Browsing by Subject "rehabilitation"

Now showing 1 - 10 of 10
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    Arts Organizations and Their Impact on Adverse Childhood Experiences
    (2017-05) Clarke, Kristine
    The following three questions will be examined through this study. First, what role do arts organizations play in relation to Adverse Childhood Experiences (ACEs)? Second, do art organizations make any impact on individuals who have experienced ACEs? Third, do these organizations create this impact knowingly or unknowingly? Through examining six organizations it appears that arts organizations serve as efficient supplemental tools in helping individuals suffering from side effects of ACEs. By combining organizational efforts around mental health, rehabilitation, and social work with those of arts organizations, individuals are able to find a pathway or alternative communication method to expressing their emotions, fears, and demons that they have been trying to keep hidden. The research has also shown that art organizations are helping people confronting ACEs without knowing that the programming is indeed helping individuals facing ACEs. Through examining these questions the recommendation from this paper is for mental health, rehabilitation, and social work organizations to acknowledge how useful the arts can be for their patients and clients, and to seek out collaborations with these organizations.
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    Brain Circuitry, Neuromodulation, and Rehabilitation in Unilateral Cerebral Palsy
    (2017-12) Rich, Tonya
    Background We investigated the safety and preliminary efficacy of transcranial direct current stimulation (tDCS) combined with occupation-centered, bimanual training in children and young adults with unilateral cerebral palsy (UCP). This study utilized cathodal tDCS to the non-lesioned hemisphere, an intervention hypothesized to inhibit excitation of the non-lesioned hemisphere. Methods Eight participants with contralateral or bilateral corticospinal tract (CST) circuitry participated in an open-label study with multiple-baseline design and combined intervention. The combined intervention consisted of 10 sessions of tDCS applied to the non-lesioned hemisphere (20 minutes) concurrently with bimanual motor training tailored to the child’s goals (120 minutes). We measured safety by monitoring the frequency of adverse events and measured intervention efficacy with the Assisting Hand Assessment. Other measurements included subjective (Canadian Occupational Performance Measure - COPM) and neurophysiologic (single pulse amplitude, cortical silent period - CSP, and motor mapping) data. Results All 8 participants were evaluated with all safety, behavioral, and neurophysiologic measures. No serious adverse events occurred. All children demonstrated improvement on at least one measure of hand function. We noted achievements of clinically significant improvements on hand function measures however no significant differences with group-level pre/post comparisons were found. Significant group-level increases were observed with subjective measures such as performance (p=.01, mean change: 2.76, 95% CI 1.77 to 3.74) and satisfaction (p=.02, mean change: 2.54, 95% CI: 1.34 to 3.74) on the COPM and the ABILHAND (p=0.04, mean change 0.19, 95% CI: 0.02 to 0.37). Neurophysiologic data suggest a decrease in amplitude of single-pulse transcranial magnetic stimulation (TMS) responses in the non-lesioned hemisphere as hypothesized, although group-level pre/post-test comparisons were non-significant. However, a decrease in the CSP duration (p<.03) and increases in the motor mapping sites suggest an excitatory influence of cathodal tDCS on the non-lesioned hemisphere. Conclusions The neurophysiologic effect of cathodal tDCS to the non-lesioned hemisphere confirmed the hypothesized inhibitory effect on amplitude of responses but also documented an excitatory effect on CSP duration and mapping sites. Future studies combining additional assessment measures and computational modeling will contribute to our understanding of the neurophysiologic influence of tDCS in children with UCP. Clinical Trials Registration: Clinicaltrials.gov NCT 02250092.
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    City of Maplewood Housing Policy Implementation: Distressed Housing Rehabilitation
    (Resilient Communities Project (RCP), University of Minnesota, 2022) Eldridge, Krystin; Weidensee, Marah; Logsden, Libby; Foley, Lucas
    This project was completed as part of a partnership between the City of Maplewood and the University of Minnesota’s Resilient Communities Project (https://rcp.umn.edu/). The goal of this project was to identify best practices to create a program that offers affordable, owner-occupied, single-family homes. City of Maplewood project lead Jeff Thomson collaborated with a team of students in Dr. Anthony Damiano’s course PA 5261 to research case studies of distressed housing rehabilitation program models, racial equity concerns and opportunities, and possible financing mechanisms. A final student report and PowerPoint presentation slides from the project are available.
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    Optimization of Repetitive Transcranial Magnetic Stimulation With Priming In Chronic Stroke
    (2014-12) Cassidy, Jessica
    Purpose: Stroke is leading cause of long-term disability in the United States. The direct destruction of neural tissue from stroke combined with imbalances in transcallosal-mediated interhemispheric inhibition complicate motor recovery. Repetitive transcranial magnetic stimulation (rTMS) is thought to condition surviving but dormant neurons in the ipsilesional primary motor cortex (M1) region to become more amenable to voluntary recruitment during affected extremity movement. Low-frequency rTMS suppresses hyperexcitability in the contralesional hemisphere which can "disinhibit" the ipsilesional hemisphere resulting in greater ipsilesional M1 excitability. A bout of high-frequency excitatory rTMS, referred to as priming, potentiates the suppressive effects of low-frequency rTMS in healthy individuals. The objective of this study was to compare changes in brain excitability and affected hand function following three different rTMS treatments to ascertain whether potential gains from priming stimulation translate to the stroke brain. Methods: Eleven adults (3 females, mean age ± SD = 66 ± 9.4 years) with chronic stroke received three treatments (active 6-Hz priming + active 1-Hz rTMS, active 1-Hz priming + active 1-Hz rTMS, and sham 6-Hz priming + active 1-Hz rTMS) to contralesional M1 in random order over a five-week course with a one-week washout period between treatments. Cortical excitability including interhemispheric inhibition, short-interval intracortical inhibition, intracortical facilitation, and cortical silent period measures along with affected hand function were analyzed using a mixed effects linear model. The model checked for carryover, treatment-by-period interactions, and baseline differences before analyzing within- and between-treatment differences from baseline. Results: Active 6-Hz primed 1-Hz rTMS produced significant within-treatment differences in short-interval intracortical inhibition and cortical silent period duration from baseline indicating reduced intracortical inhibition. Compared to active 1-Hz and sham 6-Hz primed 1-Hz rTMS, active 6-Hz priming generated significantly greater decreases in cortical silent period duration. Discussion: The utility of priming in stroke does not present in such a straightforward manner as it does in healthy individuals given that active 6-Hz priming did not potentiate all outcome measures. Several potential factors are discussed. Our significant findings support the existence of `synaptic wisdom' in the stroke brain involving the deployment of homeostatic and/or metaplastic processes that preserve synaptic function.
