Medicine and Health Sciences Commons^™

Consideration Of Executive Functioning For Physiotherapy Rehabilitation: Studies Of Physiotherapists’ Knowledge, Normative Data, And A Practice Application, Nicole A. Guitar

Electronic Thesis and Dissertation Repository

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Executive functioning (EF) refers to cognitive abilities involved in decision-making and self-regulation and can be impaired in many patients referred for physiotherapy, including older adults and people living with chronic pain. This dissertation aimed to determine what physiotherapists understood about EF, to summarize normative data for application in physiotherapy practice, and to provide an assessment of feasibility for studying EF impairments in people living with chronic pain. Study one surveyed what physiotherapists understood about EF as a concept, what EF assessments they used, and if this was influenced by their primary area of practice. Respondents (N = 262) subjectively reported …

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Femoroacetabular Impingement Syndrome: Evaluating Postoperative Rehabilitation Progress And Return To Sport Readiness, Trevor A. Day

Electronic Thesis and Dissertation Repository

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Femoroacetabular impingement syndrome (FAIS) is a common cause of non-arthritic hip pain and reduced physical activity in active young adults. It is defined as a motion-related disorder of the hip with a triad of symptoms, clinical signs, and imaging findings that represents symptomatic premature contact between the proximal femur and the acetabulum. There are two anatomical morphologies that can cause FAIS, cam, and pincer, and is a challenging clinical pathology. Patients typically undergo hip arthroscopy to repair damage to the joint and recess the bone causing the impingement. These procedures can result in positive outcomes for the patient, like reduced …

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The Effect Of Dual-Task Testing On The Balance And Gait Of People With Lower Limb Amputations: A Systematic Review, Humberto Omana, Edward Madou, Manuel Montero-Odasso, Michael W. Payne, Ricardo Viana, Susan W. Hunter

Physical Therapy Publications

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OBJECTIVE: To systematically review the literature on the effect of dual-task testing on the balance and gait of people with lower limb amputations (PLLA).

LITERATURE SURVEY: Databases MEDLINE, EMBASE, CINAHL, PsycINFO, Web of Science, and Scopus were searched in duplicate (inception to December 1, 2020).

METHODOLOGY: Inclusion criteria: participants were adults with transtibial, knee-disarticulation, transfemoral, or bilateral lower limb amputations; balance or gait was paired with a secondary task; and studies were peer-reviewed and published in English. Two authors independently reviewed articles and consensus was required. A standardized data extraction sheet was used to gather study relevant information in duplicate. …

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Co-Contraction Of Ankle Muscle Activity During Quiet Standing In Individuals With Incomplete Spinal Cord Injury Is Associated With Postural Instability, Kai Lon Fok, Jae W Lee, Janelle Unger, Katherine Chan, Kristin E Musselman, Kei Masani

Physical Therapy Publications

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Previous findings indicate that co-contractions of plantarflexors and dorsiflexors during quiet standing increase the ankle mechanical joint stiffness, resulting in increased postural sway. Balance impairments in individuals with incomplete spinal cord injury (iSCI) may be due to co-contractions like in other individuals with reduced balance ability. Here we investigated the effect of co-contraction between plantar- and dorsiflexors on postural balance in individuals with iSCI (iSCI-group) and able-bodied individuals (AB-group). Thirteen able-bodied individuals and 13 individuals with iSCI were asked to perform quiet standing with their eyes open (EO) and eyes closed (EC). Kinetics and electromyograms from the tibialis anterior (TA), …

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Functional Reach Test, Single-Leg Stance Test, And Tinetti Performance-Oriented Mobility Assessment For The Prediction Of Falls In Older Adults: A Systematic Review, Humberto Omaña, Kari Bezaire, Kyla Brady, Jayme Davies, Nancy Louwagie, Sean Power, Sydney Santin, Susan W. Hunter

Physical Therapy Publications

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OBJECTIVE: The authors sought to systematically review the existing literature on the falls-related diagnostic test properties of the Functional Reach Test (FRT), single-leg stance test (SLST), and Tinetti Performance-Oriented Mobility Assessment (POMA) in older adults across settings and patient populations.

