Rehabilitation and Therapy Commons^™

Optimizing The Composition And Delivery Of Assessment And Treatment Following Distal Radius Fracture, Michael L. Szekeres

Electronic Thesis and Dissertation Repository

Distal radius fracture (DRF) is the most common fracture.¹ The most recent Cochrane review indicated “The available evidence from randomized controlled trials is insufficient to establish the relative effectiveness of the various interventions used in the rehabilitation of adults with fractures of the distal radius”.²

Since the relative effectiveness of the various interventions used for rehabilitation after DRF is unknown, the main goal of this thesis is to focus on one aspect of both assessment and treatment to add to the current literature base. The first paper (Chapter 2) describes a new method using a modified finger goniometer …

Profiles Of Fatigue Severity And Variability Among Adolescents And Young Adults With Cerebral Palsy, Laura K. Brunton, Doreen J. Bartlett

Physical Therapy Publications

Background: Individuals with cerebral palsy (CP) experience progressive changes in functional status with the development of secondary impairments such as fatigue. Detailed accounts of the fatigue experience in CP are lacking.

Purpose: This study describes the severity and variability of fatigue in CP using the Fatigue Impact and Severity Self-Assessment.

Methods: This was a descriptive cross-sectional study surveying 130 (61 males) individuals (mean age 18 years, 11 months; SD four years, six months) with CP. Analyses comprised comparisons between two groups (Gross Motor Function Classification System (GMFCS) I and II-V), frequency counts and proportions.

Results: Significant differences exist between GMFCS …

Evaluating Factors That Affect Hand Dexterity After Distal Radius Fracture, Pavlos Bobos

Electronic Thesis and Dissertation Repository

Abstract

Objectives: The primary objective of this study was to determine the effect of age and gender on hand dexterity after distal radius fracture (DRF). The second aim of this study was to evaluate the recovery of hand dexterity in 1-year follow-up of DRF. The third purpose of this study was to determine the extent to which loss of range of motion (ROM) and grip strength predicts hand dexterity 6-months after injury

Methods: A prospective cohort study of 242 patients with DRF examined the recovery of hand dexterity across 3 time-points (3, 6 and 12 months). Dexterity testing was performed …

Fitness-To-Drive Screening Measure© : Constructing And Validating The Short Form, Shabnam Medhizadah

Electronic Thesis and Dissertation Repository

The valid and reliable Fitness-to-Drive Screening Measure^© (FTDS) is a free online proxy measure that screens for at-risk older drivers using 54 driving-related items. This secondary data analysis aims to construct and validate a short form FTDS, using 200 caregiver FTDS response sets and 200 older driver on-road assessment pass/fail outcomes. To construct the short form, exploratory factor analysis and classical test theory techniques were employed to determine the most interpretable factor model and the minimum number of items that might be used to predict fitness to drive. Next, receiver operating characteristics curves were generated to evaluate the concurrent …

Multiple-Modality Exercise And Mind-Motor Training To Improve Cardiovascular Health And Fitness In Older Adults At Risk For Cognitive Impairment: A Randomized Controlled Trial, Narlon Cassio Boa Sorte Silva, Micheal A. Gregory, Dawn P. Gill, Robert Petrella

Lifestyle Research Team

Background:The effects of multiple-modality exercise on arterial stiffening and cardiovascular fitness has not been fully explored. Objectives: To explore the influence of a 24-week multiple-modality exercise program associated with a mind-motor training in cardiovascular health and fitness in community-dwelling older adults, compared to multiple-modality exercise (M2) alone.

Methods: Participants (n=127, aged 67.5 [7.3] years, 71% females) were randomized to either M4 or M2 groups. Both groups received multiple-modality exercise intervention (60 min/day, 3 days/week for 24-weeks); however, the M4 group underwent additional 15 min of mind-motor training, whereas the M2 group received 15 min of balance training. Participants …

A Longitudinal Study To Investigate Changes In Functional Ability And Concerns In Head Neck Cancer Patients Undergoing Neck Dissection, Mariya Ehsan

Electronic Thesis and Dissertation Repository

Introduction:

The study investigated changes of shoulder/neck range of motion (ROM), shoulder strength, patient concerns and quality of life at pre-surgery and 1 month following neck dissection surgery.

Method:

Participants were 30 head and neck cancer patients selected for unilateral neck dissection. Shoulder/neck ROM and shoulder strength were measured at pre-surgery and 1 month post-surgery. The Patient Concerns Inventory-Level of Importance, University of Washington Quality of Life, Shoulder Pain and Disability Index and Neck Dissection Impairment Index were completed at the same time periods.

