Rebecca Cunningham OTD, OTR/L
Assistant Professor of Clinical Occupational Therapy
Rebecca Cunningham received her master’s and doctorate of occupational therapy degrees from the University of Southern California. Her clinical residency was completed at the USC Occupational Therapy Faculty Practice, where she provided Lifestyle Redesign services and focused on further development of the Lifestyle Redesign program for individuals living with Multiple Sclerosis. As a clinical faculty member at the USC Occupational Therapy Faculty Practice, Dr. Cunningham works with clients in the Multiple Sclerosis, chronic pain and headaches and mental health programs, and is a member of the USC Multiple Sclerosis multidisciplinary team.
Doctorate of Occupational Therapy (OTD)
2016 | University of Southern California
Master of Arts (MA)
in Occupational Therapy
2015 | University of Southern California
Bachelor of Arts (BA)
2008 | University of California, San Diego
Cunningham, R., & Valasek, S. (2019). Occupational therapy interventions for urinary dysfunction in primary care: A case series. American Journal of Occupational Therapy, 73(5), 7305185040p1-7305185040p8. https://doi.org/10.5014/ajot.2019.038356 Show abstract
Urinary dysfunction is commonly reported in primary care contexts. A shortage of primary care providers is affecting access to relevant services. Occupational therapy practitioners work in primary care settings and typically address urinary dysfunction in an outpatient context. Evidence regarding the delivery of occupational therapy interventions for urinary dysfunction in primary care has been limited. In this study, 3 women received 9–14 occupational therapy sessions in a primary care setting to address urinary symptoms. Plan-of-care duration, assessments, and urinary dysfunction interventions were individualized to accommodate personal and environmental factors. Across all case-series participants, Canadian Occupational Performance Measure scores demonstrated clinically significant improvement. Mixed results were found for SF–36 health-related quality-of-life subscale scores. Assessment scores specific to urinary dysfunction decreased, indicating reduced symptom severity and functional impact. This article provides preliminary evidence regarding the feasibility of occupational therapy interventions addressing urinary dysfunction in primary care settings.
Reeves, L., & Cunningham, R. (2019, April). Epilepsy care: An outpatient, lifestyle management approach. Poster presentation at the AOTA Annual Conference, New Orleans, LA.
Cunningham, R., & Uyeshiro Simon, A. (2018). Occupational therapy’s role in bowel and bladder symptom management in Multiple Sclerosis (Abstract). International Journal of Multiple Sclerosis Care, 20(Suppl. 1), 85. https://doi.org/10.7224/1537-2073-20.s1.1 Show abstract
Background. Bladder symptoms are reported by 80% of individuals with multiple sclerosis (MS), and approximately 50% of the MS population report bowel symptoms. Evidence demonstrates a significant correlation between urinary symptoms and longer disease duration, increased physical disability, and reduced quality of life. Bowel dysfunction can lead to decreased quality of life and social isolation. Evidence has shown that early recognition and treatment of bowel and bladder dysfunction may reduce the severity of symptom progression and improve health-related quality of life. Occupational therapists (OTs) address toileting and toileting hygiene in clinical treatment as a component of a person’s activities of daily living (ADLs). This includes positioning, care for continence needs, completion of intentional control of urination and bowel movements, and use of equipment/agents for bladder control. OT interventions that can be used to address this ADL include adaptive equipment training, pelvic floor training, relaxation techniques, bladder retraining, habit and routine management, and positioning.
Objectives. Describe OT intervention strategies for management of bowel and bladder dysfunction in patients with MS and provide a descriptive case study with clinical outcomes to demonstrate how some of these strategies can be applied clinically.
Methods. The case study subject has participated in 14 OT sessions with expected discharge in the next month. Patient’s bladder symptom management is one priority of the plan of care. The Canadian Occupational Performance Measure (COPM), Multiple Sclerosis Quality of Life Inventory (MSQLI), and RAND Short Form-36 (RAND SF-36) are the outcome measures used at pre- and post-intervention.
Results. Pre-intervention outcome data include the following: COPM overall performance score 5.4 and overall satisfaction score 4.4; RAND SF-36 sub-scores physical function 5, energy/fatigue 10, emotional well-being 76, social function 38, general health 20; and MSQLI scales MFIS 17, PDQ 5, BLCS 5, and BWCS 0. Postintervention outcome measures will be collected upon reassessment and discharge from OT services and reported at the conference.
Conclusions. This case study highlights the strategies OTs can use to address management of bladder and bowel dysfunction for individuals with MS, and it demonstrates the benefits of OT interventions in improving engagement in toileting and toileting hygiene ADL routines.
Keywords. Comprehensive care and MS, Management of activities of daily living in MS