We propose a randomized clinical trial to yield preliminary data on the added benefits of active rehabilitation during recovery after sport-related concussion in professional and amateur athletes. This trial marks an international collaborative effort involving the NFL, CFL, New Zealand Rugby, American Hockey League, and academic researchers in the United States. Specific Aims: The specific … Continued
Author Archives: John Bulluck
The primary aim of the Advancing Social-communication And Play (ASAP) intervention is to promote the social-communication and play skills of preschoolers with autism spectrum disorder (ASD) being served in public preschool programs. The ASAP grant project was a four-year, multisite study funded by the Institute of Education Sciences (IES), U.S. Department of Education was to … Continued
In 2014, the Defense and Veterans Brain Injury Center (DVBIC) released newly-developed clinical recommendations (CRs) detailing the step-wise return to unrestricted activity following mild traumatic brain injury (mTBI)/concussion. The CRs and their tools provide the medical community clear guidance for safely returning patients to pre-injury activities and more generally, for fostering positive patient outcomes. … Continued
This pilot project funded by NC State-UNC Rehabilitation Engineering Center is focused on testing the use of smartphone technology in place of laboratory grade accelerometry to measure movement in a military tactical maneuver. The POWAR-TOTAL assessment is derived from two high level mobility tasks that were part of a return-to-duty test battery, the Assessment of … Continued
Adults with stroke have a diminished ability to walk and simultaneously perform cognitive tasks (referred to as dual-task interference). Dual-task interference is attributed to a reduction in information processing capacity. Without adequate attentional resources for concurrent performance of two tasks, individuals must make a decision about which task to prioritize. Inability to flexibly allocate attention between two concurrent tasks may be an important factor contributing to dual-task interference, with critical implications for safety. This may be especially true in the real world where there are considerably more distractions and threats to stability than in clinical settings. Most studies have examined gait and dual-task performance in the laboratory, and none have studied the ability to flexibly prioritize attention in dual-task situations after stroke. Given that dual-task interference significantly impacts gait in the laboratory, it is imperative to determine if real-world environments exaggerate interference effects on gait and dual-task performance in community-dwelling individuals with stroke. The overall objective of the proposed research is to test the hypotheses that (1) single and dual-task walking in the real world differ from that in the laboratory, (2) ability to flexibly prioritize attention during dual-tasks is impaired post-stroke and this deficit is amplified in the real world, and (3) attention allocation ability is related to both motor and cognitive abilities. Using a repeated measures design, gait and cognitive performance of 20 adults with stroke and 20 age- and gender-matched healthy adults will be assessed in single and 4 different variable-priority dual-task conditions (no-priority, gait-priority, cognitive-priority, equal-priority) in the laboratory and a real-world context (grocery store). The project will employ pioneering advances in wireless technology to examine gait outside the research laboratory, in the real world. The long term goal of this research is to develop effective interventions to improve dual-task walking and minimize locomotor disability after stroke. This innovative 2-year project is expected to uncover information about the effect of environment and attention allocation ability on dual-task performance after stroke. This knowledge is critical to the development of interventions to improve attention allocation and task prioritization during dual-tasks in complex, real world environments among community-dwelling adults with stroke.
The purpose of this mixed method study is to examine the critical thinking disposition and perceptions of Radiologic Science students through the use of a standardized assessment and journaling exercises. The Radiologic Science student’s critical thinking deposition was assessed using the California Critical Thinking Deposition Inventory to determine the willingness and ability of the individual student to problem solve through use of critical thinking. A series of journaling assignments was the tool used to challenge the student’s abilities to think critically through substantive and meaningful reflection. The quantitative analysis was completed with the data collected using the CCTDI assessment. The qualitative portion was completed using a single-site case study method.
Malawi is a developing country located in southeastern Africa. Health Sciences education is available in Lilongwe, Blantyre and Zomba. The specific area of interest for this proposal is for the Diploma Radiography Programme located on the Lilongwe campus of the Malawi College of Health Sciences (MCHS). The purpose of this study is to investigate and validate student acceptance of tablet devices and the impact the devices have on student affective, cognitive and psychomotor skills.
