American Journal of Recreation TherapyAbstracts
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American Journal of Recreation Therapy
Winter 2005, Volume 4
, Number 1


Article
Reminiscing Circles: A case report
Amy L. Fish, CTRS; Nancy E. Richeson, PhD, CTRS
Winter 2005; pages 11-16

Abstract
The outcomes of a therapeutic recreation intervention using reminiscence and the well-being of persons with acquired brain injury (ABI) were examined by using the Faces scale,1 monitoring social and cognitive skills, and collecting information on a patient satisfaction survey. In a two-week project, one participant was studied from the original group of six. Mr. S completed the entire six sessions; the other participants were discharged before the completion of this project. Mr. S was a 46-year-old man of Puerto Rican descent who was admitted to the rehabilitation hospital for a cerebrovascular accident. At the completion of the intervention, Mr. S showed an increase in his well-being. The results provide information for using reminiscence as an intervention for persons with ABI. Key words: reminiscence, therapeutic recreation, well-being, acquired brain injury


Article
Characteristics that contribute to the longevity of centenarians
Jo A. Lewis, CTRS
Winter 2005; pages 17-19

Abstract
Centenarians are the fastest-growing age group with an estimated population expected to reach 2.5 million by the year 2060. In this paper, characteristics of centenarians established by the New England Centenarian Study are compared with information shared through an interview with a woman aged 96 years. Considerations for recreational therapy services are also discussed. Key words: centenarians, recreation therapy, independent function


Article
Barriers to physical activity participation in North American elderly women: A literature review
Mylène Aubertin-Leheudre, MSc; Stéphane Rousseau; Michel O. Mélançon, MSc; Jean-Philippe Chaput, BSc; Isabelle J. Dionne, PhD
Winter 2005; pages 21-30

Abstract
Physical activity is beneficial for the maintenance of physical and mental health. Nevertheless, 62 percent of women that have reached menopause are inactive. The obstacles to physical activity that are the most quoted by women aged 65 years or more are: lack of energy, lack of motivation, illness or injury, and a feeling of discomfort (mostly related to body image). In the light of this literature review, we seek to examine how these barriers are important causes of the sedentary lifestyle of North American women aged 65 years or more and what interventions could potentially counteract the hindrance to physical activity in this population. It seems that older women are not offered an environment in which they feel comfortable to practice physical activity, are not involved in the selection of physical activity they are offered, and do not feel supported by the medical environment (e.g., lack of information, imposed prescription rather than common decision with the doctor, etc.) with respect to the importance of integrating physical activity into their lifestyle. Thus, it is important to establish a dialogue with older women to understand how they perceive physical activity. In addition, discussing which factors would encourage them to be active, including them in the decision-making process, and providing them information about how physical activity can retard physical incapacity may be key factors to convince them to become physically active. Key words: women, menopause, physical activity, recreation therapy, sedentary lifestyle


Article
The prescription of recreational activity in mental health promotion and disease prevention
Carmen Russoniello, PhD, TRS/CTRS, LPC; David J. Howard, PhD, MSW, CTRS
Winter 2005; pages 31-34

Abstract
This article highlights a recent invited presentation by the US Department of Health and Human Services on the efficacy of recreational therapy in mental health promotion and prevention. The second annual Steps to a HealthierUS National Prevention Summit was convened to focus on President Bush’s HealthierUS pillars, which encourage Americans to be physically active every day, eat a nutritious diet, get preventive screenings, and make healthy choices. The Summit specifically addressed the US Secretary of Health and Human Services’ Steps to a HealthierUS Initiative, which highlights chronic disease prevention by addressing diabetes, obesity, cardiovascular disease, cancer, and asthma. Research was presented on the physiological and psychological benefits of recreational activity in disease prevention, including the prescriptive use of recreational activity in alcoholism prevention and rehabilitation, reducing obesity and secondary problems in children, and the prevention and amelioration of post-traumatic stress disorder (PTSD) symptoms in children. In each study, recreational therapy was shown to be an effective intervention by decreasing negative symptoms such as untoward stress, anxiety, and depression. Key words: disease prevention, recreation therapy, rehabilitation, mental health


