Occupational Therapy Program Student Theses, Dissertations and Capstones

Document Type

Dissertation - NSU Access Only

Degree Name

Doctor of Philosophy (PhD) in Occupational Therapy

Copyright Statement

All rights reserved. This publication is intended for use solely by faculty, students, and staff of Nova Southeastern University. No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, now known or later developed, including but not limited to photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the author or the publisher.

First Advisor

Jaqueline Reese Walter

Date of original Performance / Presentation

January 2023

Publication Date / Copyright Date

1-1-2023

Abstract

The purpose of this study was to examine the effects of neuromodulation coaching on the occupational performance and health of people with Rheumatoid Arthritis (RA). The investigator utilized a single-subject, nonconcurrent multiple baseline design with three participants. Throughout the baseline and intervention phases of data collection, all participants completed weekly online surveys including: Visual Numeric for Pain (VNS), Bristol Rheumatoid Arthritis Fatigue-Numeric Rating Scale-Version 2 (BRAF-NRS V2), and Subjective Vitality Scale (SVS). At week six of baseline phase, Participants A and B completed The Triangle Model Assessment (TMA-o) and the Canadian Occupational Performance Measure (COPM). These participants also commenced online neuromodulation coaching one hour per week over an eight-week period. At week seven of baseline phase, Participant C completed TMA-o and COPM, and commenced the online coaching process at the same frequency and duration as Participants A and B. During the final coaching session, all participants repeated the COPM. Data was collected over a 14-week period. Analysis of scores for VNS for Pain, BRAF-NRS-V2, and SVS included use of the celeration line approach, binomial test, and two standard deviation band method. A Minimally Clinical Important Difference (MCID) of two points was used to determine significance of COPM scores. Findings showed significant improvements with COPM for Participant C for occupational performance and satisfaction and Participant B for satisfaction only. Results also showed significant improvements in BRAF-NRS-V2 for fatigue effect (p=.031) and SVS (p=.004) for Participant B for binomial test and two-standard deviation band method. Replication of this study with additional participants would support the strength of these findings.

Disciplines

Occupational Therapy

Keywords

neuromodulation coaching; occupational therapy; psychoneuroimmunology; rheumatoid arthritis; single-subjects design

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