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Community Integration After In-Patient Rehabilitation For Lower Extremity Musculoskeletal Disorders: A Pilot Study, Chandni Chadha

Electronic Thesis and Dissertation Repository

Purpose: To investigate change in community integration (CI) and functional status following discharge from in-patient musculoskeletal (MSK) rehabilitation, and to explore the concordance between the Reintegration to Normal Living Index (RNLI) and patient interviews. Participants: Twenty-five individuals with lower extremity MSK disorders discharged home after rehabilitation. Methods: For all outcome measures, categories of change between successive time points were created using the minimal detectable change. Change patterns were evaluated at the group and individual level across four time intervals. Percent agreement quantified concordance between interview and RNLI data. Results: Change over time was confirmed at the group level. However, individual-level …

Properties And Applications Of Sensory Outcome Measures In Carpal Tunnel Syndrome, Derek Km Cheung

Electronic Thesis and Dissertation Repository

This thesis aimed to determine the psychometric properties and applications of sensory threshold tools and outcome measures in patients with Carpal Tunnel Syndrome (CTS). The first chapter is a psychometric study that defines clinically important difference (CID), construct validity and responsiveness of touch and vibration threshold tools and in the Symptoms Severity Scale (SSS). The study found the CID for the PSSD and for the SSS was 0.15g/mm² and 0.50 respectively. The study also found that the Vibrometer was more representative of hand function and responsive compared PSSD. The second objective of this thesis was to determine the feasibility …

Physical Therapy Following Shoulder Rotator Cuff Repair, Ravindiran Appunni

Electronic Thesis and Dissertation Repository

ABSTRACT

Introduction

Rotator cuff (RC) tears are one of the common causes of pain and disability in the upper extremity. Currently there are no fixed guidelines for choosing testing positions for shoulder range of motion measurement. Optimal rehabilitation following RC repair is yet to be defined.

Purpose and Method

The purpose was to inform about postoperative Physical therapy following rotator cuff repair, with the following objectives:

• To systematically review the content of clinical research, which addresses various physical therapy programs.
• To describe validity and responsiveness of different testing positions for goniometric measurement of shoulder active external rotation.
• To pilot test …

A Phenomenology Of Fall Prevention: Lived-Identity And Careful Practice In Community Outreach Care, James A. Shaw

Electronic Thesis and Dissertation Repository

The increasing number of injurious falls amongst older people living in the community is continuously portrayed as a major public health problem facing the Canadian health care system. As additional resources are allocated for community-based fall prevention programs, health service providers are increasingly expected to understand and enact fall prevention in effective and meaningful ways. The aim of this two-phase interpretive phenomenological study was to enhance understandings of the taken-for-granted meanings that characterize everyday practices of community-based fall prevention in order to foster more sensitive, tactful, and meaningful approaches to fall prevention with older people.

In the first phase of …

Optimizing Physical Function Following Distal Radius Fracture, Siamak Bashardoust Tajali

Electronic Thesis and Dissertation Repository

Distal Radius Fracture (DRF) is one of the most frequent of all human bone fractures. Wrist and/or finger range of motion (ROM) and grip strength are standard outcome measures used by clinicians to evaluate recovery after a hand injury. ROM is considered to be an important component of joint mobility and relates to measures of functional impairment and disability. Impaired wrist and hand ROM are related to a decrease in grip strength, grasp ability, fine manipulation, and hand function. The relationship between ROM and other physical impairments as they relate to patient-rated outcomes after DRF have not been well identified. …

Functional Recovery And Caregiver Support Of Stroke Patients Admitted For Rehabilitation In Singapore Community Hospitals (1996 To 2005), Gerald Koh

