Rehabilitation and Therapy Commons^™

Lessons Learned Through Leadership, John L. Melvin, Md, Mmsc

Department of Rehabilitation Medicine Faculty Papers

This paper identifies a number of principles I have adopted when assuming leadership roles. They evolved from experiences that suggested they would help me be more effective in these roles. I have found through using them that they are indeed helpful to me as a leader and to the organizations I lead. When comparing notes with other leaders, I find they seem to apply to others as well.

Diagnostic Problem Solving In Male Collegiate Athletic Trainers, Frederick A. Gardin, James M. Mensch

Department of Exercise Science and Physical Education Scholarship and Creative Works

Context: Knowledge and experience may be important factors for understanding expertise based upon a clinician's ability to select and execute an appropriate response as a clinician during injury evaluation.

Objective: To describe how collegiate male certified athletic trainers represent injury-evaluation domain knowledge during a situational interview using a think-aloud protocol.

Design: Qualitative.

Setting: National Collegiate Athletic Association Division I and II colleges in National Athletic Trainers' Association District 3.

Patients or Other Participants: A total of 20 male certified athletic trainers (n = 10 with less than 2 years of experience in the college setting and n = 10 with …

The Parkinson's Experience Of Group Physical Activity: Understanding Social Support, Social Comparison, Physical Self-Perceptions, And Posttraumatic Growth, Tammy L. Sheehy

Open Access Theses

Group physical activity programs for clinical populations can provide opportunities for adaptive social interactions, improving perceptions of competence, and may facilitate posttraumatic growth (positive psychological changes resulting from traumatic life experiences). Therefore, the purpose of this study was to examine how people with Parkinson's experience social interactions and physical challenges in a group physical activity program, and to investigate what role they think those experiences play in posttraumatic growth. The study employed interpretative phenomenological analysis methodology (Smith, Flowers & Larkin, 2009). N= 20 participants ( n = 12 women; age = 56-79 years) in a boxing-based group exercise program …

Service Provider Promising Practice: Job Squad, Inc. (West Virginia) - A Blog That Conveys The Importance Of Community Employment, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

Job Squad is a medium-sized CRP that provides services to individuals in 13 counties within West Virginia. In 2005, responding to customer demands, executive director Brenda Hellwig and her staff received training from Griffin Hammis Associates to offer community employment services. Once trained, the career counselors at Job Squad found that their most successful jobs were matches between job seekers and small businesses that needed their skills and could provide natural supports. The team then started the Community Economic Development blog at http:// jobsquadinc.blogspot.com/. This is a platform to communicate with employers,

Family Meanings, Contexts And Hopes Within A Clinical Trial, Laura Greis Hess, Cynthia Carter Ching, Randi Hagerman

Collected Faculty Scholarship

These qualitative analyses are a component of the clinical trial: “Effects of Sertraline Treatment for Young Children with FXS: Examination of Developmental Outcomes and Family Contexts.”

We argue that inclusion of a sociocultural perspective within the context of a clinical trial affords consideration of:

• A dynamic view of development – simultaneous consideration of biological and sociocultural factors (Vygotsky, 1978).
• Application of a bioecological framework and consideration of ever changing nested settings and contexts over time (Bronfenbrenner, 2005)

Mechanisms Of Isometric Exercise-Induced Hypoalgesia In Young And Older Adults, Kathy J. Lemley

Dissertations (1934 -)

Pain reduction following exercise (exercise-induced hypoalgesia; EIH) is well-established in young adults. Specific to isometric exercise, the greatest EIH follows low intensity contractions held for long duration. The EIH response of older adults is not known; and the mechanisms for EIH are unclear at any age. This dissertation aimed to address these unknowns through a series of three studies. In study one, repeatability of pressure pain reports (pain threshold and pain ratings) was assessed in healthy older adults, including the impact of psychological factors. Pain reports, measured before and after quiet rest, did not change following quiet rest. Higher state …

