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Hill, Melinda SPhysical Activity Behavior and Health-Related Quality of Life in Parkinson's Disease Patients: Role of Social Cognitive Variables
Doctor of Philosophy, The Ohio State University, 2016, Kinesiology
Introduction: Parkinson’s disease (PD) is a chronic neurodegenerative disease of the brain, characterized by motor symptoms–tremor, rigidity, bradykinesia, slowness/smallness, and postural instability– as well as non-motor symptoms including anxiety, depression, sleep disorders, and cognitive deficits. The average age of onset for PD is 60, with earliest patients diagnosed at age 18. One out of 100 people over age 60 have PD. PD patients’ symptoms increase over time and medication does not slow down the progression of PD. Physical activity (PA) is one lifestyle behavior that may slow the progression of the disease and improve the quality of life of PD patients by maintaining their ability to accomplish functional activities of daily living and preserve their independence. However, knowledge of the motivational factors associated with PA in PD patients remains limited. Methods: The current study aimed to i) explore the relationship of select Social Cognitive Theory (SCT) constructs: self-efficacy (SE), outcome expectations (OE), and self-regulation (SR) with PA and health-related quality of life (HRQoL); ii) explore the relationship between PA and HRQoL; and iii) determine if SCT constructs mediate the relationship between PA and HRQoL in PD patients. Results: In this online cross sectional survey of 500 idiopathic PD patients, participants self-reported an average of just over 200 minutes of moderate to vigorous physical activity per week. SE and SR were the most significant predictors of PA. SE and OE were predictive of physical HRQoL, and the addition of BMI, age, Hoehn and Yahr Score, and total number of comorbidities more than doubled the amount of variance explained. To a smaller extent, SE, OE, and SR were predictive of mental HRQoL. SCT correlates mediated the relationship of PA to HRQoL. Discussion: The study population represented a population of PD patients with a high interest in physical activity. Self-reported average weekly moderate-to-vigorous physical activity (MVPA) was much higher than expected. Future studies should attempt to validate MVPA with some type of exercise monitor that would not be sensitive to tremor or other PD specific considerations. Analysis of self-regulation subscales may provide insight into why SR was predictive of physical HRQoL when modeled alone, but not with the other SCT correlates. A deeper evaluation of outcome expectation subscales might also provide a further explanation of why OE was predictive of MVPA when modeled alone, but not with SE and SR. Physical activity was a significant predictor of both mental and physical HRQoL. The covariates BMI, age, Hoehn and Yahr Score, GDS depression score, and total number of comorbidities significantly added to the explanatory power of the relationship between PA and physical HRQoL. These factors should be considered both potential mediators and moderators in future studies in the PD population.

Committee:

Brian Focht, PhD (Advisor)

Subjects:

Behavioral Sciences; Health Sciences; Kinesiology; Physical Therapy; Rehabilitation

Keywords:

Physical Activity; Health Related Quality of Life; Parkinsons Disease; Social Cognitive Theory Constructs

Leach, Eric ThomasT.R.A.N.S.I.T. Electrical Stimulation to Improve Muscle Quality In Older Individuals: A Case Series
Bachelor of Science (BS), Ohio University, 2016, Biological Sciences
The world’s elderly population is increasing and healthcare costs are outpacing this growth. As people age, their muscles progressively weaken, often leading to physical disabilities and functional limitations later in life. Eventually, muscle weakness can interfere with a person’s ability to complete everyday activities, such as bathing, walking a few blocks down the road, or safely getting up from a chair. For elderly people, maintaining or improving muscle strength helps to maintain the ability to safely complete daily tasks. This ultimately leads to decreased healthcare costs and sustained independence. There are many well-established methods to improve muscle function in elderly people, including endurance exercise, strength training, and flexibility training. All of these modalities of exercise work through a variety of mechanisms to induce specific training effects that enhance muscle function. However, there are other forms of exercise that may provide unique benefits to muscle function that have been less extensively studied; chiefly, sprint exercise. Sprint exercise has been shown to promote an adaptation that has yet to be seen in response to any other form of exercise: improved calcium release from the sarcoplasmic reticulum of skeletal muscle. This adaptation is significant because calcium release within the muscle is an essential step in the process of muscle contraction. Surprisingly, however, sprint exercise is not even mentioned by the American College of Sports Medicine in its recommendations for older individuals. This is likely due to concerns that it would not be well-tolerated due to risks related to high intensity exercise and the stress that it places on the joints. Consequently, it may be of great benefit to develop a physical therapy intervention that could mimic the effects of sprint training for people that cannot safely execute sprint exercise. Such an intervention could be especially beneficial for older individuals, as traditional sprint exercise is seldom recommended. Russ and colleagues recently developed a treatment protocol that induces muscular adaptations in young people that are similar to those caused by sprint exercise. This protocol is based on an established physical therapy intervention known as neuromuscular electrical stimulation (NMES), which works by sending electric current through electrodes to stimulate nerves and activate specific muscles. NMES has been used in both laboratories and physical therapy clinics for decades and is commonly used as a treatment to improve muscle strength or endurance. The protocol developed by Russ et al., hereafter referred to as T.R.A.N.S.I.T. (Therapeutic Rapid Activation of the Neuromuscular System for Interval Training), applies NMES technology in a new way that improves peak rate of calcium release within the muscle (an essential step in muscle activation). This is of particular importance because improved calcium release has only been observed in response to sprint exercise training. Because calcium release declines in aging muscle, we expect that T.R.A.N.S.I.T. will improve muscle function more in elderly people than in young people. Therefore, for my thesis project, I proposed to test the effect of T.R.A.N.S.I.T. on muscle quality (muscle force / muscle size) in older individuals. Due to specific changes in muscles that occur with age, we expected that T.R.A.N.S.I.T. would be of even greater benefit to older individuals than it was to younger individuals.

