Project Planning
Prior to the start of the on-site doctoral capstone experience, extensive planning was carried out to solidify the need for the project. To asses this need, I reviewed evidence-based literature, collaborated with OTs, outdoor recreation professionals, and my expert mentor. These efforts revealed the need to further investigate the implementation of outdoor recreation-based community programming to enhance therapeutic outcomes across the lifespan.
The utilization of an outdoor recreation-based medium using a kayak and paddling exercises is shown to improve physical and psychosocial well-being as this approach promotes occupational engagement and identity development, further improving emotional well-being and non-motor symptoms (Frances, 2006).
Ground kayak paddling exercises yield significant improvements in motor-related symptoms such as axial rigidity, postural balance, muscle performance, and cognitive function (Shujaat et al., 2014; Choi & Lee, 2018).
While common non-motor symptoms such as depression are often treated with pharmaceutical intervention, paddling is unique in that participation in a paddling-based exercises program can improve many non-motor symptoms as well. This is a vital benefit as unmanaged non-motor symptoms often result in emotional distress, which can further exacerbate preexisting cognitive deficits, motor function, and overall quality of life (Marsh, 2013).
Project Overview
Project Description: The capstone project focuses on the expansion of pre-existing Parkinson's Disease programming through the creation of a ground kayak paddling program at a community senior center. Development of such programming integrates current research and preexisting PD intervention strategies to further promote social and leisure participation, manage symptoms, and improve overall quality of life.
Project Site: Siouxland Center for Active Generations
Areas of Study: (1) Program and Policy Development, (2) Clinical Practice, (3) Advocacy
Population Focus: Older Adults, Health & Wellness, Rehabilitation & Disability
Mentors
My expert and faculty mentors provided consistent oversight and collaboration in regards to capstone design and completion of identified project objectives.
Thank you to both Pat and Dr. Sowers for the constant support and encouragement throughout my 14-week doctoral capstone experience!
Project Outcomes
Outcome #1
Outcome Measure #1: In order to develop an in-depth base of knowledge in exercise-based programming for individuals with Parkinson's Disease, the student will complete Rock Steady Boxing coaching certification for the purposes of increasing competency.
To achieve this outcome measure, I increased competency in Rock Steady Boxing by becoming a certified Rock Steady Boxing coach and facilitating over 20 Rock Steady Boxing classes at the capstone project site.
Outcome #2
Outcome Measure #2: In order to demonstrate advanced knowledge of clinical Parkinson's disease-focused interventions, student will complete LSVT BIG certification through online courses.
To achieve this outcome measure, expanded my knowledge base related to clinical interventions for PD, such as the Lee Silverman Voice Treatment Big (LSVT BIG) program. To do so, I completed the 14.5-hour LSVT BIG course certification for clinicians in a virtual format. Additionally, I facilitated a presentation to OT practitioners currently completing the didactic portion of their Doctor of Occupational Therapy degree at Huntington University. The presentation included educational information related to the PD disease process, the role of OT in the clinical treatment of PD, and advocated for the use of outdoor recreation and community-based interventions to promote symptom management and quality of life across the lifespan.
Outcome #3
Outcome Measure #3: In order to continue to develop competence in recreation-based interventions, the student will create sustainable resources for a ground kayak paddling program within a facility.
To achieve this outcome measure, I designed a guide for a 6-week ground kayak paddling program, incorporating evidence-based research related to the PD disease process and intervention strategies utilized to address PD-related symptoms. To create and carry out this program, I built equipment as well as adapted pre-existing resources available at the project site. All equipment will remain at the project site to encourage program sustainability.
Outcome #4
Outcome Measure #4: The student will advocate for the role of occupational therapy in the expansion of clinical and community-based outdoor recreation opportunities to maximize therapeutic outcomes as evidenced through the completion of a manuscript specific to disability special interests.
To achieve this outcome measure, I submitted a piece of academic writing to the editor for potential publication in the American Occupational Therapy Association Rehabilitation and Disability Special Interest Section. The abstract offers a general overview advocating for the expansion of OT services at the community level and the creation and implementation of the ground kayak paddling program. Additionally, two case study examples were provided to further illustrate the benefit of outdoor recreation-based programming at the community level through participation in a 6-week ground kayak paddling program.
