Research

Programs of Research

Spinal Cord Injury

Coaching Outcomes in Community-Dwelling Adults with Spinal Cord Injuries and/or their Informal Caregivers

This study examines the outcomes of Coaching in Context on participation in community-dwelling adults with spinal cord injuries, their caregivers, or both.  MJ Mulcahey (PI). Funded by Jefferson.

Supporting Coaching Fidelity for Improved Psychosocial Outcome in Spinal Cord Injury

This project aims to develop a standard test of fidelity to coaching that is valid and precise. Namrata Grampurohit (PI). Funded by Craig H. Neilsen Foundation.

Post-Discharge Support for Caregivers of Adults with Stroke Through Telehealth Coaching in Context

This study examines the feasibility of Coaching in Context for caregivers of individuals with acute stroke and its effectiveness compared to the standard of care. Namrata Grampurohit (PI). Funded by the American Occupational Therapy Foundation.

Neuroimaging and Connectome Analysis as a Diagnostic and Prognostic Biomarker of SCI Induced Neuropathic Pain

This study will quantify the unique pattern(s) of brain connectivity in individuals with chronic SCI-induced neuropathic pain, compared to uninjured controls and individuals with SCI without pain using multimodal neuroimaging techniques. Laura Krisa, PhD Co-investigator.

Development of an MRI Template & Neuroimaging Biomarkers of the Pediatric Spinal Cord

This study will create a standardized spinal cord imaging template of the entire pediatric spinal cord between 6-17 years of age. In addition, this study will establish normative multishell diffusion imaging values for continuous segments of the cervical-thoracic pediatric spinal cord between 6-17 years of age. Lastly, a sub aim of this work is to demonstrate the feasibility of these imaging biomarkers in a group of children with chronic motor complete (American Spinal Injury Association Impairment Scale (AIS) A and B) SCI.  Laura Krisa PhD Co-Principal investigator.

Simultaneous functional MR imaging of the brain and spinal cord in patients with Parkinson’s Disease

The overall goal of this study is to collect resting-state fMRI (rsfMRI) to study intrinsic connections between the brain and cervical spinal cord (cSC) in adults with Parkinson’s disease (PD) and various movement disorders. Laura Krisa. Funded by a Jefferson Provost Award.

Early Functional & Magnetic Resonance Imaging-based biomarkers for Amyotrophic Lateral Sclerosis

This project aims to discover the feasibility of a large-scale study to identify early signs of disease progression in asymptomatic C9orf72 carriers.  Jayakrishnan Nair (PI). Funded by Jefferson Pilot Clinical Research Award.

Innovative In-home Rehabilitation Program for Persons with TBI & their Families: Home-based Occupational therapy & Management of the Environment (HOME for Us)

HOME (Home-based Occupational-therapy and Management of the Environment) for Us is an intervention delivered by occupational therapists in the home, designed to improve community reintegration, ability to manage self-identified TBI-related problems, and quality of life in persons with TBI. Tracey Earland (co-PI), and Cathy Piersol (co-I) in collaboration with Villanova University. Funded by the National Institute of Nursing Research (NINR).

A Training & Fidelity Model to Move & Scale Evidence-based Dementia Care and Caregiver Support Programs into Practice: The Case for COPE in PACE

The study aims to determine whether an online training program improves interventionist fidelity to an evidence-based dementia program (COPE) and dementia patient outcomes compared to a high-intensity face-to-face traditional form of training. Cathy Piersol (co-PI) in collaboration with the University of Pennsylvania. Funded by the National Institute of Aging (NIA).

Optimizing Care for Nursing Home Residents with Dementia: A Comparison of Two Nonpharmacologic Treatment Approaches

This study will examine the difference between the two facility-based approaches for dementia care concerning facility rates of medications dispensed to residents with dementia, leading to enhanced quality of life for the resident. Cathy Piersol (co-PI) in collaboration with the University of Pittsburgh. Funded by the Patient-Centered Outcomes Research Institute (PCORI).

