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

Electronic Thesis and Dissertation Repository

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

Electronic Thesis and Dissertation Repository

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

Electronic Thesis and Dissertation Repository

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

Electronic Thesis and Dissertation Repository

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.

Electronic Thesis and Dissertation Repository

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 …

Sex-Related Differences In Gait Characteristics And Their Associations With Symptoms In Individuals With Patellofemoral Osteoarthritis, Harvi Hart Dr.

Physical Therapy Publications

Background

Patellofemoral osteoarthritis (OA) is an important subgroup of knee OA. However, the influence of sex on gait characteristics in patients with patellofemoral OA is unknown.

Research question

Compare gait characteristics in females and males with patellofemoral OA and investigate their associations with patellofemoral joint-related symptoms and limitations.

Methods

Mixed effects polynomial regression models compared knee flexion-extension and adduction moments, knee flexion angles, and vertical ground reaction forces over 100% of stance between 26 females and 22 males with patellofemoral OA, with and without adjustment for walking speed and body mass. Multivariable linear regression models were then used to …

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 …

Rehabilitation Interventions For Physical Capacity And Quality Of Life In Adults With Post-Covid-19 Condition: A Systematic Review And Meta-Analysis., Dimitra V Pouliopoulou, Joy C Macdermid, Emily Saunders, Sue Peters, Laura Brunton, Erin Miller, Kieran L Quinn, Tiago V Pereira, Pavlos Bobos

Physical Therapy Publications

IMPORTANCE: Current rehabilitation guidelines for patients with post-COVID-19 condition (PCC) are primarily based on expert opinions and observational data, and there is an urgent need for evidence-based rehabilitation interventions to support patients with PCC.

OBJECTIVE: To synthesize the findings of existing studies that report on physical capacity (including functional exercise capacity, muscle function, dyspnea, and respiratory function) and quality of life outcomes following rehabilitation interventions in patients with PCC.

DATA SOURCES: A systematic electronic search was performed from January 2020 until February 2023, in MEDLINE, Scopus, CINAHL, and the Clinical Trials Registry. Key terms that were used to identify potentially …

Students' Attitudes, Beliefs And Perceptions Surrounding 2slgbtqia + Health Education And Inclusiveness In Canadian Physiotherapy Programs, Codie A Primeau, Holly T Philpott, Kyle Vader, Janelle Unger, Christina Y Le, Trevor B Birmingham, Joy C Macdermid

Physical Therapy Publications

BACKGROUND: Patients who identify as 2SLGBTQIA + report negative experiences with physiotherapy. The objectives were to evaluate student attitudes, beliefs and perceptions related to 2SLGBTQIA + health education and working with individuals who identify as 2SLGBTQIA + in entry-level physiotherapy programs in Canada and to evaluate physiotherapy program inclusiveness towards 2SLGBTQIA + persons.

METHODS: We completed a nationwide, cross-sectional survey of physiotherapy students from Canadian institutions. We recruited students via email and social media from August-December 2021. Frequency results are presented with percentages. Logistic regression models (odds ratios [OR], 95%CI) were used to evaluate associations between demographics and training hours …

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

Electronic Thesis and Dissertation Repository

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

Electronic Thesis and Dissertation Repository

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

Electronic Thesis and Dissertation Repository

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 …

Knowledge, Behaviours, And Training Related To 2slgbtqia+ Health Education Amongst Entry-Level Physiotherapy Students In Canada: Results Of A Nationwide, Cross-Sectional Survey, Codie A Primeau, Holly T Philpott, Kyle Vader, Janelle Unger, Christina Y Le, Trevor B Birmingham, Joy C Macdermid

Physical Therapy Publications

BACKGROUND: Individuals who identify as 2SLGBTQIA+ report worse health outcomes than heterosexual/cisgender counterparts, in part due to poor experiences with healthcare professionals. This may stem from inadequate 2SLGBTQIA+ health and inclusiveness training in health professional student education. The purpose of the study was to evaluate knowledge, behaviours, and training related to 2SLGBTQIA+ health education and inclusiveness for entry-level physiotherapy students in Canada.

METHODS: We conducted a nationwide, cross-sectional survey with physiotherapy students from accredited Canadian physiotherapy programs. We administered the survey through Qualtrics and recruited students through targeted recruitment emails and social media posts on Twitter and Instagram between August …

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

Electronic Thesis and Dissertation Repository

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 …

The Multidimensional Symptom Index: User Manual And Questionnaire, David Walton

Physical Therapy Publications

The user manual for the MultiDimensional Symptom Index, including hard copy versions in both English and Canadian French translations.

Click here for a direct link to an online interactive version of the MSI: dwalton5.pythonanywhere.com

Comparator Groups In Icu-Based Studies Of Physical Rehabilitation: A Scoping Review Of 125 Studies, Heather K O'Grady, Julie C Reid, Christopher Farley, Quincy E B Hanna, Janelle Unger, David J Zorko, Jackie Bosch, Lyn S Turkstra, Michelle E Kho

Physical Therapy Publications

OBJECTIVES: To characterize comparator groups (CGs) in ICU-based studies of physical rehabilitation (PR), including the type, content, and reporting.

