The Development And Testing Of A Gyroscope-Based Neck Strengthening Rehabilitation Device, Nicole D. Devos

Electronic Thesis and Dissertation Repository

Neck pain can be debilitating, and is experienced by the majority of people at some point over the course of their life. Resistance training has been shown to have significant improvement in pain or disability for patients. There are few options available for telerehabilitation, and the use of gyroscope stabilizers is proposed for this use. A biomechanics model of a head--neck--gyroscope system was created. In order to also model the dynamics of such a system, this work proposes a blended method using the Denavit--Hartenberg (DH) convention, popular in the field of robotics, with the Lagrangian mechanics approach to analyze an …

The Signs And Symptoms Of Discogenic Low Back Pain, Joe J. Putos

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The signs and symptoms of low back pain (LBP) associated with disc herniation (DLBP) and its underlying mechanism(s) are not well supported. One theory proposes that some low back pain (LBP) is the result of a disc herniation compressing adjacent tissues innervated with nociceptors. The theory proposes that spinal manipulation (SM) and/or mobilizations (SMOB) can reduce the size and position of the herniation, and relieve pain and improve range of motion. There is no research to support or negate the theory even though clinical evidence supports its plausibility.

In this three-part study we examined clinical practices that have an anecdotal …

Physiotherapists Description Of Patient-Centered Care, And Barriers And Facilitators Experienced To Implementation, Maclean Jordan

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Patient-centered care (PCC) is a growing standard for healthcare delivery due to the benefits to patient autonomy. Lacking a cohesive definition in the physiotherapy literature, it is also lacking in implementation. Employing interpretive description with semi-structured interviews, the goal was to understand how physiotherapists drawn from private for-profit clinics in Canada describe PCC, and barriers and facilitators to providing it. Results included requiring person-centered communication in PCC, seeing Health holistically, centering the patient in care, and being a skill that becomes clearer with practice experience. Barriers included: lack of practitioner reflexivity, patient not desiring self-directed care, and limited access to …

Development And Validation Of The Pain Resilience And Optimism Scale (Pros), Wonjin Seo

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Numerous self-report questionnaires have been used in pain research to explore patients' experiences. However, these questionnaires often employ negatively worded items that can potentially worsen patients' distress. In response to the emergence of positive psychology, this thesis aimed to develop a new questionnaire that adopts a positive and strengths-focused approach, incorporating resilience, to replace the negative items found in existing tools such as the Pain Catastrophizing Scale (PCS). First, the effectiveness of the Connor-Davidson Resilience Scale (CD-RISC) in measuring resilience following trauma was assessed through a systematic review using the COnsensus-based Standards for the selection of health status Measurement INstruments …

Sleep, Sleepiness, And Driving Performance In Healthcare Shiftworkers, Melissa Knott

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Almost half of Canadian healthcare workers are employed in rotating day/night shifts to provide essential 24-hour services. However, poor sleep quantity and quality are pervasive in shiftwork and may negatively impact cognitive functions required for driving. Furthermore, healthcare shiftworkers (HCSW) are under-represented in research examining shiftworkers’ sleep and driving performance. Thus, this dissertation examined sleep, sleepiness and driving performance in HCSW via three aims. First, chapter 2 aimed to quantify and describe HCSWs’ sleep-related driving experiences and advance the understanding of occupational adaptations used by HCSWs to meet driving demands. Second, chapter 3 aimed to quantify differences in sleep, sleepiness, …

Sex And Gender Differences In Arthritis Health Information, Tania Al-Jilawi

Electronic Thesis and Dissertation Repository

Arthritis is a common disorder that may result in pain and inflammation, making it challenging to move or continue being active. Arthritis comes in a variety of forms. The two studies of this thesis aimed to identify the influence of intersectionality, especially sex and gender, in arthritis. The first study, a structured review, evaluated the inclusion of sex/gender and intersectional identities in patient resources of three arthritis societies: the Canadian Arthritis Society, the American Arthritis Foundation, and the National Rheumatoid Arthritis Society. The appraisal tool, the Sex/Gender and Intersectional Considerations in Patient/Consumer Health Information Appraisal Tool was used to evaluate …

The Role Of Patient And Rehabilitation Factors In The Recovery Of Home And Family Work Roles Following Distal Radius Fracture, Sheena Saju Philip Ms.

