Master of Science (M.S.), University of Dayton, 2024, Mechanical Engineering

Injuries to the spinal cord can be debilitating to the function of the upper extremity. Many people with spinal cord injuries (SCIs) undergo rigorous therapies to help preserve range of motion and strength. Task specific training has been shown to offer benefits in upper extremity rehabilitation. In recent years, virtual reality has gained popularity for its ability to offer task specific training in an engaging and immersive environment. This study explores therapeutic virtual reality gaming for people with spinal cord injuries. The first aim of the study is to compare the kinematic performance of individuals with spinal cord injuries to healthy controls. This study's second aim is to characterize the qualities of the movement task, such as movement direction and block position, that generate maximum kinematic responses in the SCI group. Finally, the third study aim is to compare the effects of different movement types on overall kinematic performance. Individuals with spinal cord injuries (n=7) and healthy, age-matched, sex-matched controls (n=7) were asked to play Beat Saber in an immersive virtual reality environment. Participants were equipped with upper extremity motion capture markers, virtual reality trackers, and the virtual reality headset/controllers. Custom levels were created in Beat Saber that had different movement directions (UP, DOWN, IN, OUT) and different block positions (HIGH, LOW, MED, LAT). Trials were composed of either movements with one hand (UNI), movements mirrored about the midline (MIR), or movements in opposing directions about the midline (OPP). Participants completed six randomized trials, repeating each of these movement types twice. Results showed that the joint profiles of the participants with SCIs used less overall shoulder and elbow joint motion to accomplish the tasks, compared to the healthy controls. At the wrist, SCI participants were able to use comparable or greater wrist radial/ulnar deviation than the controls. SCI parti (open full item for complete abstract)

Doctor of Education , University of Dayton, 2024, Educational Administration

There are five developmental areas: gross motor, fine motor, communication, adaptive behavior, and social-emotional. If social-emotional skills are delayed, all other developmental areas are negatively impacted. Preschool-aged students are incapable of kindergarten readiness if they have a delay in social-emotional development as it impacts their ability to gain and retain academic knowledge. An integrated public preschool in Ohio expressed concern of increased delays in social-emotional skills following the COVID-19 shutdown. Staff noticed an increase in classroom disruptions and emotional dysregulation. To counteract this, the social- emotional program, The Zones of Regulation, was adapted and implemented throughout the preschool environment. Through the theoretical framework of street-level bureaucracy and a bottom-up approach, this qualitative participatory action research study examined the staffs' perspectives on the ease of implementation and effectiveness of the adapted version of The Zones of Regulation. The data that was collected and analyzed revealed that, in the opinion of the participants, the building-wide implementation of this program was successful and improved classroom management. Areas of the program that need improvement were revealed and an action plan was developed.

Master of Science (MS), Bowling Green State University, 2024, Communication Disorders

The purpose of this study was to examine the interaction between cognitive demands during speech production and concurrent performance of a visuomotor tracking task. Participants performed a working memory task involving embedding a numerical response in a carrier phrase. To modulate cognitive load, participants performed two speech task variants with different degrees of mental tracking effort. For the low-demand variant, participants completed the carrier phrase by counting forward from one, a task that is relatively simple and considered automatic. For the high-demand variant, participants completed the carrier phrase by performing serial subtraction by three, requiring a modest amount of mental tracking effort. Both tasks were performed in isolation and while performing a concurrent visuomotor tracking task. Concurrent serial subtraction led to a reduction in visuomotor tracking accuracy, whereas counting forward did not affect tracking accuracy. Compared to counting forward, serial subtraction was associated with a decrease in speech intensity, lip opening and closing range, and lower lip opening and closing velocities. Compared to speaking insolation, participants exhibited a reduction in lower lip opening and closing velocities and utterance-to-utterance variability when performing the visuomotor tracking task. This pattern suggests that increasing cognitive demands, compounded by divided attention requirements, can affect processing and speech production.K

Bachelor of Arts, Walsh University, 2023, Honors

Pediatric occupational therapy is a common form of therapy used to treat children with all types of developmental delays and diagnoses. One main developmental delay for school-aged children six to twelve years of age are fine motor skills. Fine motor skills are movements that are smaller than that of gross motor and involve the hands, wrists, and fingers. In school, fine motor skills include things like cutting, coloring, drawing, and handwriting. School-based occupational therapists (SBOT) play a significant role in supporting developmentally delayed children through individualized interventions to help each individual student be able to accomplish crucial fine motor milestones. In this research, interview data was collected from nine SBOT practitioners concerning the most effective interventions for fine motor delays from their perceptions and compared to that of supported research articles. The significance of this study was to identify if a group of local SBOT practitioners utilize evidence-based fine motor interventions or other approaches in practice. This results determined that SBOT practitioners' intervention techniques for fine motor skills aligned with that of empirically supported research. The main point of this research study was supported, but other findings concerning fine motor intervention in schools were recognized for future direction. Several SBOT practitioners and several research articles noted the need for collaboration of teachers, parents, and aids in expediting student fine motor development.

