The Effectiveness of Play Therapy

with Geriatric Individuals in

Rehabilitation Facilities
Natalie Maver, Emma Rain, Madisyn Ramacciotti, & Lindsey Pazdziorko
Background: Play Therapy vs. Traditional Occupational Therapy
- Play (Mohammadi et al., 2017)
- Facilitates sensory, motor, and cognitive development
- Those with life-threatening diseases need to play
- Play Therapy (Mohammadi et al., 2017)
- Classic play therapy
- Used as a way to improve mental health
- Play-based occupational therapy
- To help accomplish treatment goals
- Build one's ability to perform activities of daily living (ADL)
- Occupational Therapy (InformedHealth.org, 2006)
- Goal is to help individuals gain back the skills to live their lives more independently
- Can be used for those with cerebral medical conditions; paralysis; mental illness; muscle, joint, and skeletal
problems; amputations and prostheses; and developmental disorders
- Useful for people of any age
Background: Elderly in Rehabilitation Centers
- Deficits in range of motion and physical activity in the elderly population leads
to a decline in mental health and quality of life
- Depression, anxiety, and pain are the main factors experienced by the elderly population in
nursing homes (Ulbricht, 2019)
- A study was conducted that evaluated the prevalence of the triad in 272,311 nursing home
residents (Ulbricht, 2019)
- 25.2% had an active diagnosis of depression and anxiety
- 54.3% had depression without anxiety
- 20.5% had anxiety without depression

Decreased ADL’s &

overall QOL
Background: What is Play Therapy?
- Alternative form of therapy that utilizes different game-like activities
- Has been utilized primarily with pediatric patients
- Joint controller therapy to increase wrist and forearm range of motion
(Wilcox et al., 2016)
- It was an effective and enjoyable method of eliciting repetitive goal
movements and exercising range of motion (Wilcox et al., 2016)
- Example play therapy sessions:
- Sandplay therapy, art sessions, music sessions, bubble therapy,
building puzzles, playdough sessions, balloon play, etc.
Background: Play Therapy and the Elderly
The effects of play therapy have been primarily studied in the pediatric population, however,
it has been briefly studied in dementia patients (Tse et al., 2018):

- One group of patients received a play activities program and the other did not
- Their functional mobility and happiness were then measured
- There was significant effects on pain, depression and happiness levels but there was
no difference on activities of daily living, social engagement, behavior or mobility
between the experimental and control group

It shows potential of being beneficial to the elderly population, but more research needs to
be done
The purpose of this study is to examine the effects of
play therapy on mental and physical health of elederly
individuals in rehabilitation facilities.
Significance of the Research

- Play therapy has been shown to be beneficial when performed in pediatrics

- There have been minimal studies on play therapy that have studied the elderly
population specifically
- Each study has a specific subpopulation such as dementia patients
- No studies have been done on the general population for elderly
- There is a need to study the short term effects of play therapy on an elderly
population in rehabilitation facilities
Hypotheses
- Patients that participate in occupational play therapy sessions will perform
better on the mental health assessments and see improvements in mental
health problems
- Between normal OT sessions and OT play therapy sessions, the patients in
both groups will progress at the same rate in terms of ROM and ADL’s
- Independent variables: the form of therapy the patients receive (play therapy
vs normal OT)
- Dependent variables: Scores of Elderly Mobility Scale (EMS), Lawton
Independent Activities of Daily Living, and Geriatric Depression Scale. Values
of grip strength and ROM from injury
 Research Methods
Participant Recruitment:
- An email will be sent to the heads of the rehabilitation
facilities to ask if they would be willing to allow their
facilities to participate in the study
- Also will inform them of the methodology so they
have a complete understanding what we are trying
to research and why
- Display posters throughout the facilities to recruit
potential participants/patients
- Allows the participants to understand what play
therapy is
Inclusion Criteria:
- Men and women
- Aged 65+
- Staying in an inpatient rehabilitation facility for post-
acute care after surgery, injury, or serious illness.
 Overview of
Study Design
 Orientation
- Orientation Day 1 Exclusion Criteria Determined after Orientation

