Mary F. Baxter

Voluntary neuromuscular activation is enhanced when paired with a mechanical stimulus to human plantar soles

The purpose of this investigation was to determine if the location and the timing relative to muscle activation onset, of a mechanical stimulus applied to the soles impacted the neuromuscular activation associated with a voluntary movement. The subjects completed a series of dorsiflexion or plantarflexion movements during which a stimulus was applied to either the heel or ball of the foot at one of three time periods relative to the initiation of the agonist muscle. Surface electromyography from the tibialis anterior and soleus was collected during the movements. The results show that if the stimulus was applied shortly before agonist muscle activation, regardless of stimulation site, the neuromuscular activity associated with the movement was greatly increased.

Participation in the risk‐taking occupation of skateboarding

The purpose of this ethnographic study is to describe the values, behaviors, and beliefs of skateboarders in order to understand the meaning and identity derived from the occupation as well as cultural influences on attitudes toward injury. In‐depth interviews were conducted with seven active skateboarders. Analysis of the data led to the development of a chronology of participation in the risk‐taking occupation of skateboarding. Results of this study illustrate that achieving ones best and the core value of freedom in the skateboarding subculture outweigh the risk of injury inherent to participation in the occupation. Skateboarders accept injury as an attribute of the occupation they practice and reinforce this acceptance on a social level.

Pulmonary Rehabilitation Improves Functional Status in Oncology Patients

OBJECTIVE To determine if participation in a pulmonary rehabilitation (PR) program improved the functional and physiologic status of oncology patients with chronic symptoms of shortness of breath, fatigue, and/or exercise intolerance. DESIGN Retrospective chart review. SETTING Comprehensive cancer center. PATIENTS Oncology patients (N=30) (either a solid or a hematologic malignancy) with chronic dyspnea, exercise intolerance, and/or decreased functional status who had participated in an outpatient PR program. INTERVENTIONS The PR program used an individualized, progressive aerobic exercise program (2-3 sessions/wk for 8-12 weeks) that consisted of treadmill walking, riding on a bicycle ergometer and exercising on a sliding board. This program also included a didactic educational and psychosocial component. MAIN OUTCOME MEASURES Functional status and exercise tolerance was assessed by the 6-minute walk test (6MWT) conducted at the beginning and end of the program. Self reports of perceived exertion and dyspnea were collected during and after these tests. Physiologic status was assessed by calculating 6-minute walk work (body mass x 6-minute walk distance). RESULTS Participation in the outpatient PR program significantly increased the 6-minute walk distance (21%, P<.05) and 6-minute walk work (17%, P<.05). Dyspnea and perceived exertion scores were similar at the pre- and postrehabilitation 6MWT despite the greater physiologic demand of the post-rehabilitation 6-minute walk. No adverse events occurred during the study. CONCLUSIONS The current study, although limited in size, suggests that participation in a comprehensive outpatient PR program is safe and of benefit in a heterogeneous population of oncology patients with pulmonary symptoms.

Occupational Therapy’s Role in Cancer Survivorship as a Chronic Condition

Improved medical care has resulted in a documented increase in cancer survivors in the United States. Cancer survivors face challenges in participation across all facets of life as a result of the cancer and subsequent cancer treatments. Long-term and late-term sequelae can result in impairments in neurological systems, decreased stamina, loss of range of motion, and changes in sensation and cognition. These impairments are often long lasting, which categorizes cancer survivorship as a chronic condition. This categorization presents treatment challenges, especially in creating rehabilitation and habilitation service options that support cancer survivors. Occupational therapy provides a unique focus that can benefit cancer survivors as they face limitations in participation in all aspects of daily living. Research, advocacy, and education efforts are needed to focus on the specific rehabilitation and habilitation needs of cancer survivors to increase access to occupational therapys distinct value.

Identification of Mild Cognitive Impairments in Cancer Survivors

ABSTRACT Changes in cognitive functioning are a frequent complaint of persons diagnosed and treated for cancer. The purposes of this study were to explore the feasibility of the use of the Montreal Cognitive Assessment (MoCA) for identifying mild cognitive impairment in persons who are cancer survivors as well as begin to identify the prevalence of mild cognitive impairment in cancer survivors as identified by the MoCA. Thirty-eight cancer survivors participated in this study, and 14 scored below the cutoff score of 26 on the MoCA, which indicated mild cognitive impairment. These results indicate assessment of cognitive changes in cancer patients and survivors should be part of the occupational therapy evaluation and that the MoCA is a feasible tool for such use.

Effec ts of Cognitive Status on Life Participation of Cancer Survivors

The purposes of this study were to identify the cognitive status of cancer survivors, determine the effect of cognitive status on function and participation in daily activities, and explore how cancer survivors perceive changes in their cognition. The study used a quantitative nonexperimental cross-sectional design. The participants included 35 cancer survivors from two different sites. Instruments included the Montreal Cognitive Assessment (MoCA) and the Reintegration to Normal Index-Postal Version (RNLI-P) in the measurement of cognitive impairment and functional performance respectively. Data were also collected with a supplemental questionnaire to explore participants’ perspectives on their cognitive difficulties and current function. The participant scores on the MoCA indicated cognitive impairment (μ= 25) and their scores on the RNLI-P demonstrated subpar reintegration (μ=9.64). Twenty-one participants answered the supplemental questionnaire. In content analysis of questionnaire responses, 17/21 participants reported some level of cognitive change related to cancer and cancer treatment. Data from an open-ended question were organized into four categories: decreased participation, more selective in activities, balance in activities, and cognitive changes. Study results indicate a large percentage of cancer survivors demonstrate mild cognitive impairment as well as changes in participation in instrumental activities of daily living.

Master’s of Occupational Therapy Student Perceptions of Creative Thinking Across the Academic Program

This study was part of a larger study to describe how master’s of occupational therapy (MOT) students define and perceive their own creative thinking across the academic program. This study involved a cross-sectional quantitative study based on the self-reflective creative thinking surveys completed by the MOT students at Texas Woman’s University (N = 136). Principal component analysis (PCA) was used to reduce a large number of variables by finding which variables are redundant and measuring the same construct. The PCA resulted in three new components accounting for 68% of the variance. Three ANOVAs were conducted to explore possible differences in the students’ perceptions about creative thinking during phases of the program. This study did not reveal any significant differences among the students across the program regarding their perceptions of creative thinking. However, analysis showed rich information about the students’ perceptions of creativity. Three new components were created in response to the PCA. Overall, the students demonstrate high levels of agreement that the MOT students value creative thinking, believe it can be learned, and believe that it is important for occupational therapy practice. This study can serve as a basis for a larger study to develop assessment and/or MOT curriculum design.

The effects of sensory processing and behavior of toddlers on parent participation: A pilot study

ABSTRACT Occupational therapists treat children with sensory processing and behavioral concerns, however, little information exists on how these issues affect parent participation. This pilot study examined the sensory processing and behaviors of toddlers with developmental delays and correlated these with parents’ perceived ability to participate in occupations. Correlation analysis (n = 43) revealed weak inverse relationships existed between anxious/depressed, sleep problems, and aggressive behavior in children and parent participation but no predictive nature between these constructs and parent participation in regression analysis. Clinicians can use the results to enhance parent understanding of how child sensory and behavioral differences impact family participation and foster team collaboration.