Browsing by Author "Miller, Kristine"

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    The Effect of Locomotor Assisted Therapy on Lower Extremity Motor Performance in Typically Developing Children and Children with Cerebral Palsy
    (2019-05) Scheidler, Capi Seeger; Altenburger, Peter; Bahamonde, Rafael; Miller, Kristine; Hamby, Deborah
    Background: Ambulation is critical to a child’s participation, development of selfconcept, and quality of life. Children with cerebral palsy (CP) frequently exhibit limitation in walking proficiency which has been identified as the primary physical disability. Traditional rehabilitative treatment techniques to improve ambulation for children with CP reveal inconsistent results. Driven gait orthosis (DGO) training is a novel approach focusing on motor learning principles that foster cortical neural plasticity. Objective: The objectives are to determine if: (i) the lower extremity muscle activation patterns of children with CP are similar to age-matched TD children in overground (OG) walking, (ii) DGO training replicates muscle activation patterns in OG ambulation in TD children, (iii) the lower extremity muscle activation patterns in OG walking of children with CP are similar to their muscle activation patterns with DGO assistance, and (iv) DGO training promotes unimpaired muscle activation patterns in children with CP. Methods: Muscle activity patterns of the rectus femoris, semitendinosus, gluteus maximus and gluteus medius were recorded in the OG and DGO walking conditions of children with CP and age-matched TD. The gait cycles were identified and the data was averaged to produce final average gait cycle time normalized values. Results: In comparing the variability of the muscle activation patterns within the subject groups, CP DGO walking was considerably lower than CP OG. In comparing the muscle activation patterns in each condition, consistent differences (p < .05) were noted in terminal stance, pre-swing and initial swing phases of gait with the DGO condition consistently revealing greater muscle unit recruitment. Conclusion: The results indicate that training in the DGO provided the ability to practice with measurably repetitive movement as evidenced by decreased variability. Consistent differences were noted in muscle activation patterns in the terminal stance, pre-swing and initial swing phases of gait when most of these muscles are primarily inactive. The alteration in ground reaction force within the DGO environment may play a role in this variance. With the goal of normalizing gait, it is important that the effect of these parameters on ground reaction forces be considered in the use of DGO rehabilitation.
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    Exploring the impact of career transition on athletes and military personnel : a mixed methods study
    (2018-04-17) Shue, Sarah A.; Munk, Niki; Watson, Dennis; Matthias, Marianne; Miller, Kristine
    Sport and exercise psychology practitioners work with military service members to enhance performance prior to and during active duty but have no clear role during military career exits. Given health and wellness concerns veterans face as they transition out of the military and reintegrate back into civilian life, it may be of benefit to establish non-VA practitioners as a transitioning resource. To determine sport and exercise psychology practitioner preparedness to address military to veteran transition needs, similarities and differences between transition experiences of former athletes and military veterans is needed. A mixed methods approach, known as a convergent design, compared the transition experiences of 42 athletes and 64 veterans (N=106) during the quantitative phase and 9 athletes and 15 veterans (N=24) during the qualitative phase. The quantitative phase consisted of independent sample t-tests to determine differences in outcome scores for four valid and reliable measures: Satisfaction with Life Scale, World Health Organization’s abbreviated quality of life measure, Career Transition Inventory, and Patient Health Questionnaire Depression Scale. The qualitative phase consisted of recorded semi-structured phone interviews, which gathered information regarding an individual’s career transition experience. Overall, athlete participants represented 14 sports from the National Collegiate Athletic Association and National Association of Intercollegiate Athletics universities. Veteran participants came from each military branch and a variety of pay grades. Quantitative analysis revealed athlete and veteran participants scored similarly on each outcome measure or domain. Veteran participants had lower physical health and social relationship domain scores, but comparatively better transition control scores. Qualitative analysis revealed four themes: 1) the necessity of preparation for the transition process, 2) factors impacting the career transition process, 3) transitioning resulted in the loss of structure, and 4) establishing oneself outside of former career. Results indicate shared outcomes and perspectives between former athletes and veterans in regard to their career transition process. Transition process similarities indicate sport and exercise psychology practitioners may be qualified to effectively assist transitioning veterans in the same capacity they assist transitioning athletes.
