Recreation isn't just about using your time to have fun, despite the fact that is an enjoyable side effect; recreation is therapeutic . Targeted interventions improve overall quality of life. They improve physical, emotional, cognitive and relationship function. Below is just a few sources of evidentiary research about the effects of Recreation Therapy interventions.
Families
Therapeutic Family Camping: A Rationale
Jonathan Clark and Hyman L. KemplerThe Family Coordinator Vol. 22, No. 4 (Oct., 1973), pp. 437-442
Published by: National Council on Family Relations
The authors contend that therapy interspersed with natural life activities can be especially worthwhile to families. To evaluate this idea they brought together three disturbed families in a camp setting. Generally, they and the families thought it a valuable experience and were especially impressed with the behavioral experimentation and feedback that occurred. Relief from daily routines, relaxation, and play appeared to facilitate review of interpersonal problems. Family camping is viewed as a potential adjunct to family therapy.
The Influences of Family Leisure Patterns on Perceptions of Family Functioning
Ramon B. Zabriskie and Bryan P. McCormick Family Relations Vol. 50, No. 3 (Jul., 2001), pp. 281-289
This study conducted a preliminary test of a model of family leisure functioning by examining the relationship of core and balance family leisure patterns to family cohesion and adaptability. The results indicated favorably that families who develop a pattern of healthy leisure had better adaptation skills overall in other areas.
Reducing symptoms of post-traumatic stress in children after a natural disaster: a recreational therapy intervention
Approximately six months after Hurricane Floyd in 1999, 150 fourth-grade students were assessed for symptoms of PTSD and preferred styles of coping. A six-week recreational therapy intervention was implemented and the students were reassessed. Results indicated a 6.6% decrease in PTSD symptoms. When pre-and post-intervention data was compared with follow up data a year later, the greatest symptom reduction had occurred during the intervention phase with average symptom scores falling 11.2 times faster. In addition, eight of the fifteen coping strategies changed in direction indicating improved coping. This study demonstrates that recreational therapy interventions are effective in reducing symptoms of PTSD in children after natural disasters. Implications for future disaster relief interventions are discussed.
Leisure and family functioning in adoptive families: implications for therapeutic recreation
The purpose of this study was to examine the relationship between family leisure involvement and family functioning among intact families with adopted children of color in the USA. The sample consisted of 197 families. Data were analyzed at the parent, youth, and family perspective. The Family Leisure Activity Profile was used to determine family leisure involvement in core and balance leisure activities. FACES II was used to measure family functioning. Blocked multiple regression analyses indicated a positive relationship between family leisure and family functioning. Specifically, in the parent data, both core and balance patterns were significant predictors of family functioning, yet from the youth and family perspective only core leisure involvement was significantly related to family functioning.
Playing Together Growing Together: Parents Perspectives on the Benefits of Family Recreation in Families that Include Children with a Developmental Disability
Children with developmental disabilities derived benefits similar to those gained by the entire family from family recreation—enhanced connections with family, and the development of life-long skills and values (see Table 5). The findings also suggested, however, that these benefits were considered to be of particular importance for the children with disabilities and that families viewed themselves as playing a critical role in ensuring their attainment. As such, family recreation was not only viewed as a beneficial catalyst for skill, interest and self development, but was potentially the most accepting and enduring social and recreation outlet for children with a developmental disability.
The Influence of Challenging Outdoor Recreation on Parent-Adolescent Communication
Outcomes from this study suggest that challenging family outdoor programs provide therapeutic recreation practitioners a unique resource to help strengthen families and provide therapeutic benefits. Challenging outdoor recreation can improve communication between parents and adolescents. Healthy parent-adolescent communication can serve to moderate delinquent behaviors (Clark &Shields, 1997). Therapeutic recreation specialists working in therapeutic wilderness agencies, adventure programs, or even community based programs could benefit by the incorporation of the family unit into their treatment programs. Qualitative data suggests that keeping families working together is important. The process of working together is the critical agent in promoting open communication. Another interesting finding from the qualitative data was the influence of the staff on the participants. A common and strong theme in the data was the positive example of the staff and how that influenced families. It is important to recognize the staff, as a significant variable, influencing change in communication among participants. These findings may also influence therapeutic recreation professionals and family therapists to consider utilizing challenging outdoor recreation as an alternative means of improving family functioning over traditional therapeutic techniques. Parents seeking to build and sustain family relationships through positive communication might consider seeking out challenging outdoor experiences.
Youth
Effects of recreational therapy for youth in a secured substance abuse treatment program: An exploratory study
Timothy J. Stockhecke, MS; Heewon Yang, PhD, CTRS; Marjorie J. Malkin, EdD, CTRS Published by American Journal of Recreation Therapy Spring 2012 pg. 23-31
The purpose of the study was to examine if a recreational therapy program decreased substance craving scores among youth at a juvenile detention center. Existing data from three male and three female youths’ craving scores, recorded before and after four recreation therapy interventions per week, were used to obtain the results of the two research questions over an 8-week period. This secured substance abuse treatment program utilized the Craving Identification Management (CIM) model. The craving scores identified by the youth prior to and following all of the recreational therapy activities were analyzed through descriptive statistics to determine the effectiveness of recreation therapy (RT). Results of the research project indicated that recreational therapy may be an effective intervention for lowering the craving scores of youth in a secured substance abuse treatment program.
Developing Coordinated, Multimodal, School-Based Treatment for Young Adolescents with ADHD
Steven W. Evans, Bebhinn Timmins, Maggie Sibley, L. Casey White, Zewelanji N. Serpell and Brandon SchultzEducation and Treatment of Children Vol. 29, No. 2, Special Issue: Bringing Evidence-Based Child Mental Health Services to the Schools: General Issues and Specific Populations (MAY 2006), pp. 359-378 Published by: West Virginia University Press
The development and evaluation of effective treatments for these youth have lagged far behind that of many other disorders and age groups. This manuscript describes the treatment development process for a school-based comprehensive care model for treating middle-school aged youth with ADHD. An overview of the development process is described as well as future directions. Specific interventions that comprise the Challenging Horizons Program (CHP) are explained as well as their feasibility in public middle schools.
Who Am I? Identity Formation, Youth and Therapeutic Recreation
Facilitating the processes of exploration and commitment could be done through interventions already used by therapeutic recreation professionals. For example, therapeutic recreation professionals can and do use expressive art as a therapeutic medium. Murray (1997) described journals as away to process life-threatening illnesses, to make sense of family relationships, and to integrate ability/disability into one's identity. She stated, "participants remade their identities as persons recovering from illness or trauma by making coherent narratives in daily creative journal activities"
Adventure Therapy with Girls at Risk
In conclusion, the themes that were constructed from the data revealed that overall, the girls found positive meaning within the hiking trip and/or ropes course initiatives. The main themes constructed from the interviews with the girls were related to issues of trust, empowerment, and teamwork. In addition, the girls recognized personal value within the activities in terms of what the experiences meant to them individually. The girls seemed to internalize and feel good about what they saw in themselves.
Anxiety and Stress
Evaluation of a brief exercise intervention for high anxiety sensitivity.Anxiety, Stress, and Coping
Specifically, this study indicated that a single 20-minute bout of aerobic exercise can lead to significant reductions in anxiety sensitivity scores, as well as reductions in more specific fears of cardiovascular and respiratory symptoms, socially observable anxiety symptoms, and cognitive control over symptoms. These findings are consistent with previous research, which suggested that individuals report less fear of anxiety-related physical sensations following a single exercise session (Broman-Fulks et al., 2004). Thus, the apparent fast acting effects of aerobic exercise may make it a particularly attractive form of intervention for individuals with high anxiety sensitivity who desire rapid reductions in anxiety-related fears and associated phenomena.
The Benefits of Exercise for the Clinically Depressed
When compared with other traditional treatments for depression, exercise was just as beneficial and not significantly different from psychotherapy and other behavioral interventions... exercise was as effective as medication for reducing symptoms of depression in that sample. Interestingly, 10 month follow-up of those participants revealed that exercise group members (70%) had significantly (p=.028) lower rates of depression than those in the medication group (48%) or the combination group (54%). At 10 months, regular exercise involvement was a significant predictor of lower rates of depression.