Comparing Two Ways to Manage Lymphedema in Head and Neck Cancer Survivors: A Multi-Site Randomized Clinical Trial

This study compares clinic-based complete decongestive therapy (CDT) and home-based (a hybrid model) CDT on changes in the severity of lymphedema, symptom burden, functional status, and healthcare utilization in head and neck cancer survivors with lymphedema. Bryan A. Spinelli (site-PI) in collaboration with the University of Pennsylvania. Funded by the Patient-Centered Outcomes Research Institute (PCORI).

Testing Design Thinking Methodology to Engage Hispanic and Latino Families of Autistic Children

Roseann Schaaf, Lady Rios-Vega (PIs), J. Matthew Fields, Kristin Rising (Co-I’s)

Funded by: The Patient-centered Outcome Research Institute (PCORI)

This project is designed to improve the cultural humility of Occupational Therapy using Ayres Sensory Integration® for Hispanic and Latino families of autistic children. We use PCORI’s Stakeholder Engagement Principals to engage a diverse group of stakeholders to provide input on how to improve access to and utilization of therapy services, specifically Occupational Therapy using Ayres Sensory Integration®.

Racial and ethnic minorities with autistic children often experience delays in access to therapy services that can result in poor outcomes, decreased quality of life, and increased parental and financial stress. Many autism interventions were developed and tested with only White participants with the assumption that they could be transferable to minority populations. However, research has found that this is not the case and that interventions that are not sensitive or adapted to an individual’s culture and ethnicity do not work as well and are not used as frequently. Diverse stakeholder voices are needed to assure interventions are culturally sensitive and appropriate. In this project, we compare two stakeholder engagement methods, Design Thinking (DT) and Focus Groups (FG), to determine which is better for obtaining input on the facilitators and barriers to accessing and using therapy for children. 

The data collected will be used to culturally adapt the Occupational Therapy using Ayres Sensory Integration® intervention to assure it is culturally sensitive for the Hispanic and Latino population. The project is guided by advisory boards supporting the research team throughout the project and its dissemination. The boards include Hispanic and Latino autistic individuals, parents and caregivers, occupational therapists, teachers, autism experts, and cultural experts. By taking a humble approach, we hope to improve access to evidence-based interventions, reduce health disparities, and improve the relationship between therapists and culturally diverse clients. 

Improving Utilization of Occupational Therapy Services for Black & African American Families of Children with Autism

Rachel Dumont, Lady Rios-Vega, & Roseann Schaaf (co-PIs)

Funded by: The College of Rehabilitation Sciences, Thomas Jefferson University, and the Nancy Talbot Postdoctoral Research Fellowship, American Occupational Therapy Foundation (AOTF).

This project involves seeking the wisdom and expertise from key stakeholders, including Black and African American families, experts in African American culture and needs, and occupational therapy practitioners who provide services to Black and African American children with autism, via focus groups to identify barriers and facilitators of occupational therapy service use and access to adapt our existing evidence-based occupational therapy intervention so it is acceptable and culturally relevant for Black and African American families. 

Early Occupational Therapy to Improve Functional Outcomes for Young Children with Autism

Joanne Hunt & Roseann Schaaf (Co-PIs). 

Funded by: the New Jersey Autism Research Program

Atypical responses to sensory experiences are common in autism and impact a child’s ability to participate in essential daily activities that contribute to their development and well-being. This project addresses a critical need to develop and evaluate interventions for core features (e.g., Sensory Symptoms) of Autism in young autistic children ages 3-5 years.  Specifically, this project will develop and conduct a feasibility trial of an early intervention that targets sensory symptoms for children with Autism ages 3-5.  Findings indicate that the intervention was safe and feasible to deliver, and there was high satisfaction from parents and therapists. Pilot data show positive trends in daily living skills and individualized goals 

Measuring Sensory Features in Autism: Validity & Reliability Testing

Roseann Schaaf (PI), Anita Bundy (co-I)

Funded by: The Eagles Autism Foundation

This study will establish the reliability and validity of an assessment of sensory features for children with autism ages 3-12 year.  We administered the newly developed test of sensory functions, the Evaluation of Ayres Sensory Integration® (EASI) to confirm that it is reliable and valid for use with this population. The EASI showed strong validity and reliability for children with autism and data suggests it is a useful battery of tests for researchers and clinicians to utilize with autistic children.

