Parkinson’s Optimal Wellness and Educational Resource (POWER) Project

By 2030, over 1.3 million adults in the U.S. are predicted to be diagnosed with Parkinson’s disease (PD), with Pennsylvania exhibiting a notably high incidence (Parkinson’s Foundation, 2023; Willis et al., 2022). Despite this prevalence, non-specialist clinicians, policymakers, and the public generally remain poorly informed in adequately supporting PD (World Health Organization [WHO], 2022). There is a gap within the literature regarding occupational therapy’s (OT) role in community-based PD programming in the U.S. The Parkinson’s Optimal Wellness and Educational Resource (POWER) Project addresses this through a tertiary health approach as identified in the WHO’s Parkinson’s technical brief (2022). Informed by global data, best practices, and local needs assessment, the project was designed as a multifaceted community-based initiative. The POWER Project expands access to PD-specific rehabilitative treatment and fosters collaborative, interprofessional education for allied-health students and community partners. The capstone uses three interconnected domains- clinical practice, education, and advocacy- to enhance client care, professional education, and community support. Clinically, this reflects the various supports and barriers to implementing an interdisciplinary LSVT BIG program in partnership with a university, leveraging academic-community collaboration. Educational and advocacy efforts focus on integrating public outreach with PD-specific organizations to grow confidence in skilled workforce training and overall access to community supports. The POWER Project draws attention to OT’s role in bridging clinical practice, education, and advocacy to enhance outcomes for community-dwelling individuals affected by PD.https://digitalcommons.misericordia.edu/otd_capstone2025/1022/thumbnail.jp

Students Obtaining Tools to Achieve Regulation (SOAR)

Students Obtaining Tools to Achieve Regulation (SOAR) is a doctoral capstone project that addressed the need for integrated social emotional learning (SEL) in elementary education. SEL is an evidence-based approach shown to improve academic outcomes, behavior, and long-term life success, yet implementation barriers remain in school settings. This project aimed to enhance student regulation, classroom engagement, and teacher confidence in SEL techniques through a multi-tiered approach. A scoping review of SEL literature identified the implementation methods and barriers to SEL curricula in elementary education, which informed the development of SOAR. SOAR consisted of (a) a 20-session, movement-based SEL curriculum targeting self-awareness, self-management, and social awareness for kindergarten through fifth grade students; (b) a comprehensive SEL manual for staff; and (c) classroom self-regulation bins for in-the-moment support. Knowledge translation efforts also extended to occupational therapy students at Misericordia University. Preliminary outcomes indicated improved student SEL skills across all grades, particularly in regard to student emotional regulation skills and emotional vocabulary. These findings suggest that movement-based SEL programming created by occupational therapy practitioners may offer a feasible, sustainable model for addressing socioemotional needs and reducing disparities in educational settings. Additionally, the SOAR capstone contributes to the evolving scope of school-based occupational therapy by promoting SEL and emotional regulation as integral components of inclusive, supportive learning environments.https://digitalcommons.misericordia.edu/otd_capstone2025/1021/thumbnail.jp

Review of High-Intensity Interval Training (HIIT) Protocols for Older Adults with Cardiovascular Diseases: A Systematic Review