Committee:

David Russ (Advisor)

Subjects:

Biology; Biomedical Research; Physical Therapy; Physiology; Rehabilitation

Keywords:

muscle quality; older individuals; SR calcium release; sprint training; interval training; excitation-contraction coupling; muscle dysfunction; sarcopenia

Ezechukwu, Rebecca NneomaUsing youth perspectives to examine antisocial behavior: A qualitative investigation of the juvenile offender in context.
Doctor of Philosophy, Miami University, 2014, Psychology
The purpose of this project was to describe the juvenile offender in context to highlight areas for intervention with this vulnerable population. Youth offenders are a population that face challenges above and beyond the typical challenges of adolescence because many of the factors related to youth offending are intertwined with typical developmental processes shaped by the values and expectations that make up the youth’s cultural context. Because the issue of recidivism is key to designing and delivering effective interventions, it is important to understand the contextual factors that influence amenability to intervention, as well as the sustainability of interventions that are received. In this study, I interviewed five male offenders remanded to a juvenile corrections rehabilitation program for youth with felony offenses. Using youth perspectives, I sought to provide answers to the following questions: What are some of the life experiences among male juvenile offenders that contribute to antisocial behavior? How do developmental and contextual influences affect how youth perceive the events throughout their lives? How might these experiences account for youth responses to intervention and other system expectations while in a juvenile corrections rehabilitation facility? Each participant provided detailed accounts of his experiences. Those experiences often were described as a function of the interactions between each youth and those in his social context—his family, peer, school, and juvenile justice environments. Depending on the unique factors present in his background, each youth interpreted even similar experiences differently. Those differences in perspective strongly influenced each individual’s ability to comment on his self-image, relationships, criminal behavior, and intervention efforts. I present several implications and recommendations for intervention with the adolescent offender based on these youth perspectives. I contend that the nature of social interactions within youth contexts shape experience a great deal and thus, using contextualized understandings of behavior can improve intervention efforts with adolescents. Additionally, using youth perspectives to raise research questions and drive intervention recommendations may help transmit egalitarian values to youth and supplement traditional methods of correctional system evaluation and intervention.

Committee:

Larry Leitner, PhD (Committee Chair); Amy Garbrecht, PsyD (Committee Member); Glenn Muschert, PhD (Committee Member); Vaishali Raval, PhD (Committee Member); Virgina Wickline, PhD (Committee Member)

Subjects:

Behavioral Sciences; Developmental Psychology; Rehabilitation; Social Research

Keywords:

Adolescents; juvenile delinquency; incarcerated populations; social context; intervention; youth rehabilitation; qualitative research

Snyder, Carrie L.The System of Least Prompts to Promote Independence in Activities of Daily Living for Older Adults
Master of Science in Applied Behavior Analysis, Youngstown State University, 2011, Department of Psychology
As we age, certain predictable but avoidable changes occur. One change being that older adults come to rely on others for more and more of their daily care. Maintaining functional independence, to the extent that it's desirable, increases life satisfaction. The goal of this study was to increase independent dressing behavior for six residents diagnosed with cognitive impairments. A multiple baseline design was used to evaluate the effects of a brief training procedure for nursing staff in an assisted living facility to implement the System of Least Prompts (SLP) procedure. Generalization of independent behavior to an untargeted ADL was also assessed. A significant increase in independent dressing behavior and generalization of independent behavior to an untrained ADL was evident. Notably, resident dressing time did not increase following implementation of the SLP procedure. These results provide evidence of the effectiveness and efficiency of SLP in increasing independent behavior for older adults with cognitive impairments.

Committee:

Michael Clayton, PhD (Advisor); Rocio Rosales, PhD (Committee Member); Jane Kestner, PhD (Committee Member); Julie Boron, PhD (Committee Member)

Subjects:

Aging; Behavioral Sciences; Gerontology; Health Care; Inservice Training; Nursing; Occupational Therapy; Psychology; Rehabilitation

Keywords:

Prompting; Increase independence; Older Adults; System of Least Prompts; Activities of Daily Living (ADLs); Dressing Independence; Prompt Heirarchy; Staff training; Assisted Living Facilities; Aging; Applied Behavior Analysis

Hoch, Matthew C.Effect of Functional Fatigue on the Soleus Hoffmann Reflex in Subjects with Functional Ankle Instability
Master of Science (MS), Ohio University, 2008, Athletic Training Education (Health and Human Services)
Arthrogenic muscle inhibition of the soleus has been identified in subjects reporting functional ankle instability (FAI). This investigation sought to determine if functional muscular fatigue creates acute changes in soleus motoneuron activation that may account for alterations in dynamic ankle stabilization. All subjects completed a functional fatigue protocol and a 10-minute rest session. H-reflex recruitment curves were used to identify a stimulus that elicited submaximal H-reflexes (H20%Mmax) at 20% of the maximum muscle response. H20%Mmax was recorded prior to and every 5min following the fatigue protocol. A 2 x 2 x 6 repeated measures ANOVA was used to compare peak-to-peak H20%Mmax across time, intervention, and condition. A main effect was observed for time by intervention. The fatigue protocol caused a decrease in peak-to-peak H20%Mmax compared to the resting session. This indicates that fatigue could create a disruption in dynamic ankle stabilization; however, it does not explain sensations of instability exhibited by patients with FAI.

Committee:

Andrew Krause, PhD (Committee Chair); Chad Starkey, PhD (Committee Member); Roger Gilders, PhD (Committee Member)

Subjects:

Health Care; Rehabilitation; Sports Medicine

Keywords:

functional ankle instability; fatigue; soleus; sprain; hoffmann reflex

Karabin, Beverly LynnStudent Engagement for College Students with the Hidden Disability of Orthostatic Intolerance
Doctor of Philosophy, University of Toledo, 2009, Higher Education
This study described the factors that contribute to engagement patterns of college students with the hidden health-related disability of orthostatic intolerance. Specifically, this study used a qualitative methodology and collective-case study design to explore the categories of campus physical, institutional, academic and social engagement from a student perspective. Guided by theories from college student development, student engagement, and identity development in both the disabled and non-disabled, the research also examined student self-disclosure, self-advocacy and identity. The data collection method consisted of two in-depth interviews with five undergraduate college students over one semester and participant observation of each student in their college setting over several on-campus site sessions. Finding from the study indicate that these students encountered a number of barriers affecting all categories of engagement. Themes included lack of student centeredness, roommate difficulties, rigid institutional and classroom policies, curriculum pressure, financial penalties, lack of understanding of hidden disability, perception of lack of legitimacy of the disorder among administrators, faculties and peers, social isolation, conflicting values from peer regarding parties and alcohol use, and limited physical energy to engage on all levels. Factors that played an important role in student engagement included self-disclosure, self-advocacy, integration of disability identity, and positive faculty interactions. Although an exploratory study, it is clear that these students with hidden disabilities need assistance from higher education officials to provide a successful campus engagement experience.

Committee:

Lynne Hamer, PhD (Committee Chair); Anne Hornak, PhD (Committee Member); Blair Grubb, MD (Committee Member); Jane Ransom, PhD (Committee Member)

Subjects:

Education; Health Care; Higher Education; Nursing; Rehabilitation

Keywords:

student engagement; college students; hidden disability; orthostatic intolerance

Dutta, AnirbanDevelopment of an Electromyogram-Based Controller for Functional Electrical Stimulation-Assisted Walking After Partial Paralysis
Doctor of Philosophy, Case Western Reserve University, 2009, Biomedical Engineering

Paralysis can be caused by an injury to the spinal cord that may partially or completely interrupt communication between the brain and the muscles. If the paralyzed muscles below the level of injury remain innervated then they can be activated by applying small electrical currents in a process known as Functional Electrical Stimulation (FES). The electromyogram (EMG) is the time history of the electrical activity of a muscle that can be used to find its level of activation. This dissertation investigated the use of EMG as a command source for FES-assisted ambulation after incomplete spinal cord injury (iSCI). The synergistic modulation of the volitional EMG was used to identify the intent to transition from step to step even when partially paralyzed muscles were too weak to produce enough moment at the joint to produce effective push-off.