METHODS: The PubMed, EMBASE, and CINAHL databases were searched (inception-July 2020). Inclusion criteria were participants aged 60 years or more, prospectively recorded falls, and the reporting of falls-related predictive validity. Manuscripts not published in English were excluded. Methodological quality of reporting was assessed using the Tooth Scale.

RESULTS: Of 1071 studies reviewed, 21 met the inclusion criteria (12 POMA, 8 …

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Chronic Pain Following Musculoskeletal Injuries: Where Do Familial Factors, Depression, And Distress Fit In?, Shirin Modarresi

Electronic Thesis and Dissertation Repository

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Background: Currently, there is a paucity of effective therapeutic options for chronic pain. A better understanding of the factors that can contribute to chronic pain development and maintenance can lead to more informed prevention and management strategies.

Purpose: The driving force for this thesis comes from the biopsychosocial model of pain. The main purpose was to investigate the contribution of various psychosocial factors to chronic pain with the following objectives: 1) to systematically review the literature on the existence of a familial sub-type of complex regional pain syndrome (fCRPS); 2) CRPS can follow injuries such as distal radius fractures (DRFs), …

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The Effect Of First-Time 4-Wheeled Walker Use On The Gait Of Younger And Older Adults, Humberto A. Omana, Edward Madou, Alison Divine, Walter Wittich, Keith D. Hill, Andrew M. Johnson, Jeffrey D. Holmes, Susan W. Hunter

Physical Therapy Publications

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INTRODUCTION: The 4-wheeled walker is intended to enhance balance and gait for older adults. Yet, some research suggests that walking aids increase falls risk. An understanding of the influence of age with walker use on gait performance is required.

OBJECTIVE: To examine the effect of initial 4-wheeled walker use on spatiotemporal gait parameters between younger and older adults.

DESIGN: Cross-sectional, repeated-measures.

SETTING: Community-dwelling.

PARTICIPANTS: Twenty-five younger (age: 26.5 ± 4.1 years) and 24 older (age: 68.5 ± 10.5 years) adults participated. Younger adults were aged 18 to 35 years, whereas older adults were 50 years or older. Included were people …

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A Transformative Journey: The Lived Experience Of Healthcare Learners Participating In Pain Management Education, Zoe A. Leyland

Electronic Thesis and Dissertation Repository

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There is little emphasis on pain management education for healthcare providers. In September 2019, the Master of Clinical Science (MClSc) program in Advanced Healthcare Practice at Western University in London, Ontario introduced a new, “Interprofessional Pain Management” (IPM) field. The program follows a competency-based framework, and the learners are all practicing healthcare providers with a special interest in pain. Part of the purpose of this thesis is to describe the process of development and implementation. The objective is to provide educators and healthcare providers an in-depth look at how the pain education is experienced. This includes exploring the lived experience …

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Development Of A Low-Cost Algometer, Thomas D. Naish, Ana Luisa Trejos, Dave M. Walton

Undergraduate Student Research Internships Conference

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Many people suffer from chronic pain, the reasons for which are not always well understood. Algometers are instruments that can help clinicians understand the nature of pain by determining the force at which pain becomes noticeable or unbearable. Algometers can also be used to determine the effects that external influences can have on pain tolerance in healthy people.

The goal of this project was to develop an algometer that can measure the normal range of pain thresholds and tolerances of most patients, which ranges up to 35 lbs. Also, the result needed to be accurate to about 1% and made …

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Understanding The Impact Of Covid-19 On Physical And Mental Fatigue In Youth With Cerebral Palsy, Nathan Wc Yang Mr.

