Rehabilitation and Therapy Commons^™

Giving Back: Physiatry, Program & Patients, Seyed Amir Tahaei, Md, John F. Ditunno, Jr, Md, Frank Naso, Md, John L. Melvin, Md

Department of Rehabilitation Medicine Faculty Papers

“Giving Back” is a Jefferson tradition beginning with Dr. William Schmidt (JMCF1917-1959), who together with Dr. Frank Krusen (JMC 1921) served as Presidents of the American Academy of Physical Medicine and Rehabilitation (AAPM&R) in 1943 and 1941 respectively. Other Jefferson graduates and faculty have also served as President of the Academy including Drs. Bender (1973), Ditunno (1981), Reinstein (1993), Melvin (1998) and recent presidents in 2009-2013, Betsy Sandel (JRR 1984), Mike Lupinacci (Jefferson Resident teaching faculty) and Alberto Esquenazi (JMCF 2000). Both Krusen and Schmidt were founding members of the American Board of PM&R in 1947. Over the years many …

Computer-Based Cognitive Retraining For Adults With Chronic Acquired Brain Injury: A Pilot Study, Kitsum Li, Julie Robertson, Joshua Ramos, Stephanie Gella

Collected Faculty Scholarship

This study evaluated the effectiveness of a computer-based cognitive retraining (CBCR) program on improving memory and attention deficits in individuals with a chronic acquired brain injury (ABI). Twelve adults with a chronic ABI demonstrating deficits in memory and attention were recruited from a convenience sample from the community. Using a quasi-experimental one-group pretest–posttest design, a significant improvement was found in both memory and attention scores postintervention using the cognitive screening tool. This study supported the effectiveness of CBCR programs in improving cognitive deficits in memory and attention in individuals with chronic ABI. Further research is recommended to validate these findings …

The Fieldwork Planning Matrix – Maximizing The Learning Environment In Non-Traditional Community Based Settings, Arlene Lorch, Otd, Otr/L, Ches, Tina Angelis, Edd, Otr/L

Department of Occupational Therapy Posters and Presentations

OBJECTIVES

•Learn about a matrix guided tool utilized to plan and structure unique fieldwork experiences.

•Identify key elements associated with “matrix” implementation.

•Understand multi-faceted uses of the manual.

BACKGROUND - NONTRADITIONAL FW

•More community-based sites are needed to meet FW placement demand

•Typically, these FW sites rely upon non-traditional, distant supervision.

•These learning environments require high degree of structure to support experiential self-directed learning

•High structure requires detailed planning

•A planning matrix method to maximize the learning environment is proposed.

Can The Upper Limb Tension Test 1 (Ultt1) Stand Alone In Diagnosing Median Nerve Compression In Adult Patients With Carpal Tunnel Syndrome (Cts)?, Brianna Palmer

Critically Appraised Topics (CAT)

An appraisal was made on a validity study by Vanti et al, regarding the upper limb neurodynamic test 1 (ULTT1) for diagnosing carpal tunnel syndrome (CTS). The selected paper included current patients at an occupational medicine clinic with suspected CTS and referral for nerve conduction study (NCS).

Using Wainner’s Criteria to indicate a positive ULTT1, calculated sensitivity was 0.9167 and specificity was 0.150. In limiting criteria for a positive test by requiring provocation of 1^st-3^rd digits only, the sensitivity decreased to 0.5417, however specificity increased to 0.70.

This study was effective in defining the inclusion criteria for …

Creating An Infrastructure To Support Faculty Outcomes Research On Teaching And Learning, Susan Toth-Cohen, Phd, Otr/L, Susan Wainwright, Phd, Pt

Department of Occupational Therapy Posters and Presentations

This presentation discusses the Teaching and Learning Initiative (TLI), a comprehensive program for building faculty capacity to design and implement educational research in a school of health professions. The TLI is a staged program based on Eade's (1997) approach to capacity building, which the authors apply to the academic environment. The TLI consisted of 4 stages:

1. Initial planning and data gathering.

2. Training faculty in educational outcomes research.

3. Faculty submission of educational outcomes research for intramural funding.

4. Participatory action research approach to further develop faculty capacity for the scholarship of teaching and learning, including educational outcomes …

Combined Erp/Fmri Evidence For Early Word Recognition Effects In The Posterior Inferior Temporal Gyrus, Joseph Dien, Eric S. Brian, Dennis L. Molfese, Brian T. Gold

Center for Brain, Biology, and Behavior: Faculty Publications

Two brain regions with established roles in reading are the posterior middle temporal gyrus and the posterior fusiform gyrus. Lesion studies have also suggested that the region located between them, the posterior inferior temporal gyrus (pITG), plays a central role in word recognition. However, these lesion results could reflect disconnection effects since neuroimaging studies have not reported consistent lexicality effects in pITG. Here we tested whether these reported pITG lesion effects are due to disconnection effects or not using parallel ERP/fMRI studies. We predicted that the Recognition Potential (RP), a left-lateralized ERP negativity that peaks at about 200–250 ms, might …