This work has shown that: 1. The controllability of the surface EMG from a partially paralyzed muscle from individuals with iSCI during a visual pursuit task was similar to able-bodied subjects. 2. Surface EMG from the ipsilateral erector spinae and medial gastrconemius consistently performed well to identify the intent to step in able-bodied and iSCI subjects. 3. Spatio-temporal gait parameters with EMG-triggering were at least as good as with standard switch-triggered FES for iSCI subjects in spite of the differences in their injury levels, degree of preserved volitional control, and muscle set chosen for stimulation. 4. EMG-triggering improved the coordination of the FES-assisted iSCI gait during stand-to-walk transitions to levels similar to able-bodied gait. 5. Command sources can be selected objectively prior to implementing a fully implantable EMG-triggered FES system for walking. 6. The optimal number of command sources, features, and signal processing techniques can be determined to further improve the accuracy of EMG-triggering.

More research is needed to optimize the implantation site for EMG recording electrodes and define the technical requirements for a clinically practical EMG-triggered system to facilitate ambulation after iSCI.

Committee:

Robert Kirsch, Ph.D. (Committee Chair); Ronald Triolo, Ph.D. (Advisor); Patrick Crago, Ph.D. (Committee Member); Roger Quinn, Ph.D. (Committee Member)

Subjects:

Biomedical Research; Computer Science; Engineering; Health Care; Neurology; Rehabilitation

Keywords:

gait event detector; electromyogram; functional electrical stimulation; gait, spinal cord injury; biomechanics; neuroprosthesis; controller

Blana, DimitraFeedback Control of a High Level Upper Extremity Neuroprosthesis
Doctor of Philosophy, Case Western Reserve University, 2008, Biomedical Engineering
The main focus of this study is controller design using a model-based approach, and implementation in a high level upper extremity neuroprosthesis. This is a system that aims to restore upper limb motor function to individuals who have suffered a spinal cord injury at the highest cervical level (C1-C4), and thus have lost voluntary control of most of the shoulder and arm muscles. To determine the optimal electrode set for this system, given the limited number of available stimulating channels, a musculoskeletal model of the upper extremity was used to run a large number of simulations and evaluate all the candidate electrode sets. The model was customized to represent a tetraplegic subject with an FES system, and the optimal electrode set was the one that allowed the model to successfully perform the largest number of movements. Subsequently, a combined feedforward-feedback controller approach was developed and tested first in a simplified arm model with six muscles and two degrees of freedom. In spite of its small scale, the model included an accurate muscle model, redundancy in the number of muscles, and kinematic coupling. It demonstrated the excellent trajectory tracking performance of the controller, even in the presence of considerable muscle fatigue and external forces. Next, the same design, augmented by a controller for shoulder stability was tested in a large-scale arm model with 22 muscles and five degrees of freedom, including a complete glenohumeral joint. In addition to its tracking ability, this controller was able to ensure shoulder stability in all cases of external disturbances. Finally, the controller was implemented in one subject with high level tetraplegia, and an adaptation method was developed to adjust the controller parameters according to the characteristics of the specific individual. In order to handle the redundancy of the upper limb, adaptation was performed using co-contraction of antagonistic muscles, and activation patterns among shoulder stabilizing and moving muscles. When tested in the shoulder and elbow of the subject, the controller achieved adaptation and allowed the execution of the desired movements.

Committee:

Robert Kirsch (Committee Chair); Patrick Crago (Committee Member); Antonie van den Bogert (Committee Member); Musa Audu (Committee Member); Wyatt Newman (Committee Member)

Subjects:

Biomedical Research; Rehabilitation

Keywords:

biomechanics; functional electrical stimulation; musculoskeletal modeling; feedback control

Schrader, KateKnee Surgery: Total Knee Replacement or Partial Knee Replacement
B.S. in Exercise Science, University of Toledo, 2011, Exercise Science
Knee replacement surgery is a solution for some people with knee injuries. Osteoarthritis is a common reason for surgery, but surgery is only considered after other treatments are found to be ineffective. There are two types of surgery that may be considered for a patient: total knee replacement and partial knee replacement. From a month before surgery, the patient begins preparing for an intense procedure; after surgery, the patient recovers using follow up care and physical therapy. The details as well as the risks and benefits of each surgery are discussed to try to conclude which surgery is better for the patient.

Committee:

Doris Woods, PhD; R.K.T. (Advisor)

Subjects:

Aging; Anatomy and Physiology; Health; Kinesiology; Medicine; Physical Therapy; Rehabilitation; Surgery

Keywords:

total knee replacement; total knee arthroplasty; partial knee replacement; partial knee arthroplasty; surgery; osteoarthritis; physical therapy; rehabilitation; risks; benefits; recovery

Krebs, Kathleen A.Art Therapy Used to Enhance Steps One, Two and Three of a Twelve-step Recovery Program for Addictions Treatment
Master of Arts, Ursuline College, 2008, Art Therapy and Counseling
This grounded theory investigates whether those recovering from drug or alcohol addiction in a 90 day treatment center will benefit from group art therapy that focuses on completion of the first three steps of A.A., a primary goal of this facility as well as one of the most common treatment methods in the United States for drug and alcohol addiction. Members were asked to create art work using a different media (collage, drawing, clay and painting) for each session which corresponded to the first Three Steps of A.A., for a total of twelve sessions. Concepts of powerlessness, belief in a Higher Power, and turning their will and their lives over to a Higher Power were explored and important themes, insights, self-awareness and spirituality were discovered as well as preferences for the various media offered. Though the steps were an important topic of conversation as it related to clients artwork, the exciting element of study came through their engagement with the image created and how it mirrored where they were in the recovery process.