Article
The use of single-session cinematherapy and aggressive behavioral tendencies among adopted children—A pilot study
Heewon Yang, PhD, CTRS; Youngkhill Lee, PhD, CTRS
Winter 2005; pages 35-44

Abstract
This paper describes the effectiveness of cinematherapy based on cognitive-behavioral theory among a group of 14 adopted children with special needs who attended the Overnight Respite and Recreation Program. After baseline data were collected, the participants were assigned to an experimental group or a control group. The control group viewed a videotape without receiving systematic processing before, during, or after watching the video. For the experimental group, structured and guided processing was provided, including briefing and debriefing. In the results, there was a statistically significant mean difference between the two groups on impulsivity/impatience, a subscale of the Aggression Inventory (AI), indicating that a session that incorporated cognitive-behavioral theory helped the participants in the experimental group decrease their tendency to be impulsive and impatient. In addition, one statistically significant mean difference was found between the pre-test and post-test within the control group on a subscale entitled “physical aggression,” indicating that the level of the behavioral tendency toward physical aggression within the control group significantly increased after the movie night. Key words: cognitive-behavioral theory, cinematherapy, adopted children, aggression

Book review
Implementing Recreation and Leisure Opportunities for Infants and Toddlers with Disabilities, edited by Michael Bender and Carol Ann Baglin, Champaign, IL: Sagamore Publishing, 2003; 85 pages.
Christie L. Rears
Winter 2005; pages 45-47

American Journal of Recreation Therapy
Spring 2005, Volume 4
, Number 2


Article
Halliwick techniques: Enhancing aquatics for individuals with disabilities
Susan J. Grosse, MS
Spring 2005; pages 7-12

Abstract
Originating in England in the 1950s, the Halliwick method of swim instruction provides untold numbers of individuals with disabilities with opportunities for independent aquatic participation. From application with children with physical disabilities, Halliwick has been expanded to use with a multiage population and individuals with a large variety of cognitive, sensory, and psychoemotional disabilities. This article will provide an overview of the method itself, explain why Halliwick is so successful, and explore how Halliwick can be implemented within an existing aquatic therapy program. Effects of Halliwick on transitioning to community programming will also be presented. Key words: Halliwick techniques, aquatic activities, recreational therapy


Article
Acute physiological outcomes of a children’s weight-loss camp using exercise and dietary therapy
Paul J. Gately, PhD, MMedSci, BA (Hons); Julian H. Barth, MD, PhD, FRCP, FRCPath; Duncan Radley, BSc (Hons); Carlton B. Cooke, PhD, BEd (Hons)
Spring 2005; pages 13-20

Abstract
Childhood obesity is rapidly increasing, with few effective interventions currently available. It is therefore prudent to establish the efficacy of a range of possible intervention options. Sixty-five obese children were enrolled in the program and compared with 42 normal-weight children. They were assessed for a range of anthropometric, fitness, and metabolic variables (subsample n=10). Children in the intervention group participated in a range of recreational activities including six one-hour skill-based fun-type activities, moderate dietary restriction, and three weekly educational sessions. Significant group by time interactions on all measures showed that the campers improved all variables compared to their normal-weight peers. In addition, paired t-tests showed significant (p < 0.05) improvements in several of the metabolic variables. The program was successful in achieving significant improvements in indicators of health and well-being, whereas such changes were not found in the free-living comparison group. Follow-up studies are currently underway to assess the longer-term impact of this program. Keywords: obesity, weight-loss camp, children, exercise therapy, recreational therapy, diet, behavior modification


Article
Resistance training in older adults: The importance of muscle power and speed of movement
Stephen P. Sayers, PhD
Spring 2005; pages 21-26

