Scholars Symposium 2025: Allied Health & Psychology

Evaluation of the Effectiveness of Botulinum Neurotoxin A Injections for Pediatric Spastic Cerebral Palsy

Kate Jefson (Undergraduate)

Cerebral palsy is a neuromuscular condition caused by brain damage to the fetal or newborn brain. Spastic cerebral palsy is the most common type, with brain damage centralized to the motor cortex. Impaired neurons in the cortex transmit constant nerve impulses to skeletal muscle, causing many voluntary movements to become spastic contractions. There are a plethora of treatments for spasticity, but occupational therapy (OT) proves to be among the most effective of treatment strategies. However, a recent treatment for spastic cerebral palsy is Botulinum Neurotoxin A (BoNT-A) injections. BoNT-A is a neuromuscular blocker that prevents the release of acetylcholine from the motor nerve axon, temporarily paralyzing the muscle fibers for up to 3 months depending on dose strength and volume. According to research, OT following injections may optimize limb function and reduce the need for recurrent injections.

This clinical review analyzed the safety and efficacy of upper-limb injection of BoNT-A and compared BoNT-A to OT treatment for pediatric spastic cerebral palsy. Efficacy and safety of repeat BoNT-A injections were evaluated using the Modified Ashworth Scale and vital sign measures, assessing spasticity and general health in children with spastic cerebral palsy receiving repeat injections. Researchers concluded that BoNT-A injections are a safe treatment for patients and significantly reduce upper-limb spasticity. Additionally, BoNT-A injections combined with pediatric OT treatment were compared with OT alone in a 12-month randomized controlled trial. Outcome measures included range of motion tests and occupational performance measures, and results demonstrated that BoNT-A as an adjunct to OT led to significantly greater function during daily upper extremity tasks compared to OT treatment alone. Finally, a systematic review further demonstrated the effectiveness of BoNT-A injections for reduction in spasticity and functional improvements in children with spastic cerebral palsy; however, OT combined with BoNT-A treatment significantly optimized results. In conclusion, this literature review showed that BoNT-A is best used as an adjunct to OT, reducing spasticity and increasing functional performance of the affected limbs. Future research directions include investigation of the sustained treatment effects of BoNT-A over the long term along with the efficacy of BoNT-A for fixed contractures.

Is Gene Therapy is a Viable Treatment Option to Improve Quality of Life for Boys with Duchenne Muscular Dystrophy

Tommy Squier (Undergraduate)

Duchenne muscular dystrophy (DMD) is a universally fatal disease caused by a mutation in the DMD gene on the X chromosome. This mutation leads to a missing dystrophin protein—necessary for proper muscle function—in all striated muscle. DMD is characterized by progressive muscle weakness, loss of ambulation, and premature death. There is no cure, and the current standard of care combines corticosteroids, physical and occupational therapy, and corrective surgeries. Advanced cardiorespiratory life support is needed to prolong life. New gene therapies attempt to correct the root issue. Two of these therapies are exon-skipping and microdystrophin. Exon-skipping blocks the mutated portion of the DMD gene allowing the body to turn the remaining gene into a semi-functional protein. Microdystrophin uses a single injection of a virus to supply an abbreviated gene to all cells in the patient’s body leading to a functional protein. The purpose of this review is to determine if gene therapy is a viable treatment option to improve quality of life for boys with DMD.

Exon-skipping was the first gene therapy to be developed for DMD. A systematic review of exon-skipping therapies found two studies and three ongoing trials with at least 50 participants (aged 6–15 years). Reviewers observed an average dystrophin increase of 27% but had insufficient data to determine the change in quality of life for boys receiving these treatments.

In two studies on the second therapy, microdystrophin, treatment was provided using the medication Elevidys. The first study included four boys and the second 41 boys (all aged 4–8 years). The first study was open-label and non-random; the second was a two-part, double-blind, crossover study. Researchers used an external control group for both studies and evaluated functional outcomes using the North Star Ambulatory Assessment and safety outcomes using treatment-related adverse events. Both studies found significant improvement in all participants for all functional outcomes, and adverse events were mild or moderate. In conclusion, data was insufficient to support improvement with exon-skipping therapy but demonstrated that microdystrophin therapy greatly improved the quality of life for boys with DMD over the standard of care alone.

Undergraduates’ Adherence to Exercise After Completion of a Required Physical Activity Course

Joi Mattackal, Olivia Weller, & Katelyn Duttweiler (Undergraduate)

The purpose of this study was to investigate the level of exercise adherence of undergraduate students, after they had completed a required physical activity course. Our study is relevant because Cedarville University requires all undergraduate students to complete a physical activity course entitled "Physical Activity and Healthy Living." As a result of our semester long study, we found that most people who took the course were not able to maintain the level of fitness that they had achieved during the time of the course.

The Differences in Rehabilitation Adherence Factors Between Male and Female Collegiate Athletes

Kara Hodson (Graduate)

Importance: According to the biopsychosocial model, there are many factors that influence rehabilitation adherence in athletes. It is vital to understand how to improve adherence for the benefit of the athlete. There is a lack of research determining the differences in rehabilitation adherence factors between male and female athletes, which would help make rehabilitation more individualized.

Objective: The purpose of this study is to determine the differences in rehabilitation adherence factors between male and female collegiate athletes. 

Design: Non-experimental design utilizing an online convenience sampling method. 