Committee:

Gail Rule-Hoffman, M.Ed., LPC-S, ATR-BC, LICDC (Committee Chair); Ronna G. Posta, LPCC, LICDC (Advisor)

Subjects:

Mental Health; Psychology; Psychotherapy; Rehabilitation; Social Psychology; Therapy

Keywords:

art therapy; addictions treatment; substance abuse; twelve step recovery; psychology; mental health; counseling

Braun, Kaitlyn N.Single-Leg Power Generation in Adolescent & Young Adult Athletes Returning to Sport Following Anterior Cruciate Ligament Reconstruction
Master of Science in Exercise and Health Studies, Miami University, 2010, Physical Education, Health, and Sport Studies
The increase in adolescent and young adult sport participation has contributed to a rapid rise in sports-related knee injuries, particularly anterior cruciate ligament (ACL) injuries. Even following surgical reconstruction and comprehensive rehabilitation, asymmetries in performance of the injured knee may increase the risk of future injury. Muscle power is an important representation of an athlete‘s abilities to perform various demands imposed in sports; however, relatively little research has examined measures of single leg power in athletes following ACL reconstruction. The purpose of this study is to examine single leg power generation in adolescent and young adult athletes following ACL reconstruction. A portable force platform was used to compare power generation of the injured and uninjured legs during single leg hopping. The findings from this study offer clinical implications for future rehabilitation interventions and prevention of future injury.

Committee:

Valerie A. Ubbes, PhD, CHES (Advisor); Susan C. Lipnickey, PhD (Advisor); Randal P. Claytor, PhD (Committee Member)

Subjects:

Health; Rehabilitation; Sports Medicine

Keywords:

single leg power; power generation; ACL; ACL reconstruction; adolescent; young adult; athletes

Haworth, Joshua LewisNonlinear Analysis of Proprioceptive Training Induced Changes in Postural Control on a Dynamic Surface
Master of Science in Exercise and Health Studies, Miami University, 2008, Physical Education, Health, and Sport Studies
This research seeks to describe the postural sway performance of participants during quiet stance on a dynamic surface, longitudinally throughout a balance training program. A nonlinear method of data processing was presented, along with traditional linear statistics, as an effective movement descriptor. COP was measured on a compliant surface atop a force plate, during each laboratory visit. Results show no change in COP range, change in variability only in the anteroposterior direction, and reductions in both velocity and LyE in the mediolateral and anteroposterior directions. Reduced LyE values indicate a more periodic (self-similar) structure within the COP path. It appears that the participants were able to develop a more calculated approach to the maintenance of balance by moving both more slowly and with a more regular movement pattern. Support for the use of both a dynamic surface and a nonlinear analysis for the evaluation of postural sway has been provided.

Committee:

Mark Walsh (Advisor); Thelma Horn (Committee Member); Dean Smith (Committee Member)

Subjects:

Behaviorial Sciences; Biomedical Research; Rehabilitation; Sports Medicine

Keywords:

postural sway; nonlinear analysis; dynamic surface; balance; training; proprioception; balance; center of pressure; Lyapunov exponent; postural control; emergent behavior

Salameh, AhlamGraded Exercise Stress Testing: Treadmill Protocols Comparison Of Peak Exercise Times In Cardiac Patients
Master of Science, University of Akron, 2009, Physical Education-Exercise Physiology/Adult Fitness

Introduction and Purpose: Exercise is one of the frequent physiological stresses that can result in cardiovascular abnormalities that are not present at rest and it can help to establish a good idea on the sufficiency of cardiac function2. The Optimal exercise stress test protocol should consider the reason of the test, the results that are expected from the test, and the individuality of the population that is being tested18, 5 The duration of the optimal test should be approximately 10 to 12 minutes14.The purpose of this research was to compare a new protocol (ARP protocol) capability in categorizing patients into high or low functional capacity categories prior to exercise with Bruce and Modified Bruce protocols

Materials and Methods The study consisted of a sample of 73 Summa cardiac rehabilitation phase II patients from 1996 to date. Clinical and demographic data was abstracted from hard-copy and electronic cardiac rehab clinical files and were entered into a separate electronic Microsoft Access research database. Statistical analysis was conducted on SPSS version 16.0. Means, standard deviations and correlation matrices were generated. Multinomial Logistic Regression was incorporated to evaluate if there was a significant difference between treatments while controlling for peak estimated work output in METs and age at test administration.

Results: The study consisted of 73 patients, 29 female and 44 male. The sample has mean age of 67.06 years (SD = 10.37; range = 43.39 years). The ARP is predicted most accurately (75.8%), while the other protocol, Bruce 53.8% and Modified Bruce 35.7%, are predicted with less accuracy.

Conclusions The Accelerated Ramp Protocol (ARP) has higher accuracy in predicting the maximum work capacities in cardiac patients within the optimal time limit 8 – 12 minutes.

Committee:

Ronald Otterstetter (Advisor)

Subjects:

Health; Health Care; Public Health; Rehabilitation; Sports Medicine

Keywords:

Coronary Artery Disease; METs; Maximum Oxygen Consumption; VO2max; Stress Test; Energy Expenditure; Peak Stress Test Time

Duecker, Jody RMeasurement of Validity for Balance Assessments using a Modified CTSIB Sway Index Versus a Biodex Sway Index
Master of Science in Education, University of Akron, 2013, Physical Education-Exercise Physiology/Adult Fitness
The purpose of the study is to determine the relationship and validity of the Sway Index as measured by the Biodex Balance System (BBS) compared to the Sway Index as measured by the modified-Clinical Test of Sensory Interaction on Balance (m-CTSIB) during a balance assessment protocol. The BBS score is determined by a computer, where the m-CTSIB score is determined subjectively by an individual. Balance is an important consideration when it comes to post-concussion treatments of athletes. To understand deficits or relationships, it is important to understand balance deficits in individuals who have obtained a concussion to determine return to play protocols. It is known that balance is affected following a concussion but clinicians do not always rely on objective measurements to clear participants to return to competition. This study would provide an objective tool that can be incorporated with the other determinants to return to play decisions. It is hypothesized that the Biodex Balance System Sway Index score will positively correlate with the m-CTSIB Sway Index score. Research Questions: 1. Is there a significant difference in stability index scores when comparing different stances among different trials? 2. Is there a significant difference between overall stability index scores when comparing between trials? 3. What is the test-retest reliability of the m-CTSIB protocol on the BBS? 4. Is there a correlation of stability index scores of the four stances between trials? 5. Is there a correlation between the traditional m-CTSIB protocol scores (measured by time held in testing position seconds) and the m-CTSIB scores as measured by the BBS (measured by overall stability index)? Study participants were recruited from The University of Akron campus and any volunteers who participanted through email or sign up sheets. This study will employ all of the participants who consented to the study. All the participants agreed to the criteria in this study they must were tested three times with at least a one week between each trial to collect data. Participants were excluded from the study if they had received a concussion prior to data collection. Before participation all subject signed a consent form that was IRB approved and all assessments were completed within approximately 20 minutes. modified-Clinical Test of Sensory Interaction on Balance Before administering the m-CTSIB the individual scoring and collecting data must have a foam pad (Power Systems Airex Balance Pad 81000), stopwatch, additional spotter, and the m-CTSIB Testing Protocol. The m-CTSIB test is made-up of four 30-second conditions. The participants will stand and perform the following: 1) double leg stances on a solid surface with eyes open and 2) double leg stances on a solid surface with eyes closed, then double leg stances on a foam pad with eyes open and double leg stances on foam pad with eyes closed. Prior to testing, the participant must be instructed to remove shoes and any ankle tape. The individual conducting the test must use a rehearsed script for each participant and undergo extensive training and competency testing before the study begins. This script will provide specific directions for each participant to follow. The participant will be instructed to assume the required m-CTSIB stance by placing their hands on their opposite shoulder and keeping their head up and eyes closed (Onate, Beck, and Van Lunen, 2007). Each foot of the participant will be placed by the administer to ensure consistency. When assessing the stances the time will stop when the participant reaches 30 seconds or the participant opens their eyes, takes a step, lifts their heel off the platform, stumbles, falls, moves hands from shoulders, or grasps the railing. The time for each trial will be added up for measurement an assessed. The maximum time is 2 minutes for all stances. Biodex Balance System (m-CTSIB) The Biodex Balance System (Biodex Balance SD) (BBS) default test for assessing postural instability is the modified Clinical Test of Sensory Integration and Balance. As a result, the m-CTSIB is the protocol that will be utilized in this study. All participants will be tested on the BBS in order to obtain week 1, week 2, and week 3 measurements. Before any data collection is obtained the tester must have proper training and experience in operating the BBS. In addition, the tester must use a rehearsed script for each participant in order to keep all data collection consistent. The tester must first set all of the parameters according to the m-CTSIB protocol. For example, each participant will perform four 30-second trials in a double leg stance. Participants will be instructed to perform the first two trials on a stable surface with 1) eyes-opened and 2) eyes-closed. Next, participants will have to maintain balance on an unstable surface (foam pad) with 1) eyes-opened and then 2) eyes-closed. This data will be saved in the computer system and then printed out for objective measurement assessments. If the participant cannot complete the 30-second trial it is recorded as `fall’ (Biodex Medical Systems, Inc., 2011).