Background: Cardiovascular disease (CVD) is the leading cause of death worldwide, with approximately 17.9 million lives lost each year, and has an incidence of 77-80% amongst those 60-80 years old. HIIT is not the initial treatment of choice in those with CVD among physical therapists because of the fear and concern relating to the patient’s response to high-intensity exercise. Objective: The purpose of this systematic review was to determine the effectiveness of high-intensity interval training (HIIT) on older adults with cardiovascular disease and, if it was effective, find the proper protocol for this population. This systematic review intends to find the proper frequency, intensity, time, and type (FIIT) of HIIT for these patients to receive the maximal benefits in the safest way possible. METHODS: The search for this systematic review took place from September of 2024 to January of 2025 and used CINAHL, PubMed, and Medline databases. The search terms within these databases included: high intensity interval training, HIIT, older adults, protocol, cardiovascular, elderly, and heart disease. The inclusion criteria of these searches included participants with cardiovascular diseases, HIIT interventions, peer-reviewed, randomized controlled trials, English language, and published within the last 10 years. After a thorough review of the mentioned databases using these criteria, 12 studies were chosen to be included in this systematic review. RESULTS: The results of the chosen articles showed that HIIT was more beneficial for older adults with cardiovascular disease compared to interventions of moderate-continuous training (MCT) and control groups with no adjustments to their current exercise regimen. HIIT showed greater improvements in older adults\u27 peak VO2 max and left ventricular ejection fraction (LVEF), as well as increases in 6 MWT and QOL scales. Of the HIIT protocols examined, the most beneficial protocols were the 4x4, consisting of 4 minute high-intensity training, followed by 3 minutes of active/passive rest for 4 sets total, as well as the 2x8, using 8 minutes of high intensity training with 30 seconds of high intensity training, followed by 30 seconds of active rest, for 2 sets. There were also some benefits seen with the M-ullevaal protocol, which is 3 HIIT sets at 90% maxHR, combined with 2 moderate-continuous training (MCT) sets at 70% max HR. These protocols were performed through various activities, including walking, cycling, elliptical, and muscle strengthening exercises. CONCLUSION: There were significant physiological and psychological benefits seen amongst the older adults participating in HIIT training. Throughout a review of the 12 studies, there was little to no increase in adverse events amongst the HIIT group compared to the MCT or control groups, helping to emphasize the fact that these protocols can be performed in a safe and effective manner for this patient population. There was also an overall beneficial frequency, intensity, time, and type that can be used as a baseline for future intervention within this population. In the future, studies can be done to evaluate the difference between males and females with HIIT training, as well as studies to determine the proper intensity thresholds to reach HIIT.https://digitalcommons.misericordia.edu/research_posters2025/1004/thumbnail.jp

Know More Falling: Community-Based Fall Prevention

The aging population is expected to grow to 2 billion worldwide by 2050 (Rosado et al., 2021). Aging is classified as a determinant risk factor for falls and fall-related injuries (Rosado et al., 2021). This capstone project aimed to promote understanding and address fall prevention in the older adult population with multiple stakeholders throughout the Dallas, Pennsylvania community. Project goals included developing community partnerships, providing education and addressing wellness and health equity among community-dwelling older adults through multifaceted interventions. The literature search yielded a synthesis and analysis of current evidence focused on community-based fall programming, adding to the body of OT literature and supporting the development of a unique multimodal capstone. A focus on quality improvement ensured measurement of client outcomes to assess the value and sustainability of the program. The methods for the fall prevention program included group education and occupation-based exercises focusing on strength and balance for the purpose of preventing falls in their daily occupations. The outcome measures included a pre/post test of the Senior Fitness Test, Falls Efficacy Scale International, author-created formative and summative evaluations, and a modified version of the Interprofessional Attitudes Scale. Additionally, a collaborative interprofessional education event was offered to health-allied students among partnering universities to support continuing education for allied health students. The Interprofessional Attitudes Scale was modified and used as a pre/post test outcome measure for this capstone component. Disciplines represented included physical therapy, social work, speech language pathology, pharmacy, and sonography. The educational event supported student learning across themes of teamwork roles and responsibilities, patient centeredness, interprofessional biases, diversity and ethics, community centeredness. Attendees will learn about the development and implementation of the entry-level doctoral capstone and the resulting outcomes, explore the components of developing an entry-level doctoral capstone project and verbalize the benefits of interprofessional education in preparing students to meet the needs of older adults.https://digitalcommons.misericordia.edu/otd_capstone2025/1005/thumbnail.jp

Occupational Therapist\u27s Role in Sensory Inclusive Space Design

The rise in individuals experiencing sensory processing difficulties has revealed the challenges they face in regard to engagement in different environments and social participation. Sensory processing difficulties can impact the individual\u27s social connectedness to entertainment venues that confine larger crowds and overwhelming stimuli, causing a form of occupational deprivation. This form of occupational deprivation can not only affect the individual, but can also impact family interactions at social events. Occupational therapists have proven highly skilled when assessing and treating clients with sensory processing difficulties, as well as evaluating and adapting environments to promote successful participation. With that, there is a pressing need to identify occupational therapists\u27 perceptions of academic preparedness to act as a consultant in creating sensory friendly spaces along with determining methods of assessment and design planning used. Through the use of a survey, researchers seek to accumulate information from practitioners to further their roles as advocates for inclusivity.https://digitalcommons.misericordia.edu/surf2025/1007/thumbnail.jp