Preliminary Test Of A Real-Time, Interactive Silent Speech Interface Based On Electromagnetic Articulograph, Jun Wang, Ashok Samal, Jordan R. Green

School of Computing: Conference and Workshop Papers

A silent speech interface (SSI) maps articulatory movement data to speech output. Although still in experimental stages, silent speech interfaces hold significant potential for facilitating oral communication in persons after laryngectomy or with other severe voice impairments. Despite the recent efforts on silent speech recognition algorithm development using offline data analysis, online test of SSIs have rarely been conducted. In this paper, we present a preliminary, online test of a real-time, interactive SSI based on electromagnetic motion tracking. The SSI played back synthesized speech sounds in response to the user’s tongue and lip movements. Three English talkers participated in this …

Motor Cortex Electrical Stimulation Augments Sprouting Of The Corticospinal Tract And Promotes Recovery Of Motor Function, Jason B. Carmel, John H. Martin

Publications and Research

The corticospinal system—with its direct spinal pathway, the corticospinal tract (CST) – is the primary system for controlling voluntary movement. Our approach to CST repair after injury in mature animals was informed by our finding that activity drives establishment of connections with spinal cord circuits during postnatal development. After incomplete injury in maturity, spared CST circuits sprout, and partially restore lost function. Our approach harnesses activity to augment this injury-dependent CST sprouting and to promote function. Lesion of the medullary pyramid unilaterally eliminates all CST axons from one hemisphere and allows examination of CST sprouting from the unaffected hemisphere. We …

An Interprofessional Falls Assessment Clinic Model To Develop Collaborative Team Skills Among Health Professional Students, Tracey Vause-Earland, Ms, Otr/L, Leigh Ann Hewston, Pt, Med, Cecilia Borden, Edd, Msn, Brooke Salzman, Md, Emily Hajjar, Pharmd, Ellen Furman, Msw, Christine Hsieh, Md, Susan Parks, Md

Department of Occupational Therapy Posters and Presentations

BACKGROUND

• Older adults are at increased risk for falls and fall related injuries, leading to loss of independence, disability, and increased mortality.
• Preventing injury and falls is a national Healthy People 2010 objective. However, physicians and other health professionals frequently fail to incorporate known evidence into usual care. Screening for falls is not consistently performed as an essential assessment in older adults by primary care providers.
• Multidisciplinary assessment can be an important component in preventing falls in community dwelling adults.
• In new practice models, such as the Chronic Care Model, there is an emphasis on interdisciplinary collaboration, however health professions …

The Long-Term Effects Of Low Level Laser Therapy (Lllt) Combined With Complex Decongestive Therapy (Cdt) In The Treatment Of Breast Cancer Lymphedema: A Double-Blind, Randomized, Placebo-Controlled Study, Olivia Bramlett, Igor Daysudov, Toshi Odaira, Bethany Rodriguez

Dissertations, Theses, and Capstone Projects

Complex Decongestive Therapy (CDT), the gold standard for lymphedema treatment, fails to demonstrate long-term efficacy. The purpose of this study was to determine the long-term efficacy of low level laser therapy (LLLT) in reducing post-mastectomy lymphedema when used with CDT. The experimental group received LLLT and CDT (n = 7) while control group received sham laser and CDT (n = 7), twice a week for 4 to 8 weeks. Percent arm circumference difference between affected and unaffected limbs was collected over 18 months. Results revealed no statistical difference between both groups at all time periods: 1 (p = 0.902), 2 …

Research Components In Curriculum Of Doctor Of Physical Therapy Programs, Stephen Ingrassia, Gary Mulligan, Roman Tverdovskiy, Andy Zhu

Dissertations, Theses, and Capstone Projects

PURPOSE: The purpose of the study is to determine the current Doctor of Physical Therapy program curriculum, as it applies to research classes and research projects. We investigated the current research requirements of various DPT programs nationwide to determine DPT graduates’ preparedness to conduct research post-graduation.