Committee:

Ron Otterstetter, Dr. (Advisor); Carrie Fister, Mrs. (Committee Chair); Stacey Buser, Mrs. (Committee Chair)

Subjects:

Physiology; Rehabilitation; Sports Medicine

Keywords:

Biodex Balance System: m-CTSIB: Sway Index

Hentkowski, Brandon SComparison of Barefoot and Shod Rehabilitation Exercises For Increasing Balance and Intrinsic Foot Strength For Chronic Ankle Instability
MS, Kent State University, 2013, College and Graduate School of Education, Health and Human Services / School of Health Sciences
Although most ankle sprains are resolved with conservative treatment, persistent symptoms might remain and a number of them may develop into Chronic Ankle Instability (CAI). The purpose of this study was to observe whether barefoot training exercises would increase balance and intrinsic foot strength in chronic ankle instability as opposed to shod rehabilitation or no rehabilitation. 20 volunteers (height = 173.85 ± 10.75, weight = 80.16 ± 23.17, age = 21.05 ± 2.39) were recruited and placed into 3 separate rehabilitation protocols. A 3-week rehab protocol focusing on balance training and intrinsic foot muscle strength was performed and measurements were taken for the Athletic Single Leg Test, modified Clinical Test of Sensory Interaction & Balance, Functional Ability and Ankle Measure (FAAM), and Intrinsic Foot Muscle Test (IFMT). Change scores for FAAM were significant between participants who were shod during rehabilitation and control (p = 0.032) and for barefoot rehabilitation and control (p = 0.001). SLO (Single Leg Overall Stability) was significant between barefoot and control (p = 0.02) and trending toward significance for shoes and control (p = 0.051). No difference was seen between barefoot and shod conditions during rehabilitation. Balance training and intrinsic foot muscle strengthening significantly improved self-reported functional and static postural control for CAI and was not dependent on footwear.

Committee:

Kimberly Peer (Advisor); Angela Ridgel (Committee Member); Huston Jeffery (Committee Member)

Subjects:

Rehabilitation; Sports Medicine

Koehler, AmyBiomechanical Modeling of Manual Wheelchair Propulsion: Force Capability Investigation for Improved Clinical Fitting Procedures
Master of Science, The Ohio State University, 2017, Mechanical Engineering
The use of a manual wheelchair (MWC) for everyday mobility is associated with some degree of biomechanical risk, particularly to the user’s trunk and upper extremities (UE), due to the loads placed on the body during propulsion and transfers. An improperly fitting wheelchair can require users to exert higher force or result in awkward positions that can place unnecessary strain on the UE. The combination of repetitive motion, higher peak forces and large joint deflections may result in musculoskeletal problems or injuries. Clinical fitting methodologies are primarily categorical and qualitative and as such are based on the clinician’s perception and previous experience. Therefore, they do not provide a good basis for quantitative prediction of the impact of the wheelchair system on the user’s biomechanics and the associated risk for developing additional musculoskeletal problems. Recent studies have focused on the identification of MWC user UE injuries and clinical prescription adjustments to prevent those injuries. While many adjustments have been supported using experimental data, computational modeling allows for a wider range of test case scenarios and the inclusion of additional factors that cannot be easily estimated in vivo, including the impact of deviations and changes to a wheelchair prescription on the user’s force generation capabilities and more accurate risk identification. A few biomechanical models exist in current literature, but they are not adaptable for widespread use, utilize private software, are subject-specific or are insufficient in analyzing the user and wheelchair system. The MWC Propulsion Model 2017, created in OpenSim software by adapting a previously validated walking biomechanical model for application to a MWC and user, seeks to overcome the limitations of existing models, including accounting for a larger number of degrees of freedom and asymmetry. At this stage, the MWC Propulsion Model 2017 serves as a clinical teaching tool, focusing on the impact of the relative positioning between the axle and user on the force capabilities of the user throughout propulsion. The model is used to study the effect of a range of positions on the user’s muscle moment arms, and thus an indication of forces required for generating propulsion torque, relative to the axle in the superior-inferior, and anterior-posterior directions. Experimental data was collected (N=1) to develop a baseline expectation for the relative amount of change expected for the resultant joint kinematics and muscle moment arms across a set of clinically recommended axle positions. Changes in muscle force, often guided by the force potential that a user has in a given system, are responsible for changes in compressive shoulder joint forces, which may result in shoulder pain or pathology. By optimizing a MWC user’s system that naturally allows them to utilize healthy kinematics and larger, controlled moment arms, especially throughout the middle of the stroke cycle during the propulsive sub-phase, the user’s muscle force necessary to exert propulsive torque can be controlled and stresses can be minimized. This preliminary study indicates that there is potential for these data to serve as a prescription tool for clinicians someday after additional investigation.