Doctor of Philosophy, University of Toledo, 2023, Health Education

Older adults are a growing population with increasing health needs and expenditures. Several determinants can impact older adult health; however the US health system tends to focus on primarily individual factors. Using population-based approaches can address other factors also impacting health. Occupational therapy (OT) is a profession that could engage in population-based practice (PBP) with older adults. There is limited research on OT's involvement in PBP in the US. The purpose of this descriptive qualitative study was to explore perceptions, current engagement, and factors influencing population-based OT practice. An online survey and qualitative virtual interviews were conducted with 21 occupational therapists. Qualitative content analysis was utilized to identify emerging categories within the data. Participants had positive perceptions of OT's role in PBP and brought forth several issues that OT could address with the older adult population. Current engagement in PBP was tied to employer-initiation or personal interest. Factors that could support or hinder occupational therapists' engagement were identified, including knowledge and skills, understanding of the OT profession, employer support, resources, and the US health system. These findings can assist the field of OT in overcoming barriers to engagement and participation, along with identifying supports to promote opportunities for population-based OT practice. The issues identified within the older adult population can be starting points for OTs role in PBP with older adults. Occupational therapists can play a vital role in the health of the older adult population given the right training and supports.

Doctor of Philosophy in Health Sciences, Youngstown State University, 2023, Department of Graduate Studies in Health and Rehabilitation Sciences

This project aimed to examine the effects of a novel training program using interprofessional, multicultural learning activities to facilitate learning cultural competence with humility (CCH). Problem: Master of Occupational Therapy (MOT) academic programs have consistently satisfied curricular standards for aspects of cultural competence, but the evidence is sparse related to the contemporary constructs of CCH from instructional strategies to assessment. This project explores the effectiveness of interprofessional multicultural learning activities for CCH through the constructs of cultural awareness, knowledge, skills, and desire to prepare students to meet the purposive sample of convenience with a cohort of MOT and Counseling and Human Development (CHD) students from a single academic institution. A convergent mixed-methods design was employed for this retrospective study utilizing three outcome tools (Learning Activities Survey [LAS], Fieldwork Performance Evaluation for the Occupational Therapy Student [FWPE-OT], and the Modified Cultural Competency Self-Assessment [M-CCSA]). Quantitative and qualitative data for the constructs of CCH (cultural awareness, knowledge, skills, and desire) were compiled and analyzed to determine the effectiveness of the interprofessional multicultural learning activities of a novel training program.

Bachelor of Science, Walsh University, 2023, Honors

Purpose: To determine if there is a difference in prevalence of overweight bag carriage between males and females on a college campus to inform intervention programming. Methods: A secondary data analysis study was conducted using a data set collected by convenience sampling of individuals on Walsh University's campus. Individuals were categorized as either over or under based on whether their bag weighed over or under 10% of their body weight. Results: Data from 456 participants was utilized, of which 234 identified as female and 222 identified as male. A one-way ANOVA test identified a significant difference (p<.001) between the bag weights of females (14.77 +/- 5.27) and males (12.14 +/- 4.93). A Tukey's HSD test indicated that females significantly differed from males regarding mean bag weight (q = 7.785), with females carrying significantly heavier bags than males. Conclusion: This study identifies adult females as a population that could benefit from education intervention programming since overweight bag carriage is prevalent. This information can be utilized by occupational therapists and other health care professionals when looking at musculoskeletal health and potential causes of MSP and MSD in this population.

