Medicine and Health Sciences Commons^™

Implementation Of Increased Physical Therapy Intensity For Improving Walking After Stroke: Walk 'N Watch Protocol For A Multisite Stepped-Wedge Cluster-Randomized Controlled Trial, Sue Peters, Shannon B Lim, Mark T Bayley, Krista Best, Louise A Connell, Hélène Corriveau, Sarah J Donkers, Sean P Dukelow, Tara D Klassen, Marie-Hélène Milot, Brodie M Sakakibara, Lisa Sheehy, Hubert Wong, Jennifer Yao, Janice J Eng

Physical Therapy Publications

RATIONALE: Clinical practice guidelines support structured, progressive protocols for improving walking after stroke. Yet, practice is slow to change, evidenced by the little amount of walking activity in stroke rehabilitation units. Our recent study (n = 75) found that a structured, progressive protocol integrated with typical daily physical therapy improved walking and quality-of-life measures over usual care. Research therapists progressed the intensity of exercise by using heart rate and step counters worn by the participants with stroke during therapy. To have the greatest impact, our next step is to undertake an implementation trial to change practice across stroke units where …

Higher Intensity Walking Improves Global Cognition During Inpatient Rehabilitation: A Secondary Analysis Of A Randomized Control Trial, Sue Peters, Keith R Lohse, Tara D Klassen, Teresa Liu-Ambrose, Sean P Dukelow, Mark T Bayley, Michael D Hill, Sepideh Pooyania, Jennifer Yao, Janice J Eng

Physical Therapy Publications

Cognitive deficits are common poststroke. Cognitive rehabilitation is typically used to improve cognitive deficits. It is unknown whether higher doses of exercise to promote motor recovery influence cognitive outcomes. Our recent trial, Determining Optimal Post-Stroke Exercise (DOSE), shows more than double the steps and aerobic minutes can be achieved during inpatient rehabilitation versus usual care, and translates to improved long-term walking outcomes. Thus, the secondary analysis aim was to determine the effect of the DOSE protocol on cognitive outcomes over 1-year poststroke. The DOSE protocol progressively increased step number and aerobic minutes during inpatient stroke rehabilitation over 20 sessions. The …

Advancing Type 2 Diabetes As A Condition For Primary Referral To Physiotherapy In Canada, Sarah M. Janssen

Electronic Thesis and Dissertation Repository

Obesity and sedentary lifestyle are increasingly prevalent risk factors for type 2 diabetes (T2D), characterized by high blood glucose levels. Adoption and maintenance of healthy eating, physical activity, and exercise is recommended for lowering blood glucose and weight management. Physiotherapists are experts in prescribing safe, effective exercise to optimize health for people with co-morbid health conditions. However, T2D is not a primary condition for referral to physiotherapy services in Canada. The overall question guiding a series of three related studies was, What is the current education and perspectives of Canadian physiotherapists about their role in managing T2D? Study one surveyed …

Non-Pharmacological Management Of Community Dwelling Individuals With Osteoporosis Or At Risk Of Developing Osteoporosis, Christina Ziebart

Electronic Thesis and Dissertation Repository

Background:

Osteoporosis is a bone disease that increases the risk of fractures. In adults aged 50-65 years, a wrist fracture is usually the first sign of osteoporosis. Fracture risk increases if these individuals are not taught to exercise, eat properly, and/or identify fall risk factors early in their diagnosis.

Methods:

A meta-analysis was conducted to determine whether a home fall hazard identification program could reduce the risk of falls in community dwelling adults and an overview of exercise in individuals with a distal radius fracture (DRF). CINHAL, PubMed, EMBASE, Scopus, and Psych INFO were used to identify articles. A survey …

Lived Experience And Process Of Engagement In Physical Exercise For Older Adults With Chronic Back Pain, Melissa E. Hay

Electronic Thesis and Dissertation Repository

For older adults, physical exercise is especially important in maintaining functional independence, extending quality of life, and optimizing personal health resources. For patients with chronic pain conditions, exercise participation can significantly improve patient-reported symptoms. Older adults are the most sedentary age group with the majority not meeting the recommended duration and intensity of weekly exercise. Although nonadherence with exercise guidelines may result for a variety of reasons, adverse health conditions including chronic pain are likely of particular concern for older adults. The aim of this research, consisting of two studies employing interpretive phenomenology and constructivist grounded theory, was to understand …