New Phenotype Of Parsonage-Turner Syndrome Involving Radial And Proximal Median Nerve: A Case Report, Matthew Mcauliffe, Md, Nancy Vuong, Md, Adam L. Schreiber, Do

Department of Rehabilitation Medicine Faculty Papers

History

A 74-year-old woman developed sudden severe left shoulder, arm, and forearm pain that suddenly developed. This pain lasted approximately 2 months. Approximately 1-2 months after the resolution of the first pain she developed a different type of pain which she described as a tingling, burning, pins and needle sensation that radiated from her shoulder past her elbow into the dorsal and palmar aspect of her hand in the thumb, index, and long fingers. Additionally, she developed numbness in her hand along the palmar thumb, index, and long fingers. Two months following the onset of the initial type of pain, …

Clinical Reasoning In The Use Of Slings For Patients With Shoulder Subluxation After Stroke: A Glimpse Of The Practice Phenomenon In California, Kitsum Li, Naoko Murai, Simon Chi

Collected Faculty Scholarship

Literature reports the frequent use of shoulder slings by occupational therapists for the management of post-stroke shoulder subluxation despite the low evidence for its efficacy. To understand the clinical context that defies current research evidence, a survey was distributed among California occupational therapists. One hundred and sixty-eight participants responded to the survey, answering questions regarding the occurrences and clinical reasoning in the use of shoulder sling with patients post stroke. 81.5% of the respondents reported the use of shoulder sling. However, the actual sling prescription was limited to 28.4% of their patients. Slings were primarily prescribed for upper extremity management …

An Organization-Wide Service Improvement Approach, Jennifer Jasmine Arfaa, Phd, Mhsa, Cynthia Line, Phd, Nora Kramer, Msn, Rn, Karen Montoro, Rn, Richard D. Blob,, Maria Francesco, Jaime Stazi, Rn, Elisabeth Kunkel, Md, Susan Krekun, Md, Lizanne Mason, Rn, Kathy Evans, Rn, Lorraine Weikel, Rn, Ann D. Clark, Ms, Otr/L, Ray Wisniewski, Teresa Heavens

Department of Nursing papers and presentations

APPROACH TO PROBLEM SOLVING

High priority index questions from HCAHPS and Press Ganey surveys, including overall ratings, communication with RNs and MDs, hospital environment and response to concerns and complaints, were targeted for improvement. These high priority indices served as the basis for redesigning Patient Services using a multi-faceted approach to improve patients’ experiences.

At Thomas Jefferson University Hospital (TJUH), high performance on the Patient Experiences of Care Survey has been driven by a successful multi-tiered approach to patient services:

·Hospital leadership guided and implemented new approaches to ensure excellence in patient services is an ever-present and obtainable goal

·Physician …

Ferreira Named Chair Of Physical Therapy, Becky St. Clair

Lake Union Herald

No abstract provided.

Trans-Sacrococcygeal Joint Ganglion Impar Injection For Treatment Of Pudendal Neuralgia (3 Cases Report), Matthew Mcauliffe, Md, Linqiu Zhou, Md

Department of Rehabilitation Medicine Faculty Papers

History

Three patients, 2 male and 1 female were diagnosed with pudendal neuralgia. The female patient developed pudendal neuralgia secondary to post-herpetic neuralgia. The two male patients were caused from likely repetitive sitting injury. One patient was a truck driver causing him to sit for long periods of time and the other patient was a professional writer. The three patient initially all attempted conservative therapies, however their pain persisted. They elected to undergo Trans-sacrococcygeal joint ganglion impar injection for treatment of pudendal neuralgia.

Evidence-Based Practice In Occupational Therapy Curricula., Tina Angelis, Edd, Otr/L, Thomas G Dimarco, Susan Toth-Cohen, Edd, Otr/L

Department of Occupational Therapy Faculty Papers

The purpose of this study is to describe currently used educational strategies for teaching evidence-based practice (EBP) in entry-level master's degree occupational therapy programs in the United States. Fifty-eight entry-level occupational therapy program directors completed a survey. Results showed that occupational therapy programs consistently use a wide variety of EBP resources for teaching EBP including database searches, literature reviews, and the development of a research proposal. Less commonly used strategies include the use of case stories and journal clubs. The current study provides a baseline of existing strategies taught in entry level programs that may be built upon to gather …

The Role Of Rehabilitation Following Autologous Chondrocyte Implantation: A Retrospective Chart Review, Jenny L. Toonstra, Jennifer Sebert Howard, Timothy L. Uhl, Robert A. English, Carl G. Mattacola

Physical Therapy Faculty Publications

PURPOSE/BACKGROUND: Clinical outcomes following autologous chondrocyte implantation (ACI) are influenced by multiple factors, including patient demographics, lesion characteristics, quality of the surgical repair, and post-operative rehabilitation. However, it is currently unknown what specific characteristics of rehabilitation have the greatest influence on clinical outcomes following ACI. The purpose of this study was to conduct a retrospective chart review of patients undergoing ACI with the intent to describe this patient population's demographics, clinical outcomes, and rehabilitation practices. This study aimed to assess the consistency of the documentation process relative to post-operative rehabilitation in order to provide information and guide initiatives for improving …