Leisure and Stress Coping: Implications for Therapeutic Recreation Practice
Within the field of leisure studies there is growing evidence of the value of leisure activity and experience in the course of coping with and adjusting to the kinds of acute and chronic life stressors that clients in therapeutic recreation (TR) settings may encounter. A review of leisure-coping literature is provided, drawing on research and theory-building in the leisure studies field. Following this, implications for TR practice are outlined. This review identifies the need to give particular attention to individual differences in leisure’s influence in coping with stress, as well as to the effects of different leisure activities and experiences in developing guidelines for various aspects of TR service, including TR assessment and intervention.
Participation in outdoor recreation program predicts improved psychosocial well-being among veterans with post-traumatic stress disorder: a pilot study.
PURPOSE: Evaluate the effectiveness of a 2-day, 3-night outdoor recreation intervention involving fly-fishing in reducing the psychological concomitants of stress among 74 veterans (M = 47.27, SD = 14.55 years) with post-traumatic stress disorder (PTSD).
METHODS: Participants completed repeated assessments of attentiveness, mood, depression, anxiety, and somatic stress across 3 time periods, corresponding to 2 weeks before the trip (baseline), the last day of the trip, and a 6-week follow-up. Assessments of perceptual stress, PTSD symptoms, and sleep quality were also administered during the baseline and follow-up periods.
RESULTS: Acute effects were observed for improvements in attentiveness and positive mood states, coupled with significant and sustained reductions in negative mood states, anxiety, depression, and somatic symptoms of stress. Comparisons between the baseline and follow-up periods revealed significant improvements in sleep quality and reductions in perceptual stress and PTSD symptoms.
CONCLUSIONS: The current findings suggest that combat veterans with PTSD may benefit from participation in group-based outdoor recreation as a means to improve psychosocial well-being.
Exploring the therapeutic effects of yoga and its ability to increase quality of life.
The objective of this study was to assess the findings of selected articles regarding the therapeutic effects of yoga and to provide a comprehensive review of the benefits of regular yoga practice. As participation rates in mind-body fitness programs such as yoga continue to increase, it is important for health care professionals to be informed about the nature of yoga and the evidence of its many therapeutic effects. Thus, this manuscript provides information regarding the therapeutic effects of yoga as it has been studied in various populations concerning a multitude of different ailments and conditions. Therapeutic yoga is defined as the application of yoga postures and practice to the treatment of health conditions and involves instruction in yogic practices and teachings to prevent reduce or alleviate structural, physiological, emotional and spiritual pain, suffering or limitations. Results from this study show that yogic practices enhance muscular strength and body flexibility, promote and improve respiratory and cardiovascular function, promote recovery from and treatment of addiction, reduce stress, anxiety, depression, and chronic pain, improve sleep patterns, and enhance overall well-being and quality of life.
Blazing new trails: Adventure therapy for adolescents with eating disorders
Clients at an adolescent eating disorders day hospital were offered a three-day adventure therapy program as a unique addition to their treatment plans. Objectives of the program were to build self-esteem, enhance trust in others, try new foods outside of the hospital setting, meet weight gain parameters required by the day hospital, gain back country camping skills, and incorporate skills learned into their daily lives. Modifications to traditional adventure therapy included using meals and snacks as the basis for scheduling and providing light to moderate rather than rigorous activities. Activities included paddling, fishing, team building, trust and problem-solving initiatives, therapeutic journaling, cookouts, backpacking, and camping. After participating in the program, clients completed self-evaluations. Their responses, along with their ability to meet the weight gain parameters required by the day hospital, indicated that all the objectives of the program were met. This result reinforced that adolescents with eating disorders can successfully participate in and benefit from adventure therapy programs.
Memory Loss
Recreational Activities to Reduce Behavioral Symptoms in Dementia
Another key to successful participation involves the structure of activities. Breaking the tasks of the activity into steps ensures a flow of information and demands that can be understood and followed by the person with dementia. In summary, recreational activities hold much promise for reducing behavioral symptoms and improving quality of life for people with dementia. An informed approach to their use will maximize the effectiveness of this first-line treatment.
Evidence supporting exercise interventions for persons in early-stage Alzheimer’s disease
The purpose of this article is to grade research evidence supporting exercise-based interventions for persons with early-stage dementias and to report the recommendations of a consensus panel. The search produced 11 data based articles testing the effects of exercise interventions on a variety of outcomes. The body of evidence to support exercise interventions in the prevention and treatment of Alzheimer’s disease is growing and has potential as a treatment modality following translational studies in recreation therapy and other fields.
Simple Pleasures: a multilevel sensori-motor intervention for nursing home residents with dementia
The impact on families perceptions of visits was very powerful at both facilities. The families viewed their visits much more positively during the intervention at both facilities. The individuals interviewed stated they visited more often, stayed longer, used recreational items during the visits, and were more satisfied with visits. It is interesting to note that several of the Simple Pleasures items that had a calming effect were also items that warmed the residents. For example, the "fleecy muff", the "polar fleece hot water bottle", and the "sensory vest" were all made from polar fleece fabric. It appeared that a certain degree of disruptive behavior was caused by residents feeling cold. When given the items mentioned above the "disruptive" behavior disappeared within minutes.
Developing a Therapeutic Recreation Dementia Program: Community-wide benefits through staff education and empowerment
The project has achieved benefits beyond our initial expectations-benefits that can easily be replicated in other facilities. As a result of Pieces of the Puzzle, falls on the unit dramatically decreased, staff satisfaction appears to have increased, and CNA turnover has disappeared. All these benefits are a result of improving the teamwork on the unit, a team now driven to provide the residents with meaningful daily interactions. Overall, the combination of dementia education and new ways of problem solving empowered the staff to develop creative interventions to everyday challenges.
Effects of Animal Assistive Therapy on Agitated Behaviors and Social Interactions of Older Adults with Dementia
The effects of a therapeutic recreation intervention using animal-assisted therapy (AAT) on the agitated behaviors and social interactions of older adults with dementia were examined using the Cohen-Mansfield Agitation Inventory and the Animal-Assisted Therapy Flow Sheet. In a pilot study, 15 nursing home residents with dementia participated in a daily AAT intervention for three weeks. Results showed statistically significant decreases in agitated behaviors and a statistically significant increase in social interaction pretest to post-test.
A therapeutic cooking program for older adults with dementia: Effects on agitation and apathy
This study describes a clinical trial of a recreational therapy cooking program for older adults with dementia and disturbing behaviors living in an assisted living center. After two weeks of daily participation, results indicated a significant improvement in levels of both passivity and agitation. Biographical data collection was useful in identifying the physiological changes that occurred during each session. Implications for service delivery are included.
Autism
Play Time: An Examination Of Play Intervention Strategies for Children with Autism Spectrum Disorders
Through play, children learn a variety of skills that are fundamental to development. Many children with autism spectrum disorders have skill deficits and interfering problem behaviors that hinder developmentally beneficial play. Integrated Play Groups and Floor Time are two early intervention strategies that aim to improve qualitative play skills in young children with autism spectrum disorders. In both models, direct instruction is not provided; rather, adults provide support to child initiated interactions. The research available supports the effectiveness of the IPG and Floor Time models; however, inadequate samples and other methodological issues limit the utility of the studies. Early intervention efforts typically focus on the development of communication skills, social skills training, and the reduction of problem behaviors through direct instruction. Often a child with an autism spectrum disorder has a day filled with constant demands from adults, which when compared to the expectations placed on typically developing children, seems unnatural and developmentally inappropriate. It is proposed that skill deficits addressed through child directed and adult supported play become a standard component of early intervention practice.
The Effects of Least to Most Prompting Procedure in Teaching Basic Tennis Skills to Kids with Autism
Results revealed that least to most prompting was an effective instructional approach and all subjects increased their basic tennis skills considerably during intervention.
Effects of a leisure program on quality of life and stress of individuals with Autism Spectrum Disorder.