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Background: Distal radius fracture (DRF) is a common upper extremity fracture that causes significant impairment and leads to difficulties in fulfilling important life roles such as indoor and outdoor cleaning, meal preparation, grocery shopping, caring for others, and earning and managing family income. However, clinicians do not routinely address home and family life roles after a DRF. Patient and rehabilitation factors are crucial in addressing home and family work roles (HFWRs). The HFWR questionnaire consists of tasks that are typically performed at home.

Objective: The overarching objective of this thesis is to explore the role of patient and rehabilitation …

The Lived Experience Of Persons With Parkinson's Disease In Non-Contact Boxing Programs, Laura Mulder

Electronic Thesis and Dissertation Repository

We conducted a scoping review to identify articles examining non-contact boxing programs for persons with Parkinson’s disease (PwP). Results suggested that gait, mobility, balance, and quality-of-life were the most-studied outcomes. Many qualitative articles explored the experience within in-person boxing programs, but no articles explored experiences within virtual boxing programs. We followed this review with an interpretative phenomenological analysis aimed at addressing this research gap and interviewed six PwP who had engaged with both virtual and in-person Rock Steady Boxing programming. Results suggested that although the virtual setting improved elements of the individual experience, the physical and social aspects were better …

Association Of Fall-Related Injuries And Different Diagnoses In Older Adults Of Ontario: A Machine Learning Approach, Sorour Rostampour

Electronic Thesis and Dissertation Repository

Falls are the leading cause of injury-related hospitalizations among older adults in Canada. This study aimed to identify the most informative diagnostic categories associated with fall-related injuries (FRIs) using three machine learning algorithms: decision tree, random forest, and extreme gradient boosting tree (XGBoost). Secondary data from two Ontario health administrative databases (NACRS, DAD) covering the period 2006-2015 were analyzed. Older adults (aged ≥ 65 years) who sought treatment for FRIs in emergency departments (ED) or hospitals, as indicated by Canadian version of the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10-CA) codes for falls …

Exploring The Experience Of Sexuality And Gender During The Healthcare Transition Of The Youth With Cerebral Palsy, Umma Salma

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Background: Transition from the pediatric to adult health care system is an important phase of healthcare for youth with cerebral palsy (CP). Sexuality and gender are two very important components of health that are mostly ignored in the healthcare transition process. It is possible that health care providers only see a client’s disability, and therefore, key aspects of sexuality and gender diversity may be ignored, or deemed irrelevant as a result of their disability status. Therefore, the purpose of our study is to explore how gender and sexuality may influence the experience of health care transition for youth with cerebral …

Evaluation Of Conservative And Operative Treatments In Active Patients With Acromioclavicular (Ac) And Rotator Cuff (Rc) Injuries, Jesse Singh

Electronic Thesis and Dissertation Repository

Abstract

Introduction: Shoulder pain and disability, particularly acromioclavicular joint (ACJ) and rotator cuff (RC) injuries, are common in a physically active population. Determining operative or rehabilitative treatment plans involve multiple treatment choices influenced by the injury grade and treatment goals, such as return to sport. This thesis investigates the management of treatment for AC and RC injuries

Method: The first study is a scoping review that uses the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) to synthesize 32 studies involving athletes who have undergone conservative or operative treatment for their Rockwood grade III …

Developing Rehabilitation Treatment Decision Aid For People Living With Complex Regional Pain Syndrome (Crps), Erfan Shafiee

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This Ph.D. dissertation aimed to develop a treatment decision aid for people with Complex Regional Pain Syndrome (CRPS) using the Ottawa Decision Support Framework (ODSF). The decision aid was developed throughout a two-phase process.