Undergraduate Student Research Internships Conference

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This explorative study examined the impact of the COVID-19 pandemic, lockdowns, and social distancing on mental and physical fatigue and life role participation of youth with CP. Quantitative data included results from the Fatigue Impact and Severity Self-Assessment (FISSA), Child & Adolescent Scale of Participation (CASP) and the Participation and Environment Measure for Children and Youth (PEM-CY).

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Creation Of A Virtual Interface For Stress-Trauma Investigations Through Open World Navigation: An Exploration Of Tolerability And Physiological Reactions, Michael J. Lukacs

Electronic Thesis and Dissertation Repository

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It is estimated that as many as 50% of people suffering from Whiplash Associated Disorders (WAD) may experience chronic alterations of their activities of daily living as much as 1-year post injury. Despite their burden, there is little to evidence to suggest why some people may be more likely to acquire WAD or develop chronic symptomology. Additionally, the link between biomechanical forces at the time of impact and symptom development or recovery is poor. As a result, interest in alternative theories such as stress system reactivity have received interest in recent literature, but empirical methods to test them has been …

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Evaluating A Concern For Falling Among People With A Lower Extremity Amputation, Kristin Elizabeth Nugent

Electronic Thesis and Dissertation Repository

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The purpose of these studies was to evaluate a concern for falling (CFF) among people with a lower extremity amputation (PLEA). Study 1 evaluated relative and absolute test-retest reliability of five standardized scales which have not been previously evaluated among PLEA. Twenty-two participants completed Study 1, an online survey that was administered twice. Study 2 assessed the inter-relationship of the multiple dimensions in a CFF using nine standardized scales of measurement and open-ended questions, and the association on quality of life (QOL). Forty-eight participants completed Study 2, a onetime online survey. Study 1 provided support for the reliable use of …

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The Psychosocial And Physical Effects Of Therapeutic Horseback Riding For Children With Cerebral Palsy, Karen M. Pratt

Electronic Thesis and Dissertation Repository

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Background: Participation in specialized adapted activities such as therapeutic horseback riding (THR) is critical for children with cerebral palsy (CP) as they are at increased risk for lower habitual physical activity levels, social exclusion and mental health conditions. The benefits of THR for children CP are unclear despite positive anecdotal evidence. Purpose: The aim of the study is to explore the effects of THR participation for children with CP across multiple domains of health (psychological, social and physical) from the children themselves. Specifically, this study explored overall wellbeing including mental health, perceived independence, social inclusion and presence of fatigue and …

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Functional Performance Testing In Ice Hockey: The Role Of The Single Leg, Medial Countermovement Jump, Anthony S. Donskov

Electronic Thesis and Dissertation Repository

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Due to the physical nature of the game, injuries are common in ice hockey. Injury rates have been difficult to interpret due to the inconsistencies in the definitions of injury and athlete exposure. Consensus statements on injury definitions have been developed for sports such as soccer and rugby but have not been established in ice hockey. Furthermore, many different off-ice tests are performed, but a hockey-specific performance test has not been promoted. Accordingly, the objective for this thesis was to investigate injury rates, injury definition, athlete exposure and injury type in men’s ice hockey, and providing information on a practical …

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Development And Feasibility Of A Modified Fugl-Meyer Lower Extremity Assessment For Telerehabilitation: A Pilot Study., Sue Peters, Marcela Botero, Allison Evers, Brianna Fong, Botond Jakab, Emily Petter, Janice J Eng

Physical Therapy Publications

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BACKGROUND: The majority of stroke survivors experience motor impairment which benefits from rehabilitation treatment. Telerehabilitation, remote delivery of rehabilitation services, is a possible solution providing access to rehabilitation for stroke survivors living in rural areas or in situations like the COVID-19 pandemic where face-to-face treatment may be risky. However, valid and reliable motor impairment measures have not yet been established over a telerehabilitation platform. The Fugl-Meyer (FM) lower extremity assessment is widely used clinically and in research. Thus, the aim was to develop a modified FM for telerehabilitation (FM-tele) and assess the feasibility and preliminary agreement of FM-tele scores with …

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The Time For Translation Of Mobile Brain And Body Imaging To People With Stroke Is Now, Brian Greeley, Grant Hanada, Lara A Boyd, Sue Peters

Physical Therapy Publications

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No abstract provided.