Committee:

Sandra Metzler (Advisor); Robert Siston (Committee Member); Carmen DiGiovine (Committee Member)

Subjects:

Biomechanics; Engineering; Health Sciences; Rehabilitation

Keywords:

manual wheelchair biomechanical risk to trunk and upper extremities; computational modeling; biomechanical models

Stempky, Bradley MEffects of Therapeutic Exercise on Functional Performance, Self-Reported Outcomes and Physical Activity in Female Patients with Knee Osteoarthritis
Master of Science, University of Toledo, 2015, Exercise Science
Those who are affected by osteoarthritis (OA) of the knee have shown decreased levels of functional capacity and quality of living. This disability has been linked to decreased levels of strength and physical activity caused by pain or fatigue. Resistance training and increased levels of physical activity have shown to improve these deficits. However, an efficient way to treat a large number of patients by increasing physical activity levels has not yet been determined. Furthermore, it is unknown if a simple, body weight-based exercise program is capable of achieving similar gains as previously-developed, machine-based programs. This thesis examined the effects of a group-based, eight-week therapeutic exercise regimen on functional performance, self-reported outcomes and physical activity levels in elderly female patients with knee OA. The study design for this pilot project was that of an observational study with an embedded case series. Seven patients (mean age = 56.0±5.42) were included in the group exercise regimen. The exercise regimen was performed once a week and included body weight exercises, balancing, and walking. Self-reported outcomes and pain were measured via the Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) and Numeric Pain Rating Scale (NPRS). Functional performance was measured by use of the chair stand test (CST), timed up and go test (TUG), stair climb test (SCT), and the six-minute walk test (6MW). Physical activity levels were measured by use of accelerometers and the UCLA activity scale. All measures were collected one week previous to the eight-week exercise regimen and one week following the exercise regimen. Overall, WOMAC (34.57±15.52 to 23.42±11.96) and NPRS (5.43±1.81 to 2.29±2.93) scores improved as a result of the exercise regimen. Also, the CST (10.21±1.07 reps to 12.00±1.61 reps), TUG (9.65±1.42s to 8.23±1.44s), SCT (13.03±0.70s to 11.6±1.07s) and 6MW (454.09±59.77m to 504.21±54.64m) functional performance measures all improved as a result of the exercise regimen. All measures of self-reported outcomes, pain, and functional performance showed moderate to large effect sizes. However, only the NPRS, CST, and SCT had associated confidence intervals that did not cross zero. In general, physical activity levels did not show overall improvements as a result of the intervention. Only improvements seen in moderate levels of physical activity (211.08±68.57 min to 272.21±97.05 min) were distinguishable from the intervention. In conclusion, the implementation of an eight-week therapeutic exercise regimen resulted in gains in functional performance and self-reported outcomes. However, these gains did not translate to improvements in physical activity levels. This type of intervention shows promise in improving symptoms for women with knee OA.

Committee:

Luke Donovan, Dr. (Advisor); Michele Pye, Dr. (Committee Member); Abbey Thomas, Dr. (Committee Member)

Subjects:

Health; Health Sciences; Kinesiology; Medicine; Rehabilitation; Therapy

Keywords:

osteoarthritis; OA; knee; physical activity; functional performance; self-reported outcomes

Lewis, James R.SPIRITUAL FITNESS AND RESILIENCE FORMATION THROUGH ARMY CHAPLAINS AND RELIGIOUS SUPPORT
PHD, Kent State University, 2015, College and Graduate School of Education, Health and Human Services / School of Foundations, Leadership and Administration
LEWIS, JAMES R., Ph.D., December, 2015 Cultural Foundations in Education SPIRITUAL FITNESS AND RESILIENCE FORMATION THROUGH ARMY CHAPLAINS AND RELIGIOUS SUPPORT (237 pp.) Dissertation Advisor: Natasha Levinson, Ph.D. Catalyzed by my observations as a U.S. Army Chaplain dealing suicide in the military across the past decade, in this study, I explore and more clearly conceptualize social processes of spiritual fitness and resilience formation in a context of plurality. Guiding questions include: Why do some become suicidal through suffering, while others experience “post-traumatic growth” instead? And if this capacity is a product of resilience, how is such a resilience formed? My research through this interdisciplinary study of literatures of spiritual and social formation through education, has identified three facets of this formation process, entailing 1) socially formed 2) frameworks of meaning 3) that become resilient habitus and habits of mind only through habitual practice, often requiring broad social support, as opposed to being the individual processes often thought. I argue that the integrated components of religious and civic formation, once central to resilience formation through American public education, are now largely ineffective, and have yet to be effectively replaced. It is that process of formation, cultivation and reinforcement of a core of spiritual fitness in resilience which the research of this dissertation is intended to explore and develop. Potential legal ramifications when the language of spiritual fitness is used by public institutions such as the U.S. Army, are also addressed. Army Chaplains have effectively fostered pluralistic models of resilience formation and reinforcement through religious support since before the birth of the United States, uniquely equipping Chaplains as resources for intentional spiritual fitness and resilience formation in the pluralistic context.

Committee:

Natasha Levinson (Advisor); McClelland Averil (Committee Member); Jeffrey Wattles (Committee Member)

Subjects:

American History; American Studies; Armed Forces; Behavioral Sciences; Clergy; Cognitive Psychology; Cognitive Therapy; Comparative; Continuing Education; Counseling Education; Curriculum Development; Education History; Education Philosophy; Educational Leadership; Educational Sociology; Ethics; Individual and Family Studies; Mental Health; Military Studies; Rehabilitation; Religion; Religious Education; Social Research; Spirituality

Keywords:

spiritual fitness, formation, Army suicide, secular age, social formation, spiritual formation, personal formation, socio-cultural change, Constantinian Christian culture, habits of mind, habitus, Chaplaincy, Army Chaplains, Army Chaplain histor

Bentley, Thomas D.The Impact of an Electronic Discharge Instruction Application on the Quality of Discharge Instruction Documentation
Master of Science, The Ohio State University, 1997, Allied Medical Professions
In 1996 OSUMC implemented an in-house developed discharge instruction application termed Electronic Discharge Instructions or EDI. This system enabled physicians to complete patient discharge instructions from any OSUMC computer or terminal. Unlike most medical records that typically remain part of the confidential medical record, discharge instruction documents are reviewed by a number of individuals for a variety of purposes. Although computer systems may be used in a variety of aspects of the health care industry, could such technology improve the quality of the instructions a patient receives at discharge? A total of 210 medical records were reviewed. These were divided into two groups of 105, hand written instructions and instructions created with EDI. The results indicated that a significant difference existed between the quality of hand written discharge instructions and instructions created with EDI. The electronic instructions received an overall higher mean score of 18.82 and sd = 1.06 (n = 105). The score was higher than the manually written instruction which received a score of 14.41 and sd = 3.70 (n = 105; F = 137.611; p < .0001). In addition to overall difference the data was examined considering document type and division a statistically significant main effect for document type was observed (F = 135.66; df = 1, 204; p < .0001). The overall mean scores of discharge documentation improved by the following margins for each of the divisions; Medicine 4.17 (from 14.92 to 18.46), Surgery 4.57 (from 14.49 to 19.06) and Rehabilitation 4.41 (from 14.41 to 18.82).