Participants: The participants were Cedarville University student-athletes. Participants were recruited through an email sent out by the head athletic trainer. There was a total of 19 athletes who completed the survey, with 12 of them being female athletes and 7 of them male athletes. 

Interventions: The survey was conducted through Google Forms and included 25 questions answered on a Likert scale that addressed an athlete’s general attitude toward rehabilitation, motivation through rehabilitation, support during rehabilitation, and whether their perception of self and sport changed. The survey was open for three weeks, with one reminder email sent at the halfway point. 

Results: No inferential statistics were utilized due to the small sample size. Descriptive statistics were utilized, showing slightly varied answers in those who completed the survey. Female athletes tended to answer neutral or disagree more often across the whole survey than male athletes. All athletes answered most negatively when addressing how they felt supported during rehabilitation. Finally, male athletes had a greater desire to return to sport than females, but for both male and female athletes, their perception of self and their sport was affected.

Are Anxiety Levels Elevated in Sedentary People Compared to Physically Active People at the Collegiate Setting?

Jason Bonville (Graduate)

Importance: Mental health issues continue to rise around the world. Anxiety, specifically in the collegiate setting, has become a significant issue influencing the quality of life that people can experience. Not only is it important to know why this is happening, it is necessary to understand how to treat it effectively.

Objective: The purpose of this study was to explore the relationship between lifestyle and anxiety levels.

Design: This online non-experimental research utilized convenience sampling.

Participants: This survey was sent to the email of undergraduate and graduate students who are full-time or part-time at Cedarville University via “The Daily Buzz.” Sixty-four people participated in this study; 21 males, 42 females, and 1 who preferred not to say their gender.

Interventions: Participants were asked demographic questions, anxiety questions from the Beck Anxiety Inventory, and physical activity questions based off of the American College of Sports Medicine (ACSM) recommendations. Digital submissions were analyzed through descriptive statistics on Google Sheets after four weeks of data collection.

Results: Of the respondents, fifty-two scored low anxiety, 9 showed moderate anxiety, and 3 had concerning levels of anxiety. Thirty-five participants were physically active and 29 were physically inactive. Thirty physically active participants presented with low anxiety and 5 showed moderate or concerning levels of anxiety. Of those who were physically inactive, 23 showed low anxiety and 7 had moderate or concerning levels of anxiety.

Conclusions: When one ACSM recommendation of physical activity was met, 85% of respondents showed low anxiety (17 out of 20). When two recommendations were met, 75% of participants showed low anxiety (6 out of 8). When three recommendations for physical activity were met, 100% of participants showed low anxiety (6 out of 6). When none of the three recommendations were met, 23% of the participants showed moderate to concerning anxiety levels (7 out of 23). However, 7 out of the 12 participants with moderate to concerning anxiety levels were physically inactive. Overall, 86% of the participants who reported low anxiety were physically active.

Do Athletic Trainers Feel Prepared to Identify Human Trafficking Circumstances?

Michael Butcher (Graduate)

The purpose of this research was to distinguish and to expose the gap between the current educational background for athletic trainers and the lack of human trafficking education thereof. The results found there to be an underwhelming base level of knowledge and education on human trafficking. It was found in those surveyed that the lack of proper education was present, and that athletic trainers are ill-equipped to identify human trafficking circumstances.

Factors That Affect Concussion Reporting

Lauren Barnes (Graduate)

I would like to do a poster presentation of my masters thesis. I studied factors that affect concussion reporting within the collegiate setting at Cedarville University. I used a survey which was sent out to all athletes involved in contact Sports at Cedarville University. The survey was sent out mid fall Semester and was open for a period of four weeks. The data was analyzed and described in a master thesis paper and Presentation. This study Focused on the factors that influence an athletes decision to report concussion. Sections in my survey included, educational background, relationships, with coaches, parents, teammates, etc., concussion, education, knowledge of concussion, risks, and situational decisions. I would like to present this research through a poster in order to educate others about concussion risks, and the factors that affect concussion reporting so that athletes can understand the importance of reporting a concussion.

Emergency Action Planning in Collegiate Athletics: An Evaluation of the Current Adoption of Best Practice Recommendations

Kylar Conn (Graduate)

I am requesting the opportunity to present my graduate thesis research via a poster in this year's upcoming Scholars Symposium. My study titled "Emergency Action Planning in Collegiate Athletics: An Evaluation of the Current Adoption of Best Practice Recommendations" looked to analyze the current state of compliance regarding collegiate sport medicine staffs and their emergency action plans. This was a cross-sectional, web-based, and non-experimental study. I utilized the Qualtrics system to create a questionnaire that was then distributed to my target population via email. The questionnaire was anonymous and took less than 5 minutes to complete. After analyzing the data through descriptive statistics, ANOVA, and chi-square tests, I was able to draw the conclusion that most of the participating collegiate sport medicine staffs implemented the National Athletic Trainers' Association's best practice recommendations regarding emergency planning.

Female Athletic Trainers Working in a Secondary Setting,  who also have Children, and their Experiences with Burnout

Sarah Lagan (Graduate)

As an athletic training student and a women who has always desired to have a family I have constantly struggled with seeing if those worlds can collide. I am graduating in May and as I look ahead to my future I wanted to ask other women's opinions on having a family while working full time as an AT. The topic of work-life balance is vital to discuss in any occupation, especially in the medical world. I used a qualitative research method to collect my themes and "data" in the summer of 2024 and am now finished writing and compiling all of this data into a formal thesis. I am excited to share my results of these conversations.