School of Occupational Therapy

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    Promoting positive mental health: Calming neurodiverse children’s camp jitters
    (2023-11-01) Fletcher, Tina; Chen, Alicia; Pizarro, Edgar
    Summer camp is a special event in many people’s lives. Children make friends and learn new things while moms and dads enjoy a break from the vigilance required by parenting. Whether for a day or overnight stay, most people have happy memories of their experiences. Families with neurodiverse children might also see camp as a way for their child to dive deeply into preferred interests such as dinosaurs, outer space, or animals while in the company of others (See Figure 1). Some families, and even neurodiverse children themselves, might also take a deep breath and decide not to detail the camper’s differences, hoping they will be accepted for who they are, despite any observable behaviors that seem out of the ordinary (Johnson & Joshi, 2016; Larson, 2010; O’Nions, Happé, Evers, Boonen, & Noens, 2017). Unfortunately, mental health challenges such as situational anxiety and fear can escalate as sessions wear on and may either make or break the camping experience. Positive mental health is not merely the absence of mental health challenges but something we all stive toward to develop relationships, adapt to change, and cope with adversity (Galderisi et al., 2015). Counselors and campers can benefit from occupational therapy supports to increase the joy camp can bring.
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    Strategies and Guidelines for Sensory Havens in Sensory and Autism-Friendly Events
    (2023-06-01) Fletcher, Tina; Chen, Alicia; Norris, Ashlee; Pizarro, Edgar; Tran, Jason; Tripp, Megan
    Autism and sensory-friendly events are an increasingly common feature of community life. One predictable aspect of these events is the presence of sensory havens, which serve as a respite or self-regulation zone for neurodiverse children, family, friends, and, occasionally, their service animals. When research evidence contributes to the design of these spaces, they can positively impact the length of time people attend events and the quality of their experiences. The authors detail autism architecture guidelines and sensory regulation research, and provide practical strategies for designing and operating havens.
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    Examining the delivery mode of mental practice in reducing hemiparesis: A randomized controlled trial
    (ScholarWorks at WMU, 2023) Green, Teresa M.; Fromm, Nicole; Gayle, Farida Sita; Lee, Jinna; Wang, Wanyi; Vas, Asha K.
    Background: Mental Practice (MP) is an effective intervention to address upper extremity (UE) hemiparesis post-stroke. However, parameters for the delivery mode of MP have not been defined. Therefore, this study's purpose was to define delivery mode parameters by comparing the effectiveness of audio-guided and video-guided MP. Method: Eighteen participants, < 1-month post-stroke, with UE hemiparesis were randomized to a MP, repetitive task practice (RTP) or control group. The MP groups performed audio-guided or video-guided MP, 5x/week. The RTP group physically performed the functional tasks. The control group received traditional stroke rehabilitation. The Fugl-Meyer Assessment (FMA-UE) and Wolf Motor Function Test (WMFT) were used to assess change in UE hemiparesis. Results: Wilcoxon signed-rank test demonstrated audio MP increased FMA-UE scores from pretest (Mdn = 34.0, Mean = 34.0, SD =9.56) to posttest (Mdn = 49.0, Mean = 49.6, SD =7.5), p = .042, r = .64. Similar improvement in FMA-UE scores was found with traditional therapy. Audio MP decreased WMFT time, pretest (Mdn = 10.5, Mean = 49.9, SD = 59.1) to posttest (Mdn = 4.1, Mean = 3.5, SD = 1.4), p =.043, r =.63. Conclusion: Audio MP and traditional therapy appear to decrease impairment and increase the functional abilities of the UE following stroke. Video MP and RTP does not have this effect.
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    Pediatric congenital upper limb differences and social participation: A scoping review search protocol CINAHL
    (2023) Tuberty, Sarah; Roberts, Heather; Lightdale-Miric, Nina; Cox, Elaine
    The following is a protocol used to search the literature in Cumulative Index to Nursing and Allied Health Literature (CINAHL) database on congenital upper limb difference and social participation. Congenital upper limb difference literature is scattered and inconsistent this search string is developed from seeking subject headings and key words found in related articles and from combining the Oberg-Manske-Tonkin (OMT) and the Swanson classification systems for congenital upper limb differences from the pediatric hand surgery literature.
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    Occupational adaptation as a model for intervention in postural orthostatic tachycardia syndrome (POTS)
    (Taylor & Francis, 2021) Rich, Emily; Evetts, Cynthia L.