Committee:

Melanie Brodnik (Advisor); Carol Bininger (Committee Member); Carol Osborn (Committee Member)

Subjects:

Medicine; Rehabilitation

Costantini, OrenSERRATUS ANTERIOR MUSCLE FATIGUE EFFECTS ON SCAPULAR KINEMATICS
Master of Science, The Ohio State University, 2011, Mechanical Engineering
Background: Shoulder pain accounts for an average of 8.6 million physician visits each year in the United States. Subacromial Impingement syndrome is the most common diagnosis of shoulder pain, accounting for 44% to 65% of all complaints of shoulder pain during a physician's office visits. Methods: A protocol to bias fatigue the Serratus Anterior was used in conjunction with an electromagnetic motion capture system to track the 3D motion of the scapula and the electromyography signal of 4 muscles bilaterally in 17 subjects. The skin based motion sensors tracked humeral elevation and scapular upward rotation, internal rotation, and tilting relative to the thorax in 2 planes of elevation. The skin based electromyography sensors recorded signal from pectoralis major, serratus anterior, and upper and lower trapezius. Subjects performed 2 fatigue tasks and 3 sets of 2 kinematic tasks. Analysis: Scapular orientations relative to the thorax and electromyography signals for 3 fatigue conditions (Pre, Mid, Post) were analyzed in 10° increments for humeral elevations of 30° to 120° in the scapular plane and 30° to 110° in flexion. Electromyography signals were also analyzed while subjects held the two isometric fatigue tasks. All data were analyzed with repeated measure analysis of variance. Results: Non-dominant arms showed consistent increases in internal rotation, decreases in upward rotation, and increases in anterior tilting of the scapula relative to the thorax in flexion and the scapular plane as fatigue progressed. Dominant arms had a wider variety of motions, showing both increases and decreases in all scapular rotations. Indications of progressive muscle fatigue were found qualitatively from the first fatigue task; however, the quantitative data was inconclusive. A state of global shoulder fatigue was reached following the second fatigue task. Individual muscle contributions to motion were inconclusive. Conclusions: Non-dominant arms, when fatigue, show consistent kinematic alterations similar to those found in patients with subacromial impingement syndrome. Dominant arms show a variety of kinematic alterations, some of which similar to patients with subacromial impingement syndrome, suggesting compensation strategies are learned. If this is true, rehabilitation can affect these compensation strategies and, possibly, return patients to more healthy motions. Further studies are needed to validate the fatigue task and protocol.

Committee:

John Bolte, PhD (Advisor); John Borstad, PhD PT (Committee Member)

Subjects:

Biomechanics; Biomedical Engineering; Biomedical Research; Health; Health Sciences; Kinesiology; Mechanical Engineering; Medicine; Physical Therapy; Rehabilitation; Sports Medicine

Keywords:

Scapula; Subacromial; Impingment; Rotator Cuff; Biomechanics; Shoulder; Fatigue; Injury;

Encheff, Jenna L.Kinematic Gait Analysis of Children with Neurological Impairments Pre and Post Hippotherapy Intervention 
Doctor of Philosophy, University of Toledo, 2008, Exercise Science
Background and Purpose. The purpose of this study was to investigate the effects of a ten-week hippotherapy (HPOT) program on several temporal-spatial variables of gait as well as range of motion (ROM) at the trunk, pelvis, and hip joints in all three planes of motion over the stance phase of the gait cycle. Hippotherapy has been used as a tool by therapists for several decades to address functional limitations in patients with neuromusculoskeletal diagnoses, however, more objective measurements and data supporting HPOT as a therapeutic tool to help improve ambulation are needed. Subjects. Eleven children (6 males, 5 females; 7.9 ± 2.7 years) with neurological disorders resulting in impairments in ambulation and gross motor control in standing participated in this study. Methods. All subjects were receiving weekly traditional land-based physical or occupational therapy and elected to participate in HPOT for ten weekly sessions instead. Three-dimensional (3-D) gait analyses were performed with each child prior to the first session of HPOT. Data on cadence, velocity, stride length and step width were collected along with data regarding trunk, pelvis, and hip joint ROM. Subjects then participated in ten weekly sessions of HPOT and a second gait analysis was completed for each subject after completion of the sessions. A series of paired t-tests was performed on the temporal-spatial and kinematic data for each segment. Families of pairwise comparisons were used with the family-wise error rate set at 0.25. Results. Although no statistically significant differences were found from pre to post test for temporal-spatial data, trends in improved cadence, velocity, and stride length were seen. Significant improvements in sagittal plane pelvic and hip joint positions at initial contact (IC) and toe off (TO) phases of the gait cycle were found, and each demonstrated large effect sizes as determined via Cohen’s d. No differences in trunk ROM were determined, although trends towards more normal values were observed in all three planes at IC and TO. Discussion and Conclusion. The group’s improvement in sagittal plane pelvic and hip joint positioning and trends for improvement in trunk position, cadence, velocity, and stride length during ambulation may indicate increased postural control during the stance phase of gait after ten sessions of HPOT.

Committee:

Charles Armstrong, PhD (Committee Chair); Michelle Masterson, PT, PhD (Committee Member); Phillip Gribble, PhD (Committee Member); Christine Fox, PhD (Committee Member)

Subjects:

Health Care; Rehabilitation

Keywords:

hippotherapy; gait; pediatric therapy; gait kinematics

Fondran, Kristine MarieTHE EFFECT OF SURYA NAMASKARA YOGA PRACTICE ON RESTING HEART RATE AND BLOOD PRESSURE, FLEXIBILITY, UPPER BODY MUSCLE ENDURANCE, AND PERCEIVED WELL-BEING IN HEALTHY ADULTS
Master of Education, Cleveland State University, 2008, College of Education and Human Services
Surya Namaskara (SN) is a yoga practice(routine) that consists of a series of 12 physical postures made up of a variety of forward and backward bends. The series of movements stretch the spinal column and massage, tone and stimulate vital organs through alternately flexing the body forwards and backwards. Purpose: The purpose of the study was to determine the effects of a twice daily SN yoga practice on resting heart rate (HR) and blood pressure (BP), flexibility, upper body muscle endurance, and perceived well-being in low to moderately active adult males and females. Methods: Participants (24 females, 6 males; mean age 34 years) were randomly assigned to a yoga or control group using the fishbowl technique of random assignment with replacement. After a 3 hour introduction to proper SN techniques, the subjects were directed to perform two SN routines daily for 10 minutes each followed by a 5 minute relaxation period, 5 times per week for a period of 6 weeks. Pre and post measurements were conducted for HR, BP, hamstring flexibility, upper body muscle endurance, and perceived well-being. Inferential statistics with repeated measures (2-way ANOVA) was used to analyze the data. Results: A significant increase was found in flexibility with an improvement of 2.9 inches (p=.000) and 4.4 push-ups (p=.003) after yoga the training program, with little or no change in the control group. Conclusion: It can be concluded that SN is effective in increasing hamstring flexibility and improving upper body muscle endurance. iv