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Therapist Perception Of The Clarity And Implementability Of Relevant Recommendations From American Academy Of Orthopedic Surgeon’S Distal Radius Fracture Clinical Practice Guidelines, Saravanan Esakki

Electronic Thesis and Dissertation Repository

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Fractures of the distal radius are common and can cause substantial either transient or permanent impairment and disability.

Clinical practice guidelines (CPGs) are systematically developed statements or recommendations based on the best available evidence and aimed at assisting health care practitioners in clinical decision-making. Many professional organizations have developed practice guidelines for common clinical conditions. The overall objective of this thesis is to evaluate the therapist's perception of the clarity and implementability of rehabilitation relevant recommendations from The American Academy of Orthopaedic Surgeons (AAOS) CPG for distal radius fractures (DRF) and to identify the quality of CPG related to DRF. …

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Perspectives Of Individuals With Chronic Spinal Cord Injury Following Novel Balance Training Involving Functional Electrical Stimulation With Visual Feedback: A Qualitative Exploratory Study, David J Houston, Janelle Unger, Jae W Lee, Kei Masani, Kristin E Musselman

Physical Therapy Publications

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BACKGROUND: Individuals with an incomplete spinal cord injury (iSCI) are highly susceptible to falls during periods of walking or standing. We recently reported the findings of a novel intervention combining functional electrical stimulation with visual feedback balance training (FES + VFBT) on standing balance abilities among five individuals with motor iSCI. However, the previous publication did not report the perceived impact of the intervention on the participants' lives. In this report, the experiences of these five individuals with incomplete spinal cord injury (iSCI) who had recently completed the four-week balance training program are described.

METHODS: Five individuals with a motor …

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Publication Rate And Consistency Of Registered Trials Of Motor-Based Stroke Rehabilitation, Raabeae Aryan, David Jagroop, Cynthia J Danells, Gabriela Rozanski, Janelle Unger, Andrew H Huntley, Avril Mansfield

Physical Therapy Publications

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OBJECTIVE: To determine the publication rate of motor-rehabilitation trials poststroke and the consistency between registry records and their corresponding main publications in trial design, primary objectives and outcomes, eligibility criteria, and sample size.

METHODS: We searched 18 clinical trial registries to identify randomized controlled trials of motor-based stroke rehabilitation registered after July 2005 and completed before April 2017. Eligible trials included adults with stroke, with at least one outcome measure related to motor function. Information in the registry records was compared with that of their main publications, if any.

RESULTS: Three hundred twenty-three trials met our eligibility criteria; we were …

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Evaluating Intrinsic Fall Risk Factors After Incomplete Spinal Cord Injury: Distinguishing Fallers From Nonfallers., Kristin E Musselman, Tarun Arora, Katherine Chan, Mohammad Alavinia, Mackenzie Bone, Janelle Unger, Joel Lanovaz, Alison Oates

Physical Therapy Publications

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OBJECTIVE: To determine whether performance on measures of lower extremity muscle strength, sensory function, postural control, gait speed, and balance self-efficacy could distinguish fallers from nonfallers among ambulatory individuals with spinal cord injury or disease (SCI/D).

DESIGN: Prospective cohort study.

SETTING: Community.

PARTICIPANTS: Individuals (N=26; 6 female, aged 58.9±18.2y) with motor incomplete SCI/D (American Spinal Injury Association Impairment Scale rating C [n=5] or D [n=21]) participated. Participants were 7.5±9.1 years post injury. Seventeen participants experienced traumatic causes of spinal cord injury.