The Effect Of A Multiple Modality Mind-Motor Exercise Intervention On Single And Dual-Task Gait, Balance, And Executive Function, In Community Dwelling Older Adults With A Subjective Cognitive Complaint: A Randomized Controlled Trial., John P. Bocti

Electronic Thesis and Dissertation Repository

Cognitive decline disorders are becoming increasingly prevalent, with older adults at increased risk. Combined exercise has been recently explored as an intervention to help to prevent the decline, however cognitive activation in combination with physical activity has yet to be explored. Therefore, the purpose of the study is to determine the effects of multiple modality exercise programs in combination with a mind-motor task and their effects on mobility and cognitive variables. A total of (n=89) older adults (55+ yrs), with subjective cognitive complaints participated in a multiple modality exercise class, three days a week over six months, with the intervention …

Community Physiotherapy And Chronic Disease Self-Management For Rural Community-Dwelling Older Adults, Laura J. Graham

Electronic Thesis and Dissertation Repository

Research problem: The majority of older Canadians live with at least one chronic disease. Exercise has been shown to be an effective means to reducing symptoms, and to improving physical dysfunction in chronically ill populations; and self-management is a nationally advocated approach to dealing with the growing health care issue of chronic disease. Physiotherapists are experts in prescribing therapeutic exercise and promoting chronic disease self-management.

Methods: This two-study dissertation explored older adults’ perceptions of exercise as a self-care activity within a chronic disease self-management strategy using focused ethnography; and physiotherapists’ experiences in promoting exercise as a means to chronic disease …

Short Term Sensory And Vascular Responses To Physical Agent Modalities And Exercise In Healthy Volunteers And Patients With Distal Radius Fracture., Shaguftha Shaik

Electronic Thesis and Dissertation Repository

Currently, there is weak evidence on the effectiveness of different rehabilitation regimens following distal radius fracture (DRF). This thesis evaluated sensory and vascular effects of exercise, thermal and ultrasound interventions that can be used in the mobilization phase (cast removal) after DRF.

Methods

• This thesis includes 3 studies. The first study compared responses to Immersion in Cold water Evaluation (ICE) in the DRF and uninjured hands. Skin blood flow (Sbf), skin temperature (temp.) and sensory perception thresholds (sPT) at 2000Hz for A –beta fibres and at 5 Hz for C fibres were obtained before, immediately after ICE and 10 min …

"Any Movement At All Is Exercise": A Focused Ethnography Of Rural Community-Dwelling Older Adults' Perceptions And Experiences Of Exercise As Self-Care, Laura J. Graham, Denise M Connelly

Physical Therapy Publications

PURPOSE: To understand rural community-dwelling older adult participants' shared values, beliefs, and behaviours related to exercise as self-care.

METHODS: We conducted a constructivist-focused ethnography involving semi-structured interviews and participant observation with 17 individuals 65 years and older. Interviews were transcribed and inductively coded to develop themes related to exercise, self-care, and exercise as self-care. Field notes were triangulated with follow-up interviews and dialogue between authors to enhance interpretation.

RESULTS: Participants described exercise broadly as movement and not as a central self-care behaviour. However, awareness of the importance and health-related benefits of exercise increased after a significant personal health-related event. Participants …

Description Of Exercise Participation Of Adolescents With Cerebral Palsy Across A 4-Year Period., Laura K Brunton, Doreen J Bartlett

Physical Therapy Publications

Purpose: The primary purposes were to describe: 1) the types of exercise participation of adolescents with cerebral palsy (CP), 2) the weekly duration of stretching, strengthening, and cardiovascular exercise, and 3) how the level of activity compares to national health guidelines.

Methods: Participants were 126 males and 104 females (14.7, SD =1.7 years) who reported on the physical activities in the previous week using a questionnaire designed for this study. Analyses comprised frequency counts and proportions, stacked bar graphs and 2-way ANOVAs of exercise participation by GMFCS and gender.

Results: There was a significant interaction of GMFCS level and gender …