Electronic Thesis and Dissertation Repository

Post-acute rehabilitation is the active process where disabled persons realize their optimal recovery potential through therapy after discharge from acute hospital admissions. Community hospitals which are mainly run by family physicians in Singapore provide post-acute rehabilitation, and are similar to US inpatient rehabilitation facilities and Canada’s specialty rehabilitation facilities. This thesis is based on a national dataset of all admissions into community hospitals in Singapore from 1996 to 2005 (ten years) manually extracted from medical records of four sites by the PhD candidate. Four chapters are presented: (1) a systematic review of the rehabilitation indices from published studies and their …

The Effects Of A Home Based Virtual Reality Rehabilitation Program On Balance Among Individuals With Parkinson’S Disease, Michelle L. Gu

Electronic Thesis and Dissertation Repository

Increasingly, the Nintendo Wii gaming system has been cited as an adjunctive tool for physical rehabilitation, particularly among older adults and individuals with limited mobility. However, evidence supporting “Wii-hab” remains predominantly anecdotal. The present study evaluates the effectiveness of a 12-week home-based exercise program designed around the Wii, in improving balance of individuals with Parkinson’s disease (PD). Fifteen individuals with PD engaged in three 30-minute Wii balance-training sessions per week, for 12 weeks. Balance was assessed using a forceplate in 4 quiet standing conditions of varying difficulty at 3 testing sessions: (1) baseline; (2) 6 weeks; and (3) 12 weeks. …

How Do Parents Use Health Information With The Aid Of A Knowledge Broker When Living With And Caring For Their Young Children With Cerebral Palsy?, Stephanie E. Lagosky

Electronic Thesis and Dissertation Repository

This research aims to understand how parents use health information (such as those developed from the Move & PLAY study) with the aid of a knowledge broker when living with and caring for young children with cerebral palsy. This research was conducted under a qualitative case study methodology and used questionnaires and in-depth interviews to collect data. Findings include the complexity of both parental use of health information and the desire to use a knowledge broker. A provisional model has been created to help describe information use of parents with young children with cerebral palsy. This provisional model is an …

Enacting Occupation And Identity: Perspectives Of Children And Their Parents, Shanon K. Phelan

Electronic Thesis and Dissertation Repository

Children with disabilities are at risk for limited opportunities to engage in childhood occupations. Occupation is defined broadly as everything people need, want, or are obliged to do, and as understanding how social dimensions shape occupations and opportunities for participation. Emergent literature suggests that identities are shaped by what we do. This research examines how occupation is implicated in the shaping of identities for school-aged children with physical disabilities in light of the socio-cultural dimensions that shape opportunities for children to participate in childhood occupations.

This work is comprised of five integrated manuscripts, in addition to introduction, methodology, and …

The Effect Of Multitalker Background Noise On Speech Intelligibility In Parkinson's Disease And Controls, Talia M. Leszcz

Electronic Thesis and Dissertation Repository

This study investigated the effect of multi-talker background noise on speech intelligibility in participants with hypophonia due to Parkinson’s disease (PD). Ten individuals with PD and 10 geriatric controls were tested on four speech intelligibility tasks at the single word, sentence, and conversation level in various conditions of background noise. Listeners assessed speech intelligibility using word identification or orthographic transcription procedures. Results revealed non-significant differences between groups when intelligibility was assessed in no background noise. PD speech intelligibility decreased significantly relative to controls in the presence of background noise. A phonetic error analysis revealed a distinct error profile for PD …

Self-Presentation And Social Physique Anxiety In Injury Rehabilitation Settings, Molly Driediger

Electronic Thesis and Dissertation Repository

The objective of this dissertation was to provide an initial description of self-presentation in injury rehabilitation (i.e., physiotherapy). To accomplish this, one qualitative and two quantitative studies were conducted. Study 1 determined whether self-presentational concerns were present in this setting. Female (n = 134) and male (n = 54) undergraduate students with a mean age of 20.64 years (SD = 1.99) completed measures of Social Physique Anxiety (SPA; Hart et al., 1989), self-presentational concerns, and preferences for features of the social and physical physiotherapy environment. An examination of the relationships between these variables revealed that self-presentation exists …