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    Re-Enfranchising Felons: The Right Choice
    (2013-06-04) Hull, Thomas
    Roughly six million convicted felons cannot vote in America in 2013, a consequence of the condition of “civil death.” This study examines the issue from an historical and philosophical perspective, looks at current laws and practices in various states, and concludes that felons should be able to vote. Re-enfranchising felons will strengthen American democracy by allowing universal suffrage; it will provide for lower recidivism rates and more public safety; and it will assist the efforts of felons to both re-enter society (become a meaningful part, helping to choose candidates and decide policy) and become fully rehabilitated.
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    Scapular Mechanisms of Movement-Related Shoulder Dysfunction
    (2024) Saini, Gaura
    Background: Shoulder pain and dysfunction, including rotator cuff tears, are highly prevalent and can limit an individual’s ability to perform basic activities of daily living, work-related tasks, and recreational activities. Repetitive deformation of the rotator cuff tendons is one hypothesized mechanism of tear formation. Shoulder motion, particularly at the scapula, directly affects the position of the rotator cuff tendons with respect to surrounding structures during motion and may impact rotator cuff tendon deformation. To date, research around abnormal scapular motion has generally not investigated impacts of specific patterns of abnormal scapular motion. Additionally, there is a lack of research guiding clinicians with regard to underlying muscle activation patterns within specific movement patterns. The links between scapular movement abnormalities, muscle activation, and rotator cuff deformation remain unclear, limiting the development of precise, individualized treatment of each patient. Objectives: The overall objectives for this project were to (i) identify muscle activation in two specific scapular movement groups (excessive scapular anterior tilt, scapular lateralization), and (ii) identify rotator cuff deformation caused by surrounding structures in the same two scapular movement groups.Methods: Participants with shoulder pain were classified into the two movement patterns based on clinical exam measurements during overhead reaching, and movement patterns were confirmed using 2D/3D shape-matching. Highly accurate shoulder bone motion was obtained from biplane video radiography in three motions: abduction, flexion, and unrestricted overhead reaching. Participant-specific bone and supraspinatus (rotator cuff) tendon models were derived from magnetic resonance imaging. The bone models were projected onto and aligned with the radiography images (2D/3D shape-matching) to output the 3D joint positions throughout motion. Muscle activity was recorded simultaneously with the radiography collections using electromyography. Muscle activity of key scapulothoracic muscles were compared between groups. The proximity of the supraspinatus tendon to the coracoacromial arch and glenoid was calculated throughout motion by recreating each participant’s arm motion using models of their humerus, scapula, and supraspinatus tendon and their specific arm raising kinematics. Results: Significant interactions of group and motion type and group and range of motion interval were found for the anterior deltoid, ratio of lower trapezius/serratus anterior, and ratio of lower trapezius/anterior deltoid. Both groups had increasing anterior deltoid muscle activity as humerothoracic elevation increased, and the anterior tilt group increased across intervals to a greater extent than the lateralization group. In abduction and flexion, the anterior tilt group had a higher ratio of lower trapezius/serratus anterior compared to the lateralization group indicating relatively increased lower trapezius activity or relatively decreased serratus anterior activity in the anterior tilt group. In abduction and flexion, both groups generally had a ratio >1 indicating relatively more lower trapezius activity than serratus anterior. In unrestricted reaching, both groups had less lower trapezius activity compared to serratus anterior (ratio <1), and this occurred to a greater degree in the anterior tilt group. The anterior tilt group had a higher ratio of lower trapezius/anterior deltoid compared to the lateralization group from 31¬–60 of humerothoracic elevation. Groups were similar from 61–90°, then, though both groups had increasing ratios, the lateralization group progressively increased to a greater extent. The minimum distance between the supraspinatus tendon and the coracoacromial arch was significantly smaller in the anterior tilt group than the lateralization group. All participants experienced contact between the tendon and the glenoid regardless of movement pattern grouping. Conclusions: Individuals with a scapular anterior tilt movement pattern have differences in muscle activity of key shoulder muscles compared to individuals with a scapular lateralization pattern. The supraspinatus tendon is in closer proximity to the coracoacromial arch in people with the anterior tilt pattern, indicating that this might be a movement pattern of concern that warrants further investigation.
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    Study of St. Paul's Rehabilitation Program
    (1978) Baumgarten, Allan; Behm, Kathy Jo; Mains, Sheldon; Shippee, B. Warner
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    Traumatic brain injury: treatments
    (2010-07-22) Franc, Daniel
    Traumatic brain injury is a common episode, and prompt diagnosis is important for optimal treatment. A number of acute and chronic treatments are available for improved prognosis.