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E-Visits For Early Post-Operative Visits Following Orthopaedic Surgery Can They Add Efficiency Without Sacrificing Effectiveness, William G. Jeffery

Electronic Thesis and Dissertation Repository

We asked 217 sport surgery and 135 total knee arthroplasty (TKA) patients to complete a questionnaire (e-Visit) before attending their two and six-week post-operative appointment. Our primary objective was to use the questions asked of patients prior to their appointment to develop a model that could be used as web-based e-Visit to predict early post-operative adverse events. Gold standard comparison was the surgeon’s opinion as to the presence or absence of an event at follow-up. Secondary objective was evaluation of a simplified model. We found good area under the curve (AUC) statistics (0.76 (95% CI 0.69 - 0.84) and 0.80 …

The Effect Of High Baseline Pain On Impairment Outcomes One Year After Distal Radius Fracture, Farrukh Riaz

Electronic Thesis and Dissertation Repository

Objective

The purpose of this study is to evaluate whether high baseline pain predicts impairment outcomes in grip strength or wrist range of motion (ROM) at one year after a distal radius fracture (DRF). Impairments occur for less than 15% of patients.

Methods:

In this cohort study patients with a DRF were recruited from a hand clinic in London, Ontario. This data was collected at two evaluation time points: at baseline (within the first 10 days after fracture) and at one year after fracture. Baseline pain was assessed using the pain subscale of the Patient-Rated Wrist Evaluation (PRWE) and classified …

Advancing Social Transformation Through Occupation: A Critical Examination Of Epistemological Foundations, Discourses And Contextual Factors Shaping Research And Practice, Lisette Farias Vera

Electronic Thesis and Dissertation Repository

Widespread appeals to advance a social justice agenda have emerged within health-related fields. However, expressing a commitment to social justice has created tensions within occupational science and therapy as scholars attempt to enact social transformative scholarship while at the same time having roots within health sciences, a field largely dominated by positivist/postpositivist thinking. The broader intent of this thesis is to inform further development of occupation-based social transformative scholarship aligned with the critical paradigm.

This doctoral dissertation is comprised of five integrated manuscripts, in addition to introduction and discussion chapters. Chapter two examines the increasing use of critical perspectives and …

Using A Deliberative Dialogue To Facilitate The Uptake Of Research Evidence In Rehabilitation For Children With Cerebral Palsy, Alisiyah Daya

Electronic Thesis and Dissertation Repository

This study explores how to facilitate the use of research evidence to optimize outcomes for children with cerebral palsy (CP) in practice. Findings from two studies were used as the basis for exploring how to comprehensively assess developmental trajectories of children with CP and plan individualized interventions. Seventeen affiliated stakeholders (e.g. physicians, senior leadership, frontline clinicians, families and youth with CP) participated in this study.

Data from a deliberative dialogue and interviews were analyzed using grounded theory methods with a pragmatic perspective. The results highlighted that all areas of practice must engage in knowledge translation to be effective. Stakeholders outlined …

Dynamic Loading And Pain In Knee Osteoarthritis: Effects Of Limb Realignment And Ligament Reconstruction Surgeries, Kendal Marriott

Electronic Thesis and Dissertation Repository

Painful loading of the knee during walking is a key feature of knee osteoarthritis (OA). The external knee moments derived from three-dimensional gait analysis represent dynamic knee loads and may help evaluate surgical interventions. However, the relationships between knee moments and pain and the effects of surgery remain unclear. The overall purpose of this thesis was to investigate knee moments and pain during walking in patients with moderate medial knee OA, including the effects of limb realignment and ligament reconstruction surgeries. This thesis includes three studies investigating knee moments in patients with medial compartment tibiofemoral OA.

Chapter 2 describes a …

A Cross- Sectional Study Of Stress Biomarkers And Their Associations With Post-Trauma Complaints, And How Those Associations Are Moderated By Early Life Adversity, Sadia Siraj

Electronic Thesis and Dissertation Repository

Chronic musculoskeletal pain results in significant personal, economic, and social burden. Early identification and intervention in those people with acute pain that are likely to transition into a state of chronicity can prevent the onset of chronic pain before it emerges and becomes resistant to treatment. This study investigated the potential stress biomarkers associated with acute pain and disability and how those associations are influenced by early life adversities.

