Rehabilitation and Therapy Commons^™

Occupational Therapy On College Campuses: Facilitating Student Success Through Occupation, Kristy Coen, Carlin Daley, Kieran Lewis, Susan Madigan, Karen Mccarthy, Clodagh Nolan, Áine O'Dea, Linda Reen, Liath Sheehan, Orla Sullivan

Occupational Therapy | Faculty Conference Presentations

Purpose: To explore how occupational therapy services fit into a supported education model on college campuses.

Rationale: College students present with many strengths and challenges in college settings. There are limited services for young adults to succeed in college and students with various diagnoses face challenges in the areas of time management, organization, academic skills, and in social areas of college (Orentlicher, & Olson, 2010; Rogers, Kash-MacDonald, Bruker, & Maru, 2010). Higher education is a role emerging area for occupational therapists, and there are some pioneering occupational therapists who have discovered multiple ways to provide services to students who are …

1st Place Research Paper: The Effectiveness Of Yoga Therapy On An Adult, Post-Stroke Population: A Systematic Review, Baylor E. Hogan

Kevin and Tam Ross Undergraduate Research Prize

Objectives: The objectives of this paper are to (1) give a brief overview of stroke pathophysiology (2) outline yoga as a therapeutic strategy (3) present the current research on yoga rehabilitation for stroke (4) discuss the efficacy of yoga for chronic stroke.

Methods: Relevant terms were searched in PubMed, Web of Science, Academic OneFile, ScienceDirect, and Google Scholar electronic databases. Studies were excluded if they contained pediatric stroke, non-stroke neurological diseases, or subjects with comorbidities. Statistically significant data was extracted for the primary measures of nine trials.

Results: Four studies measured statistically significant outcomes (p<0.05). These included improvements in balance, independence, endurance, trait anxiety, fear of falling, self-efficacy, pain, strength, range of motion (ROM), activity, participation, and quality of life (QoL). Discussion: Lack of statistical significance in post-stroke depression (PSD) measures may be due to inadequate intervention length or a psychosocial cause of depression. Improvements in balance, flexibility, and strength from yoga participation permitted progress in disability and functionality. Finally, overall health-related quality of life (HRQL) is affected by the severity of mental disorders and physical disability. Yoga can have a positive effect in both domains and therefore, may improve HRQL.

Conclusion: …

Reliability Of Clinical Evaluators Of Spasticity In Patients With Stroke, Tiffany Alvino, Shiney David, Chelsea Gendvil

Dissertations, Theses, and Capstone Projects

Spasticity is characterized by hyperexcitable stretch reflexes with amplitude increases in response to velocity dependent passive movement and resistance. Spasticity is the result of abnormal function of segmental and suprasegmental neuronal circuits. The objective of this study was to determine any positive correlation between three clinical evaluators of spasticity (i.e., the pendulum test, the patellar tendon tap test (PTT), and the Modified Ashworth scale) in their reliability to assess spasticity in people post-stroke. It was hypothesized that the use of force movement sensors along with surface electromyography increases the reliability of the standardized clinical tests. The results show that all …

Traditional Chinese Medicine: A Survey To Assess Inclusion In Dpt Curricula In The United States, Michael Erickson, Paul Nasri, David Perrotto

Dissertations, Theses, and Capstone Projects

The objective of this study is to assess the current level of inclusion of Traditional Chinese Medicine (TCM) in Doctor of Physical Therapy curricula in the United States. This survey provides self-reported data regarding the challenges associated with incorporating TCM into the curriculum. All 228 CAPTE (Commission on Accreditation in Physical Therapy Education) accredited Doctor of Physical Therapy (DPT) programs were included in this survey instrument. A College of Staten Island (CSI) Human & Animal Protection Office (HARPPO) approved survey was e-mailed to the chairperson of each DPT program and respondent data was stored via a secure Survey Monkey® online …

Multi-Digit Coordination In Absence Of Cutaneous Sensory Feedback During Grasping Tasks, Christina Gioeli, Kerry Mcpartlan, Emily Reid, Matthew Turturro