Findings support the contention that participation in recreation activities positively influenced the stress and quality of life of adults with ASD. There was a significant decrease in overall scores of stress levels for participants over the course of the study and there was a significant increase in the four factors of quality of life that were measured (satisfaction, independence, competence and social interaction) as well as the total score for quality of life from baseline to the end of the intervention 12 months later. In contrast, the control group demonstrated no significant improvements related to stress or quality of life. Implications of these findings to leisure services and the quality of life of individuals with ASD are discussed. Conclusion Findings support the contention that participation in recreation activities positively influenced the stress and quality of life of adults with ASD.
Cerebral Palsy
Recreation Therapy and Cerebral Palsy
Therefore, recreation therapy, or therapeutic recreation, is an important step in helping an individual with cerebral palsy become a well-rounded individual afforded the benefits that physical, mental, and social experiences provide. Recreation therapy focuses on inclusion, not exclusion, by allowing the individual to participate and be an integral part of activities they enjoy and learn from.
However, recreation therapy also has another purpose – to enhance the ability of a child with cerebral palsy to plan, strategize and perform tasks in an effort to achieve improved physical functioning and encourage emotional well-being by facilitating inclusion into activities they benefit by and enjoy. This provides quality of life.
Chronic Illness
Health-related quality of life changes of children and adolescents with chronic disease after participation in therapeutic recreation camping program.
The therapeutic recreation camping program had a positive impact on HRQoL of children and adolescents living with cancer, diabetes mellitus and JIA. The experience enhanced their self-perception in all age groups and reduced the autonomy of children under 14 years of age. This study is an innovative use of the KIDSCREEN-52 questionnaire to measure the outcome effectiveness of a psychosocial rehabilitation program and to assess and compare HRQoL of children living with different chronic diseases.
Optimizing Lifelong Health and Well-Being: A Health Enhancing Model of Therapeutic Recreation
The Optimizing Lifelong Health through Therapeutic Recreation model is presented and discussed as part of the ongoing dialogue regarding new approaches to conceptualizing and delivering therapeutic recreation services. Through the elements of selecting, optimizing,compensating, and evaluating (Bakes & Baltes, 1990), therapeutic recreation specialists work with individuals who have illness, disease, and/or lifelong disability to achieve and maintain leisure lifestyles that will enhance their health and well-being across the life course.
Developmental Disabilities
Social Inclusion Through Recreation
It should be remembered, however, that while all recreation and leisure programs have the potential to facilitate social inclusion, not all necessarily fulfill this promise. Organizational attitudes and beliefs supportive of inclusion and the right of persons with disabilities to access the same programs as their peers without disabilities are a prerequisite. Direct service staff who have a knowledge of and experience working with persons with disabilities as well as a passion for inclusion are also a necessity. The ability and willingness of staff to make necessary accommodations and adaptations are a direct result of this knowledge, experience, and passion. Parents, families, and guardians also play a role as they must accept the fact that persons with disabilities need to be able to select the specific recreation and leisure activities in which they want to become engaged themselves and that involvement in just about any program carries with it some risk.While representing only a part of the “inclusion puzzle,” recreational programs carried out by organizations that truly understand what social inclusion entails, provide adequate supports and accommodations, and are staffed by individuals who accept and celebrate diversity in all of its forms provide an opportunity for persons with disabilities to take a step closer to fulfilling their dreams of full inclusion within the communities in which they live.
Adapted Physical Education and Therapeutic Recreation in Schools
Adapted physical education is a mandated service, whereas therapeutic recreation and traditional recreation are considered related services under the Individuals with Disabilities Education Act. In this article, the authors describe the distinctions between the services, recognition of need for referral, methods of assessment, sample Individualized Education Program goals with short-term objectives and/or benchmarks, strategies for the classroom teachers, and interventions and service delivery models typically used by physical education teachers and recreational therapists.
Spinal Cord Injury
Using exercise to enhance subjective well-being among people with spinal cord injury: The mediating influences of stress and pain.
Analyses of covariance indicated that after 3 months, exercisers reported less pain, depression, and stress, as well as greater perceived quality of life and better physical self-concept than controls (ps<.05). Regression analyses revealed that changes in pain and stress mediated exercise-induced changes in perceived quality of life and depression. Conclusion: Changes in pain and stress may be mechanisms by which exercise improves SWB among people with SCI.
Relationship of therapeutic recreation inpatient rehabilitation interventions and patient characteristics to outcomes following spinal cord injury: the SCI-Rehab project.
Greater participation in TR-led leisure skill and community activities during rehabilitation is a positive predictor of multiple outcomes at rehabilitation discharge and the 1-year injury anniversary demonstrating that TR activities are associated with a return to a productive and healthy life after SCI. Further research should focus on the impact of TR on longer-term outcomes to determine whether relationships continue or change as persons continue to adapt to their life after SCI.
Returning to the Community with a Spinal Cord Injury: Implications for Therapeutic Recreation
Results of this study support the importance of including the perceptions of people with SCI when attempting to understand the relevance of leisure and social relationships to their integration into the community. By using such perceptions social contacts were identified as being important in facilitating community integration. It was clear from the data that leisure can be a context for the establishment and, perhaps the maintenance and development of such social contacts. TR specialists are encouraged to consider strategies to overcome limitations associated with rehabilitation environments by continuously planning for participants' integration into the community. TR services can be designed to enhance the social support of people with SCI in ways that facilitate their return to the community
Exercise is Medicine™: Exercise Prescription After SCI to Manage Cardiovascular Disease Risk Factors
Exercise is underutilized in the battle against cardiovascular disease (CVD) for both the nondisabled and spinal cord—injured (SCI) populations. The American College of Sports Medicine and American Heart Association have launched the Exercise is Medicine™ initiative to facilitate widespread adoption of exercise as a practical treatment option by increasing awareness and providing structured guidance. We review the initiative, current exercise recommendations for the nondisabled, supporting evidence in the SCI population, and appropriate SCI-related alterations to exercise prescription. Finally, we provide resources supporting the prescription process for persons with SCI.
Stroke
Wii Video Games as Home Based Therapy for Stroke Patients
Dr. Saposnik explained that “The repetitive tasks and task-specific activities involved in the Wii gaming technology engage the “mirror neuron system” that is linked to brain plasticity.” He added that “Some part of the brain or set or cluster of neurons may activate just by watching other people making movements.” Although the study found some differences in grip strength improvement between the 2 groups, after adjusting for baseline differences, this was not significant.
According to Dr. Saposnik, “The rationale behind testing this gaming technology in post-stroke therapy is that current approaches are time consuming, have only a modest effect, are research and therapy intensive, and usually have a poor compliance. In addition, standard rehabilitation is not always available and can be costly. In contrast; the virtual reality Nintendo gaming system is more accessible and attractive to patients. They tend to be “more engaged” and have more fun with the Wii games.”
Cancer
Nature-based experiences and health of cancer survivors.
PURPOSE: Although exposure to, and interaction with, natural environments are recognized as health-promoting, little is understood about the use of nature contact in treatment and rehabilitation for cancer survivors.
METHODS: This narrative review summarizes the literature exploring the influence of nature-based experiences on survivor health. Key databases included CINAHL, EMBASE, Medline, Web of Science, PubMed, PsycArticles, ProQuest, and Cancerlit databases.
RESULTS: Sixteen articles met inclusion criteria and were reviewed. Four major categories emerged: 1) Dragon boat racing may enhance breast cancer survivor quality of life, 2) Natural environment may counteract attentional fatigue in newly diagnosed breast cancer survivors, 3) Adventure programs provide a positive experience for children and adolescent survivors, fostering a sense of belonging and self-esteem, and 4) Therapeutic landscapes may decrease state-anxiety, improving survivor health.
CONCLUSIONS: This review contributes to a better understanding of the therapeutic effects of nature-based experiences on cancer survivor health, providing a point of entry for future study.
