium: A Case Report, Gilissa T. Schjang, Evan M. Pucillo

St. Augustine, Fall 2018

The purpose of this case report is to investigate how weight shifts and a heel lift affects a patient's center of mass in respect to their base of support to improve posture, balance, and gait which will aid in decreasing falls.

The patient demonstrated functional improvements by reducing the amount of assistance required from a caregiver for transfers and gait. Improvements in balance will allow the patient to sit on the toilet and edge of bed for toileting and dressing more independently.

Older adults with BD or other similar balance disorders are at risk for increased falls.⁵ This case …

Effectiveness Of Stretching And Arch Strengthening In A 10-Year-Old Male With Calcaneal Apophysitis, Hannah Hardesty, Catherine M. Andrea

St. Augustine, Fall 2018

The aim of this case report is to create an independent exercise program to minimize pain while allowing continued participation in recreational activities.

Calcaneal apophysitis is a common condition in children that often results in the cessation of physical activity and participation in social activities, which can have a negative effect on both physical and mental well-being.^2-5 This case demonstrates positive outcomes with the use of static/dynamic stretching combined with arch strengthening in the rehabilitation of a patient with bilateral calcaneal apophysitis without reducing the child’s participation in daily and recreational activities.

Effects Of Trigger Point Dry Needling In Conjunction With Intramuscular Electrical Stimulation For A Patient With Lumbar Radiculopathy: A Case Report, Mayur Patel, Todd Bourgeois

St. Augustine, Fall 2018

The purpose of this case was to see the benefits of Trigger Point Dry Needling in conjunction with Intramuscular Electrical Stimulation for the treatment of lumbar radiculopathy regarding the range of motion, strength, sensation, reduction of pain, improve functional ability, and quality of life.

Traditional interventions for this diagnosis include strengthening exercises, modalities such as transcutaneous electrical stimulation, and even surgery as a last resort. There is limited research available regarding Trigger Point Dry Needling in conjunction with Intramuscular Electrical Stimulation for lumbar radiculopathy.⁴ This case report supports the idea that this physical therapy treatment intervention has positive outcomes …

Transitioning From The Level Surface To Stairs In Children With And Without Down Syndrome: Motor Strategy And Anticipatory Locomotor Adjustments, Huaqing Liang, Xiang Ke, Jianhua Wu

Physical Therapy Faculty Research

Background: Children with Down syndrome (DS) show underdeveloped motor strategy and anticipatory locomotor adjustments (ALA) before crossing an obstacle. Stairs presents another important setting to study environment navigation and motor adaptation. Inclusion of external ankle load is often used to perturb the stability of a system and observe the emergence of new patterns.

Research question: How do stair height and external ankle load affect motor strategy and ALA in 5-to-11-year-old children with typical development (TD) and with DS when approaching the stairs?

Methods: Fourteen children with DS and 14 age- and sex-matched children with TD participated in the study. They …

Using Concept Mapping To Develop A Human Rights Based Indicator Framework To Assess Country Efforts To Strengthen Rehabilitation Provision And Policy: The Rehabilitation System Diagnosis And Dialogue Framework (Resyst), Dimitrios Skempes, John L. Melvin, Per Von Groote, Gerold Stucki, Jerome Bickenbach

Department of Rehabilitation Medicine Faculty Papers

Background: Rehabilitation is crucial for the realization of the right to health and a proper concern of global health. Yet, reliable information to guide rehabilitation service planning is unavailable in many countries in part due to the lack of appropriate indicators. To ensure universal health coverage and meet the central imperative of "leaving no one behind" countries must be able to assess key aspects of rehabilitation policy and provision and monitor how they have discharged their human rights responsibilities towards those most disadvantaged, including people with disability. This article describes the process of developing an expert guided indicator framework to …

Integration Of Therapies In Autistic Children; A Survey Based In Karachi, Pakistan, Masnoon Akhter, Mussarat Ashraf, Adnan Ali, Irum Rizwan, Rehana Rehman

Department of Biological & Biomedical Sciences

A cross-sectional study was conducted from January to June 2016 on autistic children at the Autism Unit of Dow University of Health Sciences to compare speech therapy, occupational therapy and combination of both for rehabilitation of autistic children in the selected population. A total of 55 children with autism age range from 1-12 years of both gender and all ethnic groups were recruited. All data was analysed in IBM-SPSS version 23.0. Pearson chi-square test was used to determine association of type of therapy with the diagnosed age of child, gender, mode of delivery, history of vaccination and parent's education. Educated …

Bringing Employment First To Scale: Support Coordination Strategies That Impact Employment Outcomes And Services For Individuals Served By State Intellectual/Developmental Disabilities Agencies, Barbara Brent, Rie Kennedy-Lizotte, Mary Lee Fay, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

Leadership from NASDDDS and ICI worked together to determine topics for a series of white papers on policies that influence employment outcomes for individuals with IDD. This white paper is the third in a series of five. It provides an overview of strategies that support coordinators, or case managers, use to influence employment outcomes for individuals with IDD who are receiving state funded services.