Committee:

Kathleen Little, PhD (Committee Chair); E. Michael Loovis, PhD (Committee Member); Kenneth Sparks, PhD (Committee Member)

Subjects:

Health; Physical Education; Rehabilitation; Sports Medicine

Keywords:

yoga; sun salutation; surya namaskara; flexibility; upper body strength; hamstring flexibility; perceived well-being

Joseph, Mary-Anne M.A Phenomenological Study Exploring the Educational, Vocational and Social Experiences of College Educated Individuals Who are Visually Impaired
Doctor of Philosophy (PhD), Ohio University, 2010, Counselor Education (Education)

Students who are visually impaired have significantly lower educational and vocational success rates than their nondisabled peers (Hasazi, Johnson, Hasazi, Gordon, & Hull, 1989; Nagle, 2001). A qualitative phenomenological study was conducted to explore the educational, vocational and social experiences of college educated individuals who were visually impaired in order to determine how these experiences impacted them educationally, vocationally and socially. The participants of the study were 16 individuals who were visually impaired, nine were college students and seven were college graduates. The findings of this study fell under three primary themes:1) Self Advocacy and Acquiring Accommodation, 2) Work Related Experiences and 3) Reactions to Visual Impairment.

Five findings were related to Self Advocacy and Acquiring Accommodations, they included: 1) The reasonable accommodations that were received by college students who were visually impaired. 2) The positive and negative role of college and university Disability Support Service offices. 3) The inaccessibility of technology on college campuses, 4) Self advocacy and 5) Transportation. Six findings were related to Work Related Experience, they included: 1) The employer's lack of knowledge about visual impairment. 2) Self advocacy. 3) A lack of work experience. 4) Working in companies with a primarily blind population. 5) Inaccessible software and 6) Transportation. Six findings were found to be related to Reactions to Visual Impairment, they include: 1) People’s reaction to visual impairment. 2) The participant’s reaction to their own visual impairment. 3) Involvement in organizations for the blind and visually impaired, 4) Transportation and 5) Use of a White Cane. Recommendations were made for college and university disability personnel, rehabilitation professionals and individuals who are visually impaired.

Committee:

Mona Robinson (Advisor); John Smith (Committee Member); Adah Ward-Randolph (Committee Member); Jerry Olsheski (Committee Member)

Subjects:

Education; Higher Education; Rehabilitation

Keywords:

visual impairment; college educated; education; employment; social experience

Sheets, Willard A.The Process People with Schizophrenia or Schizoaffective Disorder Use to Return to or Initialy Secure Eemployment Following Diagnosis
Doctor of Philosophy (PhD), Ohio University, 2009, Counselor Education (Education)

Research indicates that people with schizophrenia or schizoaffective disorder have a high rate of unemployment. This qualitative phenomenological study was designed to explore the perceptions of eight individuals with either disorder who have secured employment after diagnosis. The rationale for this study arises from the researcher‘s desire to find the process which was used by individuals with either disorder to become employed. It was the researcher‘s assumption that uncovering such a process could lead to implementation of employment as a therapeutic goal of treatment with such individuals.

The purposefully selected sample consisted of eight individuals from a Midwestern state who have been diagnosed with either disorder. The primary method of data collection was three in-depth interviews. The data were organized according to the research and field-developed questions asked of participants. Analysis and interpretation of findings were completed using the van Kaam method of qualitative data processing. The research revealed that participants in the study interpreted recovery as living in asmuch of a perceived degree of normalcy as possible. Recovery was found to be a developmental concept among participants. The six following categories were developed from the data: self-help; employment; assistance with employment; benefits of employment; functioning at a perceived normal level while living as full a life as possible with the illness; and recovery to employment. Five themes were found: self-care; supports; issues of employment; rewards of employment; and recovery process. Fourteen sub-themes emerged from the analysis of data. They were as follows: medication compliance; stress reduction; approaching employment gradually and carefully; stigma; disclosure of condition; formal accommodations; change of employers due to problems of disability; lack of failure; family and friends; governmental support; private supports; intrinsic rewards of employment; extrinsic rewards of employment; developmental process; and normalcy.

Recommendations are offered for mental health and rehabilitation professionals who work with this population and for further research possibilities. Given that multiple factors are present in an individual‘s recovery to the point of employment with either disorder, the recommendations suggested should be considered on an individual basis.

Committee:

Tracy C. Leinbaugh, PhD (Committee Chair); Jerry Olsheski, PhD (Committee Member); Patricia Beamish, PhD (Committee Member); Gregory Janson, PhD (Committee Member)

Subjects:

Rehabilitation

Keywords:

Schizophrenia and Employment; Schizoaffective Disorder and Employment; Psychiatric Disability and Employment; Schizophrenia; Schizoaffective Disorder; Work as Treatment; Schizophrenia Spectrum Disorders and Employment; Work

Swogger, Roxanne MichelleInstitutional Batterer's Intervention Program Within the Ohio Department of Rehabilitation and Correction
Master of Science in Criminal Justice, Youngstown State University, 2008, Department of Criminal Justice
The study evaluated the effectiveness of the batterer's intervention program within the Ohio Department of Rehabilitation and Correction, Personal Responsibility of Violence Elimination (P.R.O.V.E.). Through the completion of P.R.O.V.E., inmates should be able to identify their own abusive behavior, identify their thought patterns that lead to abusive behavior, identify alternatives to abusive behavior and identify types of abuse. To determine if the program meets these objectives, inmates participating in the P.R.O.V.E. program were administered a 20 item pre- and post- test. The institutions were Grafton Correctional Institution, Marion Correctional Institution, Richland Correctional Institution and North Coast Correctional Treatment Facility. Findings indicated that program participants were able to identify their own abusive behavior, identify alternatives to abusive behavior and identify types of abuse. Findings of this study did not support hypothesis 2, concluding that program participants were not able to identify their thought patterns that lead to abusive behavior.

Committee:

Tammy King, PhD (Advisor); John Hazy, PhD (Committee Member); Christian Onwudiwe, PhD (Committee Member)

Subjects:

Behaviorial Sciences; Criminology; Rehabilitation; Social Research

Keywords:

Batterer's Intervention; Reentry Program; Ohio institution

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