DATA SOURCES: We followed a five-stage scoping review methodology, searching five databases from inception to June 30, 2022. Study selection and data extraction were completed independently, in duplicate.

STUDY SELECTION: We screened studies by title and abstract, then full-text. We included prospective studies with greater than or equal to two arms enrolling mechanically ventilated adults (≥ 18 yr), with any planned PR intervention initiated in the ICU.

DATA EXTRACTION: We conducted a quantitative content analysis of authors' description of CG type …

Spatial Characteristics Of Reactive Stepping Among People Living With Chronic Incomplete Spinal Cord Injury, Matthew G Heffernan, Jae Woung Lee, Katherine Chan, Janelle Unger, Susan Marzolini, Timothy N Welsh, Kei Masani, Kristin E Musselman

Physical Therapy Publications

Objective: Compare the spatial characteristics of reactive stepping between individuals with chronic motor incomplete spinal cord injuries (iSCI) and able-bodied (AB) individuals.

Design: Cross sectional.

Setting: Lyndhurst Centre.

Participants: Twelve individuals with iSCI (3 males, 53.6 ± 15.2 years old) and 11 age- and sex-matched AB individuals (3 males, 54.8 ± 14.0 years old).

Interventions: The Lean-and-Release test was used to elicit reactive stepping. A horizontal cable, attached at waist height, was released when 8-12% body weight was supported in a forward lean position. Participants underwent up to 10 Lean-and-Release trials in a session. Kinematic and …

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

Electronic Thesis and Dissertation Repository

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 …

The Satisfaction And Recovery Index, David Walton

Physical Therapy Publications

User Manual for the Satisfaction and Recover Index, including versions of the tool in English, French-Canadian, Persian, and Japanese translations

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

Electronic Thesis and Dissertation Repository

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 …

Association Between Measures Of Cognitive Function On Physical Function In Novice Users Of A Lower Limb Prosthesis, Humberto Omana, Courtney Frengopoulos, Manuel Montero-Odasso, Michael W. Payne, Ricardo Viana, Susan W. Hunter

Physical Therapy Publications

BACKGROUND: Cognitive impairment is prevalent in people with lower limb amputations (PLLA) and is associated with adverse outcomes, such as falls and worse rehabilitation outcomes. Physical function tests are essential to examine abilities; however, no research in PLLA has clarified the magnitude of cognitive demands amongst available tests in users novice at walking with a prosthesis.

METHODS: People from inpatient prosthetic rehabilitation were recruited. Inclusion criteria were: age ≥ 50 years, unilateral transtibial amputation and able to walk independently. Gait velocity and the L Test under single-task (usual) and dual-task (walking while counting backwards) conditions assessed functional mobility. The Four …

Association Between Balance Confidence And Basic Walking Abilities In People With Unilateral Transtibial Lower-Limb Amputations: A Cross-Sectional Study, Humberto Omaña, Courtney Frengopoulos, Manuel Montero-Odasso, Michael W. Payne, Ricardo Viana, Susan W. Hunter

Physical Therapy Publications

INTRODUCTION: Falls are common for people with lower-limb amputations (PLLA). Low balance confidence is also prevalent, is worse in PLLA not reporting walking automaticity, and is known to negatively affect prosthesis use, social engagement, and quality of life. Moreover, walking with a prosthesis requires continuous attention. Low balance confidence may act as a distractor imposing an additional cognitive load on the already cognitively demanding task of walking with a prosthesis.

METHODS: Adults with unilateral, transtibial amputations were recruited. The Activities-specific Balance Confidence (ABC) scale quantified balance confidence. The L Test assessed basic walking abilities under single-task (ST) (usual) and dual-task …

Critiquing Representations Of Intellectual Disability In Occupation-Based Literature, Rachel Reparon, Pamela Block, Ann Fudge Schormans, Debbie Laliberte Rudman, Gail Teachman

Occupational Therapy Publications

Background: Within and beyond occupation-based scholarship, concerns abound regarding the pervasiveness of discourses that promote a negative, deficit-based view of intellectual disability and associated consequences for disabled people’s lives. Such representations risk reducing the complexities of human doing and being and can limit the occupational possibilities of this group. Yet, there is a lack of critically reflexive research exploring how disability is discursively constructed in occupation-based literature.

Aims/Objectives: This paper critically analyses representations of intellectual disability within occupation-based literature. It considers the influence of such representations on the occupational possibilities of people labelled intellectually disabled.

Methods: This review employed a …

Premotor And Posterior Parietal Cortex Activity Is Increased For Slow, As Well As Fast Walking Poststroke: An Fnirs Study, Shannon B Lim, Sue Peters, Chieh-Ling Yang, Lara A Boyd, Teresa Liu-Ambrose, Janice J Eng

Physical Therapy Publications

Background and Purpose. The ability to change gait speeds is important for interacting with the surrounding environment. Gait speed modulation poststroke is often impaired and is related to decreased walking independence after stroke. Assessment of brain activation during walking at different speeds can provide insight into important regions for facilitating gait recovery. The purpose is to determine: (1) the symmetry of brain activation as individuals increase or decrease their gait speed, (2) the activation levels in frontal to parietal brain regions during walking at different speeds, and (3) the relationship between an individual’s stroke impairment or their ability to modulate …