Stacy Fritz - Academia.edu (original) (raw)

Papers by Stacy Fritz

Journal of the American Heart Association, 2019

Background Survivors of stroke face movement disability and increased cardiovascular disease and ... more Background Survivors of stroke face movement disability and increased cardiovascular disease and stroke risk. Treatment includes rehabilitation focused on functional movement with less emphasis on aerobic capacity. After rehabilitation, survivors of stroke must self‐manage activity with limited appropriate community programs. Lack of structured activity contributes to sedentary behavior. The objective of this systematic review and meta‐analysis is to review aerobic programs for stroke survivors similar in activity and dosage to cardiac rehabilitation programs to determine their efficacy for improving aerobic and walking capacity. Methods and Results Preferred Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines were used to review 5 databases. Group interventions for survivors of stroke with a primary aerobic component and dosage from 18 to 36 visits over 8 to 18 weeks (matching cardiac rehabilitation requirements in the United States) were included. The 6‐minute walk ...

Physiotherapy Canada

Purpose: This study investigated the feasibility of a physical activity intervention for people w... more Purpose: This study investigated the feasibility of a physical activity intervention for people with stroke and their care partners and the role social support plays in physical activity adherence. Method: The study used a single-group, pretest–posttest design with follow-up. Participants were adults with chronic stroke and their care partners. The intervention consisted of 8 weeks of structured, group-based physical activity classes, followed by 19 weeks of self-directed physical activity. Recruitment, adherence, safety, and retention were assessed. Familial social support was assessed before and after the 8-week structured portion and again 19 weeks later. Results: A total of 21 participants (15 people with stroke, 6 care partners), mean age 67.6 (SD 11.6) years, were recruited; 19 (90.5%) completed the 19-week assessment. No adverse events were experienced during the programme. Attendance during the 8-week portion was better than during the 19-week portion (mean difference 0.95; ...

Journal of Alzheimer's Disease

Background: The Reducing Disability in Alzheimer’s Disease (RDAD) program is an evidence-based in... more Background: The Reducing Disability in Alzheimer’s Disease (RDAD) program is an evidence-based intervention found to be feasible for implementation in community settings in the United States, and effective in reducing depression, one of the major behavioral and psychological symptoms of dementia (BPSD). Objective: The goal of the study is to culturally adapt the RDAD for persons with dementia living in community settings of Thailand. Methods: Key adaptation steps included: 1) assess the community, 2) understand/select the intervention, 3) consult with experts/stakeholders, 4) decide what needs to be adapted, 5) adapt the original program, 6) train staff, and 7) pilot test the adapted materials. Results: Modifications to the original RDAD protocol included changes in number of sessions, mode of delivery, and the specific pleasant activities targeted. The pilot test demonstrated the feasibility and acceptance of the adapted RDAD intervention protocol. Implementers were able to compreh...

Stroke, 2021

For survivors of stroke, walking can improve endurance, community participation and decrease risk... more For survivors of stroke, walking can improve endurance, community participation and decrease risk of subsequent stroke. Unfortunately, survivors take 4000 fewer steps per day compared to other adults. Early identification of survivors prone to long-term inactivity would be valuable, as interventions could be implemented to improve physical activity (PA) levels and reduce subsequent stroke risk. Secondary data from the Locomotor Experience Applied Post Stroke (LEAPS) trial was used. Included participants had walking speeds of <0.80 m/s at 2 months post-stroke. Daily steps were assessed at 2 months and 1 year post-stroke using an activity monitor. Stepwise regression was used to predict daily step counts at 1 year based on modifiable (walking speed, endurance, balance, balance confidence, daily step counts) and nonmodifiable (age at time of stroke, gender, race, ethnicity, initial stroke severity, side of stroke and LEAPS intervention group) factors. Data was available for 206 surv...

Alzheimer's & Dementia, 2021

The Reducing Disability in Alzheimer’s Disease (RDAD) protocol is an evidence‐based intervention ... more The Reducing Disability in Alzheimer’s Disease (RDAD) protocol is an evidence‐based intervention (EBI) found to be feasible for implementation in community settings, and effective for reducing behavioral and psychological symptoms of dementia (BPSD) and improving caregiver outcomes (Teri et al., 2003; 2008). This study adapted the RDAD for delivery in Thai community settings, so that core components of the intervention—knowledge, communication, pleasant events, behavioral modification and physical activity—could be implemented through home‐based care by community‐based health personnel.