Doctor of Education , University of Dayton, 2022, Educational Leadership

This mixed methods Dissertation in Practice (DiP) explored supportive practices for school-based occupational therapists employed in Northwestern Pennsylvania. This comparative case study specifically examined differences in self-efficacy and job satisfaction for occupational therapists and occupational therapy assistants employed by local education agencies, called intermediate units. Two intermediate units were selected for examination, one with and one without mentorship and onboarding policies. In order to explore structures of support, qualitative data via interviews and quantitative data via surveys were collected from participants from the Central Intermediate Unit 10 (CIU10) and Seneca Highlands Intermediate Unit 9 (IU9). Participants from these two organizations were selected as the IU9 does not include mentorship or induction policies or practices, and the CIU10 has developed a formalized onboarding and mentorship program for newly hired school-based therapists. Quantitative and qualitative data were collected concurrently. Through semi-structured interviews with participants from the IU9, therapists reported high levels of self-efficacy related to their jobs, but lower perceptions of job satisfaction as compared the CIU10. In contrast, therapists from the CIU10 participants reported generally higher feelings of job satisfaction, satisfaction with organizational commitment and connectedness, and opportunities for advancement. Findings highlight the need for more robust and comprehensive onboarding procedures including revision of the employee handbook to include occupational therapy as a recognized discipline. The proposed action plan, the Mentorship and Induction Program, includes a timeline and logic model that outlines minimal guidelines for onboarding as well as a year-long mentorship program. This model has been created to remedy the need for more robust supportive practices within the IU9, in addition to discussion. Implications we (open full item for complete abstract)

Doctor of Education (Ed.D.), University of Findlay, 2022, Education

Occupational therapy education standards have recently changed to require students to demonstrate knowledge and use of the safe and effective application of physical agents. This change, which occurred in 2020, is more rigorous in the area of deep thermal and electrotherapeutic agents than in previous revisions. This mixed-methods convergent study surveyed occupational therapists who are also Certified Hand Therapists to learn how they developed competence in the use of electrotherapeutic and deep thermal physical agents and what they believed to be effective educational methods in their learning. A survey gathered quantitative data for the study. Follow-up semi-structured interviews were completed to gather qualitative data. Data analysis included descriptive statistics for quantitative data and demographic data, as well as inferential statistics through the use of single-factor analyses of variance with post hoc testing. Results indicated practitioners use a variety of training methods to develop competence in the use of complex physical agents. Continuing education and fieldwork education resulted in higher levels of independence when compared with manufacturer's sales representative training. Continuing education, fieldwork education, entry-level education, post-professional education, and on-the-job training were associated with higher levels of competence than no training at all, indicating the aforementioned methods were all effective in developing competence. Triangulated results support learner demonstration, supervised and repetitive practice, and feedback during learning as essential methods for developing competence in complex physical agents. This study provides recommendations for effective educational methods for teaching and learning complex physical agents applicable to occupational therapy educators, novice practitioners, and occupational therapy students.

Doctor of Philosophy, The Ohio State University, 2022, Health and Rehabilitation Sciences

Stroke survivors with poststroke depressive and anxiety symptoms (PSDAS) have increased mortality and decreased functional independence. Occupational therapy (OT) providers offer valuable insight to the treatment of PSDAS, as OT providers are uniquely qualified to address physical and mental sequelae of stroke. However, only approximately half of OT providers report feeling satisfied with the mental health care they provide to stroke survivors. Rehabilitation after a stroke often begins in inpatient rehabilitation (IPR) and therefore investigation of OT mental health care provided in this setting is warranted. This dissertation encompasses a mixed methodological examination of OT mental health care delivery to stroke survivors in an academic medical center IPR setting. Chapters 2 and 3 present the results of retrospective electronic health record (EHR) analyses of OT provider PSDAS documentation. Descriptive quantitative and directed content EHR analyses were performed to characterize practice for OT providers addressing PSDAS in IPR. Ninety of 213 (42%) stroke survivors admitted to the IPR facility during the 2019 review period were included in the EHR analyses. The results of the descriptive quantitative analysis determined that OT providers (N=23) did not perform any objective PSDAS screens, nor were any goals written to target reduced PSDAS. There were two instances of provider referral; one provider referred to rehabilitation psychology only and another provider referred to both rehabilitation psychology and the attending physiatrist. For the directed content EHR analyses, treatment strategies documented by OT providers were mapped to interventions in an evidence-based review published in the American Journal of Occupational Therapy for addressing emotional challenges after stroke. OT providers documented PSDAS interventions among 60 stroke survivors with PSDAS, 67% of included patients. Supportive techniques, including empathetic listening and th (open full item for complete abstract)