    Postural Orthostatic Tachycardia Syndrome (POTS) often presents with chronic symptoms and impacts a wide variety of areas of occupation, including activities of daily living, sleep, work, school, leisure, play, and social participation. The Occupational Adaptation theory supports practitioners in offering clients opportunities to develop internal adaptive processes to achieve relative mastery in desired occupations. The present manuscript provides a foundation for Occupational Adaptation theory as an appropriate model for intervention in POTS with specific assessments and interventions to guide occupational therapy practitioners in implementing this approach. A case study describes the use of Occupational Adaptation in the clinical intervention of a college student with POTS.
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    Cognitive rehabilitation: Mild traumatic brain injury and relevance of OTPF
    (Hindawi, 2023) Vas, Asha; Luedtke, Anna; Ortiz, Eryn; Mackie, Natalie; Gonzalez, Samantha
    There is increased awareness of the long-term cognitive sequelae of mild traumatic brain injury (mTBI). Therefore, researchers and clinicians have developed and tested cognitive training protocols to address these challenges. The current review summarized literature that examined existing cognitive rehabilitation/training programs. Specifically, the review listed the impact of these programs on functional domains informed by the Occupational Therapy Practice Framework (OTPF). Literature between the years 2008 and 2022 was gathered from nine databases. Results indicate that several cognitive rehabilitation programs have proven to positively influence domains of occupation, client factors, performance, and context. Occupational therapy practitioners have an opportunity to engage in mTBI management. Furthermore, adopting domains of OTPF may guide assessments, treatment planning, and long-term follow-up.
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    Occupational therapy health and wellness programming for a client living with cancer
    (American Occupational Therapy Association AOTA Press, 2022) Polo, Katie M.; Baxter, Mary Frances; Wallis, Nicole
    Cancer and cancer treatments can poorly affect performance of daily activities and quality of lifeduring and after treatment for persons living with and beyond cancer (Neo et al., 2017). Authorsof a systematic review found that 36.7% to 54.6% of persons living with and beyond cancerreported having disabilities related to performance in basic ADLs and IADLs after cancertreatments (Neo et al., 2017). Some of the common cancer-related side effects that presentbarriers to performance are cancer-related fatigue, sleep disturbances, cancer-related cognitiveimpairments, and stress (Baxter et al., 2017).
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    A survey of interventions for cancer survivors provided by occupational therapy practitioners
    (Nova Southeastern University, 2022) Polo, Katie M.; Baxter, Mary F.
    Purpose: Currently, there is a lack of research exploring evidence-based occupational therapy intervention practices at the activity level in survivorship care, which is important to identify for future research and clinical needs of the profession. The purpose of this study was to describe what activity level interventions OT practitioners are using and report any practice trends that might exist.
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    Predictors of hospital readmissions for people with chronic conditions
    (Western Michigan University, 2023) Tkach, Melanie Moriss; Bowyer, Patricia; Neville, Marsha; Wolf, Timothy J.; Goodman, Gerald R.
    Background: Hospital readmissions remain prominent in health care. Functional, cognitive, and environmental factors predict hospital readmissions but may not be thoroughly measured or addressed prior to discharge.
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    Gist-reasoning in adults with traumatic brain injury
    (International Brain Injury Association, 2012) Vas, Asha; Chapman, Sandra B.
    One remarkable capacity of the human brain is its adeptness in extracting ‘gist’ from information that we encounter everyday (Bartlett, 1932, Chapman, Sparks, Levin et al., 2004; Reyna & Brainerd, 1995). Researchers refer to gist as global meanings gleaned from verbal or auditory information (e.g., Kintsch, 1994; vanDijk & Kintsch, 1983). For example, the gist of a movie may include a general sense of the story line or the relation between the key characters and events in the movie. Chapman and colleagues (2004) extend this notion of gist to introduce a construct labeled ‘gist-reasoning’ that denotes the ability to form novel and abstract level meanings than conveyed by the concrete details. That is, gist-reasoning involves combining the explicit input/details of the movie through complex reasoning to construct deeper level interpretations. In essence, gist reasoning is a perfect example of the adage ‘the whole is more than the sum of its parts”. The metric of gist-reasoning has proven sensitive in characterizing deficiencies in abstracting meanings from complex information in adolescents with TBI, who had near normal IQ as compared to their non-injured peers (Chapman, Gamino, Cook et al., 2006). Furthermore, improvements in gist-reasoning ability have been associated with increased performance on measures of immediate memory, working memory, inhibition, and switching (Anand, Chapman, Rackley et al., 2010; Vas, Chapman, Cook et al., 2011). However, training of basic cognitive processes such as memory and attention did not improve higher-level gist-reasoning (Gamino, Chapman, Hull et al., 2010). Thus, gist-reasoning could be best understood as a complex task that is positively associated with cognitive control processes (e.g. working memory, inhibition, switching) and immediate memory.