METHODS: Participants of the current study were recent DPT college graduates selected from DPT programs across the United States. Subjects were asked to participate in a brief online survey questionnaire in reference to their DPT program research curriculum.

RESULTS: A total of 215 DPT programs contacted, out of which 39 schools were able to …

Corticospinal Integration In Healthy Humans, Amanda Asmar, Leandra Manfredini, Kerri Mclean, Christina Scannapieco

Dissertations, Theses, and Capstone Projects

Synchronized arrival of neuronal signals from the periphery and motor cortex has been associated with neuronal plasticity and motor learning. The main objective of this study was to examine neuronal interactions following excitation of descending motor axons from the primary motor cortex (M1) and spinal neuronal circuits via transcranial magnetic stimulation (TMS) and transcutaneous electric stimulation of the spine (tsESS) in 15 healthy humans while seated semiprone. TMS was delivered below or above the resting motor evoked potential (MEP) threshold, for the tibialis anterior (TA) muscle, while tsESS was delivered at the lowest stimulation intensity that evoked responses in most …

Cortical Modulation Of Spinal Reflexes In Healthy Humans, Caitlin Bedell, Joseph Capogrosso, Kristin Thomas, Charlotte Westmoreland

Dissertations, Theses, and Capstone Projects

Considerable evidence suggests that monosynaptic and polysynaptic spinal reflexes are prone to corticospinal inputs. The goal of this study was to establish the cortical modulation of monosynaptic and polysynaptic spinal reflexes in healthy humans. Cutaneomuscular responses were evoked following stimulation of the medial edge of the right foot with a 30 ms pulse train every 10 s via a bipolar electrode and recorded from the ipsilateral tibialis anterior (TA) muscle. Across subjects, medial edge foot stimulation was delivered at 1.2 to 1.5 times the response threshold. The soleus H-reflex was evoked and recorded via conventional methods. The effects of transcranial …

Comparing Nmes Stimulation Intensity At Various Lengths Of The Tibialis Anterior, Brent Brookbush, Maya Hakami, Jennifer Wolff, Amy Zelin

Dissertations, Theses, and Capstone Projects

The purpose of this study was to determine if placement of electrodes at various distances along the Tibialis Anterior muscle belly had a significant effect on the intensity of stimulation needed to evoke a contraction using neuromuscular electrical stimulation (NMES). Twenty subjects between the ages of 21-65 in good health and presented with no precautions to NMES were recruited from the CUNY Hunter College physical therapy department. Two reference lines were drawn on subjects’ legs, one outlining the tibial crest (L1), and another from the most lateral portion of the tibial plateau to the center of the lateral malleolus (L2). …

The Effect Of Tdcs On Cd-1 Mouse Behavior Post Induced Sensorimotor Cortex Injury, Michelle Gardella, Natalia Gozias, Kristina Laktionova, Tricia Roehrig

Dissertations, Theses, and Capstone Projects

The functional topography of the motor cortex has been shown to be modifiable by transcranial direct current stimulation (tDCS). tDCS works by directing electrical currents into the brain which induces alterations in neuroplastic cortical excitability. This experiment’s aim was to test the effect of tDCS on recovery of skilled locomotion, recovery of balance, and recovery of grip strength after bilateral electrolytic lesions to sensorimotor cortices in mice. Tests employed in this experiment included the ladder test, grip test, and a balance pole test. We were able to show that 4 days of tDCS post brain injury in mice produced improvements …

Comparison Of An Intermittent Vs. Continuous Walking Program In Persons With Multiple Sclerosis Using The 6 Minute Walk Test: A Randomized Crossover Pilot Study, Stefanie Dicarrado, Bridget Dungan, Elizabeth Huallpa, Jacob Potrzeba

Dissertations, Theses, and Capstone Projects

Background: Difficulty with gait is one of the most common complaints of persons with MS (pwMS) and can be due to many causes, including neurogenic fatigue. Neurogenic fatigue is one of the most common MS symptoms, and can prevent pwMS from walking longer distances, thus limiting their ability to improve gait endurance. Intermittent walking, a technique where persons take breaks during walking rather than walking continuously, may allow for pwMS to walk longer distances due to less accrual of fatigue.