School-based Practice Application of Ayres Sensory Integration® 

Maria Cerase & Roseann Schaaf (co-PIs)

This study evaluated the current factors, including the supports and barriers identified by school-based occupational therapists impacting Occupational Therapy using Ayres Sensory Integration® intervention in school-based practice

Ayres Sensory Integration® Parent Education Modules 

These studies adapted the Ayres Sensory Integration® Parent Education Modules to improve knowledge translation (Roan, et al, 2022) and cultural sensitivity for Mandarin-speaking Chinese families of autistic children (Chan, in preparation).

Testing the Feasibility of a Telehealth Intervention for Children with Autism 

Roseann Schaaf (PI); Elizabeth Ridgway (Co-I)

This project adapts an evidence-based, manualized protocol of occupational therapy using Ayres Sensory Integration® for autistic children ages 4-12 to be delivered via telehealth. An additional aim of this study is to evaluate the acceptability, feasibility, and implementation fidelity of the adapted intervention. 

Sensory Integration Therapy in Autism: Mechanisms & Effectiveness 

Roseann Schaaf & Sophie Molholm (co-PIs)

Funded by: The National Institute of Child Health & Development NIH R01 HD082814-01A1

This comparative effectiveness study will compare occupational therapy using the principles of sensory integration to behavioral intervention for children with Autism and measure change in multisensory integration via evoked related potentials (EEG).

Sensory Functions in Autism

The study aims to build a model to describe the contributions of sensory processing and integration on the autism phenotype by investigating the mechanisms of sensory processing in autism, focusing on vision, audition, and tactile processing.  Roseann Schaaf (PI). Funded by the Nancy Lurie Marks Foundation. 

Early occupational therapy intervention for young children with autism.

This project will develop and pilot test an early intervention that targets sensory symptoms for children with ASD ages 3-5.  Outcome measures will be at the participation and function levels of the ICF. Funded by the Philadelphia Eagles Autism Foundation. Roseann Schaaf, in collaboration with RWJ Barnabas Children's Specialized Hospital. Funded by the New Jersey Department of Health.

Testing the feasibility of a telehealth intervention for autistic children

This project adapts occupational therapy intervention to a telehealth delivery model for children with autism and tests its acceptance and usability in a feasibility trial. Roseann Schaaf in collaboration with Virginia Polytechnic Institute & State University. Funded by the National Institutes of Health (NIH).

Sensory Integration Treatment:  Efficacy and Mechanisms  

This comparative effectiveness study compares occupational therapy using the principles of sensory integration to behavioral intervention for children with autism and measures the change in multisensory integration via evoked related potentials (EEG). Roseann Schaaf (PI). Funded by a Jefferson Provost Award.

A Sensory Friendly Vaccine Clinic for autistic persons

The aim is to create a sensory-friendly experience for children with autism during routine receipt of healthcare in medical offices and vaccine clinics and measure outcomes. Roseann Schaaf (PI). Funded by the Delaware Health Sciences Alliance (DHSA).

Group Coaching in Spinal Cord Injury: Examining Feasibility and Fidelity

This study examines the feasibility of providing group coaching to individuals with spinal cord injury and their natural caregivers. The study also investigates the content validity of the Coaching in Context Fidelity Measure for this group coaching application. Namrata Grampurohit (PI), Marie-Christine Potvin (Co-I). Funded by Jefferson

Group Coaching for Neurodivergent STEM Undergraduate Students

This study examines the feasibility and utility of group coaching as a co-curricular support for neurodivergent undergraduate STEM students. Marie-Christine Potvin (Co-PI) and Stephen Podowitz-Thomas (Co-PI). Funded by Jefferson

Research Inclusion Supplement

This project intends to provide research experience to students from minoritized groups. The student will engage in our group coaching studies. Namrata Grampurohit (PI), Marie-Christine Potvin (Co-I). Funded Craig H Neilsen Foundation

Coaching Outcomes in Community-Dwelling Adults with Spinal Cord Injuries and/or their Informal Caregivers

This study examines the outcomes of Coaching in Context on participation in community-dwelling adults with spinal cord injuries, their caregivers, or both.  MJ Mulcahey (PI). Funded by Jefferson.