Exploring Exercise And Youth With A Disability, Kimberly B. Simpson

Electronic Thesis and Dissertation Repository

The purpose of this dissertation was to explore the exercise participation of youth with a disability. The studies are grounded in self-determination theory (SDT) (Deci & Ryan, 1985) and follow the General Model of Program planning (GMPP). The first study in this dissertation involved assessment interviews to explore exercise and youth with a disability. In the assessment interviews (Study 1), youth highlighted their desire for physical activity opportunities that promoted their independence, socializing with peers, and success in reaching fitness goals in a community based setting. The interviews with youth matched the central tenants of SDT that being: autonomy, relatedness …

Motor Control Of Exercise That Emphasizes Speed Post-Stroke, Vicki L. Gray

Electronic Thesis and Dissertation Repository

Purpose: To investigate whether a single session of closed kinetic chain (CKC) and open kinetic chain (OKC) exercises emphasizing speed post-stroke could evoke changes in the motor control and whether these improvements would transfer to postural tasks.

Methods: Thirty-two individuals post-stroke and 32 age- and sex- matched controls performed a single session of 50 fast squats and steps (Chapter 3). Internal perturbations (arm raise/load drop) were used to assess postural responses before exercises (Pre), immediately after exercises (Post) and 15 minutes after exercises (Retention) (Chapter 4). Eleven individuals post-stroke performed a single session of 50 fast knee and ankle OKC …

The Effects Of Leg Length Discrepancy On Gait And Balance, Colin E. Dombroski

Electronic Thesis and Dissertation Repository

Leg length discrepancy is a condition shown to affect 25-70% of the general population. The ubiquitous nature of leg length discrepancy can prove frustrating to many clinicians, particularly due to lack of consensus surrounding the amount of discrepancy that necessitates treatment.

The present research is intended to address the uncertainty surrounding diagnostic and treatment thresholds, through three related studies. In the first study, leg length discrepancy was manipulated in a sample of 15 healthy young adults, using a novel heel-to-toe lift (creating discrepancies of 5mm, 20mm, and 30mm), and the effects of this new discrepancy was observed on the spatial-temporal …

Fatigue And Mobility Post-Stroke, Svetlana Knorr

Electronic Thesis and Dissertation Repository

Fatigue post-stroke is a disabling and persistent symptom affecting many stroke survivors. Despite its high prevalence, the pathophysiology underlying this phenomenon remains obscure. Thus, the aim of this thesis was to study the neuromuscular basis underlying fatigue post-stroke and its association with self-reported fatigue and with the performance of tasks incorporating balance and mobility components.

Community-dwelling stroke survivors who had mild to moderate deficits in functional balance and mobility participated in a series of investigations. Chapter 2 describes the initial validation of the Community Balance and Mobility (CB&M) scale for use in persons with chronic stroke. Chapter 3 reported the …

Prehabilitation For Total Knee Arthroplasty: A Patient-Centred Approach To Maximizing Surgical Outcomes, Carly D. Mckay

Electronic Thesis and Dissertation Repository

The purpose of this dissertation was to investigate the role of prehabilitation in post-operative recovery for patients undergoing total knee arthroplasty (TKA) for osteoarthritis. Study one was a meta-analysis that aimed to consolidate the body of knowledge regarding prehabilitation for TKA patients. Study two compared the Lower Limb Tasks Questionnaire (LLTQ) to the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) in terms of agreement and responsiveness. Study three investigated the effect of a six-week pre-surgical strength training program on post-operative outcomes (quadriceps strength, mobility, pain, self-reported function, health-related quality of life, arthritis self efficacy) for TKA patients. Finally, study …

Walk Softly And Carry A Big Stick: Strategies To Decrease Dynamic Knee Joint Loading, Daniel J. Bechard