Creative Arts
Helping and Hindering Processes in Creative Arts Therapy Group Practice Ditty Dokter Group Vol. 34, No. 1, CREATIVE ARTS THERAPY (MARCH 2010), pp. 67-83 Published by: Eastern Group Psychotherapy Society
This article reports on the findings from a therapeutic community based research project in the U.K. National Health Service eliciting client and therapist perceptions of helping and hindering processes in creative arts therapies groups. The study is used to contextualize different theoretical approaches within creative arts therapy groups and to highlight therapist interventions such as structuring and interpretation. Current debates about the arts as a facilitator or hindrance to working through group transference will be illustrated with case vignettes from early engagement with arts therapies groups in young adult psychiatry.
Aquatic Therapy
Aquatic Therapy: A Viable Therapeutic Recreation Intervention
There is evidence to indicate that aquatic therapy has numerous psychological and physical benefits. Furthermore, aquatic therapy appears not only to improve physical and psychological functioning, but also maintain health and daily life functioning. In addition,aquatic therapy is valuable because it is con-ducted in water which often improves participants' comfort and increases their confidence in achieving functional independence (Guillemin et al., 1994; Hurley & Turner,1991). The health care trend of shorter hospital stays and an emphasis on outpatient care has resulted in a need for therapeutic recreation interventions to be applied across a myriad of environments. The facilitation technique of aquatic therapy can result in an increase in participants' functional ability while they participate in an enjoyable leisure activity which encourages inclusion in their communities.
The Effect of Aquatic Therapy on Strength of Adults with Multiple Sclerosis
THERAPEUTIC RECREATION JOURNAL Vol. 37, No. 3, 224-239, 2003
Ellen Broach and John Dattilo
This study was conducted to examine the effects of an Aquatic Therapy (AT) exercise program on strength of four participants with relapsing-remitting multiple sclerosis. A single subject,multiple-probe design across participants was used to collect data. Measures of strength were operationalized through upper and lower extremity measures of quadriceps, hamstrings, hip flexion, biceps, triceps, and shoulder abduction strength. Mixed results prevent definitive conclusions regarding the effect of AT on strength. However, these results do have implications for people with multiple sclerosis with regard to strength since all individuals either maintained or improved strength.
Aquatic Therapy In Community-Based Therapeutic Recreation:Pain Management In a Case of Fibromyalgia
THERAPEUTIC RECREATION JOURNAL Vol. 35, No. 1, 57-69, 2001 Kenneth E. Mobily and Marie D. Verburg
The purpose of this case report was to describe the effects of an aquatic exercise program with an individual with fibromyalgia. A 59 year old female school teacher with fibromyalgia participated in an aquatic therapy program for a period of four and one-half months in a community-based therapeutic recreation setting. Shortly after participation was initiated, she reported relief from acute pain. Later, improvement in the degree to which pain interfered with functional activities was noted. In particular, she reported returning to work on a half-time basis and regained the stamina to participate in her favorite recreation and social activities. Findings from this case are consistent with those obtained from larger clinical trials using exercise interventions with persons diagnosed with fibromyalgia. Implications for community-based therapeutic recreation are discussed.
Exercise in 94°F Water for a Patient With Multiple Sclerosis
The patient did not experience heat sensitivity or fatigue throughout the program, and her manual muscle test grades and mobility improved.
Case Comparison of Response to Aquatic Exercise: Acute Versus Chronic Conditions
The purpose of this case report was to describe the effects of individualized aquatic exercise programs with two participants with knee impairments. The first participant was a 17-year-oldhigh school soccer player with an acute knee injury (torn anterior cruciate ligament). She demonstrated significant improvement in functional abilities over the course of the nine week intervention. The second participant was a 33-year-old female with a chronic knee condition(rheumatoid arthritis) localized to the right knee. Although she demonstrated only marginal progress in functional outcomes over the course of six months of participation, improvement in swimming ability was remarkable. The cases were compared and contrasted relative to valid data collection methods and response to aquatic exercise. Results suggested that both quantitative and qualitative data may be useful in determining the effectiveness of aquatic exercise programs. In particular, qualitative data provided insight into the meaning of the activity for the second participant
Prescribed Exercise Therapy
Comparing the effects of aquatic and land-based exercise on the physiological stress response of women with fibromyalgia.
Authors Kelley, C.; Loy, D. P. Journal Therapeutic Recreation Journal 2008 Vol. 42 No. 2 pp. 103-118
While many studies have suggested various treatment mechanisms for individuals with fibromyalgia (FMS), few have examined the impact of aquatic and land-based exercise on the physiological stress response in women with fibromyalgia. Due to the increased physiological and psychological stress associated with fibromyalgia, additional research examining the physiological responses to stress and interventions addressing stress in the FMS population is warranted. The present study examined salivary cortisol response of women with fibromyalgia during land-based exercise (i.e., walking on a treadmill) and aquatic exercise (i.e., Ai Chi). A single-subject alternating treatment design (N=3) was selected to compare the effectiveness of Ai Chi and treadmill walking on salivary cortisol levels. Cortisol samples were obtained from each participant prior to and immediately following each treatment session to serve as a psycho-physiological marker of stress. Results suggested both aquatic and land-based exercise had a positive influence in reducing salivary cortisol in women with FMS; however, exercising at a moderate pace on a treadmill proved to be the superior treatment intervention. Results of this study may potentially help women with FMS discover an alternate or additional treatment to assist in coping with stress related to chronic illness.
The Benefits of Exercise for the Clinically Depressed
When compared with other traditional treatments for depression, exercise was just as beneficial and not significantly different from psychotherapy and other behavioral interventions... exercise was as effective as medication for reducing symptoms of depression in that sample. Interestingly, 10 month follow-up of those participants revealed that exercise group members (70%) had significantly (p=.028) lower rates of depression than those in the medication group (48%) or the combination group (54%). At 10 months, regular exercise involvement was a significant predictor of lower rates of depression.
Evaluation of a brief exercise intervention for high anxiety sensitivity.Anxiety, Stress, and Coping
Specifically, the present study indicated that a single 20-minute bout of aerobic exercise can lead to significant reductions in anxiety sensitivity scores, as well as more specific fears of cardiovascular and respiratory symptoms, socially observable anxiety symptoms, and cognitive dyscontrol. These findings are consistent with previous research,which suggested that individuals report less fear of anxiety-related physical sensations following a single exercise session (Broman-Fulks et al., 2004). Thus, the apparent fast acting effects of aerobic exercise may make it a particularly attractive form of intervention for individuals with high anxiety sensitivity who desire rapid reductions in anxiety-related fears and associated phenomena.
Exercise for treating fibromyalgia syndrome
There were a total of 2276 subjects across the 34 included studies; 1264 subjects were assigned to exercise interventions. The 34 studies comprised 47 interventions that included exercise. Effects of several disparate interventions on global well-being, selected FM signs and symptoms, and physical function in individuals with FM were summarized using standardized mean differences (SMD). There is moderate quality evidence that aerobic-only exercise training at recommended intensity levels has positive effects global well-being (SMD 0.49, 95% CI: 0.23 to 0.75) and physical function (SMD 0.66, 95% CI: 0.41 to 0.92) and possibly on pain (SMD 0.65, 95% CI: -0.09 to 1.39) and tender points (SMD 0.23, 95% CI: -0.18 to 0.65). Strength and flexibility remain under-evaluated.
Using exercise to enhance subjective well-being among people with spinal cord injury: The mediating influences of stress and pain.
Analyses of covariance indicated that after 3 months, exercisers reported less pain, depression, and stress, as well as greater perceived quality of life and better physical self-concept than controls (ps<.05). Regression analyses revealed that changes in pain and stress mediated exercise-induced changes in perceived quality of life and depression. Conclusion: Changes in pain and stress may be mechanisms by which exercise improves SWB among people with SCI.
Exercise is Medicine™: Exercise Prescription After SCI to Manage Cardiovascular Disease Risk Factors
Exercise is underutilized in the battle against cardiovascular disease (CVD) for both the non-disabled and spinal cord—injured (SCI) populations. The American College of Sports Medicine and American Heart Association have launched the Exercise is Medicine™ initiative to facilitate widespread adoption of exercise as a practical treatment option by increasing awareness and providing structured guidance. We review the initiative, current exercise recommendations for the non-disabled, supporting evidence in the SCI population, and appropriate SCI-related alterations to exercise prescription. Finally, we provide resources supporting the prescription process for persons with SCI.