Dissertations, Theses, and Capstone Projects

Motor learning and adaptation to object properties and task requirements requires integration of cutaneous sensory feedback with motor commands. Joint mechanics constantly change, with individual joints or muscles compensation so performance output is the same per task. Effects of mixed cutaneous sensory feedback on multi-digit coordination is not well understood. Investigators sought to determine the influence absent cutaneous sensory feedback has on motor learning and adaptation, and how the CNS coordinates multi-digit mechanical output to adapt to manual tasks, with partially intact digital sensory feedback. 19 participants were randomly assigned for three-digit anesthesia administration (TIM- thumb, index, middle; TRL- thumb, …

Physiopathology And Intervention In Osteoarthritis: A Systematic Review, Justin Gelesky, Dylann C. Germann, Amanda Percaccio, Rachelle Schick

Dissertations, Theses, and Capstone Projects

In the United States, osteoarthritis (OA) is the most common chronic illness in the adult population affecting an estimated 27 million individuals with a yearly health care cost of over $150 billion (CDC, 2014; Lawrence et al., 2008). The pathological osteoarthritic process results in the progressive degradation of articular cartilage due to chemical and biological imbalances within a joint (Weiland et al., 2005). These imbalances are not well understood and neither are the biomechanical joint changes that occur as a result. Due to these limitations, treating and monitoring this condition is a challenge to clinicians and the processes are currently …

The Efficacy Of Motor Imagery Training On Range Of Motion, Pain And Function Of Patients After Total Knee Replacement, Noorelhoda Mahmoud, Marc A. Razzano Jr., Karen Tischler

Dissertations, Theses, and Capstone Projects

The present study examined the potential of motor imagery training and investigated the role of motor imagery instructions (audio) to improve knee range of motion after a total knee replacement. The participants were randomly assigned to either an experimental motor imagery group (n=4) or a control group (n=6). Both groups performed specific exercises to improve their knee range of motion and strengthen their muscles. Participants in the Motor Imagery group performed a motor imagery training exercise for a knee flexion stretch on the stairs prior to performing the actual exercise. The motor imagery group demonstrated a significantly greater increase in …

Language-Mixing In Discourse In Bilingual Individuals With Non-Fluent Aphasia, Avanthi Paplikar

Dissertations, Theses, and Capstone Projects

Language-mixing (LM) as defined by Chengappa (2009, p. 417) is an “intra-sentential phenomenon referred to as the mixing of various linguistic units (morphemes, words, modifiers, phrases, etc.), primarily from two participating grammatical systems”. LM is influenced by grammatical, environmental, and social constraints (e.g., Milroy & Wei, 1995; Bhat & Chengappa, 2005). Researchers have suggested that LM in patients with aphasia is a communicative strategy used to achieve successful exchanges between speakers; the effectiveness of this mixing, however, had yet to be demonstrated quantitatively.

In the current study we investigated whether LM is present in bilingual speakers with aphasia, and if …

Paired Associative Transspinal And Transcortical Stimulation Produces Bidirectional Plasticity Of Human Cortical And Spinal Motor Pathways, Luke Dixon, Mohamed Ibrahim, Danielle Santora

Dissertations, Theses, and Capstone Projects

Anatomical, physiological, and functional connectivity exists between primary motor cortex (M1) and spinal cord neurons. Paired associative stimulation (PAS) produces enduring changes in M1 based on the Hebbian principle of associative plasticity. The present study aims to discover immediate neurophysiological changes on human corticomotor pathways by pairing noninvasive transspinal and transcortical stimulation via transcranial magnetic stimulation (TMS). We delivered paired transspinal and transcortical stimulation for 40-min at precise interstimulus intervals with TMS being delivered after (transspinal-transcortical PAS) or before (transcortical-transspinal PAS) transspinal stimulation. Transspinal-transcortical PAS markedly decreased intracortical inhibition, increased intracortical facilitation and M1 excitability with concomitant decreases of motor …

A Literature Review Of Studies Evaluating Rotator Cuff Activation During Early Rehabilitation Exercises For Post-Op Rotator Cuff Repair, Samuel N. Wells, Jodi R. Schilz, Timothy L. Uhl, A. Burke Gurney