Supporting Coaching Fidelity for Improved Psychosocial Outcome in Spinal Cord Injury

This project aims to develop a standard test of fidelity to coaching that is valid and precise. Namrata Grampurohit (PI). Funded by Craig H. Neilsen Foundation.

Post-discharge Support for Caregivers of Adults with Stroke through Telehealth Coaching in Context

This study examines the feasibility of Coaching in Context for caregivers of individuals with acute stroke and its effectiveness compared to the standard of care. Namrata Grampurohit (PI). Funded by the American Occupational Therapy Foundation.

Clinicians’ Perceptions of Infusing Coaching into their Occupational Therapy Practice

This project explores the extent to which occupational therapists trained in coaching during their entry-level education infuse coaching components and attributes in their practice. Marie-Christine Potvin (PI). Funded by Jefferson.

 

Utility of the Jefferson Teamwork Observation Guide for Measuring Collaborative Practice Competencies

This research assesses collaborative practice competencies in healthcare students and providers across different settings and professions. We seek valuable guidance for improving interprofessional education programs to enhance students' readiness for collaborative practice in healthcare and improved collaborative practice to optimize health outcomes. Christopher Keating (PI) in collaboration with Jefferson Center for Interprofessional Education. Funded by Jefferson. 

Understanding the nuances of Pre-clinical & Human Clinical Trial Outcome Measures

This project is developing a matrix of upper and lower extremity measures used in animal and human spinal cord injury research and identifying similarities and differences in the measures. Gaps in measurement for translation will be identified. MJ Mulcahey (PI). Funded by Thomas Jefferson University Office of the Provost

Knowledge Translation of Outcome Measures for Clinicians

In collaboration with the Rehabilitation Measures Task Force, instrument summaries and Archives of Physical Medicine and Rehabilitation tearsheets are developed routinely. The crosswalk of Rehabilitation Measures to the NINDS Common data elements is also a related project. Namrata Grampurohit. Funded by

Normative Reference Values of Thoracolumbar Spine Motion in Adolescent Females 

This study seeks to establish normative values for the spine of healthy female adolescents between 10-17 years of age. MJ Mulcahey (PI). Funded by the pediatric Spine Foundation. 

Measuring the Pain Experience in Individuals with Lateral Elbow Tendinopath

The research aims to measure pain in lateral elbow tendinopathy by examining various factors and their associations to personalize treatment approaches. Christopher Keating (PI) in Collaboration with Baylor University, Tufts, and Mercer University. Funded by Jefferson. 

Operative vs non-operative management of ventral hernia: a population based study of long-term benefits and consequences

This study compared the long-term outcomes of surgical repair versus conservative management for ventral hernias, focusing on physical therapy needs, constipation, and spine/pelvic pain conditions. This research will delve into optimizing pain management strategies and enhancing post-operative care to improve patient outcomes in ventral hernia repair. Christopher Keating in collaboration with Jefferson Health Departments of Surgery and Rehabilitation. Funded by Jefferson. 

Rehabilitation after minimally invasive cementless Total Hip Arthroplasty by direct anterior approach

This research focuses on the standard of rehabilitation after minimally invasive total hip arthroplasty using the direct anterior approach, emphasizing the importance of tailored rehabilitation protocols for optimizing patient outcomes. Christopher Keating and Louis N. Hunter in collaboration with the University of Bolognia. Funded by Jefferson and Istituto Ortopedico Rizzoli.

Predicting and Improving Velocity in Collegiate Pitchers Using Spine Manipulation

This research investigated the effects of spinal manipulation on pitching velocity in collegiate pitchers and the potential impacts on shoulder mobility and pain perception. This research is exploring the long-term effects of spinal manipulation on injury prevention and optimizing return-to-sport criteria using physical performance metrics. Christopher Keating (PI), Ricker Adkins, and Stephen Thomas in Collaboration with the University of Colorado. Funded by Jefferson.