Abstract
As the United States population grows and life expectancy increases, physical disability related to aging has become a serious problem. A commonly prescribed rehabilitation program to improve physical functioning in older adults has been resistance training; however, there is uncertainty regarding its effectiveness. Traditionally, slow-velocity resistance training with a strengthening component has been most commonly prescribed in older adults, yet most functional tasks performed under “everyday” living conditions do not usually involve these types of muscle contractions. Functional tasks most commonly encountered during the day often require movements at higher speeds and with variable external resistances. This article will review the rationale for the use of low-resistance, high-velocity training in the older adult population and why the recreational therapist should consider providing more velocity-based movements into a therapeutic exercise protocol. Key words: therapeutic recreation, older adults, resistance training, exercise


Article
Measuring leisure: The reliability of the Idyll Arbor Leisure Battery among individuals with spinal cord injuries
Erica M. Botner-Marigold, MSc; William C. Miller, PhD, OT; Janice C. Vetter, MA
Spring 2005; pages 27-37

Abstract
A spinal cord injury (SCI) results in many changes that may challenge an individual’s ability to participate in leisure. Despite the benefits, leisure has been overlooked in rehabilitation research because it is difficult to measure. Scales exist that measure leisure behavior; however, few have been tested for reliability, and even fewer have been developed for specific use among individuals with SCI. The purpose of this study was to provide estimates of the internal consistency and test-retest reliability of the Idyll Arbor Leisure Battery (IALB) in a sample of 41 individuals with SCI. The IALB consists of four previously developed scales that measure leisure attitude, leisure motivation, leisure satisfaction, and leisure interests. Test-retest reliability for the total scales and for most of the subscales was within an acceptable range for using the scales in descriptive research settings (Intraclass Correlation Coefficients > 0.75), and some evidence for their clinical use was discussed. Key words: spinal cord injury, leisure, Idyll Arbor, recreational therapy


Article
Inspiratory muscle training in the treatment of chronic obstructive pulmonary disease: Randomized controlled trial
Kevin Sykes, PhD, MSc, MIBiol; Ho Wing Hang, MSc, BSc (Physio)
Spring 2005; pages 39-48

Abstract
The objective of this study was to investigate the effects of including inspiratory muscle training (IMT) in the Pulmonary Rehabilitation Centre four-week inpatient program of exercise training (EXT) in Chinese patients with chronic obstructive pulmonary disease (COPD). This was a randomized controlled trial with repeated measures, which took place in the Pulmonary Rehabilitation Centre at Tai Po Hospital in Hong Kong. The participants consisted of 40 patients with COPD (34 men and six women, age range 60 to 84 years). Participants were randomly allocated to two groups: Group 1 (EXT, n = 20) and Group 2 (EXT+IMT, n = 20). Both groups participated in the four-week exercise program and received a 16-hour course in health education. In addition, Group 2 received IMT using a threshold-loaded inspiratory muscle trainer at loads that increased progressively from 30 percent to 60 percent of maximal inspiratory pressure. The main outcome measures were exercise performance [six-minute walk test (6MWT), peak oxygen consumption (VO2Peak), and dyspnea during heavy exercise], inspiratory muscle strength, and quality of life (chronic respiratory disease questionnaire). Group 1 showed significant improvements in the 6MWT, dyspnea rating during heavy exercise, and inspiratory muscle strength (all p < 0.001). Significant improvements were also demonstrated in the quality-of-life domains of dyspnea and mastery (both p < 0.001) and fatigue and emotion (both p < 0.05). There was no increase in VO2Peak. In comparison, Group 2 similarly demonstrated significant changes in the 6MWT, dyspnea during heavy exercise, inspiratory muscle strength, and quality-of-life domains (all p < 0.001) and an increase in VO2Peak (p < 0.001). The overall improvements were greater in Group 2 than in Group 1. There were no significant changes in expiratory lung volumes in either group. Including a progressive program of IMT in combination with aerobic and resistance EXT in a pulmonary rehabilitation program yielded added health benefits to this group of COPD patients, improving exercise performance, inspiratory muscle strength, dyspnea, and psychosocial health–related quality of life. It is suggested that this treatment, education, and exercise program could be adapted for use by recreational therapists in leisure settings to improve this disabling condition, enhancing health, independence, and well-being in a very cost-effective manner. Key words: inspiratory muscle training, exercise training, quality of life, chronic obstructive pulmonary disease, recreation therapy