Allstar Abilities Sports Camp: A Community-Based Sports Program for Children with Disabilities

The focus of this Doctoral Capstone Experience (DCE) was creating the Allstar Abilities: Sports Camp to provide children with disabilities with the opportunity and environment to participate in team sports and sports activities. Within the local community surrounding Misericordia University there are few opportunities for children with disabilities to participate in these kinds of activities. This creates an occupational injustice for this population. Through research and needs assessments it was found that only sports such as baseball and basketball were locally available for this population to safely participate in. The Allstar Abilities: Sports Camp was then created to fill this void in the community and provide this service to this specific population. The program was developed using an occupational therapy lens to give it the appropriate session structure to meet the camp members needs and encourage participation during each session. The goal of this program is to provide children with disabilities with a safe, inclusive, appropriate, and structured environment to participate in various sports activities. The Allstar Abilities: Sports Camp implemented a client-centered approach to teaching children about different sports and how to complete the basic skills while meeting their specific needs throughout the session. Individual assessments were completed with the camp members and their families to determine their current needs and interests related to occupational engagement in sports. To assist the program leader during sessions, student volunteers were recruited from Misericordia University’s healthcare majors and athletic programs. The volunteers completed three in-depth training sessions which better prepared them for the camp sessions and allowed them to provide guided assistance as needed for each camp member. This multifaceted and inclusive program promoted the appropriate environment, session structure, and client-centered assistance during each session to fill this gap within the community.https://digitalcommons.misericordia.edu/otd_capstone2025/1015/thumbnail.jp

The Involvement of cAMP in the Secretion of IL-10

Schwann cells have been found to play a key role in inflammation and repair following nerve injury. During nerve injury, the myelin sheath becomes damaged, stimulating Schwann cells to secrete cytokines and initiate an inflammatory response. They begin the process of repair by stimulating macrophages to make pro-inflammatory cytokines, such as Tumor Necrosis Factor-Alpha (TNF-a), and anti-inflammatory cytokines, such as Interleukin 10 (IL-10) which promotes healing and injury. Although it is clear Schwann cells play a role in nerve repair, there is still yet to be known regarding the exact mechanisms by which they do so. In vitro, Lipopolysaccharide (LPS), can induce systematic inflammation and stimulate the production of inflammatory mediators, like tumor necrosis factor alpha (TNF-α) and Interleukin 10 (IL-10). Reports on LPS-stimulated microglial cells treated with forskolin at various time points revealed an increase in IL-10 mRNA levels. A similar study conducted on LPS-treated RT4-Schwann cell lines that were stimulated with forskolin for 3 hours resulted in the secretion of TNF- α. To further explore the effects of forskolin in LPS-stimulated Schwann cells, the role of IL-10 secretion was examined. It was hypothesized that IL-10 secretion will be increased in LPS-treated Schwann cells and IL-10 secretion will be higher in LPS-treated Schwann cells that are stimulated with forskolin. Cells from the RT4-D6P2T Schwann cell line were treated with 0.1,1, or 10 μg/mL of LPS, or 1, 2, 3 μM forskolin (F), or combinations of LPS and F treatments for 3 and 24 hours in N2 media in a 24 well plate. Using the ELISA, IL-10 secretion, was higher in LPS + F treated cells than in LPS-stimulated or F treated cells only. IL-10 was increased at 1 μg/mL of LPS with all treatments of F at 24 hours (404+/- 231.3%, 586+/-226.2%, 474+/-299.1%). Surprisingly, IL-10 was higher in LPS-stimulated cells at 3 hours with 10 μg/mL of LPS + 3 μM F(462+/-60.35%) than at 24 hours (66+/-66.3%). In summary, it appears as though all the combination treatments of LPS and F factors, may act in unity to upregulate IL-10, while being dependent on time. These findings suggest that, during nerve injury, the cAMP pathway may have the ability to counteract inflammation by secreting IL-10 in LPS-stimulated Schwann cells is dependent on the concentration of and duration. A better understanding of the balance between the pro and anti-inflammatory cytokines during nerve injury may provide more information.https://digitalcommons.misericordia.edu/surf2025/1003/thumbnail.jp

Athletes Thriving Health, Resilience, and Inspiration for Victory and Empowerment (THRIVE): A University Athletics Mental Health Program