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    Does tele-health training stack up to on-site executive control training for youth and adults with TBI?
    (International Brain Injury Association and North American Brain Injury Society, 2016) Vas, Asha; Cook, Lori; Keebler, Molly; Chapman, Sandra
    Medical practitioners have long recognized potential contributions that tele-health (also referred to as tele-medicine or tele-practice) can make regarding equitable access of services, especially in rural and remote populations (Scalvini, et al., 2004). Tele-health has become integral to many hospitals to (1) increase patient access to care, (2) enable health care providers to connect with patients, (3) provide consultation, health monitoring, mental health services, education, pharmacological services, and (4) offer counselling. According to American Hospital Association (2015), 52% of hospitals utilized some form of tele-health in 2013, and the number of hospitals and other medical institutions adopting tele-health approaches is expected to increase in the coming years.
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    Neurocognitive outcomes following reasoning training in adults with mild TBI [Abstract]
    (The International Neuropsychological Society, 2014) Vas, Asha; Keebler, M.; Rodriguez-Larrain, G.; Krawczyk, D.; Chapman, S.
    Objective: The current study compared cognitive and functional benefits of two programs in adults with mTBI (GOS-e-7, BDI < 20). One training program, SMART, focused on complex reasoning using strategies of strategic attention, integration, and innovation. The second program (Brain Health Workshop, BHW) focused on understanding brain health through education of brain anatomy and effects of lifestyle behavior on brain health. Both group-programs were comparable in training hours, engagement in group discussions, and assignments. Benefits of the programs were compared pre- vs. post-training on complex reasoning, executive function, memory, and daily life skills.
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    Difference in bilateral upper limb muscle activation during the assisting hand assessement in children affected by unilateral cerebral palsy
    (The Gait and Clinical Movement Analysis Society, 2022) Puissegur, Ophelie; Ulman, Sophia; Roberts, Heather; Shierk, Angela; Loewen, Alex; Erdman, Ashley; Tulchin-Francis, Kirsten
    INTRODUCTION Cerebral palsy (CP) refers to a group of childhood-onset disorders that affect an individual’s ability to move and maintain posture due to a brain lesion occurring during in utero development. When the lesion affects motor areas on one side of the brain, an impairment of movement and posture will be manifested on the contralateral side. The most common CP condition is called unilateral cerebral palsy (UCP), leading to challenges with daily activities due to decreased function [1] and use of their affected upper limb. The purpose of this study was to evaluate side-to-side muscle activation differences during the Assisting Hand Assessment (AHA), a performance based assessment that measures how children with upper limb impairments use their involved limb as an assisting hand during bimanual activities [2].
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    Impact of abobotulinumtoxinA treatment on the assisting hand assessment in children with hemiparesis due to cerebral palsy: Results from an international, Phase 3, pivotal study (abstract)
    (The International Society of Physical and Rehabilitation Medicine, 2021) Shierk, A.; Pyrzanowska, W.; Bonikowski, M.; Regnault, B.; Page, S.; Delgado, M.
    Background and Aims: When used in conjunction with occupational therapy, the aim of botulinum toxin treatment in children with upper-limb spasticity is to produce a selective reduction in muscle spasticity while optimising the effects of therapies used for improving range of motion, enhancing motor ability and functional skills. We assessed effect of a single abobotulinumtoxinA injection cycle on bimanual performance in children with hemiparesis due to cerebral palsy (CP).
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    Goal attainment after treatment with Abobotulinumtoxina and a tailored home therapy programme in children with upper limb spasticity: Descriptive, exploratory analysis of a large randomized, controlled study
    (Medical Journals Sweden, 2022) Carranza-del Rio, Jorge; Dursun, NIgar; Cekmece, Cigdem; Bonikowski, Marcin; Pyrzanowska, Weronika; Dabrowski, Edward; Tilton, Ann; Oleszek, Joyce; Volteau, Magali; Page, Simon; Shierk, Angela; Delgado, Mauricio R.
    Objective: This exploratory analysis of a large, randomized, double-blind study (NCT02106351) describes the effect of treatment with abobotulinumtoxinA followed by a tailored home exercises therapy programme in enabling children with upper limb spasticity due to cerebral palsy to achieve their functional goals using goal attainment scaling (GAS).