Families
Therapeutic Family Camping: A Rationale
Jonathan Clark and Hyman L. KemplerThe Family Coordinator Vol. 22, No. 4 (Oct., 1973), pp. 437-442
Published by: National Council on Family Relations
The authors contend that therapy interspersed with natural life activities can be especially worthwhile to families. To evaluate this idea they brought together three disturbed families in a camp setting. Generally, they and the families thought it a valuable experience and were especially impressed with the behavioral experimentation and feedback that occurred. Relief from daily routines, relaxation, and play appeared to facilitate review of interpersonal problems. Family camping is viewed as a potential adjunct to family therapy.
The Influences of Family Leisure Patterns on Perceptions of Family Functioning
Ramon B. Zabriskie and Bryan P. McCormick Family Relations Vol. 50, No. 3 (Jul., 2001), pp. 281-289
This study conducted a preliminary test of a model of family leisure functioning by examining the relationship of core and balance family leisure patterns to family cohesion and adaptability. The results indicated favorably that families who develop a pattern of healthy leisure had better adaptation skills overall in other areas.
Reducing symptoms of post-traumatic stress in children after a natural disaster: a recreational therapy intervention
Approximately six months after Hurricane Floyd in 1999, 150 fourth-grade students were assessed for symptoms of PTSD and preferred styles of coping. A six-week recreational therapy intervention was implemented and the students were reassessed. Results indicated a 6.6% decrease in PTSD symptoms. When pre-and post-intervention data was compared with follow up data a year later, the greatest symptom reduction had occurred during the intervention phase with average symptom scores falling 11.2 times faster. In addition, eight of the fifteen coping strategies changed in direction indicating improved coping. This study demonstrates that recreational therapy interventions are effective in reducing symptoms of PTSD in children after natural disasters. Implications for future disaster relief interventions are discussed.
Leisure and family functioning in adoptive families: implications for therapeutic recreation
The purpose of this study was to examine the relationship between family leisure involvement and family functioning among intact families with adopted children of color in the USA. The sample consisted of 197 families. Data were analyzed at the parent, youth, and family perspective. The Family Leisure Activity Profile was used to determine family leisure involvement in core and balance leisure activities. FACES II was used to measure family functioning. Blocked multiple regression analyses indicated a positive relationship between family leisure and family functioning. Specifically, in the parent data, both core and balance patterns were significant predictors of family functioning, yet from the youth and family perspective only core leisure involvement was significantly related to family functioning.
Playing Together Growing Together: Parents Perspectives on the Benefits of Family Recreation in Families that Include Children with a Developmental Disability
Children with developmental disabilities derived benefits similar to those gained by the entire family from family recreation—enhanced connections with family, and the development of life-long skills and values (see Table 5). The findings also suggested, however, that these benefits were considered to be of particular importance for the children with disabilities and that families viewed themselves as playing a critical role in ensuring their attainment. As such, family recreation was not only viewed as a beneficial catalyst for skill, interest and self development, but was potentially the most accepting and enduring social and recreation outlet for children with a developmental disability.
The Influence of Challenging Outdoor Recreation on Parent-Adolescent Communication
Outcomes from this study suggest that challenging family outdoor programs provide therapeutic recreation practitioners a unique resource to help strengthen families and provide therapeutic benefits. Challenging outdoor recreation can improve communication between parents and adolescents. Healthy parent-adolescent communication can serve to moderate delinquent behaviors (Clark &Shields, 1997). Therapeutic recreation specialists working in therapeutic wilderness agencies, adventure programs, or even community based programs could benefit by the incorporation of the family unit into their treatment programs. Qualitative data suggests that keeping families working together is important. The process of working together is the critical agent in promoting open communication. Another interesting finding from the qualitative data was the influence of the staff on the participants. A common and strong theme in the data was the positive example of the staff and how that influenced families. It is important to recognize the staff, as a significant variable, influencing change in communication among participants. These findings may also influence therapeutic recreation professionals and family therapists to consider utilizing challenging outdoor recreation as an alternative means of improving family functioning over traditional therapeutic techniques. Parents seeking to build and sustain family relationships through positive communication might consider seeking out challenging outdoor experiences.
Youth
Effects of recreational therapy for youth in a secured substance abuse treatment program: An exploratory study
Timothy J. Stockhecke, MS; Heewon Yang, PhD, CTRS; Marjorie J. Malkin, EdD, CTRS Published by American Journal of Recreation Therapy Spring 2012 pg. 23-31
The purpose of the study was to examine if a recreational therapy program decreased substance craving scores among youth at a juvenile detention center. Existing data from three male and three female youths’ craving scores, recorded before and after four recreation therapy interventions per week, were used to obtain the results of the two research questions over an 8-week period. This secured substance abuse treatment program utilized the Craving Identification Management (CIM) model. The craving scores identified by the youth prior to and following all of the recreational therapy activities were analyzed through descriptive statistics to determine the effectiveness of recreation therapy (RT). Results of the research project indicated that recreational therapy may be an effective intervention for lowering the craving scores of youth in a secured substance abuse treatment program.
Developing Coordinated, Multimodal, School-Based Treatment for Young Adolescents with ADHD
Steven W. Evans, Bebhinn Timmins, Maggie Sibley, L. Casey White, Zewelanji N. Serpell and Brandon SchultzEducation and Treatment of Children Vol. 29, No. 2, Special Issue: Bringing Evidence-Based Child Mental Health Services to the Schools: General Issues and Specific Populations (MAY 2006), pp. 359-378 Published by: West Virginia University Press
The development and evaluation of effective treatments for these youth have lagged far behind that of many other disorders and age groups. This manuscript describes the treatment development process for a school-based comprehensive care model for treating middle-school aged youth with ADHD. An overview of the development process is described as well as future directions. Specific interventions that comprise the Challenging Horizons Program (CHP) are explained as well as their feasibility in public middle schools.
Who Am I? Identity Formation, Youth and Therapeutic Recreation
Facilitating the processes of exploration and commitment could be done through interventions already used by therapeutic recreation professionals. For example, therapeutic recreation professionals can and do use expressive art as a therapeutic medium. Murray (1997) described journals as away to process life-threatening illnesses, to make sense of family relationships, and to integrate ability/disability into one's identity. She stated, "participants remade their identities as persons recovering from illness or trauma by making coherent narratives in daily creative journal activities"
Adventure Therapy with Girls at Risk
In conclusion, the themes that were constructed from the data revealed that overall, the girls found positive meaning within the hiking trip and/or ropes course initiatives. The main themes constructed from the interviews with the girls were related to issues of trust, empowerment, and teamwork. In addition, the girls recognized personal value within the activities in terms of what the experiences meant to them individually. The girls seemed to internalize and feel good about what they saw in themselves.
Anxiety and Stress
Evaluation of a brief exercise intervention for high anxiety sensitivity.Anxiety, Stress, and Coping
Specifically, this study indicated that a single 20-minute bout of aerobic exercise can lead to significant reductions in anxiety sensitivity scores, as well as reductions in more specific fears of cardiovascular and respiratory symptoms, socially observable anxiety symptoms, and cognitive control over symptoms. These findings are consistent with previous research, which suggested that individuals report less fear of anxiety-related physical sensations following a single exercise session (Broman-Fulks et al., 2004). Thus, the apparent fast acting effects of aerobic exercise may make it a particularly attractive form of intervention for individuals with high anxiety sensitivity who desire rapid reductions in anxiety-related fears and associated phenomena.
The Benefits of Exercise for the Clinically Depressed
When compared with other traditional treatments for depression, exercise was just as beneficial and not significantly different from psychotherapy and other behavioral interventions... exercise was as effective as medication for reducing symptoms of depression in that sample. Interestingly, 10 month follow-up of those participants revealed that exercise group members (70%) had significantly (p=.028) lower rates of depression than those in the medication group (48%) or the combination group (54%). At 10 months, regular exercise involvement was a significant predictor of lower rates of depression.