Result:

A significant drop in ROM and strength were found after surgery. Patients’ concerns changed over …

Investigating The Relationship Between Vascular Health, Gait, And Cognition In Community-Dwelling Older Adults Without Dementia, Michael A. Gregory

Electronic Thesis and Dissertation Repository

Cardiovascular disease (CVD) risk factors contribute to neuropathological changes within regions of the brain that are involved with both cognitive and motor control processes, and have been identified as potentially modifiable dementia and gait dysfunction risk factors. Exercise training is a corner-stone treatment for vascular risk factor control, and evidence suggests that physical and cognitive training can benefit cognition and gait; however, the exercise training modality that can provide the greatest cognitive benefit remains elusive. Therefore, the purpose of this thesis was three-fold: (i) to determine whether CVD risk factors and gait were associated with cognitive functioning, (ii) to determine …

Selectivity Of Conventional Electrodes For Recording Motor Evoked Potentials: An Investigation With High‐Density Surface Electromyography, Alessio Gallina, Sue Peters, Jason L. Neva, Lara A. Boyd, Jayne Garland

Physical Therapy Publications

Introduction

The objective of this study was to determine whether motor evoked potentials (MEPs) elicited with transcranial magnetic stimulation and measured with conventional bipolar electromyography (EMG) are influenced by crosstalk from non-target muscles.

Methods

MEPs were recorded in healthy participants using conventional EMG electrodes placed over the extensor carpi radialis muscle (ECR) and high-density surface EMG (HDsEMG). Fifty MEPs at 120% resting and active motor threshold were recorded. To determine the contribution of ECR to the MEPs, the amplitude distribution across HDsEMG channels was correlated with EMG activity recorded during a wrist extension task.

Results

Whereas the conventional EMG identified …

Longitudinal Evaluation Of Patient Concerns After Surgery For Head And Neck Cancer, Isabel Wozniczka

Electronic Thesis and Dissertation Repository

The primary purpose of this study was to investigate and describe the longitudinal effects of shoulder and neck mobility, strength, and quality of life (QOL) following neck dissection (ND) surgery and identify the concerns of head and neck cancer (HNC) patients. ND is one of the standard procedures for treating HNC, which results in many complications and dysfunctions that can have an effect on a patient’s QOL.

The study had 27 eligible HNC participants who underwent ND, of which eight participated in the shoulder range of motion (ROM) and strength and 12 participated in the QOL patient-reported outcomes analysis. The …

The Prevalence, Location, Severity, And Daily Impact Of Pain Reported By Youth And Young Adults With Cerebral Palsy., Laura Brunton, Sarah Hall, Adrienne Passingham, Julie Wulff, Rich Delitala

Physical Therapy Publications

PURPOSE: To describe the prevalence, location, severity, and daily impact of pain reported by youth and young adults with cerebral palsy (CP). A secondary aim was to identify any significant associations between the constructs of interest.

METHOD: An observational study of 112 participants with CP to understand their experience of pain through a questionnaire. Participants were 56 males and 55 females with a mean age of 18y 9mo (SD 4y 5mo).

RESULTS: Pain was reported by 75% of males and 89% of females. Both severity and impact of pain were significantly greater in females. In addition, severity and impact of …

The Role Of Postural Stability And Other Factors In Distal Radius Fracture, Sheena Saju Philip

Electronic Thesis and Dissertation Repository

The objective of the thesis was to describe the factors leading to falls in distal radius fracture (DRF) events, explore patient perceived risk of falls, and postural stability. A mixed method study described the type of fall in DRF patients (n= 1454) and patient perceived contributing factors (n=29). A prospective cohort study examined the postural stability and related fall risk of DRF participants (n=137) in Biodex Balance System (BBS) and compared to normative values. Environmental factors were a major contributor to DRF events. Older adults (44 to 65 years) had the highest rate of DRF (female: male ratio of 2:1). …

Disability And Return To Work Following Musculoskeletal Injury, Qiyun Shi

Electronic Thesis and Dissertation Repository

Musculoskeletal disorders (MSDs) are injuries, damage or disorders affecting the musculoskeletal system including muscles, ligaments, nerves, tendons, bones or cartilage etc. MSDs are highly prevalent and associated with sickness absence, reduced work efficiency, job changes and earlier retirement.. They also affect daily activity and social functioning. Although many MSDs are accompanied by minor symptoms and settled spontaneously, approximately 10% of the workforce with MSDs have difficulty resuming their original work or exit the workforce permanently. Return to work after MSDs is complex, and is influenced by many factors including physical, psychological, economic and social factors.