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    A survey on NICU therapists' role for infants with hypoxic ischemic encephalopathy following therapeutic hypothermia
    (Association of Schools of Allied Health Professions, 2022) Perez, Madison; Poskey, Gail
    Purpose: This descriptive study aimed to survey therapists working in neonatal intensive care units (NICUs) and identify the neonatal therapists' role for infants status post therapeutic hypothermia.
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    Exploration of parent perspectives and adaptation to shaken baby syndrome: An occupational therapy approach
    (2007-12) Poskey, Gail; Hersch, Gayle; Fannin, Ron; Candler, Cathy; Spencer, Jean
    Shaken Baby Syndrome is a violent and deadly form of child abuse. However, it is a preventable tragedy. Infant crying is the major precipitating factor that causes an adult to shake an infant or small child. The purpose of this research was to examine from an occupational therapy perspective current prevention strategies of Shaken Baby Syndrome (SBS) and to explore adaptive strategies used by parents in response to inconsolable infant crying. The first study provided a program evaluation of a parent education class. The parent education class was developed to address infant crying and the dangers of SBS and provided primary prevention for parents and caregivers with infants in a neonatal intensive care unit. The study established that the participants did perceive the class to be an effective method of addressing infant crying and conveying the dangers of SBS. The second study included a qualitative inquiry utilizing a phenomenological tradition to explore the parent's perspective on the lived experience of infant crying. In-depth interviews with six parents who had directly experienced the phenomenon of infant crying were conducted. The themes of: longing for answers, heightened emotions and coping strategies emerged from the data. A discussion of these themes along with clinical implications for practice and future research are presented. Caregiving with an infant is considered a co-occupation, thus the infant and parent's response to infant crying is viewed as a co-occupation. The parent's thoughts, feelings, behaviors and actions in response to infant crying were explored in the third study by using a qualitative research approach of participant observations, a questionnaire and field notes. The results of the analysis identified three major themes: the immediate response to crying, routines, and utilizing movement as a coping strategy. Lastly, Chapter 6 offers a summary of the key findings from the three research studies. This section of the dissertation provides a synthesis of the studies, suggestions for future research, and implications for occupational therapy practice in SBS prevention programs.
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    Cognitive-physical-functional correlates in chronic brain injury: A pilot study
    (Termedia Publishing, 2022) Vas, Asha K.; Spees, Stephen; Wang, Wanyi; Chambers, Keatyn
    Introduction: Functional challenges persist even years following brain injury. Integrating multiple domains as part of therapy may improve global outcomes. The purpose of this study is to investigate the relationships among cognitive, physical and functional domains in adults with chronic brain injury.
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    Comparing learning platform impact on low vision education for occupational therapists
    (Western Michigan University, 2020) Perea, Jaimee D.; Sit, William
    This pilot study examines the impact of face-to-face, remote, and hybrid learning platforms on satisfaction, confidence, and knowledge-application of occupational therapy practitioners during a synchronous low vision continuing education program. Fifteen participants were divided into three groups, each corresponding to one learning platform. They engaged in two 45-min learning sessions and completed pre, post, and follow-up surveys to measure the impact of the learning platform on the dependent variables of satisfaction, confidence, and knowledge application. No significant differences were found between learning platforms for the three variables, but improvements from pre to follow-up survey were found to be significant for confidence and knowledge application for all groups. These f indings indicate that similar education provided to occupational therapy practitioners may result in improved confidence and knowledge application to clinical practice from the beginning to the end of the educational program, despite the learning platform. Flexibility with online learning options increased participation and adherence rates. Synchronous remote and hybrid learning platforms may be as effective as traditional face-to-face methods, specifically with increasing practitioner confidence and knowledge application. Remote options may reduce peer interactions but increase flexibility and convenience with scheduling for program scalability and accessibility.
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    Development of a pediatric goal-centered upper limb spasticity home exercise therapy program for use in a phase-III trial of Abobotulinumtoxina (dysport®)
    (Taylor & Francis, 2018) Shierk, Angela; Jiménez-Moreno, Cecilia; Roberts, Heather; Ackerman-Laufer, Shirley; Backer, Gretchen; Bard-Pondarre, Rachel; Cekmece, Cigdem; Pyrzanowska, Weronika; Vilain, Claire; Delgado, Mauricio R.
    Aims: To create a standardized home exercise therapy program that could be implemented by international sites to provide a consistent level of therapeutic intervention for pediatric patients participating in an ongoing Phase-III, randomized, controlled trial of repeat abobotulinumtoxinA injections for pediatric upper limb spasticity (NCT02106351).