Physical Therapy Faculty Publications

Despite the modern advancement of surgical repair equipment and techniques, many rotator cuff repairs do not clinically heal. Prescribed rehabilitative exercises must appropriately load the repaired muscle-tendon complex to promote healing and prevent capsular adhesions without damaging the repair. The clinician must possess an understanding of the anatomy and physiology of the healing rotator cuff, and understand the importance of the plane of movement, speed of the movement, position of the extremity, level of assistance, and type of resistance used. Electromyography (EMG) provides a useful means to determine muscle activation levels during specific exercises. Descriptions of specific exercises and EMG …

Effects Of Laryngeal Restriction On Pharyngeal Peristalsis And Biomechanics: Clinical Implications, Rita Shaker, Patrick Sanvanson, Gokulakrishnan Balasubramanian, Mark Kern, Ashley Wuerl, Allison S. Hyngstrom

Physical Therapy Faculty Research and Publications

To date, rehabilitative exercises aimed at strengthening the pharyngeal muscles have not been developed due to the inability to successfully overload and fatigue these muscles during their contraction, a necessary requirement for strength training. The purpose of this study was to test the hypothesis that applying resistance against anterosuperior movement of the hyolaryngeal complex will overload the pharyngeal muscles and by repetitive swallowing will result in their fatigue manifested by a reduction in pharyngeal peristaltic amplitude. Studies were done in two groups. In group 1 studies 15 healthy subjects (age: 42 ± 14 yr, 11 females) were studied to determine …

Effects Of Adjustments To Wheelchair Seat To Back Support Angle On Head, Neck, And Shoulder Postures, Afnan M. Alkhateeb

Loma Linda University Electronic Theses, Dissertations & Projects

Background: People spend a long time in the sitting position may have poor alignment that leads to neck and back pain. A wheelchair represents mobility for people with cerebral palsy, who are unable to walk. They spend long periods of time sitting in their wheelchair. Opining the seat to back support angle of the wheelchair enable realignment body segments and improves posture. Objective: 1) assessed the validity/reliability of Coach’s Eye (CE) smart device application, 2) examined the effect of seat to back support angle adjustments on head, neck, and shoulder posture in the sitting position, and 3) compared changes in …

Differences Among Life Care Planners And Physiatrists Regarding The Likelihood And Frequency Of Secondary Complications For Persons With Spinal Cord Injury, Noel A. Ysasi, Irmo Marini, Matt Sprong, Irasema Silva

School of Rehabilitation Services & Counseling Faculty Publications

Life care planners (LCPs) who provide expert witness testimony must provide their professional opinions within a certain degree of life care planning probability or essentially a 51% chance or greater likelihood of the good or service occurring. In cases involving spinal cord injury (SCI), such opinions become complicated when attempting to include the costs of future secondary complications (SCs) that may or may not have a consistent body of empirical support and/or several physician specialists supporting the probability of occurrence. The present study surveyed 243 life care planners (LCPs), life care planning physiatrists (physiatrist LCPs), and non-life care planning physiatrists …

Clinical Assessment Of Pragmatics (Caps): A Validation Study, Adriana Lavi

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was bi-fold: to develop and analyze the validity and reliability of a comprehensive pragmatic language diagnostic tool, the Clinical Assessment of Pragmatics as well as comparatively examine and analyze pragmatic language profiles of three groups of adolescents. These included students with Language Impairment (LI), High-Functioning Autism (HFA) and typically developing students. During the validation phase of the study, thirty participants, ages 14 to 16 years old, were administered 3 pragmatic judgment and 3 pragmatic performance subtests comprised of 10 items each for a total of 60 test items. A series of validity and reliability measures …

Effect Of Progressive Gaze Stability Exercises On Holistic Aspects Of Chronic Motion Sensitivity, Shilpa B. Gaikwad

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Motion sensitivity, also referred to as motion sickness, is a common condition among general population. It is a complex syndrome and is associated with presence of nausea and vomiting headache, drowsiness, cold sweating, pallor of varying degrees, increased salivation. Postural instability and anxiety are also identified to be associated with motion sensitivity. There is a close relationship between the vestibular system and motion sensitivity and vestibular system. The aim of this study was to investigate the effect of progressive gaze stability exercises on holistic aspects of chronic motion sensitivity. Methods: A single blind randomized controlled trial was conducted where …

How Should We Teach Lumbar Manipulation? A Consensus Study, Michael O'Donnell, Jo Armour Smith, Alex Abzug, Kornelia Kulig

Physical Therapy Faculty Articles and Research

Background Spinal manipulation is an effective intervention for low back pain, yet there is little consistency in how this skill is taught.