American Journal of Recreation Therapy
Summer 2005, Volume 4
, Number 3


Article
Newsbriefs
Summer 2005; pages 5-5

Abstract
Camp—A therapeutic treatment for children with ADHD. Nominations being accepted for William Bronson Award of Excellence.


Article
Guest editorial. Laughter—A great form of recreation therapy
Kevin Sykes, MSc, PhD
Summer 2005; pages 9-10


Article
Social skills training in recreational rehabilitation of schizophrenia patients
Daniel R. Mueller, MA; Volker Roder, PhD
Summer 2005; pages 11-19

Abstract
Leisure-time activities and contacts are among the unmet needs of schizophrenia patients. However, there is a lack of evidence-based specific psychotherapy to improve recreational skills in patients with schizophrenia. During the past few years, our research group has developed a manualized cognitive social skills training (SST) program for recreational functioning (experimental group, EG), which is applied in groups of six to eight patients. The aim of the present study was to compare the EG with a conventional, unspecific SST program (control group, CG) in a controlled trial. A total of 70 schizophrenia patients participated in the study (EG, n = 35; CG, n = 35). The aims of the study were to investigate effects in functional domains of schizophrenia, as well as in recreational skills, therapy motivation, and well-being, within a follow-up phase of one year. Results indicated a better outcome for EG patients in terms of psychopathology and recreational skills compared to CG patients. Significant effects were found for EG and CG in neurocognition, general social skills, and well-being. In addition, recreational skills were significantly associated with therapy motivation, general social functioning, negative symptoms, and intelligence. In view of these favorable effects, the recreation therapy program could constitute an effective treatment within multimodal psychiatric rehabilitation of schizophrenia patients. Key words: schizophrenia, social skills training, cognitive behavior therapy, recreation therapy


Article
Content validation and pilot studies of the Therapy Effectiveness Evaluation for Animal-Assisted Therapy instrument
Joan Glacken, EdD; Marilyn K. Lawrence, MS
Summer 2005; pages 21-24

Abstract
Few evaluation tools exist for recreational therapists to use for guidance when considering whether to initiate animal-assisted therapy and evaluate the effectiveness of the therapy on clients. The purpose of this study was to determine the content validity of the Therapy Effectiveness Evaluation for Animal-Assisted Therapy instrument and whether the instrument is an effective tool in measuring improvement for functional domains (cognitive, physical, social, and emotional) of adult clients. The client data collected during the validation study were analyzed, and positive increases from pre- and post-test assessments were statistically significant (a = 0.05) for all four functional domains. This is a strong indication that animal-assisted therapy is a viable strategy for improving cognitive, physical, social, and emotional functioning in adults. Key words: animal-assisted therapy, evaluation tool, recreation therapy


Article
Breast cancer treatment: The effect on and therapeutic role of leisure
Charlene S. Shannon, PhD
Summer 2005; pages 25-31

Abstract
Despite the fact that breast cancer is a significant health issue for many women, little research attention has been devoted to understanding the leisure issues these women might face during treatment. This qualitative study obtained the perspective of eight women who had a breast cancer experience and sought to understand the effects of treatment on their leisure and the role that leisure played while they were in the treatment. Themes were developed related to the leisure constraints the women faced, the role leisure played in mitigating the psychological effects of treatment, and the lack of emphasis by healthcare professionals on leisure-related issues. The article also outlines possible roles for the therapeutic recreation specialist in helping women prepare for and respond to leisure issues during treatment. Key words: recreation therapy, breast cancer, leisure interventions