Athletes Thriving Health, Resilience, and Inspiration for Victory and Empowerment (THRIVE) is an occupational therapy (OT) doctoral capstone project that was created to address increased rates of mental health concerns as well as significant levels of mental health stigma among university athletes (Johnson, 2022). The goals of this capstone project were to educate and train athletes in mental health and wellness to support healthy engagement in occupations, promote self-advocacy with seeking mental health services, and increase athletic department staff comfortability and capability with addressing athlete mental health. OT programs and interventions with this population are mainly in the context of concussion rehabilitation. There is limited to no evidence in OT mental health prevention programming and interventions for athletes of all age groups. This project exhibits the effectiveness of a holistic mental health and wellness program, created through an OT lens, to promote health at various levels of education and training. The project took place at Misericordia University Athletics and involved education sessions for the athletic department staff, mental health training sessions for specific teams, mental and physical health and wellness sessions for the general athlete population, and the development and distribution of three mental health resource manuals for both the athletic department staff and the athletes. Results of the project showed improved mental health and wellness in the areas of anxiety, social participation, stress management, self-advocacy, sleep health, confidence, and occupational balance among the athlete participants. Results also showed increased competence and confidence among the athletic department in their ability to effectively manage athlete mental health concerns. Many participants expressed the need for a program like this and the value that this specific capstone project had on the athletic department to support university athletes on and off the field.https://digitalcommons.misericordia.edu/otd_capstone2025/1027/thumbnail.jp

Let\u27s Get Connected (LCG)

The Let’s Get Connected (LGC) doctoral capstone project aimed to improve the social skills of primary school students through program development, education, and clinical intervention in order to encourage a more inclusive environment in the school. Regarding program development, LGC incorporated universal OT services during recess for all second grade students to socialize as a class. During the “All-In Recess” portion of the program, social emotional skills were taught through games that encouraged students to socialize and include all of their peers. The second tier included “Breakfast Bunch and Lunch Bunch”, which consisted of small social participation groups held during the breakfast and lunch periods for students who were at risk of experiencing difficulties with socializing with their peers. Students who participated in this group learned sensory and emotional regulation strategies and practiced social skills with their peers. The third tier involved working with students in a specialized classroom to run a snack cart in order to work on social participation skills. Working together to prepare and provide snacks to teachers helped these students to practice various social skills. Teacher education on sensory integration’s effect on social participation and specific sensory strategies that teachers can implement was provided to teachers via a didactic presentation. OT services focussed on social participation were also provided to students on the site mentor’s OT caseload. OT’s distinct value was evident in the Let’s Get Connected doctoral capstone project which empowered student social participation in an inclusive format in the public school sector.https://digitalcommons.misericordia.edu/otd_capstone2025/1031/thumbnail.jp

Caregiver Resources for Aging with an Intellectual and/or Developmental Disability (RAIDD)

Caregivers of individuals with intellectual and/or developmental disabilities (IDD) are essential in supporting health, well-being, and aging in place; however, they are often overlooked in policy and occupational therapy (OT) practice. Caregivers frequently experience heightened levels of stress, anxiety, depression, physical fatigue, and social marginalization. Adults with IDD face disproportionately high rates of chronic disease and mental health conditions, and despite the development of resources to support this population, caregivers report barriers to locating, understanding, and utilizing these assets. A scoping review was conducted to determine and explore the needs of caregivers and the systemic challenges they face, including fragmented services, discrimination, and the lack of accessible resources. Findings confirmed the need for occupation-centered interventions that promote health, inclusion, and dignity for caregivers and individuals with IDD. The Caregiver AIDS Capstone Project, focused on addressing the complex needs of caregivers supporting adults and older adults with IDD. A central component of the project was the development of a free, digitally accessible booklet, which provides clear and practical information on future planning, transitioning out of the education system, social and recreational opportunities, financial resources, relationships and intimacy, and housing options. Additionally, a community resource fair was held in Wilkes-Barre, Pennsylvania, to connect caregivers with local services to better prepare them for the future. Feedback on both the booklet and resource fair were positive, highlighting the value of the information provided and connections created. OT is uniquely positioned to address these caregiver challenges through advocacy, caregiver education, and community-based interventions that promote engagement in meaningful occupations.https://digitalcommons.misericordia.edu/otd_capstone2025/1003/thumbnail.jp