Leisure and Stress Coping: Implications for Therapeutic Recreation Practice
Within the field of leisure studies there is growing evidence of the value of leisure activity and experience in the course of coping with and adjusting to the kinds of acute and chronic life stressors that clients in therapeutic recreation (TR) settings may encounter. A review of leisure-coping literature is provided, drawing on research and theory-building in the leisure studies field. Following this, implications for TR practice are outlined. This review identifies the need to give particular attention to individual differences in leisure’s influence in coping with stress, as well as to the effects of different leisure activities and experiences in developing guidelines for various aspects of TR service, including TR assessment and intervention.
Participation in outdoor recreation program predicts improved psychosocial well-being among veterans with post-traumatic stress disorder: a pilot study.
PURPOSE: Evaluate the effectiveness of a 2-day, 3-night outdoor recreation intervention involving fly-fishing in reducing the psychological concomitants of stress among 74 veterans (M = 47.27, SD = 14.55 years) with post-traumatic stress disorder (PTSD).
METHODS: Participants completed repeated assessments of attentiveness, mood, depression, anxiety, and somatic stress across 3 time periods, corresponding to 2 weeks before the trip (baseline), the last day of the trip, and a 6-week follow-up. Assessments of perceptual stress, PTSD symptoms, and sleep quality were also administered during the baseline and follow-up periods.
RESULTS: Acute effects were observed for improvements in attentiveness and positive mood states, coupled with significant and sustained reductions in negative mood states, anxiety, depression, and somatic symptoms of stress. Comparisons between the baseline and follow-up periods revealed significant improvements in sleep quality and reductions in perceptual stress and PTSD symptoms.
CONCLUSIONS: The current findings suggest that combat veterans with PTSD may benefit from participation in group-based outdoor recreation as a means to improve psychosocial well-being.
Exploring the therapeutic effects of yoga and its ability to increase quality of life.
The objective of this study was to assess the findings of selected articles regarding the therapeutic effects of yoga and to provide a comprehensive review of the benefits of regular yoga practice. As participation rates in mind-body fitness programs such as yoga continue to increase, it is important for health care professionals to be informed about the nature of yoga and the evidence of its many therapeutic effects. Thus, this manuscript provides information regarding the therapeutic effects of yoga as it has been studied in various populations concerning a multitude of different ailments and conditions. Therapeutic yoga is defined as the application of yoga postures and practice to the treatment of health conditions and involves instruction in yogic practices and teachings to prevent reduce or alleviate structural, physiological, emotional and spiritual pain, suffering or limitations. Results from this study show that yogic practices enhance muscular strength and body flexibility, promote and improve respiratory and cardiovascular function, promote recovery from and treatment of addiction, reduce stress, anxiety, depression, and chronic pain, improve sleep patterns, and enhance overall well-being and quality of life.
Blazing new trails: Adventure therapy for adolescents with eating disorders
Clients at an adolescent eating disorders day hospital were offered a three-day adventure therapy program as a unique addition to their treatment plans. Objectives of the program were to build self-esteem, enhance trust in others, try new foods outside of the hospital setting, meet weight gain parameters required by the day hospital, gain back country camping skills, and incorporate skills learned into their daily lives. Modifications to traditional adventure therapy included using meals and snacks as the basis for scheduling and providing light to moderate rather than rigorous activities. Activities included paddling, fishing, team building, trust and problem-solving initiatives, therapeutic journaling, cookouts, backpacking, and camping. After participating in the program, clients completed self-evaluations. Their responses, along with their ability to meet the weight gain parameters required by the day hospital, indicated that all the objectives of the program were met. This result reinforced that adolescents with eating disorders can successfully participate in and benefit from adventure therapy programs.
Memory Loss
Recreational Activities to Reduce Behavioral Symptoms in Dementia
Another key to successful participation involves the structure of activities. Breaking the tasks of the activity into steps ensures a flow of information and demands that can be understood and followed by the person with dementia. In summary, recreational activities hold much promise for reducing behavioral symptoms and improving quality of life for people with dementia. An informed approach to their use will maximize the effectiveness of this first-line treatment.
Evidence supporting exercise interventions for persons in early-stage Alzheimer’s disease
The purpose of this article is to grade research evidence supporting exercise-based interventions for persons with early-stage dementias and to report the recommendations of a consensus panel. The search produced 11 data based articles testing the effects of exercise interventions on a variety of outcomes. The body of evidence to support exercise interventions in the prevention and treatment of Alzheimer’s disease is growing and has potential as a treatment modality following translational studies in recreation therapy and other fields.
Simple Pleasures: a multilevel sensori-motor intervention for nursing home residents with dementia
The impact on families perceptions of visits was very powerful at both facilities. The families viewed their visits much more positively during the intervention at both facilities. The individuals interviewed stated they visited more often, stayed longer, used recreational items during the visits, and were more satisfied with visits. It is interesting to note that several of the Simple Pleasures items that had a calming effect were also items that warmed the residents. For example, the "fleecy muff", the "polar fleece hot water bottle", and the "sensory vest" were all made from polar fleece fabric. It appeared that a certain degree of disruptive behavior was caused by residents feeling cold. When given the items mentioned above the "disruptive" behavior disappeared within minutes.
Developing a Therapeutic Recreation Dementia Program: Community-wide benefits through staff education and empowerment
The project has achieved benefits beyond our initial expectations-benefits that can easily be replicated in other facilities. As a result of Pieces of the Puzzle, falls on the unit dramatically decreased, staff satisfaction appears to have increased, and CNA turnover has disappeared. All these benefits are a result of improving the teamwork on the unit, a team now driven to provide the residents with meaningful daily interactions. Overall, the combination of dementia education and new ways of problem solving empowered the staff to develop creative interventions to everyday challenges.
Effects of Animal Assistive Therapy on Agitated Behaviors and Social Interactions of Older Adults with Dementia
The effects of a therapeutic recreation intervention using animal-assisted therapy (AAT) on the agitated behaviors and social interactions of older adults with dementia were examined using the Cohen-Mansfield Agitation Inventory and the Animal-Assisted Therapy Flow Sheet. In a pilot study, 15 nursing home residents with dementia participated in a daily AAT intervention for three weeks. Results showed statistically significant decreases in agitated behaviors and a statistically significant increase in social interaction pretest to post-test.
A therapeutic cooking program for older adults with dementia: Effects on agitation and apathy
This study describes a clinical trial of a recreational therapy cooking program for older adults with dementia and disturbing behaviors living in an assisted living center. After two weeks of daily participation, results indicated a significant improvement in levels of both passivity and agitation. Biographical data collection was useful in identifying the physiological changes that occurred during each session. Implications for service delivery are included.
Autism
Play Time: An Examination Of Play Intervention Strategies for Children with Autism Spectrum Disorders
Through play, children learn a variety of skills that are fundamental to development. Many children with autism spectrum disorders have skill deficits and interfering problem behaviors that hinder developmentally beneficial play. Integrated Play Groups and Floor Time are two early intervention strategies that aim to improve qualitative play skills in young children with autism spectrum disorders. In both models, direct instruction is not provided; rather, adults provide support to child initiated interactions. The research available supports the effectiveness of the IPG and Floor Time models; however, inadequate samples and other methodological issues limit the utility of the studies. Early intervention efforts typically focus on the development of communication skills, social skills training, and the reduction of problem behaviors through direct instruction. Often a child with an autism spectrum disorder has a day filled with constant demands from adults, which when compared to the expectations placed on typically developing children, seems unnatural and developmentally inappropriate. It is proposed that skill deficits addressed through child directed and adult supported play become a standard component of early intervention practice.
The Effects of Least to Most Prompting Procedure in Teaching Basic Tennis Skills to Kids with Autism
Results revealed that least to most prompting was an effective instructional approach and all subjects increased their basic tennis skills considerably during intervention.
Effects of a leisure program on quality of life and stress of individuals with Autism Spectrum Disorder.
