Rehabilitation and Therapy Commons^™

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 …

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 …

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 …

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 …

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 …

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 …

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 …

Use Of Participant-Generated Photography In A Research Contribution Course, Maryellen Thompson

The Open Journal of Occupational Therapy

This paper describes the use of small, qualitative studies focused on interviews done with participant-generated photographs as an effective and efficient way of teaching research to entry-level masters students. A comparison of using time-use diaries vs. participant-generated photography is presented to explicate the research process and demonstrate the advantages of using photography, including ease of data collection and data sharing. Over a three-year period of using participant-generated photographs as a guide for semi-structured interviews, students have consistently expressed enjoyment of the research process and increased empathy with their research participants.

Therapists As Educators: The Importance Of Client Education In Occupational Therapy, Kate E. Decleene, Angelia J. Ridgway, Julie Bednarski, Lori Breeden, Gina Gabriele Mosier, Deborah Sachs, Donna Stephenson

The Open Journal of Occupational Therapy

Client education is a major component of everyday health care practice. Entry-level occupational therapy (OT) accreditation standards require educators to teach students how to demonstrate the ability to educate clients, family, caregivers, and significant others to facilitate their skills related to personal occupations. Although these standards are a necessity, entry-level programs are not required to teach students the teaching methodologies that support human learning. However, the educational standards do require students to apply the principles of teaching and learning processes. This project explored the evidence in teaching and learning strategies and how these were introduced to OT students during their …

Children With Developmental Disabilities And Their Motivation To Play, Lindsey Askins, Brittany Diasio, Dagmara Szewerniak, Susan M. Cahill

The Open Journal of Occupational Therapy

The purpose of this qualitative study was to examine how and when children with developmental disabilities aged nine to 12 years spontaneously demonstrated play behaviors indicative of intrinsic motivation. Data was collected from six child participants and four parent participants through the use of the Pediatric Volitional Questionnaire (PVQ) and semi-structured photo-elicitation interviews. Overall, the children who participated in this study sought out play experiences with which they were familiar in their natural environments. Specifically, they sought out experiences that afforded them the opportunity to exercise control over their environment and create a sense of predictability. Each of the children …

Stakeholder Recommendations To Refine The Fitness-To-Drive Screening Measure, Sherrilene Classen, Sandra M. Winter, Craig A. Velozo, Elizabeth M. Hannold, Jason Rogers

The Open Journal of Occupational Therapy

In developing the web-based Fitness-to-Drive Screening Measure (FTDS) and keyform (results output) for use to identify at-risk older drivers, we examined the needs, perspectives, and suggestions of three stakeholders groups: occupational therapy practitioners, certified driver rehabilitation specialists (CDRSs), and family members/caregivers. We conducted three focus groups, which were moderated, recorded, transcribed, and analyzed using directed content analysis. Respondents in two focus groups also rated FTDS aspects (e.g., ease of use, format, and relevance), using a visual analog scale (VAS, 0-10 scale with 10 being excellent). All three stakeholder groups contributed to the development of the web-based FTDS. Results from occupational …

Indicators Of Simulated Driving Skills In Adolescents With Autism Spectrum Disorder, Sherrilene Classen, Miriam Monahan, Stephanie Hernandez

The Open Journal of Occupational Therapy

Adolescents are at high risk for motor vehicle crashes (MVCs). Teens with autism spectrum disorder (ASD) may have an even greater risk for MVCs due to impaired visual, cognitive, and motor skills critical for driving. This prospective two group study demonstrated the demographic, clinical, and simulated driving skill differences of seven adolescents with ASD (mean age = 15.14, SD ±1.22) compared to 22 healthy controls (HC) (mean age = 14.32, SD ±.72) through a comprehensive driving evaluation (CDE) conducted by an occupational therapist certified driving rehabilitation specialist (OT-CDRS). Adolescents with ASD performed poorer on right eye …

Trading In Our Paradigm Shifts For A Staircase, Diane Powers Dirette

The Open Journal of Occupational Therapy

No abstract provided.

You've Got A Friend In Me: Effectiveness Of Social Skills Interventions For Children With Adhd, Michelle Carlton, Kelly Davis, Jacquelyn Matlack, Marietta Van Ness

Collaborative Research and Evidence shared Among Therapists and Educators (CREATE Day)

Children diagnosed with ADHD present with the core symptoms of inattention and hyperactivity/impulsivity, which lead to challenges with school based activities, including peer interactions, academics, and extracurricular activities (McClelland, Morrison, & Holmes, 2000; Hoza, 2007). Current research identifies social skills interventions as a potential strategy for occupational therapists (OTs) to address these participation challenges of children with ADHD, however there is a multitude of interventions that fall under this umbrella. The variety of social skills interventions allows for flexibility and diversity in implementation, but poses the challenge of choosing the most effective intervention. This choice should be informed by evidence-based …