Contributions Of The Kölliker-Fuse Nucleus To Coordination Of Breathing And Swallowing, Joshua M. Bonis, Suzanne E. Neumueller, K. L. Krause, Lawrence Pan, Matthew R. Hodges, Hubert V. Forster

Physical Therapy Faculty Research and Publications

Herein we compare the effects of perturbations in the Kölliker–Fuse nucleus (KFN) and the lateral (LPBN) and medial (MPBN) parabrachial nuclei on the coordination of breathing and swallowing. Cannula was chronically implanted in goats through which ibotenic acid (IA) was injected while awake. Swallows in late expiration (E) always reset while swallows in early inspiration (I) never reset the respiratory rhythm. Before cannula implantation, all other E and I swallows did not reset the respiratory rhythm, and had small effects on E and I duration and tidal volume (V_T). However, after cannula implantation in the MPBN and …

Conceptualization And Design Of A Surface Translation Balance Training Device, Annie Djukic, Omri Tayyara, Deborah Espy, Majid Rashidi

Undergraduate Research Posters 2013

Research supports the idea that dynamic control of both a person's center of mass and base of support are necessary to prevent falls, and that older adults can learn this combined control through specific balance training. Effective balance training requires a large number of repetitions of task-specific practice. Externally induced movements have been employed in balance studies both to test and train balance responses, most often using mechanized surface perturbations. These systems however are quite expensive; therefore, we chose to investigate a more cost effective solution focusing on surface translation for balance training in our lab.

We performed a literature …

Early Intervention Provider Use Of Child Caregiver-Teaching Strategies, Philippa Campbell, Phd, Catherine Ehret-Coletti, Ms

Department of Occupational Therapy Faculty Papers

Most current early intervention approaches emphasize the importance of a provider role as teacher or coach, a role in which providers give parents or other caregivers information about how to optimize children’s growth and development (Stremel & Campbell, 2007). However, few studies have examined the information that should be provided for caregivers or how this information is best delivered to caregivers although a number of rating scales are able to distinguish between roles of direct service provider for the child (e.g., traditional) and triadic interaction among provider, caregiver, and child (Campbell & Sawyer, 2007; Salisbury & Cushing, 2013). Related factors …

Changes In Hemodynamic Responses In Chronic Stroke Survivors Do Not Affect Fmri Signal Detection In A Block Experimental Design, Nutta-On Promjunyakul, Brian D. Schmit, Sheila Schindler-Ivens

Physical Therapy Faculty Research and Publications

The use of canonical functions to model BOLD-fMRI data in people post-stroke may lead to inaccurate descriptions of task-related brain activity. The purpose of this study was to determine whether the spatiotemporal profile of hemodynamic responses (HDRs) obtained from stroke survivors during an event-related experiment could be used to develop individualized HDR functions that would enhance BOLD-fMRI signal detection in block experiments. Our long term goal was to use this information to develop individualized HDR functions for stroke survivors that could be used to analyze brain activity associated with locomotor-like movements. We also aimed to examine the reproducibility of HDRs …

Fatigue And Recovery From Dynamic Contractions In Men And Women Differ For Arm And Leg Muscles, Jonathon Senefeld, Tejin Yoon, Marie K. Hoeger Bement, Sandra K. Hunter

Exercise Science Faculty Research and Publications

Introduction: Whether there is a gender difference in fatigue and recovery from maximal velocity fatiguing contractions and across muscles is not understood. Methods: Sixteen men and 19 women performed 90 isotonic contractions at maximal voluntary shortening velocity (maximal velocity concentric contractions, MVCC) with the elbow flexor and knee extensor muscles (separate days) at a load equivalent to 20% maximal voluntary isometric contraction (MVIC). Results: Power (from MVCCs) decreased similarly for men and women for both muscles (P > 0.05). Men and women had similar declines in MVIC of elbow flexors, but men had greater reductions in knee extensor MVIC force and …

Picturing Life, Molly Bathje

The Open Journal of Occupational Therapy

The cover art of the summer 2013 issue of The Open Journal of Occupational Therapy provided by Jonathan Darnall reflects his unique life perspective, current roles, and values. An exploration of Jon’s life experience reveals how creative arts, including photography, have positively influenced his life and inform OT practitioners about the benefits of photography as an intervention and an occupation.

Enhancing Client-Centeredness In Parkinson's Disease Care: Attending To The Psychosocial Implications Of Lived Experience, Jeffrey D. Holmes, Sara Lutz, Mike Ravenek, Debbie L. Rudman, Andrew M. Johnson

The Open Journal of Occupational Therapy

Evidence-based practice requires that clinicians interpret the best research evidence in the context of their clinical experience, while at the same time considering client knowledge and experiences. Although clinicians are becoming increasingly skilled at the evaluation of research evidence, the evidence-based practice process often neglects client values and self-identified health issues. Ignoring these key aspects of client-centered practice may lead to interventions that fail to target the implications of a client’s disease that are important to occupational participation and quality of life (QOL). A focus on client-centeredness is particularly important in progressive neurodegenerative disorders, such as Parkinson’s disease, where there …