Master of Science, The Ohio State University, 2022, Anatomy

Practitioners and educators continually evaluate alternative teaching methodologies to increase the learning of anatomical and clinical based skills. Traditionally, anatomy and clinical skills are taught separately to students in both physical and occupational therapy curricula. Formaldehyde preservation is seen as the primary embalming methodology within anatomical education but has been described as lacking when utilized within educational institutions. This study aimed to evaluate the integration of clinical skills into anatomical education using an alternative preservation technique called Imperial College London- Soft Preservation (ICL-SP). Physical and occupational therapy students completing the Musculoskeletal Anatomy course were presented with donors preserved with either formaldehyde or ICP-SP. The students were tasked with traditional dissection and with performing clinical test on the different donors followed by the completion of a questionnaire. The inclusion of ICL-SP donors showed there was a better model for the representation of the vascular system and the nervous system without showing significant deficits in any other categories when compared to formaldehyde. The integration of clinical skills and anatomical curriculum presented increased student perceived understanding of associated anatomy (p < 0.05), gave better understanding of how anatomy is important to their professions (p < 0.05) and increased motivation to learn anatomy (p < 0.05). Students noted ICL-SP was more beneficial for clinical skill procedures (Lachman's test: p < 0.05; Valgus Stress Test of the Elbow: p < 0.05). In conclusion, the integration of clinical skills into anatomical education can potentially provide student learning with higher confidence performing clinical skills and may be complemented by the utilization of the new ICL-SP methodology.

Doctor of Education (Ed.D.), University of Findlay, 0, Education

Occupational therapy is a profession that assists individuals to engage in daily activities and encourages people to live life to its fullest (AOTA, 2018). Complex trauma, such as repeated physical, emotional, or sexual abuse, and intense emotion, including anxiety, depression, anger, sadness, etc, affect individuals across the life span and impacts their daily occupational performance. Occupational therapists should be including holistic evaluations and interventions related to sensory modulation with this population However, due to multiple barriers in the medical model environment this may not be occurring. This study sought to understand how level two occupational therapy students perceive their ability to carry over sensory-based interventions and gathering holistic information during the evaluation from a community-based setting to a medical model setting. Qualitative research data was gathered using an online survey deployed to a convenience sample recruited through The University of Findlay Occupational Therapy Program. The results indicated that all twelve participants completed holistic evaluations and included sensory-based interventions in the community-based settings; while only seven of the twelve felt they were able to use holistic approaches during evaluation in the medical model setting. Also, in the medical model setting six participants did not use sensory-based approaches and six used these approaches with some of their clients. This study identified significant findings regarding the perceptions of barriers to not completing these holistic interventions or evaluations. The barriers implicate that the profession may not be addressing complex trauma and intense emotions to the full potential within the medical model setting effectively and this could indicate that the profession is not completely fulfilling the vision, scope of practice, or distinct value.

Bachelor of Arts, Walsh University, 2021, Honors

Cerebral palsy (CP) is a life-long disorder, therefore, people diagnosed with it need to find the best treatment plan and long-term care. There are several different routes for treatment and animal-assisted therapy (AAT) could potentially be found to significantly impact someone with CP as it has been found to provide benefits to other people (Nepps et al., 2014; Tsai et al., 2010; and Velde et al., 2005). This study looks at how occupational therapists, physical therapists, and students studying to become therapists view AAT, in general, and, specifically, how they view AAT as an intervention for treatment with patients who have been diagnosed with CP, which has not been studied before. This study recruited graduate students from Walsh University and licensed therapists to complete a survey. Among what was discovered was that knowledge of AAT's use with CP patients was significantly associated with perceived effectiveness and the impact of AAT on CP patients' feelings was significantly correlated with the likelihood of future use of AAT with CP patients. Although more research is needed, the results of the current research serve as a promising outlook on the effectiveness and impact of AAT and the likelihood of AAT being used with CP patients.