Bringing Employment First To Scale: Pushing The Integrated Employment Agenda: A Case Study Of Maryland’S High-Performing Employment System, Jean Winsor, Cady Landa, Allison C. Hall, Caro Narby, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

This brief summarizes data collected from key informants in Maryland about the state’s efforts to support integrated employment for people with intellectual and developmental disabilities (IDD). It highlights features that contribute to the effectiveness of Maryland’s collaborative structures that have resulted in the state’s success in achieving integrated employment outcomes for individuals with IDD across three state systems: IDD, vocational rehabilitation (VR), and education. Presentation of these features is organized by the seven elements of the Higher-Performing States Employment Framework. These elements have been found to be important in achieving higher rates of competitive integrated employment outcomes for people with …

Statedata: The National Report On Employment Services And Outcomes Through 2016, Jean Winsor, Jaimie Ciulla Timmons, John Butterworth, Alberto Migliore, Daria Domin, Agnes Zalewska, John Shepard, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

Recent legislation and regulation governing Medicaid Home and Community-Based Services (HCBS), the Workforce Innovation and Opportunity Act of 2014 (WIOA), and settlement agreements between states and the U.S. Department of Justice are clarifying federal intent and paving the way to supporting opportunities for people with disabilities to have meaningful jobs in their communities. With an increasing emphasis on integrated employment and an Employment First philosophy, the nation is poised for transformation that could put Americans with disabilities on a path out of poverty and towards self-sufficiency. However, there remains a significant gap in employment rates between people with and without …

Sustaining Daily Management With Gemba Walks: A Scheduling Model, Suneela Nayak, Ruth Hanselman, Stephen Tyzik, Amy Sparks

Operations Transformation

SUSTAINING DAILY MANAGEMENT WITH GEMBA WALKS: A SCHEDULING MODEL

At an academic tertiary care medical center, there are 110 Operational Excellence teams across 4 campuses. Every weekday, 10 GEMBA walks occur with the 11^th on Wednesdays. The expanding program has made daily leadership visits to all KPIs challenging. As a result, consideration of reduced gemba walks to departments who have met specific maturity/performance criteria.

The scope of the eight-week pilot consisted of 13 pre-identified teams that have weekly workflows. The teams must have met a baseline level of performance. Performance was scored for 9 variables measuring engagement, PDSA, use …

Generalist Versus Specialist Nurses' Knowledge, Attitudes, And Behavioral Intentions Toward Promoting Pulmonary Rehabilitation For Patients With Chronic Obstructive Pulmonary Disease: A Cross-Sectional Correlational Study, Su-Er Guo, Hsueh-Chen Shen, Chizimuzo T. C. Okoli, Yen-Chi Liao, Kuen-Daw Tsai, Ming-Shian Lin, Hsin-Tien Hsu

Nursing Faculty Publications

Pulmonary rehabilitation (PR) is an effective strategy to manage chronic obstructive pulmonary disease (COPD), though its utilization rate is low. One reason for this low utilization rate is that nurses do not provide COPD patients with enough health education to increase the patient's motivation for PR participation. This study examined knowledge, attitudes, and behavioral intention toward PR promotion. The study also investigated the correlates of behavioral intentions to promote PR among pulmonary nurses.

A cross-sectional correlational design was used. Overall, 284 nurses (all women) from chest medicine and general internal medicine wards in 3 hospitals within Midwest Taiwan were recruited. …

Experience Of Robotic Exoskeleton Use At Four Spinal Cord Injury Model Systems Centers, Allen W. Heinemann, Arun Jayaraman, Chaithanya K. Mummidisetty, Jamal Spraggins, Daniel Pinto, Susan Charlifue, Candy Tefertiller, Heather B. Taylor, Shuo-Hsiu Chang, Argyrios Stampas, Catherine L. Furbish, Edelle C. Field-Fote

Physical Therapy Faculty Research and Publications

Background and Purpose: Refinement of robotic exoskeletons for overground walking is progressing rapidly. We describe clinicians' experiences, evaluations, and training strategies using robotic exoskeletons in spinal cord injury rehabilitation and wellness settings and describe clinicians' perceptions of exoskeleton benefits and risks and developments that would enhance utility.

Methods: We convened focus groups at 4 spinal cord injury model system centers. A court reporter took verbatim notes and provided a transcript. Research staff used a thematic coding approach to summarize discussions.

Results: Thirty clinicians participated in focus groups. They reported using exoskeletons primarily in outpatient and wellness settings; 1 center used …

Swallow Strength Training Exercise For Elderly: A Health Maintenance Need, D. Agrawal, Mark Kern, F. Edeani, Gokulakrishnan Balasubramanian, Allison S. Hyngstrom, Patrick Sanvanson, Rita Shaker

Physical Therapy Faculty Research and Publications

Background: Recent studies have shown high prevalence of oropharyngeal dysphagia associated with frailty‐ and age‐related muscle weakness. Strength training exercises have been advocated for locomotive health maintenance in the elderly and have shown positive outcomes. As muscles involved in oropharyngeal phase of swallowing are also comprised of striated muscles, the aim of this study was to determine biomechanical effect of a novel resistance exercise program, Swallowing Against Laryngeal Restriction (SALR), on pharyngeal phase swallowing in the healthy elderly. Methods: A total of 28 volunteers (75 + 7 years; 17 females) with no complaint of dysphagia were studied using video fluoroscopy …