Findings support the contention that participation in recreation activities positively influenced the stress and quality of life of adults with ASD. There was a significant decrease in overall scores of stress levels for participants over the course of the study and there was a significant increase in the four factors of quality of life that were measured (satisfaction, independence, competence and social interaction) as well as the total score for quality of life from baseline to the end of the intervention 12 months later. In contrast, the control group demonstrated no significant improvements related to stress or quality of life. Implications of these findings to leisure services and the quality of life of individuals with ASD are discussed. Conclusion Findings support the contention that participation in recreation activities positively influenced the stress and quality of life of adults with ASD.
Cerebral Palsy
Recreation Therapy and Cerebral Palsy
Therefore, recreation therapy, or therapeutic recreation, is an important step in helping an individual with cerebral palsy become a well-rounded individual afforded the benefits that physical, mental, and social experiences provide. Recreation therapy focuses on inclusion, not exclusion, by allowing the individual to participate and be an integral part of activities they enjoy and learn from.
However, recreation therapy also has another purpose – to enhance the ability of a child with cerebral palsy to plan, strategize and perform tasks in an effort to achieve improved physical functioning and encourage emotional well-being by facilitating inclusion into activities they benefit by and enjoy. This provides quality of life.
Chronic Illness
Health-related quality of life changes of children and adolescents with chronic disease after participation in therapeutic recreation camping program.
The therapeutic recreation camping program had a positive impact on HRQoL of children and adolescents living with cancer, diabetes mellitus and JIA. The experience enhanced their self-perception in all age groups and reduced the autonomy of children under 14 years of age. This study is an innovative use of the KIDSCREEN-52 questionnaire to measure the outcome effectiveness of a psychosocial rehabilitation program and to assess and compare HRQoL of children living with different chronic diseases.
Optimizing Lifelong Health and Well-Being: A Health Enhancing Model of Therapeutic Recreation
The Optimizing Lifelong Health through Therapeutic Recreation model is presented and discussed as part of the ongoing dialogue regarding new approaches to conceptualizing and delivering therapeutic recreation services. Through the elements of selecting, optimizing,compensating, and evaluating (Bakes & Baltes, 1990), therapeutic recreation specialists work with individuals who have illness, disease, and/or lifelong disability to achieve and maintain leisure lifestyles that will enhance their health and well-being across the life course.
Developmental Disabilities
Social Inclusion Through Recreation
It should be remembered, however, that while all recreation and leisure programs have the potential to facilitate social inclusion, not all necessarily fulfill this promise. Organizational attitudes and beliefs supportive of inclusion and the right of persons with disabilities to access the same programs as their peers without disabilities are a prerequisite. Direct service staff who have a knowledge of and experience working with persons with disabilities as well as a passion for inclusion are also a necessity. The ability and willingness of staff to make necessary accommodations and adaptations are a direct result of this knowledge, experience, and passion. Parents, families, and guardians also play a role as they must accept the fact that persons with disabilities need to be able to select the specific recreation and leisure activities in which they want to become engaged themselves and that involvement in just about any program carries with it some risk.While representing only a part of the “inclusion puzzle,” recreational programs carried out by organizations that truly understand what social inclusion entails, provide adequate supports and accommodations, and are staffed by individuals who accept and celebrate diversity in all of its forms provide an opportunity for persons with disabilities to take a step closer to fulfilling their dreams of full inclusion within the communities in which they live.
Adapted Physical Education and Therapeutic Recreation in Schools
Adapted physical education is a mandated service, whereas therapeutic recreation and traditional recreation are considered related services under the Individuals with Disabilities Education Act. In this article, the authors describe the distinctions between the services, recognition of need for referral, methods of assessment, sample Individualized Education Program goals with short-term objectives and/or benchmarks, strategies for the classroom teachers, and interventions and service delivery models typically used by physical education teachers and recreational therapists.
Spinal Cord Injury
Using exercise to enhance subjective well-being among people with spinal cord injury: The mediating influences of stress and pain.
Analyses of covariance indicated that after 3 months, exercisers reported less pain, depression, and stress, as well as greater perceived quality of life and better physical self-concept than controls (ps<.05). Regression analyses revealed that changes in pain and stress mediated exercise-induced changes in perceived quality of life and depression. Conclusion: Changes in pain and stress may be mechanisms by which exercise improves SWB among people with SCI.
Relationship of therapeutic recreation inpatient rehabilitation interventions and patient characteristics to outcomes following spinal cord injury: the SCI-Rehab project.
Greater participation in TR-led leisure skill and community activities during rehabilitation is a positive predictor of multiple outcomes at rehabilitation discharge and the 1-year injury anniversary demonstrating that TR activities are associated with a return to a productive and healthy life after SCI. Further research should focus on the impact of TR on longer-term outcomes to determine whether relationships continue or change as persons continue to adapt to their life after SCI.
Returning to the Community with a Spinal Cord Injury: Implications for Therapeutic Recreation
Results of this study support the importance of including the perceptions of people with SCI when attempting to understand the relevance of leisure and social relationships to their integration into the community. By using such perceptions social contacts were identified as being important in facilitating community integration. It was clear from the data that leisure can be a context for the establishment and, perhaps the maintenance and development of such social contacts. TR specialists are encouraged to consider strategies to overcome limitations associated with rehabilitation environments by continuously planning for participants' integration into the community. TR services can be designed to enhance the social support of people with SCI in ways that facilitate their return to the community
Exercise is Medicine™: Exercise Prescription After SCI to Manage Cardiovascular Disease Risk Factors
Exercise is underutilized in the battle against cardiovascular disease (CVD) for both the nondisabled and spinal cord—injured (SCI) populations. The American College of Sports Medicine and American Heart Association have launched the Exercise is Medicine™ initiative to facilitate widespread adoption of exercise as a practical treatment option by increasing awareness and providing structured guidance. We review the initiative, current exercise recommendations for the nondisabled, supporting evidence in the SCI population, and appropriate SCI-related alterations to exercise prescription. Finally, we provide resources supporting the prescription process for persons with SCI.
Stroke
Wii Video Games as Home Based Therapy for Stroke Patients
Dr. Saposnik explained that “The repetitive tasks and task-specific activities involved in the Wii gaming technology engage the “mirror neuron system” that is linked to brain plasticity.” He added that “Some part of the brain or set or cluster of neurons may activate just by watching other people making movements.” Although the study found some differences in grip strength improvement between the 2 groups, after adjusting for baseline differences, this was not significant.
According to Dr. Saposnik, “The rationale behind testing this gaming technology in post-stroke therapy is that current approaches are time consuming, have only a modest effect, are research and therapy intensive, and usually have a poor compliance. In addition, standard rehabilitation is not always available and can be costly. In contrast; the virtual reality Nintendo gaming system is more accessible and attractive to patients. They tend to be “more engaged” and have more fun with the Wii games.”
Cancer
Nature-based experiences and health of cancer survivors.
PURPOSE: Although exposure to, and interaction with, natural environments are recognized as health-promoting, little is understood about the use of nature contact in treatment and rehabilitation for cancer survivors.
METHODS: This narrative review summarizes the literature exploring the influence of nature-based experiences on survivor health. Key databases included CINAHL, EMBASE, Medline, Web of Science, PubMed, PsycArticles, ProQuest, and Cancerlit databases.
RESULTS: Sixteen articles met inclusion criteria and were reviewed. Four major categories emerged: 1) Dragon boat racing may enhance breast cancer survivor quality of life, 2) Natural environment may counteract attentional fatigue in newly diagnosed breast cancer survivors, 3) Adventure programs provide a positive experience for children and adolescent survivors, fostering a sense of belonging and self-esteem, and 4) Therapeutic landscapes may decrease state-anxiety, improving survivor health.
CONCLUSIONS: This review contributes to a better understanding of the therapeutic effects of nature-based experiences on cancer survivor health, providing a point of entry for future study.
Creative Arts
Helping and Hindering Processes in Creative Arts Therapy Group Practice Ditty Dokter Group Vol. 34, No. 1, CREATIVE ARTS THERAPY (MARCH 2010), pp. 67-83 Published by: Eastern Group Psychotherapy Society
This article reports on the findings from a therapeutic community based research project in the U.K. National Health Service eliciting client and therapist perceptions of helping and hindering processes in creative arts therapies groups. The study is used to contextualize different theoretical approaches within creative arts therapy groups and to highlight therapist interventions such as structuring and interpretation. Current debates about the arts as a facilitator or hindrance to working through group transference will be illustrated with case vignettes from early engagement with arts therapies groups in young adult psychiatry.