Journal of allied health, 2020

BACKGROUND Admission committees have the difficult task of selecting candidates with the greatest... more BACKGROUND Admission committees have the difficult task of selecting candidates with the greatest likelihood of success for their programs and the profession. Because of limitations in defining the successful candidate, we attempted to predict who will become a "student with perceived difficulty" within a doctor of physical therapy (DPT) program using data available during the time of application. METHODS A retrospective analysis of 479 students from three entry-level DPT programs. The dependent variable was student with perceived difficulty status. Student characteristics were compared using unpaired t-tests (or non-parametric equivalent) and chi-squared tests. Receiver operating characteristic curves were constructed for variables significantly associated with student status to compare the predictive capabilities of the student characteristics and identify cutpoints that maximized sensitivity and specificity. We examined the predictive capabilities of clusters of charact...

PLOS ONE, 2021

BackgroundSurvivors of stroke are often deconditioned and have limited opportunities for exercise... more BackgroundSurvivors of stroke are often deconditioned and have limited opportunities for exercise post-rehabilitation. Cardiac Rehabilitation (CR), a structured exercise program offered post-cardiac event in the United States (U.S.), may provide an opportunity for continued exercise.The purpose of this study was to examine the feasibility of integrating survivors of stroke into an existing, hospital-based CR program through an assessment of (1) recruitment, uptake and retention, (2) adherence and fidelity, (3) acceptability and (4) safety.MethodsA mixed methods design combined a single group, pre-post design, pilot feasibility study with an imbedded qualitative inquiry. Survivors of stroke were recruited into a standard 12-week, 36 visit CR program.ResultsFifty-three survivors were referred, 29 started and 24 completed the program. Program uptake rate was 55% and completion rate was 83%. Eleven completers and one non-completer participated in the qualitative interviews. Program comp...

Journal of Neurologic Physical Therapy, 2007

Stroke is the leading cause of disability in the United States. At present, there is a paucity of... more Stroke is the leading cause of disability in the United States. At present, there is a paucity of experimental evidence available to indicate what physical therapy techniques are effective for improving mobility in an individual with chronic stroke. The purpose of this study was to determine the feasibility and effect size of an intensive mobility training program for people with chronic stroke. A convenience sample of eight individuals with chronic stroke received an intensive mobility intervention for 3 hours per day for 10 consecutive weekdays. Treatment outcomes were assessed using standardized outcomes of gait, balance, and mobility including the GAITRite to collect spatial and temporal parameters of gait, the Falls Efficacy Scale, Berg Balance Scale, Dynamic Gait Index, and Timed Up and Go. Data were collected at four different time points: baseline, pre-test, post-test, and 3 months after intervention. The overall effect size of the intervention was 0.72, with changes in balance having much greater effects than changes in gait or mobility. The group demonstrated an average improvement from pre- to post-tests of 12 points on the Berg Balance Scale where a change of 6 is considered a minimal detectable change. This intense mobility training was a feasible intervention for this sample and demonstrated large effect sizes for balance outcome measures. Future studies incorporating more participants, a standard control, and more emphasis on gait would provide insight into the effectiveness and clinical relevance of this intervention.

Stroke, 2005

Background and Purpose— Constraint-induced movement therapy (CIMT) is a rehabilitative strategy u... more Background and Purpose— Constraint-induced movement therapy (CIMT) is a rehabilitative strategy used primarily with the post-stroke population to increase the functional use of the neurologically weaker upper extremity through massed practice while restraining the lesser involved upper extremity. Whereas research evidence supports CIMT, limited evidence exists regarding the characteristics of individuals who benefit most from this intervention. The goal of this study was to investigate the potential of 5 measures to predict functional CIMT outcomes. Methods— A convenience sample of 55 individuals, >6 months after stroke, was recruited that met specific inclusion/exclusion criteria allowing for individuals whose upper extremity was mildly to severely involved. They participated in CIMT 6 hours per day. Pretest, post-test, and follow-up assessments were performed to assess the outcomes for the Wolf Motor Function Test (WMFT). The potential predictors were minimal motor criteria (ac...

Neurorehabilitation and Neural Repair, 2009

Background. The Wolf Motor Function Test (WMFT) is an impairment-based test whose psychometrics h... more Background. The Wolf Motor Function Test (WMFT) is an impairment-based test whose psychometrics have been examined by previous reliability and validity studies. Standards for evaluating whether a given change is meaningful, however, have not yet been addressed. Objectives. To determine the standard error of measurement (SEM) and minimal detectable change (MDC) for the WMFT. Methods. Data were collected from 6 university laboratories that participated in the EXCITE national clinical trial and included 96 individuals with sub-acute stroke (3—9 months). Measurements were made by blinded evaluators who were trained and standardized to administer the WMFT, which was completed on 2 occasions 2 weeks apart. No intervention was given between testing sessions. Results. The WMFT Performance Time score has a SEM of 0.2 seconds and a MDC95 of 0.7 seconds. The individual task timed items MDC 95 ranged from 1.0 second (turn key in lock) to 3.4 seconds (reach and retrieve) with individual task ite...