The Effect Of Telerehabilitation On Missed Appointment Rates, Lyn T. Covert, John T. Slevin, Jessica Hatterman

Neurology Faculty Publications

The purpose of this study was to examine the effect of telerehabilitation on missed appointment rates in a rehabilitation clinic. Clients fail to attend scheduled appointments for a variety of reasons. Unmet appointments represent a loss of financial support as well as diminished efficiency and capacity to provide services. Speech therapy utilizing multiple appointments is most difficult to maintain during a treatment regimen. This may cause individuals to miss appointments and therefore not achieve desired results. For this study, researchers utilized an intense speech therapy technique, the Lee Silverman Voice Treatment (LSVT®) to measure compliance with scheduled appointments. Participants were …

Knee Extensor Fatigability During Different Resistance Exercise Protocols In Young And Old Adults, Jose Delgadillo

Master's Theses (2009 -)

Aging is associated with decreased muscle strength, power, and contraction velocity, and increased fatigability of the lower limb muscles during dynamic contractions. The aims of this thesis were to compare young in and old men and women in: (1) fatigability of the knee extensors for two types of dynamic fatiguing protocols that are the basis of resistance training protocols, and (2) the central and peripheral mechanisms of fatigue during the two types of dynamic fatiguing protocols. Twenty young (19-24, 22.2 ± 1.3 years, men = 10) and twenty old adults (64-85, 73.8 ± 5.4, men = 10) performed: two different …

Promis Pain Interference Is Superior Vs Numeric Pain Rating Scale For Pain Assessment In Foot And Ankle Patients, David N. Bernstein, Meghan Kelly, Jeff Houck, John P. Ketz, Samuel Flemister, Benedict F. Digiovanni, Judith F. Baumhauer, Irvin Oh

Faculty Publications - College of Physical Therapy

Background: The Numeric Pain Rating Scale (NPRS) is a popular method to assess pain. Recently, the Patient-Reported Outcomes Measurement Information System (PROMIS) has been suggested to be more accurate in measuring pain. This study aimed to compare NPRS and PROMIS Pain Interference (PI) scores in a population of foot and ankle patients to determine which method demonstrated a stronger correlation with preoperative and postoperative function, as measured by PROMIS Physical Function (PF).

Methods: Prospective PROMIS PF and PI and NPRS data were obtained for 8 common elective foot and ankle surgical procedures. Data were collected preoperatively and postoperatively at a …

Emotional Exhaustion, Depersonalization, And Feelings Of Decreased Personal Accomplishment Oh My: What Message Are We Sending To Our Students?, Nikki Sleddens, Betsy J. Becker

Posters and Presentations: Physical Therapy

PURPOSE:

The purpose of this presentation is to address the issue of burnout amongst PTs through the lens that addressing this issue in our profession may very well be the first step in building resilience in the academic and clinical environments.

METHODS AND/OR DESCRIPTION:

Physical therapy student well-being is a priority for academic institutions. Yet, are we, as academic and clinical faculty, who are responsible for promoting student well-being, “well” ourselves? Could burnout of our academic and clinical faculty impact our student’s wellness? Burnout is a syndrome described as emotional exhaustion, depersonalization, and feelings of decreased personal accomplishment. All effects …

Home-Based, Square-Stepping Exercise Program Among Older Adults With Multiple Sclerosis: Results Of A Feasibility Randomized Controlled Study, Emerson Sebastião, Edward Mcauley, Ryosuke Shigematsu, Brynn C. Adamson, Rachel E. Bollaert, Robert W. Motl

Exercise Science Faculty Research and Publications

There is very little known about exercise rehabilitation approaches for older adults with multiple sclerosis (MS), yet this growing segment of the MS population experiences declines in cognition and mobility associated with disease progression and aging. We conducted a RCT examining the feasibility of a 12-week, home-based Square-Stepping Exercise (SSE) program in older adults with MS. Older adults with MS (N = 26) with mild-to-moderate levels of disability were recruited and randomized into the intervention (i.e., SSE) or a minimal activity, attention-control conditions. Participants in the SSE condition received a mat for home-based practice of the step patterns, an …

Idiopathic Proximal Tibiofibular Joint Laxity In A Collegiate Baseball Player: A Case Report, Stephen A. Cage, Brandon J. Warner, Diana M. Gallegos, Phil Stevenson

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 baseball player suffering from symptomatic laxity of the proximal tibiofibular joint. Background: Injuries to the proximal tibiofibular joint are rare, and generally accompanied by some form of trauma. Typically, dislocations of the proximal tibiofibular joint occur in an anterior direction, and require reduction and possible fixation as a first course of treatment. Treatment: A 20-year-old collegiate baseball player reported to the athletic training clinic complaining of idiopathic lateral right knee pain. The patient could not recall a mechanism, but recalled an insidious onset of pain that …