Although there are extensive studies …

Constraining Kinematics During Single-Leg Squats And Step-Ups Can Reduce Quadratus Lumborum Activation And Facilitate Gluteal Activation, Shaylyn Kowalchuk

Electronic Thesis and Dissertation Repository

Increased quadratus lumborum activation and decreased gluteal activation may lead to lateral pelvic drop and increased hip adduction and internal rotation during single-leg exercises. These activation patterns and motions are associated with low back pain or lower extremity injuries. The purpose of this study was to evaluate if mechanically restricting hip adduction and internal rotation of the femur affected muscle activation. Twenty female track and field athletes performed single-leg squats and step-ups, and the quadratus lumborum, gluteus medius and maximus muscles activations were measured with surface electromyography. This study tested the hypothesis that mechanically restricted exercises would decrease quadratus lumborum …

An Evaluation Of The Effectiveness Of A Simulated Classroom-Based Intervention On Concussion Rehabilitation Among Individuals With Persistent Post-Concussion Symptoms, Bedoor Alqenai

Electronic Thesis and Dissertation Repository

Although recent clinical and scientific effort has focused on the development of guidelines for post-concussion return to play/work/learn, there is still relatively little literature that addresses specific treatment methods by which this can be accomplished. Accordingly, this study investigated the effect of a 7-week simulated classroom-based intervention on the self-reporting of symptom scores among 71 individuals with persistent concussion symptoms (26 men and 45 women). All participants were provided with novel strategies for reading, writing, study skills, social communication and technology use. Self-assessment of symptoms were obtained weekly, both before and after each session of the treatment program, in an …

Linking Insight To Behaviour Change In A Life Coaching Intervention For Women, Tracy A. Robinson

Electronic Thesis and Dissertation Repository

Solving a problem with insight provokes a change of mind and concomitantly, behaviour. This mixed method study examined moments of insight during life coaching to determine whether having moments of insight led to more meaningful and sustained behavior change. Moments of insight and non-insight were tracked over nine life-coaching sessions with a population of women (N=6) and their coaches (N=6). Validated measures of problem-solving ability, psychological well-being, and mindfulness were collected before and after the intervention, along with behaviour change goals, Wheel of Life® satisfaction, and a personal strength profile. At eight weeks post intervention, sustainability was assessed via an …

The Effects Of Manual Tooth Brushing On Parotid And Submandibular/Sublingual Gland Salivary Flow Rates In Healthy Young And Older Adults, Kristen M. Trottier

Electronic Thesis and Dissertation Repository

Saliva is crucial for the maintenance of oral health. Individuals with reduced salivary flow may experience a distortion in taste, difficulty swallowing, and impaired articulation of speech. Research has shown that tooth brushing increases whole salivary flow rates in older adults. It is important to determine whether this increase results from the modulation of parotid gland salivary flow, submandibular and sublingual gland salivary flow, or both. Saliva produced from the parotid gland aids in digestive processes, while saliva secreted from the submandibular and sublingual glands promotes protection of the oral cavity. A within-subjects methodology was used to examine the effects …

The Phenomenology Of Masters Alpine Ski Racers: Experiencing Ski Racing In Old Age, Carly Litchfield

Electronic Thesis and Dissertation Repository

This thesis is a study of the lived experience of ten older adult alpine ski racers in their continued participation in ski racing. The aim of this study was to gain an understanding of the experiences of these older adults as they continued to compete in ski racing. Masters skiers between the ages of 69 and 82 participated in individual interviews lasting between 30 and 60 minutes. Data analysis was completed using van Manen’s phenomenological methods and the visual technique of mind mapping. The major theme that emerged was the importance of being a ski racer to participants’ identities. The …

Development Of Holistic Classification Systems For Children With Cerebral Palsy, Deepa Jeevanantham

Electronic Thesis and Dissertation Repository

Cerebral palsy (CP) is a complex disorder. There is a gap in the literature in classifying children with CP broadly. The purpose of this thesis was to develop holistic classification systems for children with CP. As a first step, a search was conducted to explore the strategies used to classify children with developmental co-ordination disorder and autism-spectrum disorder. Two versions of holistic classification systems named the body function index in cerebral palsy (BFI-CP) versions I and II were developed using two methods. Then, the relationship and differences among the developed classification systems and the Gross Motor Function Classification System (GMFCS) …

Three-Year Trajectories Of Global Perceived Quality Of Life For Youth With Chronic Health Conditions, Janette Mcdougall, David J. Dewit, Megan Nichols, Linda Miller, F. Virginia Wright

Occupational Therapy Publications

Purpose Objectives of this longitudinal study were to examine 3-year trajectories of global perceived quality of life (QOL) for youth with chronic health conditions, as obtained from youth and parent reports, and to identify personal and environmental factors associated with the trajectory groups for each perspective.