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    The Impact of Yoga on Quality of Life after Stroke
    (Office of the Vice Chancellor for Research, 2012-04-13) Schmid, Arlene A.; Van Puymbroeck, Marieke; Miller, Kristine; Altenburger, Peter; Dierks, Tracy; Schalk, Nancy; DeBaun, Erin; Damush, Teresa; Williams, Linda; Chagdes, Stephanie; Dye, Lauren; Moore, Richelle; Racine, Lisa
    Abstract Objective: Evaluate the effect of an innovative 8 week yoga-based rehabilitation intervention on 1) stroke specific quality of life (QoL) and 2) activity and participation scores in veterans with chronic stroke. Rationale/Background: Declines in Quality of Life (QoL), activity, and participation are common after stroke. Such declines are related to increased mortality, dependence, and costs. As more people live with long-term effects of stroke, it is necessary to develop innovative and evidence-based rehabilitation and occupational therapy interventions to improve QoL, activity, and participation in people with chronic stroke. Methods: • Participants- Participants included veterans with chronic stroke (>9 months) who had completed all occupational and physical therapy after stroke, reported some residual disability or functional loss after stroke; and scored >4 out of 6 on the Short Mini Mental Status Exam. • Setting- All data were collected in the Rehabilitation and Integrative Therapy lab at an urban university. • Design- This was a mixed methods pilot study of an 8 week yoga-based rehabilitation intervention. Data were collected before and after the 8 week yoga intervention. Data collection was completed by a trained research assistant. We used paired t-tests and Wilcoxon non-parametirc tests as appropriate to compare group change in scores over the 8-weeks. • Measure(s)- Measures included the Stroke Specific Quality of Life scale (SSQoL) (high score=better QoL) to measure QoL and activity and participation were measured with the ICF Measure of Participation and Activity (IMPACT) (low score=less limitations in activity and participation). Both are valid and reliable instruments. Qualitative comments were collected during focus groups after the intervention. Supportive qualitative comments regarding improved QoL and activity and participation are included. All qualitative comments were reviewed by two researchers, and exemplar quotes are included.
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    Understanding intention to use telerehabilitation : applicability of the Technology Acceptance Model (TAM)
    (2017-11-09) Almojaibel, Abdullah; Munk, Niki; Fisher, Thomas; Comer, Amber; Miller, Kristine; Justiss, Michael; Bakas, Tamilyn
    Background: Pulmonary rehabilitation (PR) has the potential to reduce the symptoms and complications of respiratory diseases through an interdisciplinary approach. Providing PR services to the increasing number of patients with chronic respiratory diseases challenges the current health care systems because of the shortages in health care practitioners and PR programs. Using telerehabilitation may improve patients’ participation and compliance with PR programs. The purpose of this study was to examine the applicability of the technology acceptance model (TAM) to explain telerehabilitation acceptance and to determine the demographic variables that can influence acceptance. Methods: A cross-sectional survey-based design was utilized in the data collection. The survey scales were based on the TAM. The first group of participants consisted of health care practitioners working in PR programs. The second group of participants included patients attending traditional PR programs. The data collection process started in January 2017 and lasted until May 2017. Results: A total of 222 health care practitioners and 134 patients completed the survey. The results showed that 79% of the health care practitioners and 61.2% of the patients reported positive intention to use telerehabilitation. Regression analyses showed that the TAM was good at predicting telerehabilitation acceptance. Perceived usefulness was a significant predictor of the positive intentions to use telerehabilitation for health care providers (OR: 17.81, p < .01) and for the patients (OR: 6.46, p = .04). The logistic regression outcomes showed that age, experience in rehabilitation, and type of PR increased the power of the TAM to predict the intention to use telerehabilitation among health care practitioners. Age, duration of the disease, and distance from the PR center increased the power of the TAM to predict the intention to use telerehabilitation among patients. Conclusion: This is the first study to develop and validate a psychometric instrument to measure telerehabilitation acceptance among health care practitioners and patients in PR programs. The outcomes of this study will help in understanding the telerehabilitation acceptance. It will help not only to predict future adoption but also to develop appropriate solutions to address the barriers of using telerehabilitation.