Bachelor of Science (BS), Ohio University, 2021, Translational Health

An increasing percentage of the population of children are affected by autism spectrum disorders (ASD). Children with ASD often have difficulty interacting with others and deviating from routine, which can negatively impact the quality of their lives. The purpose of this study was to examine the effects of proprioceptive occupational therapy interventions on children with ASD. The retrospective case study variables obtained from patient records include demographics, occupational therapy appointment observations, and functional independence and interaction with the environment observations (e.g., eye contact, speech production, facial expressions). Children with ASD (N= 4; 3±0.82 years), were provided proprioceptive input during occupational therapy appointments (such as deep pressure, heavy work tasks, tactile input), and the occupational therapist noted the child's behavior. Speech production, eye contact, greeting hello/goodbye, taking turns, task completion, functional use of play items, facial expressions, and impulse control were ranked by the occupational therapist on scale of 1 (dysfunctional) to 4 (fully functional). The scores were combined to give a total percent functioning/engagement with the environment and others. The average change in the percent functioning/engagement from the first to last observed session was +2.1%. By recording these observations at each appointment, changes were tracked from session to session. Each subject showed improvement, by an average of +1, in at least one variable (e.g., eye contact, task completion, taking turns, and functional use of play items). There is no clear method of delivery to garner the best outcomes in those with ASD. Types, modes, and individual symptoms need further exploration to yield pertinent and reproducible interventions for increased positive functioning in those with ASD.

Bachelor of Science, Wittenberg University, 2019, Psychology

Knowledge on the significance of therapeutic alliance in pediatric occupational therapy would allow occupational therapists (OTs) to provide more effective care to children. This study investigated the correlation between therapeutic alliance for OTs and both child patients and their parents, and therapeutic progress of children. The study also investigated the correlation between therapeutic alliance among these individuals and family adherence. Twenty-five parents participated, reporting their therapeutic alliance with the OTs, as well as the child-therapist alliance. Four OTs reported on their own alliance with child patients and their parents, as well as progress of the child on OT goals. Both parents and OTs reported on adherence. Results showed that with the parent-therapist therapeutic alliance, therapist report of bond and collaboration were both significantly associated with therapeutic outcome of the child client and family adherence from the therapist perspective. Results also showed that with child-therapist therapeutic alliance, parent report of bond and collaboration were both significantly associated with therapeutic outcome of the child and therapist report of collaboration was associated with therapeutic outcome of the child and therapist report of family adherence. This study contributes to a better understanding of factors that correlate with better patient progress in pediatric occupational therapy.

Doctor of Philosophy, The Ohio State University, 2020, Health and Rehabilitation Sciences

Stroke is one of the leading causes of severe long term-disability in the United States, primarily due to the secondary complication of weakness or paralysis in one half of the body called hemiplegia. Action observation (AO) is an intervention technique for hemiplegia that involves watching a video of another person performing a task, and then physically performing the same task. Repetitive task practice (RTP) is another intervention that utilizes repetitive physical performance of a task. Both have been found to be effective individually to decrease UL motor impairment and increase UL functional performance for patients with hemiplegia, but a novel combination of these two interventions has not been explored before. In the progression of the scientific process for developing novel research questions and guiding study procedures, feasibility and pilot (Phase II) studies answer essential questions about the conduct of a trial, study procedures, and scientific assessment. Within Thabane's categorization system, the four main reasons for completing feasibility and pilot studies are 1) process, 2) resources, 3) management, and 4) scientific. The novel combination of AO and RTP to decrease the effects of post stroke UL hemiplegia has not been studied before, and needs to be investigated in a Phase II feasibility and pilot study prior to completing a Phase III Randomized Control Trial (RCT). The objective of this dissertation was to complete a pilot randomized controlled single-blinded, parallel-group study comparing AO plus RTP to Placebo plus RTP. This trial aims to determine 1) the process feasibility (retention rate, recruitment rate, enrollment, and understanding of study questionnaires, follow rate, and subject compliance with treatment protocol), and scientific feasibility (safety/ occurrence of adverse events), 2) the scientific reason for feasibility of response to intervention in UL motor impairment outcomes, 3) the scientific reason for feasibility of re (open full item for complete abstract)

Doctor of Philosophy, The Ohio State University, 2019, Health and Rehabilitation Sciences

