Posted by Mark on 4/20/2005, 3:13 pm Sincerely, San Jose State University Name (Initials Only) Date of Birth Male Female Diagnosis/Injury Date of Onset of Diagnosis/Injury Where did you receive medical/rehabilitation services? Length of stay of medical/rehabilitation services inpatient outpatient Which of the following rehabilitation services did you/do you receive? In which sports activities did you participate prior to diagnosis/injury? Check all that apply Please Circle or Highlight your answer to the following questions 1) On a scale of 1-10, 1 being not important and 10 being very important, how (Not important) 1 2 3 4 5 6 7 8 9 10 (very important) (None) 1 2 3 4 5 6 7 8 9 10 (Highest) (no help) 1 2 3 4 5 6 7 8 9 10 (most help) 5) In your opinion, in what area/s has participating in sports helped you most? (number ___ Physical rehabilitation; ___ Social Participation; ___ Emotional stability ___ Psychological rehabilitation Additional Comments:
64.136.26.228
To Whom It May Concern:
My name is Mark Neves, and I am an occupational therapy student at San Jose State University. I have been given the opportunity to perform a research project for an honors course, in which I am examining the effects of sports intervention in occupational therapy rehabilitation for youth between the ages of 10 and 25 years old. I am sending you this survey requesting your participation in this study. It is my expectation that the survey will take no more than 15 minutes to complete. All information will remain confidential, and your identity and any personal information will remain anonymous. Once I receive your completed survey, any identifying info, will be removed/discarded. If you are interested in participating in this study, please answer the attached questionnaire and return it by email, to nevesmark@hotmail.com as soon as possible. I would like to have all surveys returned no later than April 11th. I would like to thank you for your time and your participation in this study.
This research study has been approved by the Occupational Therapy Department at San Jose State University. If you have any questions about this project, please contact Professor Amy Killingsworth at (408) 924-3073.
Mark Neves
Department of Occupational Therapy
One Washington Square
San Jose, Ca 95192-0059
Ph: (408) 605-5353
Email: NevesMark@hotmail.com
Occupational Therapy Services and its Relationship to Sports
Occupational therapy Speech therapy
Physical therapy Recreation therapy
Basketball Skiing
Football Swimming
Baseball Surfing
Soccer Other
In which sports activities do you now participate? Check all that apply
Basketball Skiing
Football Swimming
Baseball Surfing
Soccer Other
important is it for you to be able to participate in sports activities?
2) On a scale of 1-10, 1 being none and 10 being the highest degree, to what degree has
participating in sports aided in your rehabilitation and overall quality of life?
3) If you answered yes to receiving occupational therapy services, on a
scale of 1-10, 1 being no help and 10 being most help, how much did your occupational therapist help you achieve your goal of participating in sports activities?
4) If you answered yes to receiving occupational therapy services, did your occupational
therapist use sports or sport related activities in your rehabilitation? Yes No
If yes, how was sports integrated into your rehabilitation program?
If no, how do you think the occupational therapist might have integrated occupational therapy into your rehabilitation program?
top 2 in ranking order.)
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