Additional Accomplishments
- Gained experience with group facilitation of Silver Sneaker exercise classes.
- Had the opportunity to collaborate with an OT and learn more about the clinical use of the Interactive Metronome for Parkinson's Disease, balance, and more.
- Collaborated with local parks and recreation professionals to discuss the potential implementation of an adapted kayak ramp at an area lake.
Curricular Threads
Future Implications
Implications for OT
- The use of an outdoor recreation-based medium and kayak paddling exercises yielded improvements in physical function and emotional well-being in individuals with PD.
- Illustrates the imperative need for accessible community programming to enhance therapeutic outcomes.
Implications for my Career
- Gained hands-on experience with common age-related impairments and diagnoses.
- Gained professional certifications that I can utilize as a future clinician.
- Have created a foundation to continue to participate in Rock Steady Boxing Programming
If you are interested in connecting, please email me at: devon.piersma@gmail.com
References
Alexandre de Assis, I. S., Luvizutto, G. J., Bruno, A. C., & Sande de Souza, L. A. (2020). The proprioceptive neuromuscular facilitation concept in parkinson disease: A systematic review and meta-analysis. Journal of Chiropractic Medicine, 19(3), 181–187. https://doi.org/10.1016/j.jcm.2020.07.003
American Occupational Therapy Association. (2020). Occupational therapy practice framework (4th ed.). American Journal of Occupational Therapy, 74(1). https://doi.org/10.5014/ajot.2020.74S2001
Choi, W., & Lee, S. (2018). Ground kayak paddling exercise improves postural balance, muscle performance, and cognitive function in older adults with mild cognitive impairment: A randomized controlled trial. Medical Science Monitor, 24, 3909–3915. https://doi.org/10.12659/msm.908248
Crepeau, E.B., & Schell, B.A. B. (2009). Analyzing occupations and activity. In E. B. Crepeau, E. S. Cohn, & B. A. B. Schell (eds.), Willard and Spockman’s occupational therapy (11th ed., pp. 359-374). Philadelphia: Lippincott Williams & Wilkins.
Frances, K. (2006). Outdoor recreation as an occupation to improve quality of life for people with enduring mental health problems. British Journal of Occupational Therapy, 69(4), 182–186. https://doi.org/10.1177/030802260606900406
Gong, W. (2020). Effects of dynamic exercise utilizing PNF patterns on the balance of healthy adults. Journal of Physical Therapy Science, 32(4), 260–264. https://doi.org/10.1589/jpts.32.260
Granacher, U., Gollhofer, A., Hortobágyi, T., Kressig, R. W., & Muehlbauer, T. (2013). The importance of trunk muscle strength for balance, functional performance, and fall prevention in seniors: A systematic review. Sports Medicine, 43(7), 627–641. https://doi.org/10.1007/s40279-013-0041-1
Hindle, K., Whitcomb, T., Briggs, W., & Hong, J. (2012). Proprioceptive Neuromuscular Facilitation (PNF): Its mechanisms and effects on range of motion and muscular function. Journal of Human Kinetics, 31(2012), 105–113. https://doi.org/10.2478/v10078-012-0011-y
Marsh, L. (2013). Depression and Parkinson’s disease: Current knowledge. Current Neurology and Neuroscience Reports, 13(12). https://doi.org/10.1007/s11910-013-0409-5
Petzinger, G. M., Fisher, B. E., McEwen, S., Beeler, J. A., Walsh, J. P., & Jakowec, M. W. (2013). Exercise-enhanced neuroplasticity targeting motor and cognitive circuitry in parkinson's disease. The Lancet Neurology, 12(7), 716–726. https://doi.org/10.1016/s1474-4422(13)70123-6
Shujaat, F., Soomro, N., & Khan, M. (2014). The effectiveness of kayaking exercises as compared to general mobility exercises in reducing axial rigidity and improve bed mobility in Parkinson’s patients. Pakistan Journal of Medical Sciences, 30(5), 1094–1098. https://doi.org/10.12669/pjms.305.5231
Credits:
Created with images by watcherfox - "Man on wooden self-made kayak in calm blue lake" • standret - "man floating on lake in a kayak at fantastic sunset."