Article
Chronic fatigue syndrome: Implications for the therapeutic recreation profession
Megan Schwalm-Lopez, MA; Richard D. MacNeil, PhD
Summer 2005; pages 32-40

Abstract
Chronic fatigue syndrome (CFS) is a disorder that affects an estimated 90 million people worldwide. As widespread as the syndrome is, there has been little systematic research completed focusing on the nature of the disorder or interventions for treating it. The little research that does exist points to the fact that recreational activities may help people with CFS cope with their condition, but CFS has seldom been addressed in therapeutic recreation (TR) literature. The purpose of this paper is to examine CFS and to demonstrate its significance with respect to the TR profession. The paper presents an overview of CFS including primary characteristics, etiology, common problems, and functional expectations. It also proposes a rationale, based on the Optimizing Lifelong Health through Therapeutic Recreation model, for the use of TR in treating individuals with CFS. The paper concludes with a brief discussion of implications for TR practice with this population. Key words: chronic fatigue syndrome, treatment, therapeutic recreation, OLH-TR model


Article
Efficacy and effectiveness of an exercise program as community support for schizophrenic patients
Alejandro Torres-Carbajo, PhD; José Manuel Olivares, MD, PhD; Hipólito Merino, PhD; Hermelinda Vázquez, OT; Antonio Díaz, PhD; Estela Cruz, PhD
Summer 2005; pages 41-47

Abstract
The goal of this research was to evaluate the cost of an exercise program and the relapse rate of patients enrolled in it during a 10-year period. Forty subjects diagnosed with clinically stable schizophrenia were included in the study. Of these subjects, 20 (experimental group, EG) participated in the exercise program for a mean of 4.1 years (range, two to 10 years), while the remaining 20 individuals (control group, CG) were seen in the outpatient clinic of the Mental Health Center for a mean of 4.0 years (range, two to eight years). Relapse was evaluated before and after starting maintenance treatment, with an assessment of the costs of each therapy. There were no differences between the two groups in terms of the type, amount, and cost of drug treatment. The two groups showed significantly fewer relapses than in their earlier history, although the reduction was significantly greater in the EG than in the CG. The EG also showed very important savings on total costs. Enrollment in an exercise program is considered a more effective and efficient treatment than standard care for schizophrenic patients. It may help to ensure patient adherence, a feeling of belonging, relapse reduction, and reduced overall healthcare costs. Key words: schizophrenia, outpatient programs, exercise, recreation, cost

American Journal of Recreation Therapy
Fall 2005, Volume 4
, Number 4


Article
Newsbriefs
Fall 2005; pages 5-6

Abstract
Exercise reduces risk of breast cancer. New NIH study on benefits of fun. NCTRC job analysis study. Increased television watching and childhood obesity.


Article
Editorial. What’s missing in our profession?
Linda L. Buettner, PhD, CTRS, Editor-in-Chief
Fall 2005; pages 9-10


Article
The relationship between free-time boredom and aggressive behavioral tendencies among college students with disabilities
Heewon Yang, PhD, CTRS; Taeho Yoh, PhD
Fall 2005; pages 11-16

Abstract
The purpose of this study was to examine the relationship between aggressive behavioral tendency and free-time boredom among college students with disabilities. Subjects were 101 college students with different types of disabilities (i.e., physical disabilities, sensory disabilities, learning disabilities, mobility issues, and brain injury) at a large Midwestern university. Overall, the respondents reported having an aggressive behavioral tendency to some degree. However, they did not perceive that they were bored in their free time. Results indicated that there is a positive correlation between aggressive behavioral tendency and free-time boredom. In particular, Speed of Time, a subscale of the Free-Time Boredom assessment scale, showed the highest correlation with Physical Aggression, a subscale of the Aggression Inventory. Findings of this study provide therapeutic recreation specialists with valuable insights for practice. Key words: aggressive behavior, free-time boredom, physical aggression, verbal aggression, recreation therapy intervention