The overall purpose of this Goal 2: Development and Innovation project is to enhance the existing Advancing Social-communication and Play (ASAP) intervention through development of a technologically supported system of home-school collaboration. ASAP was originally designed as a classroom-based intervention, in which the educational teams serving preschool-aged children with autism spectrum disorder (ASD) were trained to implement the intervention. The primary focus of ASAP is to improve the social-communication and play skills of children with ASD. Although preliminary child outcomes for ASAP appear promising, other anecdotal and empirical data demonstrate the need to better involve parents in intervention planning and implementation. Importantly, establishing effective ways to support home-school communication early on sets the stage for longer-term relationships between school providers and parents (Izzo, Weissberg, Kasprow, & Fedrich, 1999). Thus, the specific goal of this project is to develop and pilot test a responsive website as the primary method of supporting home-school collaboration. The website developed through the Promoting ASAP Collaboration through Technology (PACT) project is responsive in that it can generate individualized recommendations based on the child’s needs. The website will be able to support parents in assessing their children’s current social-communication and play skills at home, determining appropriate child goals based on the assessment, self-monitoring their implementation, and documenting child progress; also, the website will promote reciprocal communication about ASAP between parents and the school-based team. Within the context of home-school communication, parents want both informal, personal conversations with teachers as well as strategies to supplement classroom teachings at home (Wanat, 2010). The PACT project addresses both of these needs.
The potential benefits of conventional transcranial Direct Current Stimulation (tDCS) using sponge-pad electrodes have been demonstrated in small pilot studies for motor rehabilitation after stroke and the treatment of aphasia after stroke. Unfortunately, conventional sponge-electrode montages lead to diffuse stimulation throughout cortex with less-than-optimal intensities at the desired target brain regions. In previous work, collaborators at CCNY and Soterix developed a more targeted implementation of tDCS, high-definition tDCS (HD-tDCS), tested it for feasibility, and piloted the technology in the clinical treatment of anomia in aphasic stroke survivors. The goal of this study is to determine if a Phase III efficacy clinical trial on aphasia treatment with HD-tDCS is warranted and to prepare the technology and regulatory process for such an event. In brief, the aims of the study are 1) to perform a double-blind, randomized, multicenter, sham-controlled clinical efficacy study to assess the short-term benefits of adjunctive HD-tDCS in the treatment of aphasia, and 2) to prepare the device hardware, targeting tools, and regulatory approvals for a pivotal clinical trial.
Cerebral palsy (CP) is the most common cause of physical disability in children, impacting approximately 1 in 500 young Australians and 2-3 in 1,000 young Americans. Most of these children live to within five years of a typical lifespan, depending on the severity of the disorder. However, after age 21 when they exit the school systems, the availability and accessibility of formalized support services significantly declines for most individuals.. There is a paucity of evidence related to health outcomes and quality of life (QoL) for individuals with CP after eighteen years of age but some evidence does suggest this gap in services when transitioning to adulthood can have a significant impact on health outcomes and QoL . Determining the degree to which adults with CP are integrated into their communities is a key to developing successful interventions as individuals and families look for involvement in the community to improve QoL when employment and education opportunities are limited. Presently, it is unknown as to which community activities adults with CP engage, where they are participating, what resources they are accessing, and what barriers they are facing. This proposal aims to utilize GPS and GIS information linked with physical activity data to compare community integration in a cohort of adults with cerebral palsy across two hemispheres with differing national healthcare systems. These two teams of experienced investigators bring diverse expertise to this project and all share the same passion to overcome the historical lack of services for this population and to develop efficacious interventions to improve health outcomes and QoL The results will inform providers in both countries about the real-time intensity and contexts of activity that define community integration and help to identify key barriers and facilitators to integration, with the ultimate goal of improving quality of life for adults with CP. In our cohort of adults who are 18-65 years, classified in GMFCS Levels I-III (n=180) we will: (1) utilize GPS and GIS mapping to measure community integration and describe the locations, activities and resources important in integration for adults with CP. (2) examine the relationship between community integration measures and individual factors of current function related to impairments and mobility, service provision, and employment status. (3) examine the relationship between community integration measures and environmental factors of accessibility to community resources and population density, and describe barriers to resources and services from the perspective of adults with CP.