The first phase involved understanding the existing evidence and the factors influencing decision-making in CRPS rehabilitation: priorities and preferences of patients and therapists were considered. This phase encompassed the integration of diverse sources of evidence, including systematic reviews, overview of systematic reviews, critical appraisal of guidelines, and a survey exploring patients' and therapists' priorities and preferences for CRPS rehabilitation interventions. All forms of evidence were used …

A Community Dweller’S Perspective Of A Day Shoulder Arthroplasty Surgery., Bansari D. Patel Ms.

Electronic Thesis and Dissertation Repository

The following study was a qualitative interpretive descriptive study aimed at investigating immediate barriers or difficulties in the lives of the community dwellers as well as modifications occurring in the daily routine activities shortly after the out-patient total shoulder arthroplasty procedure. The personal and surgical factors affecting at-home recovery were focussed alongside exploring the coping mechanisms and adaptations in everyday day life. The study mainly focused on the initial three weeks' duration after the discharge. The study followed the constructivist paradigm, adopting the interpretive description methodology. A total of 19 subjects who underwent same/ single day discharge total shoulder arthroplasty …

Exploring The Relationship Between Hemispheric Prefrontal Cortex Activation, Standing Balance, And Fatigue In Individuals Post-Stroke: A Fnirs Study, Sarthak Kohli

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Balance impairments are common after stroke. Reasons for this are multifactorial and include motor dysfunction and fatigue. Limited research has explored the combined effects of post-stroke fatigue and balance on brain activation patterns. Research has shown that prefrontal cortex (PFC) activation may be involved in both motor control and fatigue throughout the recovery process post-stroke. The aim of this thesis was to determine whether: (1) PFC activation levels change between standing balance tasks, (2) PFC hemispheric activation is asymmetric during standing balance tasks, and (3) fatigue levels are associated with task-based activation. Patients with hemiparesis were recruited from the inpatient …

Valued Strategies In The Development And Implementation Of Interprofessional Education Placements, Olajumoke Akintomide

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Background: Interprofessional education (IPE) is increasingly being recognized as an essential component of training future healthcare providers. IPE allows students to learn collaboratively preparing them for future collaborative practice. Purpose: This study aimed to identify strategies valued by rehabilitation therapy students and clinical instructors in the development and implementation of IPE placements. Method: Through interviews and focus groups, this study explored the experiences and perspectives of students and clinical instructors regarding IPE placements for students in rehabilitation therapy programs. Results: Four major themes emerged from the findings of this study relating to the development and implementation of IPE placements. Themes …

Depression As A Prognostic Factor For Lumbar Spinal Stenosis Outcomes, Ariel M. Morales

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Lumbar spinal stenosis (LSS) is a degenerative disease common in older adults and is associated with significantly reduced health-related quality of life and increased disability. Depression has been found to be associated with poorer health-related outcomes in patients with spinal conditions. A systematic review was conducted to examine the literature regarding the prognostic value of depression for LSS outcomes. Findings suggest small to moderate prognostic value of depressive symptoms for postoperative outcomes in patients with LSS, with strong evidence for disability. Next, a secondary analysis of a cohort study was conducted to investigate two objectives. The first objective was to …

Vertebral Endplate Structural Defects: Measurement, Prevalence And Associated Factors, Aliyu Lawan

Electronic Thesis and Dissertation Repository

Objective: To synthesize current knowledge on the association of endplate structural defects (EPSD) with back pain (BP), improve EPSD measurement, and investigate EPSD prevalence, distribution, and association with age and body mass index (BMI).

Methods: In study 1, a systematic review was conducted on five databases for studies reporting on the association between EPSD and BP. Studies 2 and 3 used CTs and mCTs of 19 embalmed cadavers to examine the diagnostic accuracy of common EPSD assessment methods, and to develop and validate a novel method. Study 4 used the novel method on 200 adult males’ MRI to estimate EPSD …

How We Debrief: An Interpretive Description Of Social Service Community Workers' Experiences, Andrea C. Krywucky

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The aim of this research was to understand current practices of debriefing being used or not used in community social service organizations and the presumed frameworks or evidence justifying these practices in London, Ontario. The geographical area under concern has seen an increasing poverty gap, lack of affordable housing, toxic drug crisis, with mental health issues being exasperated by the pandemic. Social service agencies are overwhelmed with caseloads, creating an increase in need of care for frontline workers, as they are the first point of contact for many. This research utilized an interpretive description methodology to explore workers’ experiences and …