Journal of Athletic Training, 2010

Context: Organizational effectiveness and the continuity of patient care can be affected by certa... more Context: Organizational effectiveness and the continuity of patient care can be affected by certain levels of attrition. However, little is known about the retention and attrition of female certified athletic trainers (ATs) in certain settings. Objective: To gain insight and understanding into the factors and circumstances affecting female ATs' decisions to persist in or leave the National Collegiate Athletic Association Division I Football Bowl Subdivision (NCAA D-I FBS) setting. Design: Qualitative study. Setting: The 12 NCAA D-I FBS institutions within the Southeastern Conference. Patients or Other Participants: A total of 23 women who were current full-time ATs (n = 12) or former full-time ATs (n = 11) at Southeastern Conference institutions participated. Data Collection and Analysis: Data were collected via in-depth, semistructured interviews, transcribed verbatim, and analyzed via a grounded theory approach. Peer review and member checking methods were performed to est...

Archives of Physical Medicine and Rehabilitation, 2011

An intensive intervention for improving gait, balance, and mobility in individuals with chronic i... more An intensive intervention for improving gait, balance, and mobility in individuals with chronic incomplete spinal cord injury: a pilot study of activity tolerance and benefits. Arch

Journal of the American Heart Association, 2021

Background Cardiac rehabilitation (CR) is a structured exercise program prevalent in the United S... more Background Cardiac rehabilitation (CR) is a structured exercise program prevalent in the United States for people with cardiovascular disease that has been shown to increase cardiovascular endurance and improve quality of life. Despite similar cardiovascular risk factors, stroke is not among the covered diagnoses for CR. The purpose of this study was to examine the participant impact of integrating survivors of stroke into the exercise portion of an existing hospital‐based CR program through measures of physical function and other health impacts and through qualitative evaluation of participant perception. Methods and Results Subacute and chronic survivors of stroke were integrated into a standard 12‐week, 3 sessions per week, exercise‐based CR program. A total of 29 began the program, 24 completed the program, and 18 were available for 6‐month follow‐up. Quantitative measures were compared preprogram with postprogram with t ‐test or equivalent, and preprogram with postprogram to 6‐...

Current Geriatrics Reports

Purpose of Review This article presents an overview of the main technologies used to estimate gai... more Purpose of Review This article presents an overview of the main technologies used to estimate gait parameters, focusing on walking speed (WS). Recent Findings New wearable and environmental technologies to estimate WS have been developed in the last 5 years. Wearable technologies refer to sensors attached to parts of the patient’s body that capture the kinematics during walking. Alternatively, environmental technologies capture walking patterns using external instrumentation. In this review, wearable and external technologies have been included. From the different works reviewed, external technologies face the challenge of implementation outside controlled facilities, an advantage that wearable technologies have, but have not been fully explored. Additionally, systems that can track WS changes in daily activities, especially at-home assessments, have not been developed. Summary Walking speed is a gait parameter that can provide insight into an individual’s health status. Image-based, walkways, wearable, and floor-vibration technologies are the most current used technologies for estimating WS. In this paper, research from the last 5 years that explore each technology’s capabilities on WS estimation and an evaluation of their technical and clinical aspects is presented.

Journal of Aging and Physical Activity, 2014

Walking speed (WS) is a valid, reliable, and sensitive measure appropriate for assessing and moni... more Walking speed (WS) is a valid, reliable, and sensitive measure appropriate for assessing and monitoring functional status and overall health in a wide range of populations. These capabilities have led to its designation as the “sixth vital sign”. By synthesizing the available evidence on WS, this scholarly review article provides clinicians with a reference tool regarding this robust measure. Recommendations on testing procedures for assessing WS, including optimal distance, inclusion of acceleration and deceleration phases, instructions, and instrumentation are given. After assessing an individual’s WS, clinicians need to know what this value represents. Therefore, WS cut-off values and the corresponding predicted outcomes, as well as minimal detectable change values for specific populations and settings are provided.

Journal of Neurologic Physical Therapy

Physical Therapy

Objective People with Parkinson disease (PD) have low physical activity (PA) levels and are at ri... more Objective People with Parkinson disease (PD) have low physical activity (PA) levels and are at risk for cardiovascular events. The 3 purposes of this study were to determine a step threshold that corresponds to meeting aerobic PA guidelines, determine effects of treadmill exercise on PA, and quantify the relationship between changes in daily steps and fitness. Methods This was a secondary analysis of the Study in Parkinson’s Disease of Exercise trial, which randomized participants to high-intensity treadmill exercise, moderate-intensity treadmill exercise, or usual care for 6 months. Daily steps and moderate- to vigorous-intensity PA (MVPA) were assessed at baseline and once each month using an activity monitor. Fitness was assessed via graded exercise test at baseline and at 6 months. A step threshold that corresponds to meeting PA guidelines was determined by receiver operating characteristic curves. The effect of treadmill exercise on PA was examined in those below the step thres...