Stress level was determined according to the plasma level of stress biomarkers (cortisol, BDNF, TGFB1) and self-report measures of stress following musculoskeletal traumatic events. The magnitude and direction of associations of …

Reliability And Validity Of The Star Excursion Balance Test In Patients With Knee Osteoarthritis, Lauren Kanko

Electronic Thesis and Dissertation Repository

The purpose of this study was to investigate the measurement properties of the star excursion balance test (SEBT) in patients with knee osteoarthritis (OA). Specific objectives were to estimate: 1) test-retest reliability, 2) concurrent validity of observer measurements compared to a 3D motion capture system, and 3) longitudinal validity in response to 12 weeks of neuromuscular exercises. Thirty-eight patients diagnosed with knee OA participated. They performed the SEBT on three test occasions. The first two test sessions were completed within one week and the third was 12 weeks later. Participants performed exercises at home over the 12-week period. Intraclass correlation …

How Do Individuals With Cerebral Palsy And Their Families Prefer To Receive And Use Evidence-Based Information To Individualize Services To Optimize Outcomes?, Tianna D. B. Deluzio

Electronic Thesis and Dissertation Repository

The main objectives of this study were to: (1) describe the format in which children with cerebral palsy (CP) and their parents prefer to receive information pertaining to development; (2) understand how children with CP and their parents intend to use this information; and (3) gain insight on how children with CP wish to be represented in the information in terms of being both comprehensive and respectful. Ten children with CP and their parent(s) or guardian(s) participated. Semi-structured interviews were conducted and analyzed using constant comparative analysis. Eight themes were created related to the type and format of information preferred …

Dual-Task Gait Assessment In Lower Extremity Amputees, Courtney A. Frengopoulos

Electronic Thesis and Dissertation Repository

The purpose of these studies was to develop a reliable dual-task functional mobility protocol and investigate changes in dual-task performance over time in lower extremity amputees. Relative and absolute test-retest reliability of the protocol were evaluated across the population in a study consisting of three groups, with 20 participants per group. A pilot study of 16 participants investigated change in dual-task performance between discharge from rehabilitation and follow-up for both cognitively normal and cognitively impaired individuals. Gait was assessed by the developed protocol as well as an electronic walkway (GaitRITE®). All three groups in Study 1 had excellent relative test-retest …

Assessing The Impact Of Caregiver Outcomes On Function And Reintegration Of Stroke Survivors Participating In A Community Stroke Rehabilitation Program., Spencer R. Thompson

Electronic Thesis and Dissertation Repository

There is a limited amount of literature evaluating the relationship between caregivers, and the stroke survivors’ function and reintegration. The objectives were to evaluate the association between caregivers’ lifestyle changes on function and the role of functioning as a moderator between caregiving and reintegration among stroke survivors receiving community-based rehabilitation. Data were collected from January 2011 to January 2016. A one-way repeated measures analysis of variance and multivariable linear regression were performed on Functional Independence Measure, Bakas Caregiving Outcomes Scale, Reintegration to Normal Living Index across admission, discharge, and follow-up. Mean age was 70.2±13.17 years with 58% males (n=200). A …

Links Between Physical And Mental Health: Assessment Of Therapeutic Riding’S Effect On Children With Special Needs, Sabah I. Hasan

Brescia Psychology Undergraduate Honours Theses

This observational study examined the effect of therapeutic riding (TR) on four domains, physical skills, positive values, social skills, and self-identity in children with special needs. Participants were recruited from SARI Therapeutic Riding and were divided, based on observation, into more or less severe diagnosis categories. It was predicted that children with less severe diagnosis would show more of an increase on the four domains, especially physical skills due to TR. Participants were observed using an observational checklist at pre- and post-riding lessons. Results showed non-significant differences in all four domains, however, there was a tendency for scores to increase …

Predicting Response To Medial Branch Blocks: A Clinical Decision Making Tool, Swati Mehta

Electronic Thesis and Dissertation Repository

Chronic neck pain can lead to long-term disability and socio-economic burden. Several demographic, clinical, and psychosocial factors have been implicated in the development of neck pain disability. These factors may also influence management of neck pain. Optimal treatment often requires targeting interventions based on specific diagnosis. One of the most common cause of neck pain is cervical facet joint injury. Currently, the gold standard for diagnosing facetogenic injury is through the medial branch block (MBB) procedure. Though the procedure is relatively safe, it is still invasive and may result in adverse effects. In Canada, access to this procedure is limited …