Browsing by Author "Siegel, Sondra"

Now showing 1 - 3 of 3
  • Thumbnail Image
    Publication
    IS DUAL TASK ABILITY FULLY RECOVERED IN ATHLETES WHO HAVE COMPLETED THE CONCUSSION RETURN-TO-PLAY PROTOCOL?
    (2023-04-20) Hartman, Zachary; Marquis, Gabrielle; Siegel, Sondra
    Purpose: This study investigated deficits in dual task ability in collegiate athletes with acute concussions who have completed the return-to-play protocol. While previous research has demonstrated the persistence of deficits using standard cognitive tests, this study specifically addressed performance in a contextually relevant, sports-related challenge. Methods: Concussed and non-concussed college athletes completed a demographics and history questionnaire, and were assessed for balance using the Balance Error Scoring System test. For the novel test, gait parameters were measured under three conditions using an instrumented gait mat. Conditions included: walking at a comfortable pace, walking while watching a sport-related video and performing a cognitive task, and walking while watching the video and performing the cognitive and a secondary physical task. The cognitive task was also performed by the participant in a standing position. Response accuracy on the cognitive task was recorded for all conditions. Outcome Measures: Measures included gait speed, cadence, stance percentage, step variability, and response accuracy for the cognitive task. Results: The control group demonstrated better performance than the experimental group with comfortable gait and with gait plus the cognitive task, with significant differences in stride width percentage, percentage of stance time, and cadence. There were no apparent differences between the two groups for the condition of gait combined with cognitive and physical tasks. There were no significant differences in response accuracy between the groups; participants demonstrated near 100% accuracy under all conditions. Conclusions: Greater impairments in gait were seen in all participants as the cognitive and physical task became more challenging, but accuracy in the cognitive task was not sacrificed in either group. Gait parameters measured during a sport-related cognitive task may be sufficient to discern a difference in performance between concussed and non-concussed athletes and may be more relevant to a return-to-play decision than standard cognitive tests.
  • Thumbnail Image
    Publication
    RELIABILITY OF THE BALANCE ERROR SCORING SYSTEM IN STUDENTS: REAL TIME VS. ASYNCHRONOUS ANALYSIS
    (2024-04-18) Arnold, Anne E.; Bubar, Britney A.; Caputo, Alyssa A.; Morin, Tyler J.; Siegel, Sondra
    Purpose/Hypothesis: Postural control in stance is often assessed following a concussion using the Balance Error Score System (BESS). The BESS includes observation of a person’s balance in 6 different positions. The rater counts how many balance errors occur during each condition. If a patient makes a large number of errors in rapid succession, it may be difficult for the rater to count them accurately, leading to a decrease in reliability. Thus the purpose of this study was to determine whether reliability of the BESS could be improved by using a videorecording of the test, allowing raters to manipulate the recording as needed. Previous studies have shown that the reliability of the BESS is good for novice raters and much higher for experts. Our hypothesis was that viewing a video recording of a participant performing the BESS would improve the reliability for novice raters. Methods: Two pairs of two student researchers were trained by the primary investigator in the scoring of the BESS. Forty-six healthy participants were then recruited by word of mouth and fliers. Each participant performed the BESS while being video recorded and observed by one pair of students. Each student independently scored the participant’s performance. Six weeks later, each student independently scored the video recordings of the same participants. Intraclass Coefficients (ICC) were generated to determine interrater and intrarater reliability. Results: For both pairs, the ICC showed greater agreement for the total BESS scores of the live sessions (.72 and .90) as compared to the recorded sessions (.52 and .74). ICCs for intrarater reliability ranged from .34 to .71. Conclusions: Watching and manipulating a recording of a BESS test does not lead to improved reliability among novice raters. Scoring of the BESS test should be done based on the live session.
  • Thumbnail Image
    Publication
    THE IMPACT OF A PHYSICAL THERAPY EDUCATION PROGRAM ON IMPLICIT BIAS AND CULTURAL COMPETENCY
    (2025-04-17) Ketch, Abigail; McGovern, Abigail; Pelletier, Sophie; Seitz, Kim; Spencer, Jonathan; Siegel, Sondra
    Purpose: Cultural competency is essential for physical therapists in providing equitable care to diverse populations. Extensive research has demonstrated that implicit biases adversely affect healthcare delivery across various disciplines such as nursing and medicine; however, limited attention has been given to understanding the impact of physical therapy education on bias. This study aimed to determine whether the Husson University Doctor of Physical Therapy (HUDPT) program reduces bias and improves cultural humility in its students, and whether the didactic courses or clinical experiences have a greater influence on these changes. Methods: Participants included the classes of 2024-2027 in the HUDPT program. Students completed two assessments at three time points: (1) the Cultural Competence Self-Assessment Checklist (CCSAC) and (2) the Harvard Implicit Association Test (IAT). Data were collected at the following times: 1) during year one of the DPT program (DPT1), before exposure to clinical rotations, 2) during year two of the program (DPT2), before two 12-week clinical rotations, and 3) during year 3 (DPT3), after all clinical rotations. Kruskal-Wallis tests were conducted to analyze differences among time points, followed by Tukey’s post hoc test. Results: A statistically significant difference was found in implicit bias scores between DPT1 and DPT3 (p<.05), with a trend toward a difference between DPT2 and DPT3 (p=.06). However, there were no significant differences among the tests of cultural competence for the three groups. Conclusion: These findings suggest that the combination of didactic education and clinical experiences may contribute to decreases in implicit bias; however, these experiences did not appear to influence students' explicit self-assessment of cultural competence. Further research must be done to assess whether increased exposure to greater diversity in patient populations or coursework would further impact scores.