Electronic Thesis and Dissertation Repository

Excessive dynamic loading of the knee joint, quantified indirectly during three dimensional gait analysis, is a risk factor for the progression of knee osteoarthritis (OA). The overall objective of this thesis was to explore the effects of prolonged walking and the use of Nordic walking poles on selected gait characteristics indicative of knee joint load. The first study evaluated the time-varying behaviour, reliability, and validity of selected gait kinematics during 60 minutes of treadmill walking in 20 healthy adults. Maximum lateral trunk lean angle and maximum toe-out angle did not change over time, were consistent from day to day and …

Development And Testing Of A Low Vision Product Selection Instrument (Lv-Psi): A Mixed-Methods Approach, Daniel Fok

Electronic Thesis and Dissertation Repository

In Canada, it is conservatively estimated that $46 million is lost per annum from low vision (LV) assistive technology device (ATD) abandonment alone. The proper matching of the person and the technology during the selection process has been theorized as necessary to mitigate inappropriate abandonment. In the current dissertation, a mixed-methods approach with qualitative and quantitative study components was used to develop and test a LV product selection instrument (LV-PSI) that may help with the matching process.

The key qualitative aspect of the study included two qualitative research sessions with LV participants (N=10). Each session was made up of two …

Assessment Of Occupational Competence In Dementia: Identifying Key Components Of Cognitive Competence And Examining Validity Of The Cognitive Competency Test, Briana M. Zur

Electronic Thesis and Dissertation Repository

Considering the links between dementia and everyday living, occupational therapists are called upon to make recommendations regarding appropriate living arrangements for persons with dementia. Re-framed as occupational competence, this is often accomplished by an evaluation of cognitive competence. Within the context of an aging population, a key question is how to best inform decisions regarding occupational competence, using cognitive competence as an indicator. The Cognitive Competency Test (CCT) is a tool used to evaluate cognitive competence and inform judgments about occupational competence in individuals with dementia. This thesis incorporates two studies that identified cognitive components that predict occupational competence in …

A Stakeholder Generated Conceptualization For Successful Return To Work Outcome Evaluation: A Concept Mapping Approach, Rhysa Leyshon

Electronic Thesis and Dissertation Repository

Measurement of return to work (RTW) lacks attention to outcomes of relevance to all stakeholders. The objective of this thesis was to define what constitutes a successful RTW outcome from a stakeholder perspective and determine how to best measure it. A concept mapping method was used to create a conceptualization of successful RTW outcome based on indicators of interest and importance to various stakeholders. RTW researchers were questioned and the literature was searched for measures that mapped to the conceptualization and concepts. Stakeholders, made up of RTW consumers and providers, generated 48 indicators of successful RTW which were subsequently grouped …

Physical Function During Performance-Based Tasks And Throughout Daily Life. Is It Different Across Levels Of Frailty?, Olga Theou

Electronic Thesis and Dissertation Repository

The overall aim of this thesis was to provide a more focused understanding about the physical function of older women across levels of frailty. The specific aims were: 1) Examine the physical function of older women across levels of frailty during performance-based tasks and throughout their normal daily life; and 2) Review the effectiveness of current exercise interventions for the management of frailty. To answer these aims an observational study of community-dwelling older women (63-100 years) from rural Greece and a comprehensive systematic review on the impact of exercise on frail older adults were conducted. The performance-based measures that had …

Survivors On The Edge: The Lived-Experience Of Professional Musicians With Playing-Related Injuries, Christine A. Guptill

Digitized Theses

The purpose of this study was to understand the lived-experience of professional instrumental musicians who have experienced playing-related injuries. This study used a hermeneutic phenomenological methodology developed to examine this lived-experience. In-depth interviews were conducted with ten professional musicians. This was followed by a focus group where preliminary findings were presented to participants and their feedback was sought. Other sources of lived-experience included participant-observation by the researcher, who is a musician and has experienced injuries; and biographic and artistic representations of musical performance and its loss, including literature, films and television.

The findings were summarized in a visual representation unique …