A Long-Term Follow-Up Of The Stability Study: Multicenter Rct Comparing Anterior Cruciate Ligament Reconstruction With And Without Lateral Extra-Articular Tenodesis In Individuals At High Risk Of Graft Failure, Katelyn M. Inch

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One hundred and ninety-six patients at the Fowler Kennedy Sport Medicine Clinic (FKSMC) undergoing anterior cruciate ligament (ACL) reconstruction (ACLR) were randomized as part of the multi-center STABILITY study to receive either an isolated ACLR or ACLR with a lateral extra-articular tenodesis (LET). The STABILITY study followed these patients up to two years postoperative, and a long-term follow-up protocol was initiated afterwards. Eighty-two patients from this center were seen at three, five and seven years postoperative as part of a long-term follow-up. Our primary outcome was a composite outcome of instability and graft failure. Secondary outcomes included patient-reported outcome measures …

Mindfulness With Children And Youth: A Hermeneutic Phenomenological Inquiry Into Paediatric Therapists' Experiences, Kirsten S. Smith

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Background: Mindfulness has become popular as a treatment approach for many health conditions and has been taken up by diverse health practitioners in recent years. While research into mindfulness-based interventions is on the rise, much of this research originates in the field of psychology and is aimed toward adult populations. Occupational therapists, including those working with children and youth, have begun to take up mindfulness to support their clients to participate in daily activities, and there is evidence that clinical uptake has outpaced research in this area.

Method: A scoping review was undertaken to understand the breadth of literature regarding …

The Clinical Value Of Oculomotor Assessments Across The Continuum Of Concussion, Dillon Richards

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Concussions are complex conditions that are difficult to manage medically. Variations in symptom presentation, intricate neurophysiological processes, and the availability of a variety of possible assessment tools may contribute to this complexity. Clinicians must use a broad approach, employing both subjective symptom assessment and objective assessments to confirm a diagnosis and/or monitor progression and recovery. Oculomotor function after concussion may be an important indicator of injury, given the interconnectedness of oculomotor function, vestibulo-ocular and visual systems, and even cognition. Oculomotor function may be assessed objectively or indirectly using patient-reported symptom checklists as part of subjective assessments. One way of objectively …

The Lived Experiences Of Pain And Fatigue In Persons Living With Neurological Conditions: A Phenomenological Study, Lauren L. Kane

Electronic Thesis and Dissertation Repository

Purpose: The aim of the study was to understand the experiences and impact of pain and fatigue and to further explore the relationship between participants' descriptions of their lived experiences with these phenomena within and across multiple sclerosis, Parkinson's disease, and cerebral palsy. Methods: Semi-structured interviews were used to interview nine participants about their experiences of living with pain and fatigue in their respective conditions. A new phenomenological approach was adopted, and data was analyzed inductively using interpretive phenomenological analysis. Results: Three final themes including a lack of understanding, negative perceptions of pain and fatigue, and coping strategies used to …

Adaptation With Injury, Family Role Responsibilities, & Social Support After Distal Radius Fracture (Drf), Hajra Batool

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This study is a qualitative interpretive descriptive study aimed at elucidating the impact of distal radius fracture (DRF) on patients' activities of daily living (ADLs), professional and familial duties, and social support during the healing process. The study focuses on fracture healing during the immobilization phase of injury. This study lies in the constructivist paradigm employing the interpretive description method. A total of 20 participants with DRF in casts were recruited by purposeful sampling from the Hand & Upper limb Centre, St. Joseph’s Hospital enrolled and interviewed over the telephone. Data was analyzed by Braun and Clarke’s Thematic Analysis Approach. …

Reframing Childhood Disability: Pushing Boundaries In The Rehabilitation Sciences, Emily J. Cox