MAIN OUTCOME MEASURES: Participants completed laboratory-based and clinical measures of postural control, gait speed, balance self-efficacy, and lower extremity …

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Brain Activity During Real-Time Walking And With Walking Interventions After Stroke: A Systematic Review, Shannon B. Lim, Dennis R. Louie, Sue Peters, Teresa Liu-Ambrose, Lara A. Boyd, Janice J. Eng

Physical Therapy Publications

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AbstractInvestigations of real-time brain activations during walking have become increasingly important to aid in recovery of walking after a stroke. Individual brain activation patterns can be a valuable biomarker of neuroplasticity during the rehabilitation process and can result in improved personalized medicine for rehabilitation. The purpose of this systematic review is to explore the brain activation characteristics during walking post-stroke by determining: (1) if different components of gait (i.e., initiation/acceleration, steady-state, complex) result in different brain activations, (2) whether brain activations differ from healthy individuals. Six databases were searched resulting in 22 studies. Initiation/acceleration showed bilateral activation in frontal areas; …

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The Effect Of Dual-Task Testing On Balance And Gait Performance In Adults With Type 1 Or Type 2 Diabetes Mellitus: A Systematic Review, Humberto Omana, Edward Madou, Manuel Montero-Odasso, Michael Payne, Ricardo Viana, Susan W. Hunter

Physical Therapy Publications

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BACKGROUND: Individuals with diabetes mellitus (DM) are susceptible to balance, gait and cognitive impairments. Importantly, diabetes affects executive function, a set of cognitive processes critical to everyday cortical function and mobility. Reduced executive function is a risk factor for falls in people with DM. Dual-task testing, the completion of two tasks at once, enables the examination of the cognitive-mobility relationship. A synthesis of the literature on the effects of dual- task testing on the balance and gait of individuals with DM has not been performed.

OBJECTIVE: To systematically review the literature on the effect of dual-task testing on balance and …

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The Effect Of Perturbation-Based Balance Training And Conventional Intensive Balance Training On Reactive Stepping Ability In Individuals With Incomplete Spinal Cord Injury Or Disease: A Randomized Clinical Trial, Janelle Unger, Katherine Chan, Jae W Lee, B Catharine Craven, Avril Mansfield, Mohammad Alavinia, Kei Masani, Kristin E Musselman

Physical Therapy Publications

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Introduction: Impaired balance leads to falls in individuals with motor incomplete spinal cord injury or disease (iSCI/D). Reactive stepping is a strategy used to prevent falls and Perturbation-based Balance Training (PBT) can improve this ability.

Objective: The objective of this study was to determine if PBT results in greater improvements in reactive stepping ability than frequency-matched Conventional Intensive Balance Training (CIBT) in adults with iSCI/D.

Design: Randomized clinical trial.

Setting: Tertiary SCI/D rehabilitation center.

Participants: Twenty-one adults with chronic (>1 year) iSCI/D were randomized. Due to one drop out 20 participants completed the study.

Methods: Participants were randomly allocated …

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Biofeedback As An Intervention For Persistent Post-Concussive Symptoms: A Randomized Feasibility Trial, Marquise M. Bonn, Liliana Alvarez, Laura J. Graham, James W. Thompson, James P. Dickey

Physical Therapy Publications

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Background

Case reports indicate that low-resolution electromagnetic tomography neurofeedback and heart rate variability biofeedback may improve physiological functioning in individuals with persistent post-concussive symptoms. However, it is unclear whether larger-scale studies are feasible.

Purpose

To evaluate the feasibility of a combined low-resolution electromagnetic tomography neurofeedback and heart rate variability biofeedback intervention for individuals with persistent post-concussive symptoms.

Methods

Individuals with persistent post-concussive symptoms were randomized into intervention and control groups, and their baseline and post-test assessments were compared to a healthy control group. Outcomes included self-report questionnaires, resting electroencephalograph and electrocardiograph recordings, and a driving simulation task. Participants in the …

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