Objectives: The purpose of this pilot study was to examine whether a program of intermittent walking will result in a …

Influences Of Motor Control Instruction And Taping On Center Of Pressure And Scapulothoracic Kinematics During Reaching For Individuals With Hemiparesis, Michelle De Guzman, Tatyana Farber, Anna Kochanova, Jonathan Lazarus

Dissertations, Theses, and Capstone Projects

Purpose: To determine if application of Kinesiotape™ was able to normalize the overall reaching motion by analyzing both surface electromyographic data and force platform feedback. Design: This study utilizes a case-control design.

Subjects: 5 control and 5 stroke survivors age >40 were recruited for this study through flyers at Burke Rehabilitation Hospital, White Plains, NY.

Methods: Surface EMG electrodes were applied to upper extremity (UE) and lower extremity (LE) muscles and an accelerometer placed on the reaching UE. Subjects stood on a force platform and reached towards a target at shoulder height. The task was repeated 5-7 times with right …

Motor Imagery And Action Observation As An Alternative Gait Training Intervention For The Elderly, Matthew F. Cirelli, Brian Fettner, Lindita Ismaili, Danielle Jordan

Dissertations, Theses, and Capstone Projects

Motor imagery (MI) is the mental representation of movement without any body movement. Action observation (AO) is a non-physical method of training, in which the learner observes the action of another individual. Eighteen subjects between ages 60-80 were randomly assigned to 3 training groups, the MI, AO and motor training groups. All subjects were assessed and measured with the Expanded Timed-Get Up and Go (TUG) test and Figure-8-Walk (F8W) test. All three groups yielded a significant improvement in difference in total TUG time (<0.05). When individual aspects of the TUG were considered, the sit to stand component improved in the MI and Motor groups. The results of this study suggest that MI and AO can improve cadence and have an effect mirroring that of motor practice. If utilized properly, MI and AO may be indicated as a rehabilitation intervention adjunct to gait training, and potentially decrease the risk of falls in the elderly population.

The Performance Of Dancers On The Lower Quadrant Y Balance Test, Heather Cole, Jinny Mcgivern, Anna Morejon, Tiffany Sudol

Dissertations, Theses, and Capstone Projects

The Lower Quadrant Y-Balance Test (YBT-LQ) is an evidence-based screening tool that measures one’s ability to maintain unilateral stance while reaching the contralateral leg in the anterior (ANT), posteromedial (PM), and posterolateral (PL) directions. The purpose of this study was to observe the performance of collegiate dancers on the YBT-LQ and compare it with that of other athletic populations from previously published studies. 39 healthy collegiate dance majors at the Purchase College Conservatory of Dance (ages 17-24 years; mean years of dance training 12.9 ± 3.9 years) participated in this study. Subjects stood on the central platform of the YBT-LQ …

Falls Prevention Training At New York Presbyterian Hospital: Does Education Regarding Fall Prevention Reduce Incidence Of Falls After Discharge To Home From An Acute Rehabilitation Facility?, Yuning Chiu, Michelle Frager, Hyunseok Lee, Solange Wong

Dissertations, Theses, and Capstone Projects

The objective of this study was to determine the compared effectiveness of different instruction types for fall prevention training in an inpatient rehabilitation setting based on 6-month falls incidence. This study included 89 English-speaking patients aged 18-90 who participated in a fall prevention training program at New York Presbyterian Hospital’s inpatient rehabilitation center. Patients were divided into two class types, a group or an individual class. Both classes were subdivided into with and without a caregiver. A 10-Meter Walk Test, the Montreal Cognitive Assessment (MoCA), and admission and discharge Functional Independence Measure (FIM™) scores were recorded for baseline comparisons among …