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The purpose of this study was to critically examine the ways that dominant discourses surrounding childhood disability, as constructed in the neoliberal context, shape knowledge and practice in children’s rehabilitation. I carried out a critical discourse analysis of text within the rehabilitation sciences, including peer-reviewed research, websites, and qualitative interview transcripts. Drawing on disability studies scholarship as well as my Foucauldian conceptual framework, I called attention to complex interactions between discourse, power, and knowledge that shape thought and action in the rehabilitation sciences. My findings suggest that despite a growing recognition of the harms associated with deficit-based understandings of disability, …

Exploring The Inter-Relationship Between Cognitive And Motor Function In People With Lower Limb Amputations, Humberto Adolfo Omaña Moreno

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The main objective of the present dissertation was to expand our understanding of the inter-relationship between cognition and mobility in people with lower limb amputations (PLLA). Study 1 systematically reviewed the literature to assess the effects of dual-task testing on the balance and gait of PLLA. A total of twenty-two studies were included. Overall, PLLA demonstrated a disproportionately greater dual-task effect than controls, characterized by increased sway velocity and reduced pace and rhythm, and increased asymmetry when balance or walking was paired with a secondary task. Additionally, the dual-task effect was not influenced by differences in etiology, level of amputation, …

The Investigation Of Prosthetic Rehabilitation Outcomes Following A Lower Limb Amputation In The Oldest Old, Ashvene Sureshkumar

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This thesis sought to investigate the changing characteristics of people with lower limb amputations (LLAs) who participate in prosthetic rehabilitation programs and evaluate an under-investigated subgroup; the oldest old (aged 80 years and older). Study 1 included 601 consecutive admissions to a Canadian prosthetic rehabilitation program from 2012 to 2019. Although participant’s age did not increase at admission over time, individuals presented with a higher number of comorbidities each year. Participants were admitted from amputation surgery faster over time. Study 2 assessed functional prosthetic rehabilitation outcomes for the oldest old against participants aged 50 to 79 years old. Despite the …

The Coping Strategies Of Older Adults With Age Related Vision Loss (Arvl) – A Narrative Account, Zakara J. Stampp

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The goal of this study was to share the stories of older adults with age-related vision loss (ARVL) and how they have coped to maintain meaningful occupational engagement. Grounded in a constructivist paradigm, data collection and analysis were guided by the narrative inquiry methodology. The participants consisted of six older adults aged 60 or older, diagnosed with one of the following ARVL conditions: macular degeneration, diabetic retinopathy, and/or glaucoma. Participants were recruited from vision loss non-profit organizations such as the Canadian National Institute for the Blind (CNIB) and the Alliance for Equity of Blind Canadians (AEBC). One older adult was …

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

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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 …

Piloting A Study To Examine Children’S Understandings Of Chronic Pain And Coping, Kristina P. Ferreira

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Many of our understandings of how children conceptualize and cope with chronic pain are drawn from adult accounts or extrapolated from research in adult populations. Accordingly, there is scant knowledge relating to children’s own experiences of chronic pain and coping. This study begins to address this gap by piloting a methodology combining arts-based methods with semi-structured interviews to generate data with children aged 6-13 years. Participants with chronic pain were invited to draw and/or photograph what represents a ‘good pain day’ and ‘a bad pain day’, before engaging in a tailored, semi-structured interview. Results, interpreted using a constructivist lens, contribute …

To Develop A Clinically Friendly Multi-Segment Kinematic And Kinetic Foot Model And Test It On Pre-/Post-Hto Patients With Medial Knee Osteoarthritis And Knee Varus, Songlin Zhu

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This study aims to develop a clinically useful multi-segment foot model that will enable the analysis of foot kinematics and kinetics in an optical motion capture laboratory setting. This study will also test the new multi-segment foot model on patients with knee osteoarthritis and varus knee alignment that is corrected by high tibial osteotomy (HTO). The multi-segment foot model divides the foot into four functional segments: the hindfoot, midfoot, forefoot and hallux. An X-Z-Y-Cardan angle rotation convention was used to determine intersegmental dorsi/plantar flexion, inversion/eversion, and internal/external rotation. Joint moments, joint powers and medio-longitudinal arch (MLA) height/length ratio were also …