Recreational Therapy

Polytraumatic injuries, defined as two or more injuries sustained in the same incident
that affect multiple body parts or organ systems and result in physical, cognitive, psychological,
or psychosocial impairments, emerged during Operation Iraqi Freedom (OIF) and
Operation Enduring Freedom (OEF). These injuries are complex and require special care.
In response, the US Veterans Health Administration established the polytrauma system of
care (PSC) in 2005. Current research identifies recreational therapy (RT) is a primary healthcare
service within the PSC; however, given its recent creation, little is known about the
role and function of RT in this setting. This study explored the role and function of RT in the
PSC using a Delphi design across five PSC sites in the United States, with special emphasis
on RT assessments used, diagnoses seen, RT interventions applied, RT outcomes targeted,
RT discharge planning processes, and team collaboration. Seven of a possible 30 recreational
therapists participated yielding a 23 percent response rate. The results may serve as
a springboard for identifying best practices, strengthening evidence-based practice, and
advancing RT research in polytrauma care.

Veterans from Operation Iraqi Freedom (OIF), Operation Enduring Freedom (OEF), and the
Vietnam era have sustained multiple injuries and disabilities as a result of their service,
including Traumatic Brain Injury (TBI), Post-Traumatic Stress Disorder (PTSD), and depression.
The use of outdoor recreation as a therapeutic modality for civilians with TBI has been
found to correlate with greater self-awareness and positive affect, however, scarce literature
exists regarding its use and outcomes for veterans. To explore this, a veteran from the
Vietnam era reporting a history of depression who is involved with a white water kayaking
group completed a series of surveys designed to measure its effect on perceived selfawareness
and positive affect. The case study reported that involvement with the white
water kayaking group improved his perceived self-awareness. The case study also reported
the highest positive affect and lowest negative affect immediately after traveling down
the river during a white water kayaking river trip. More research in this area is needed.

Revision: 20171129c The approaches discussed in this document can be applied to all RPG Formats in various ways, with different strengths and weaknesses presenting in each format: Tabletop, Live-Action (LARP), computer-based (including solo, multiplayer, augmented reality (AR), virtual reality (VR), etc.), or solo adventure books/modules. Ideally a mix of all 4 formats would likely have the most powerful effects. This document focuses primarily on the tabletop format of role-playing games, though not exclusively. A number of well research techniques that can be used to increase the likelihood of participants better encoding information into their memory, include the following considerations: • Avoid divided attention situations, keeping distractions from the topic being studied to a minimum, to reduce the risk of various interference factors. • Deep level processing (172), including using " why questions " to improve elaboration & distinctiveness (173). To further the elaboration, focus on the specific meaning of the concept, and try to relate it to prior knowledge reinforcing the interconnections to concepts that you have already learned (172). • Distributed-practice / differential learning. Spread learning & retrieval/rehearsal trials out over time, rather than " mass learning " aka cramming. Address limitations of the processing of new information from Short Term Memory (STM) into Long Term Memory (LTM) process, considering chunking and other relevant issues, by having the study time broken up into shorter segments, with breaks in between, or topic shifts alternating, for a more distributed learning approach over time, rather than trying to cram (mass learning) in a very short time. • Over-confidence, or inaccurate self-assessment of competency areas. Use techniques and/or technologies that provide more objective feedback on areas you are struggling with, and help direct more time in the areas needing more work, and less time in the areas actually already mastered. • It is also critical to once again emphasize getting enough sleep, as well as sufficient exercise. All of the above is significantly inhibited by lack of sufficient sleep and exercise strongly promotes cognitive processes.

In modern times, park gardens and green areas are seen as one of the most important leisure time activities. At the same time, parks that are open spaces for common use within the city are indispensable places for the individual in terms of interaction and socialization. However, it has been seen that there is not enough research on park gardens and green areas in Turkey or in other countries. The purpose of this study is to reveal the factors that affect the motivation to go to park gardens and green areas. In order to accomplish this aim, it was applied a survey of 204 individuals selected with easy sampling method. As a result of the research, it is seen that there are four factors: discharge, personal development, quality life and economic situation and sports activities. Looking at the average of the factors it was determined that discharging has the highest average. This is followed by sports activities and personal development. However, the quality of life and the economic situation are found to have the lowest average.

Abstract: This workshop provides an update on (1) the science-base for community-based programming to maximize physical, cognitive, and social health of individuals with moderate-to- severe disabilities from brain injury; (2) outcomes used to measure benefits of participation in community-based programming; and (3) challenges and supports to program sustainability and outcomes.

The research on obesity management in the spinal cord injury (SCI) population makes three things clear. First, obesity is under assessed, under managed, and under studied in the SCI population. The development of SCI specific assessment tools and diagnostic criteria is necessary to accurately identify obesity in the SCI population (Gater, 2007; Rajan, McNeely, Warms, & Goldstein, 2008). The current assessment tools (such as body mass index, ideal body weight, and waist circumference) provide limitations since they are either dependent upon a standing height measurement or a standing waist measurement and their able bodied cutoff points may not be sensitive enough to detect obesity in the SCI population (Rajan et al., 2008). Secondly, clinicians wishing to address obesity management with SCI clients must recognize the need to address lifestyle behaviors, such as adherence to a proper diet and physical activity levels, together; clinicians should not assume that participation in leisure time physical activity (LTPA) is automatically associated with a healthy diet (Knight, Buchholz, Martin Ginis, & Goy, 2012). Likewise, clinicians have to recognize the need for specific, individualized education regarding health risks for secondary chronic diseases such as obesity, cardiovascular disease, and diabetes and the relationship between such risk factors and participation in LTPA (Bassett & Martin Ginis, 2011; Buchholz et al., 2012). And lastly, influencing client personal factors, such as intentions and social support, through targeted interventions will have the largest impact on increasing LTPA participation levels and maintaining an active pattern trajectory over time (Martin Ginis et al., 2012; Sweet & Martin Ginis, 2012. Furthermore, most of the current research available is based on the epidemiological data originally collected in Canada during the creation of the Study of Health and Activity in People with Spinal Cord Injury (SHAPE-SCI), which measured LTPA participation using the The Physical Activity Recall Assessment for People with Spinal Cord Injuries, as well as, physiologic characteristics through physical measurements and blood draws (Martin Ginis et al., 2008). While this has led to numerous spin-off studies whose results have provided essential information on correlations between LTPA and a number of factors in the SCI population, it also highlights the drastic need for further, continuing research on activity in the SCI population—especially in the United States.