- Informed consent We will be excluding:

- Health History Questionnaire (HHQ) - Those in the rehabilitation facility for cardiac
to understand patient risks and rehabilitation
history - Those with recent amputations and
paralyzation
- Orientation Day 2 - Those with diseases affecting the nervous
- EMS, Lawton IADL scale, and system and brain chemistry
Geriatric Depression Scale
Examples of diseases include those with:

- Parkinson’s
- Alzheimer's
- Dementia
Testing Requirements & What is Being Collected
Functional & Psychological Testing

Participants will be tested using the following scales before and after participation in the study:
- Elderly Mobility Scale (EMS)
- Standardized test that is used to measure the mobility of elderly individuals
- We chose this because it is designed specifically for our desired age group

- Lawton IADL Scale (Independent Activities of Daily Living)

- Test that assesses a person’s ability to perform daily activities and actions
- We chose this because it gives an overview of the person’s daily capabilities

- Geriatric Depression Scale

- This is a self-reported survey that measures the level of depression in elderly individuals
- We chose this because it assesses the individual’s mental health

These help measure depression and pain levels. We chose these because they relate to the elderly
population and are specifically for this age group.
 Testing Requirements & What is Being Collected

We are measuring improvements in strength and range of motion, so we will record these testing
results before and after participation in the study depending on what area of the body needs
tested based on each individual's injury(s).

The following equipment will be used:

Goniometer measures range of motion of joint. Jamar dynamometer measures grip strength.
Training Protocol
Our study will include the following regime:
- 8 week program
- 3 sessions per week on Monday, Wednesday, and Friday for 60 minute
sessions

Each session will include:

- 10 minutes of heat therapy
- 25 minutes of play therapy or a regular occupational therapy session
- 15 minutes of motion & strengthening exercises
- 10 minutes of a cool down
Training Protocol
Explanation of Variables
Improved functionality leads to better mental health in the elderly:
- Play activities programs are good for reducing pain and improving mental health of
nursing home residents with dementia. (Tse et al., 2018)

Play therapies cause the body to release hormones similarly to activities of

enjoyment (Vaswani, 2022):
- Help to lower the stress hormone cortisol in the body
- Boosts the ‘feel good’ hormone oxytocin
- Has an effect on stress related illnesses and enhances sleep which can lead to
improved mental focus, better immune system, and mood.
Thank You!
Any Questions?
Natalie Maver
Lindsey Pazdziorko
Emma Rain
Madisyn Ramaciotti
References:
InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care
(IQWiG); 2006-. What is occupational therapy? 2020 Aug 27. Available from:
https://www.ncbi.nlm.nih.gov/books/NBK561515/
Mohammadi, A., Mehraban, A. H., & Damavandi, S. A. (2017). Effect of Play-based Occupational
Therapy on Symptoms of Hospitalized Children with Cancer: A Single-subject Study. Asia-Pacific
journal of oncology nursing, 4(2), 168–172. https://doi.org/10.4103/apjon.apjon_13_17
Ulbricht, C. M., Hunnicutt, J. N., Hume, A. L., & Lapane, K. L. (2019). Depression, Anxiety, and Pain
among Newly Admitted Nursing Home Residents. The journal of nursing home research sciences,
5, 40–48. https://doi.org/10.14283/jnhrs.2019.8
Vaswani, V. (2022) What can play therapy offer? Arts Mental Health. from
https://www.artsmentalhealth.org/whatcanplaytherapyoffer
Wilcox, B. J., Wilkins, M. M., Basseches, B., Schwartz, J. B., Kerman, K., Trask, C., Brideau, H., &
Crisco, J. J. (2016). Joint-Specific Play Controller for Upper Extremity Therapy: Feasibility Study
in Children With Wrist Impairment. Physical therapy, 96(11), 1773–1781.
https://doi.org/10.2522/ptj.20150493