Methods Youth with various chronic conditions aged 11–17 years and one of their parents were recruited from eight children’s treatment centers. Latent class growth analysis was used to investigate perceived QOL trajectories (separately for youth and parent perspectives) over a 3-year period (four data collection time points spaced 12 months apart). Multinomial logistic regression …

Platelet Rich Plasma In Musculoskeletal Pathologies, Nicole L. Kaniki

Electronic Thesis and Dissertation Repository

Purpose: To evaluate the effectiveness of platelet rich plasma (PRP) in musculoskeletal injuries.

Methods: We completed a review of the literature on the use of PRP in tendon, muscle, bone, and intra-articular injuries (Chapter 2). We completed a systematic review and meta-analysis on the effectiveness of PRP in ultrasound guided versus palpation guided injections of PRP in non-operative treatment of tendon and muscle injuries using an indirect analysis method (Chapter 3). We conducted a randomized controlled trial to determine the effectiveness of PRP versus corticosteroid (CS) injections in patients with plantar fasciitis (Chapter 4).

Results: Most studies …

Markerless Radiostereogammetry Of The Shoulder Joint In Humans: Comparisons Of Scapulohumeral Kinematics Between Individuals With Healthy And Supraspinatus-Impaired Shoulders, Ashley N. Hannon

Electronic Thesis and Dissertation Repository

The purpose of this collection of studies was to further develop the knowledge of shoulder motion in order to better understand joint function through direct measurement of 3D scapulohumeral joint kinematics using a technique of high accuracy. Markerless, bi-planar fluoroscopic radiostereometric analysis using a generic shoulder model was developed in this thesis, reducing the amount of radiation exposure to subjects. The studies compared kinematic data of the scapulohumeral joint in six degrees of freedom with a precise, in-vivo measuring technique. Data were collected on young and older healthy individuals, individuals with a torn supraspinatus and post-surgical intervention.

Although this generic …

Improving Patient Adherence: A Look At Causal Knowledge, Treatment Credibility, And Treatment Expectancy, Kyra L. Mackenzie

Undergraduate Honors Theses

Lack of patient adherence to Cardiac Rehabilitation programs is a commonly reported problem (Bryne, Walsh, & Murphy, 2005) and is associated with increased morbidity and re-hospitalization rates (Platt, Green, Jayasinghe, & Morrissey, 2014). Factors that can increase the perceived credibility and expectancy of a treatment program predict better adherence (Nock, Ferriter, & Holmberg, 2007). A better understanding of a treatment rationale may improve treatment credibility and expectancy. For this study, causal knowledge is examined as a way to increase understanding because it has been shown to increase acquisition and retention of novel medical information (Goldszmidt, Minda, Devantier, Skye, & Woods, …

Optimizing The Rehabilitation Of Elbow Lateral Collateral Ligament Injuries, Ranita Harpreet Kaur Manocha

Electronic Thesis and Dissertation Repository

Elbow lateral collateral ligament (LCL) injuries frequently arise following trauma, and can result in disabling instability. Typically such injuries are managed with immobilization followed by a graduated exercise regime; however there is minimal biomechanical evidence to support current treatment protocols. This investigation examines the in vitro effectiveness of several rehabilitation techniques using a custom elbow motion simulator. It was found that active range of motion is safest in the overhead position (n = 7). Early motion in this position may reduce the incidence of elbow stiffness without compromising ligament healing following LCL injury. Forearm pronation and active motion stabilize …

A Study To Understand And Compare Evidence Based Practice Among Health Professionals Involved In Pain Management, Vanitha Arumugam

Electronic Thesis and Dissertation Repository

Pain management is a common concern of multiple health professionals. Evidence-based practice (EBP) in pain management is a recognized approach used to improve health outcomes. EBP tools can facilitate its implementation. PAIN⁺ is a tool that provides access to pre-appraised current best research evidence on pain to support clinical decisions. It is important to understand the knowledge, attitudes and behavior of professionals towards EBP and more specifically how they access research about pain management.