Stroke remains a leading cause of long-term disability in the United States. While significant medical advances have led to decreased stroke mortality rates, incidence of stroke has remained roughly the same. This has resulted in an increased number of stroke survivors living with upper extremity (UE) hemiparesis requiring occupational therapy (OT). Despite a significant increase in the number of stroke rehabilitation trials over the past decade, a recent systematic review and meta-analysis found insufficient evidence that any experimental interventions were superior to conventional rehabilitation for improving UE motor function post-stroke. While it may be true that novel interventions are no more effective than conventional rehabilitation, an equally probable reason is the large disparities in dosage, frequency, and interventions used across control groups in clinical trials. In the stroke rehabilitation literature, control interventions are often referred to as standard care or conventional rehabilitation. Concerningly, the majority of stroke rehabilitation trials lack an empirically based rationale for how control interventions are comparable to standard care rehabilitation. Inadequate descriptions of, and rationales for, control interventions across stroke rehabilitation trials are significant barriers to the advancement of evidence-based practice. Without a true understanding of `standard care' in real-world practice, there is no way to know if the control intervention is truly comparable. There is an urgent need to characterize `standard care' rehabilitation to inform control intervention development and improve interpretability of clinical trial results. The purpose of this study was to investigate current practices of occupational therapy practitioners in outpatient rehabilitation settings to address upper extremity hemiparesis in adult stroke survivors. In Chapter 2, a cross-sectional e-mail survey was sent to OT practitioners across the United States (open full item for complete abstract)

Doctor of Education (Ed.D.), University of Findlay, 2019, Education

A classroom intervention increasing in popularity is the use of stability balls in lieu of traditional classroom chair seating. Stability balls are promoted as an effective alternative to chairs at a class wide level, yet there are few published studies documenting positive outcomes in academic achievement and on-task behavior. The purpose of this descriptive quantitative study was to investigate the outcomes on academic achievement and on-task behavior when replacing regular classroom chairs with stability balls. Student and teacher perceptions were also studied to determine if students were aware of any benefits the stability balls may offer. Using an A-B-C design, students in a second-grade class participated in a baseline, intervention, and choice phase while the researcher used observational data and STAR Math data to make judgements on any academic achievement and on-task behavioral gains made during the research period. Students used the stability balls during the intervention phase and had the option of a stability ball or a regular classroom chair during the choice phase. Stability balls did make a large increase on the amount of on-task behavior shown in the second-grade students, however, academic gains were not made in the treatment group as they were in the control classes (classes using regular chairs). Students were given a survey to determine levels of enjoyment and perceptions of gains made when using the stability balls. Some students participated in student interviews with the researcher to further determine understanding of the stability balls and academic and on-task gains. Students clearly enjoyed using the stability ball and most reported wanting to continue using the stability ball after the research commenced. While some students made a connection between stability balls and academic and on-task gains, most students were not able to make the connection. Teachers who participated in the study were given a teacher survey to determine student e (open full item for complete abstract)

Bachelor of Arts, Walsh University, 2019, Honors

The purpose of this study was to examine what differences exist between the items included in the Attention Deficit/Hyperactivity Disorder (ADHD) and Sensory Processing Disorder (SPD) diagnoses with the goal of identifying information for a future differential diagnostic tool. Past research has often identified SPD as part of ADHD instead of a separate diagnosis. This study delineates the diagnostic criteria of each. Factor analysis was completed on data collected from a survey distributed to students attending Walsh University, in North Canton, Ohio, to determine which SPD symptoms exclusively align with SPD or exclusively with ADHD and which ADHD symptoms align exclusively with ADHD or SPD. The results of this study 13 SPD items (SPD1, 2, 3, 4, 5, 6, 7, 8, 14, 17, 18, 19, 20), and 11 ADHD items (ADHD1, 2, 3, 4, 5, 7, 8, 9, 10, 11, 13) clearly aligned with their own factor making them good differentiating items. These items distinguish differences in symptoms between the two diagnoses which would be beneficial in future research and diagnostic tools focused on ADHD and SPD.

Master of Science in Electrical Engineering, Cleveland State University, 2018, Washkewicz College of Engineering

Rehabilitation exercises needs have been continuously increasing and have been projected to increase in future as well based on its demand for aging population, recovering from surgery, injury and illness and the living and working lifestyle of the people. This research aims to tackle one of the most critical issues faced by the exercise administers-Adherence or Non-Adherence to Home Exercise problems especially has been a significant issue resulting in extensive research on the psychological analysis of people involved. In this research, a solution is provided to increase the adherence of such programs through an automated real-time assessment with constant visual feedback providing a game like an environment and recording the same for analysis purposes. Inertial sensors like Accelerometer and Gyroscope has been used to implement a rule-based framework for human activity recognition for measuring the ankle joint angle. This system is also secure as it contains only the recordings of the data and the avatar that could be live fed or recorded for the treatment analysis purposes which could save time and cost. The results obtained after testing on four healthy human subjects shows that with proper implementation of rule parameters, good quality and quantity of the exercises can be assessed in real time.