Article
A pilot study comparing environments in which relaxation is taught: Investigating the potential of Snoezelen for chronic pain management
Patricia A. Schofield, RN, PhD
Fall 2005; pages 17-27

Abstract
The purpose of this study was to evaluate the use of Snoezelen, or sensory stimulation and relaxation, as a therapeutic intervention for use in the management of chronic pain patients. The study compared the use of Snoezelen to traditional relaxation within the pain clinic setting. Seventy-three adult patients were recruited from a convenience sample and then randomly assigned into control and experimental groups. The control group was given access to a relaxation program within a pain clinic setting; the experimental group was given access to a Snoezelen environment for the same amount of time. Assessments were carried out at three time intervals on a range of symptoms designed to reflect the multidimensional nature of the chronic pain experience, including pain intensity, quality, anxiety, depression, coping, confidence, and quality of life. Although both groups demonstrated some improvements in their outcome measures, the experimental group appeared to do better, thus suggesting that Snoezelen is as good as, if not slightly better, than a traditional relaxation environment. Key words: Snoezelen, sensory stimulation, chronic pain, relaxation, recreation therapy


Article
The systematic fluctuations of self-efficacy, happiness, and anxiety during one game of bowling
James B. Wise, PhD, CTRS; Vanessa Javes Peter McAfee
Fall 2005; pages 29-34

Abstract
The purpose of this study was to determine if self-reported values of self-efficacy, happiness, and anxiety systematically fluctuated during one game of bowling. The hypothesis was that the values of the constructs would change when the environment was altered. Study participants were 14 university students who were novice or recreational bowlers. Self-efficacy, happiness, and anxiety values were collected from each participant before he/she rolled a ball. Data for each construct for each participant were plotted on separate graphs and visually inspected. In general, and as hypothesized, the values of the variables fluctuated as the environment changed. The conclusion was reached that this information should be incorporated into the multivariate explanatory models of human behavior therapeutic recreation specialists develop to guide their professional practice. Key words: anxiety, happiness, multivariate models, recreation, self-efficacy


Article
Computer-assisted stimulating activities for elders with dementia: A review
Sunghee H. Tak, PhD, MPH, RN; Cornelia Beck, PhD, RN; Linda L. Buettner, PhD, CTRS; Fred Clark, BS
Fall 2005; pages 35-42

Abstract
Multisensory activities stimulate cognitive processing, reduce the risk of dementia, and diminish boredom and excessive unstructured time in elders. Advances in computer technology have the capacity to offer multisensory activities appropriate to elders’ cognitive and functional ability while providing enjoyment to elders and a brief respite to caregivers. This article will describe the benefits of recreational use of computer-assisted stimulating activities for elders with memory loss, discuss the nascent research in this area, and explore the implications of this research in clinical practice. It will also provide a rationale for long-term care facilities to offer interdisciplinary computerized activity programs for residents with dementia. Key words: computer-assisted activities, cognitive stimulation, dementia, memory loss, recreation therapy


Article
Reiki adds a new dimension to the term “quality of life” in the nursing home community
Tuesday May Thomas
Fall 2005; pages 43-48

Abstract
Reiki, or the practice of therapeutic touch, is a recreational activity that can support the healing process of nursing home patients and enhance their quality of life. Such a program is facilitated by a Reiki “master” or a Reiki “attuned” and trained facilitator, and provides a platform for residents to experience Reiki as a form of complimentary healing through gentle touch therapy. This manuscript discusses the results of a one-year study of a Reiki program used in a nursing home, along with guidelines for setting up a similar program in a healthcare facility. Participants were diagnosed with Alzheimer’s disease, Parkinson’s disease, and dementia. Also included were individuals undergoing stroke recovery, along with those experiencing imbalances of a psychological nature such as stress, anxiety, and depression. Results indicated that Reiki had a positive influence on all study participants. Key words: recreation therapy, Reiki, ripple effect, touch, quality of life