The overarching purpose of this thesis is to better understand how clinicians from different professions involved in pain management view EBP and implement specific strategies …

Toward A Mixed-Methods Research Approach To Content Analysis In The Digital Age: The Combined Content-Analysis Model And Its Applications To Health Care Twitter Feeds, Eradah O. Hamad, Marie Y. Savundranayagam, Jeffrey D. Holmes, Elizabeth Anne Kinsella, Andrew M. Johnson

Health and Rehabilitation Sciences Publications

BACKGROUND: Twitter’s 140-character microblog posts are increasingly used to access information and facilitate discussions among health care professionals and between patients with chronic conditions and their caregivers. Recently, efforts have emerged to investigate the content of health care-related posts on Twitter. This marks a new area for researchers to investigate and apply content analysis (CA). In current infodemiology, infoveillance and digital disease detection research initiatives, quantitative and qualitative Twitter data are often combined, and there are no clear guidelines for researchers to follow when collecting and evaluating Twitter-driven content.

OBJECTIVE: The aim of this study was to identify studies on …

Knowledge ‘Translation’ As Social Learning: Negotiating The Uptake Of Research-Based Knowledge In Practice, Katherine Salter, Anita Kothari

Health and Rehabilitation Sciences Publications

BACKGROUND: Knowledge translation and evidence-based practice have relied on research derived from clinical trials, which are considered to be methodologically rigorous. The result is practice recommendations based on a narrow view of evidence. We discuss how, within a practice environment, in fact individuals adopt and apply new evidence derived from multiple sources through ongoing, iterative learning cycles.

DISCUSSION: The discussion is presented in four sections. After elaborating on the multiple forms of evidence used in practice, in section 2 we argue that the practitioner derives contextualized knowledge through reflective practice. Then, in section 3, the focus shifts from the individual …

Development And Initial Validation Of Novel Multi-Planar Neck Strength Assessment And Neuromuscular Training Protocols, Theo H. Versteegh

Electronic Thesis and Dissertation Repository

Concussions are a serious health concern in today’s active society. There are many contributing factors to concussions but one that is starting to draw significant attention is the potential role the neck muscles play in mitigating concussive forces. There is evidence that stronger neck muscles may decrease an individual’s concussion risk. In order to fully define this role, an appropriate outcome measure for assessing neck strength is required. Once this is established, methods of training to improve neck strength can be evaluated for their effect on neck strength and subsequently effect on concussion risk. This thesis included three studies. Chapter …

“Activated, But Stuck”: Applying A Critical Occupational Lens To Examine The Negotiation Of Long-Term Unemployment In Contemporary Socio-Political Contexts, Debbie Rudman, Rebecca Aldrich

Occupational Therapy Publications

Solutions for the problem of long-term unemployment are increasingly shaped by neoliberally-informed logics of activation and austerity. Because the implications of these governing frameworks for everyday life are not well understood, this pilot study applied a critical occupational science perspective to understand how long-term unemployment is negotiated within contemporary North American socio-political contexts. This perspective highlights the implications of policy and employment service re-configurations for the range of activities that constitute everyday life. Methods: Using a collaborative ethnographic community-engaged research approach, we recruited eight people in Canada and the United States who self-identified as experiencing long-term unemployment. We analyzed interviews …

“Why Would I Want To Go Out?”: Age-Related Vision Loss And Social Participation, Debbie Rudman, Deborah Gold, Colleen Mcgrath, Biljana Zuvela, Marlee Spafford, Rebecca Renwick

Occupational Therapy Publications

Social participation, a key determinant of healthy aging, is often negatively impacted by age-related vision loss (ARVL). This grounded theory study aimed to understand social participation as a process negotiated in everyday life by older adults with ARVL. Interviews, audio diaries, and life-space maps were used to collect data with 21 older adults in two Ontario cities. Inductive data analysis resulted in a transactional model of the process of negotiating social participation in context. This model depicts how environmental features and resources, skills and abilities, and risks and vulnerabilities transacted with values and priorities to affect if and how social …

Consensus Classifications Of Gross Motor, Manual Ability, And Communication Function Classification Systems Between Therapists And Parents Of Children With Cerebral Palsy., Doreen J Bartlett, Barbara Galuppi, Robert J Palisano, Sarah Westcott Mccoy

Physical Therapy Publications

No abstract provided.