Objectives The purpose of this study was to identify what educators and clinicians believe are important characteristics of the patient and operator position prior to side-lying lumbar manipulation and the patient position and operator motion during the manipulative thrust.

Design A multi-disciplinary correspondence-based Delphi method

Methods Three rounds of questionnaires were sent to physical therapists, osteopaths and chiropractors. Consensus was established in Round 3 if at least 75 % of respondents identified a characteristic as very important/extremely important …

Enhancement Of Aging Rat Laryngeal Muscles With Endogenous Growth Factor Treatment, Joseph C. Stemple, Richard D. Andreatta, Tanya S. Seward, Vrushali Angadi, Maria Dietrich, Colleen A. Mcmullen

Physical Therapy Faculty Publications

Clinical evidence suggests that laryngeal muscle dysfunction is associated with human aging. Studies in animal models have reported morphological changes consistent with denervation in laryngeal muscles with age. Life‐long laryngeal muscle activity relies on cytoskeletal integrity and nerve–muscle communication at the neuromuscular junction (NMJ). It is thought that neurotrophins enhance neuromuscular transmission by increasing neurotransmitter release. We hypothesized that treatment with neurotrophin 4 (NTF4) would modify the morphology and functional innervation of aging rat laryngeal muscles. Fifty‐six Fischer 344xBrown Norway rats (6‐ and 30‐mo age groups) were used to evaluate to determine if NTF4, given systemically (n = 32) …

Sub-Clinical Neck Symptoms, Disability, Posture, And Muscle Function In Computer Users, And The Effect Of Education Versus Education And Deep Cervical Flexor Exercise, Donna Lynne Skelly

Department of Physical Therapy Student Theses, Dissertations and Capstones

Purpose: 1, to determine effect of education and exercise on neck pain, disability, cervical posture and muscle function in office workers with sub-clinical neck symptoms; 2, to determine differences in forward head posture in preferred and standardized posture, and 3, to explore the influence of time on work posture in a sub-group of office workers. Subjects: Sixty-six office workers with sub-clinical neck symptoms who utilize computers at least 4 hours per day participated. A sub-group of 27 were videotaped to assess posture over a workday. Methods: Videotaping was performed 15 minutes of the first and last hour of the workday …

The Feasibility Of Using Metacognitive Strategy Training To Improve Performance, Foster Participation, And Reduce Impairment Following Neurological Injury, Timothy J. Wolf

Arts & Sciences Graduate Student Theses and Dissertations

Executive function is central to our ability to learn and participate in everyday life activities and rehabilitation outcomes for individuals with executive dysfunction after neurological injury are poor. The impairments and performance challenges these individuals experience are typically not identified appropriately so they often do not receive adequate rehabilitation and can have significant challenges returning to complex everyday life activities. The vast majority of rehabilitation efforts to support individuals with neurological injuries with executive dysfunction are based on a restoration model that aims to improve cognitive function with the expectation that these gains will translate to everyday life. The available …

Revealing The Quality Of Movement: A Meta-Analysis Review To Quantify The Thresholds To Pathological Variability During Standing And Walking, Niklas König Ignasiak

Physical Therapy Faculty Articles and Research

Neuromotor processes are inherently noisy, which results in variability during movement and fluctu-ations in motor control. Although controversial, low levels of variability are traditionally considered healthy, while increased levels are thought to be pathological. This systematic review and meta-analysisof the literature investigates the thresholds between healthy and pathological task variability.

After examining 13,195 publications, 109 studies were included. Results from over 3000 healthy sub-jects and 2775 patients revealed an overall positive effect size of pathology on variability of 0.59 forwalking and 0.80 for sway. For the coefficient of variation of stride time (ST) and sway area (SA), upperthresholds of 2.6% …