Aquatic Therapy
Aquatic Therapy: A Viable Therapeutic Recreation Intervention
There is evidence to indicate that aquatic therapy has numerous psychological and physical benefits. Furthermore, aquatic therapy appears not only to improve physical and psychological functioning, but also maintain health and daily life functioning. In addition,aquatic therapy is valuable because it is con-ducted in water which often improves participants' comfort and increases their confidence in achieving functional independence (Guillemin et al., 1994; Hurley & Turner,1991). The health care trend of shorter hospital stays and an emphasis on outpatient care has resulted in a need for therapeutic recreation interventions to be applied across a myriad of environments. The facilitation technique of aquatic therapy can result in an increase in participants' functional ability while they participate in an enjoyable leisure activity which encourages inclusion in their communities.
The Effect of Aquatic Therapy on Strength of Adults with Multiple Sclerosis
THERAPEUTIC RECREATION JOURNAL Vol. 37, No. 3, 224-239, 2003
Ellen Broach and John Dattilo
This study was conducted to examine the effects of an Aquatic Therapy (AT) exercise program on strength of four participants with relapsing-remitting multiple sclerosis. A single subject,multiple-probe design across participants was used to collect data. Measures of strength were operationalized through upper and lower extremity measures of quadriceps, hamstrings, hip flexion, biceps, triceps, and shoulder abduction strength. Mixed results prevent definitive conclusions regarding the effect of AT on strength. However, these results do have implications for people with multiple sclerosis with regard to strength since all individuals either maintained or improved strength.
Aquatic Therapy In Community-Based Therapeutic Recreation:Pain Management In a Case of Fibromyalgia
THERAPEUTIC RECREATION JOURNAL Vol. 35, No. 1, 57-69, 2001 Kenneth E. Mobily and Marie D. Verburg
The purpose of this case report was to describe the effects of an aquatic exercise program with an individual with fibromyalgia. A 59 year old female school teacher with fibromyalgia participated in an aquatic therapy program for a period of four and one-half months in a community-based therapeutic recreation setting. Shortly after participation was initiated, she reported relief from acute pain. Later, improvement in the degree to which pain interfered with functional activities was noted. In particular, she reported returning to work on a half-time basis and regained the stamina to participate in her favorite recreation and social activities. Findings from this case are consistent with those obtained from larger clinical trials using exercise interventions with persons diagnosed with fibromyalgia. Implications for community-based therapeutic recreation are discussed.
Exercise in 94°F Water for a Patient With Multiple Sclerosis
The patient did not experience heat sensitivity or fatigue throughout the program, and her manual muscle test grades and mobility improved.
Case Comparison of Response to Aquatic Exercise: Acute Versus Chronic Conditions
The purpose of this case report was to describe the effects of individualized aquatic exercise programs with two participants with knee impairments. The first participant was a 17-year-oldhigh school soccer player with an acute knee injury (torn anterior cruciate ligament). She demonstrated significant improvement in functional abilities over the course of the nine week intervention. The second participant was a 33-year-old female with a chronic knee condition(rheumatoid arthritis) localized to the right knee. Although she demonstrated only marginal progress in functional outcomes over the course of six months of participation, improvement in swimming ability was remarkable. The cases were compared and contrasted relative to valid data collection methods and response to aquatic exercise. Results suggested that both quantitative and qualitative data may be useful in determining the effectiveness of aquatic exercise programs. In particular, qualitative data provided insight into the meaning of the activity for the second participant
Prescribed Exercise Therapy
Comparing the effects of aquatic and land-based exercise on the physiological stress response of women with fibromyalgia.
Authors Kelley, C.; Loy, D. P. Journal Therapeutic Recreation Journal 2008 Vol. 42 No. 2 pp. 103-118
While many studies have suggested various treatment mechanisms for individuals with fibromyalgia (FMS), few have examined the impact of aquatic and land-based exercise on the physiological stress response in women with fibromyalgia. Due to the increased physiological and psychological stress associated with fibromyalgia, additional research examining the physiological responses to stress and interventions addressing stress in the FMS population is warranted. The present study examined salivary cortisol response of women with fibromyalgia during land-based exercise (i.e., walking on a treadmill) and aquatic exercise (i.e., Ai Chi). A single-subject alternating treatment design (N=3) was selected to compare the effectiveness of Ai Chi and treadmill walking on salivary cortisol levels. Cortisol samples were obtained from each participant prior to and immediately following each treatment session to serve as a psycho-physiological marker of stress. Results suggested both aquatic and land-based exercise had a positive influence in reducing salivary cortisol in women with FMS; however, exercising at a moderate pace on a treadmill proved to be the superior treatment intervention. Results of this study may potentially help women with FMS discover an alternate or additional treatment to assist in coping with stress related to chronic illness.
The Benefits of Exercise for the Clinically Depressed
When compared with other traditional treatments for depression, exercise was just as beneficial and not significantly different from psychotherapy and other behavioral interventions... exercise was as effective as medication for reducing symptoms of depression in that sample. Interestingly, 10 month follow-up of those participants revealed that exercise group members (70%) had significantly (p=.028) lower rates of depression than those in the medication group (48%) or the combination group (54%). At 10 months, regular exercise involvement was a significant predictor of lower rates of depression.
Evaluation of a brief exercise intervention for high anxiety sensitivity.Anxiety, Stress, and Coping
Specifically, the present study indicated that a single 20-minute bout of aerobic exercise can lead to significant reductions in anxiety sensitivity scores, as well as more specific fears of cardiovascular and respiratory symptoms, socially observable anxiety symptoms, and cognitive dyscontrol. These findings are consistent with previous research,which suggested that individuals report less fear of anxiety-related physical sensations following a single exercise session (Broman-Fulks et al., 2004). Thus, the apparent fast acting effects of aerobic exercise may make it a particularly attractive form of intervention for individuals with high anxiety sensitivity who desire rapid reductions in anxiety-related fears and associated phenomena.
Exercise for treating fibromyalgia syndrome
There were a total of 2276 subjects across the 34 included studies; 1264 subjects were assigned to exercise interventions. The 34 studies comprised 47 interventions that included exercise. Effects of several disparate interventions on global well-being, selected FM signs and symptoms, and physical function in individuals with FM were summarized using standardized mean differences (SMD). There is moderate quality evidence that aerobic-only exercise training at recommended intensity levels has positive effects global well-being (SMD 0.49, 95% CI: 0.23 to 0.75) and physical function (SMD 0.66, 95% CI: 0.41 to 0.92) and possibly on pain (SMD 0.65, 95% CI: -0.09 to 1.39) and tender points (SMD 0.23, 95% CI: -0.18 to 0.65). Strength and flexibility remain under-evaluated.
Using exercise to enhance subjective well-being among people with spinal cord injury: The mediating influences of stress and pain.
Analyses of covariance indicated that after 3 months, exercisers reported less pain, depression, and stress, as well as greater perceived quality of life and better physical self-concept than controls (ps<.05). Regression analyses revealed that changes in pain and stress mediated exercise-induced changes in perceived quality of life and depression. Conclusion: Changes in pain and stress may be mechanisms by which exercise improves SWB among people with SCI.
Exercise is Medicine™: Exercise Prescription After SCI to Manage Cardiovascular Disease Risk Factors
Exercise is underutilized in the battle against cardiovascular disease (CVD) for both the non-disabled and spinal cord—injured (SCI) populations. The American College of Sports Medicine and American Heart Association have launched the Exercise is Medicine™ initiative to facilitate widespread adoption of exercise as a practical treatment option by increasing awareness and providing structured guidance. We review the initiative, current exercise recommendations for the non-disabled, supporting evidence in the SCI population, and appropriate SCI-related alterations to exercise prescription. Finally, we provide resources supporting the prescription process for persons with SCI.
