Medicine and Health Sciences Commons^™

Evaluating Cardiovascular Dysfunction During Increased Activity And Exercise Rehabilitation Following Incomplete Thoracic Spinal Cord Injury In The Adult Rat., Kathryn A. Harman

Electronic Theses and Dissertations

Spinal cord injury (SCI) results in whole-body dysfunction. While the majority of SCI research is focused on improving locomotor function after injury, cardiovascular (CV) disease continues to be the leading cause of morbidity in the chronic SCI patient population. The combination of injury-induced destruction of autonomic pathways, maladaptive plasticity within lumbosacral circuits, and the progressive decline in physical fitness contribute to the poor CV status of SCI individuals. Currently, there is little emphasis on implementing appropriately-timed acute rehabilitation techniques aimed to curtail maladaptive remodeling and improve CV outcomes. Furthermore, no pre-clinical or clinical studies have investigated the most appropriate time-course …

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). …

Reliability And Validity Of The Star Excursion Balance Test For Patients With Chronic Patellar Instability, Andrew D. Firth

Electronic Thesis and Dissertation Repository

The Star Excursion Balance Test (SEBT) is an eight-direction, maximal-reach balance test whose measurement properties are unknown in participants with chronic patellar instability. We designed an observational study with repeated measures to evaluate the test-retest reliability, cross-sectional and longitudinal construct validity, sensitivity to change and responsiveness of the SEBT in this population. Fifteen patients completed the SEBT and reported outcomes at baseline and two weeks and four patients completed testing three months later at the Fowler Kennedy Sports Medicine Clinic.

Intra-class correlation coefficients (ICC) for the SEBT were fair to good, ranging from 0.66-0.84. The SEBT demonstrates good cross-sectional construct …

Drop Vertical Jump Landing Mechanics Following Anterior Cruciate Ligament Reconstruction With And Without Lateral Extra-Articular Tenodesis, Michal Daniluk

Electronic Thesis and Dissertation Repository

The use of combined anterior cruciate ligament (ACL) plus lateral extra-articular tenodesis (LET) reconstruction has shown promising results during clinical testing, however, no studies have examined its effectiveness during a dynamic functional task. We used the drop vertical jump (DVJ) to compare in vivo biomechanics of ACL reconstructed patients with and without LET.

Our primary outcome was peak knee abduction moment during stance phase. Secondary kinetic and kinematic outcomes included peak initial contact and stance values for knee abduction angle, knee flexion moment and angle, knee internal rotation moment and angle, and vertical ground reaction force. We also assessed fear …

Clinical And Cost-Effectiveness Of A Locking Versus Non-Locking Fixation Plate In Medial Opening Wedge High Tibial Osteotomy, Codie Primeau

Electronic Thesis and Dissertation Repository

We investigated the clinical and cost-effectiveness of using a locking versus non-locking fixation plate in medial opening wedge high tibial osteotomy (HTO) for patients with medial compartment knee osteoarthritis. Medical charts were retrospectively reviewed up to 12 months following HTO for 144 patients who received a locking plate and 105 patients who received a non-locking plate. Surgeon notes provided the time to return to full weight- bearing. Participants had completed the Knee injury and Osteoarthritis Outcome Score (KOOS) preoperatively, six and 12 months postoperatively. Hospital and provincial administrative databases provided direct and indirect cost data. Improvements in KOOS scores were …

Inpatient Versus Outpatient Total Hip Arthroplasty, Michael Pollock

Electronic Thesis and Dissertation Repository

We conducted a randomized controlled trial to evaluate patients undergoing a total hip arthroplasty (THA) who were discharged from the hospital either on the day of surgery (outpatient) or were admitted overnight following surgery (inpatient). Our primary outcome was the rate of serious adverse events during the first three months postoperatively. Secondary outcome measures included cost, patient satisfaction, functional outcomes, quality of life and pain. We found no statistically significant difference between the two groups in serious adverse events. We found that outpatient THA was less expensive from the perspectives of the hospital and ministry of health; but the difference …

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) …

Response Shift And Functional Outcomes In Individuals With Chronic Ankle Instability, Cameron J. Powden

Health Services Research Dissertations

Ankle sprains are one of the most common injuries sustained by those who are physically active. One in three individuals will develop a condition known as chronic ankle instability (CAI) after suffering a single ankle sprain. These individuals suffer from recurrent bouts of ankle instability, residual symptoms, and a myriad of other mechanical and functional impairments as well as health-related quality of life (HRQL) deficits. Due to the abundance of health consequences associated with this condition it is imperative to establish evidence based interventions that are focused on restoring function and HRQL to pre-injury statuses.

The overarching purpose of this …

Effect Of Additional Lumbosacral Corset On The Outcome Of Patients With Non-Specific Acute Low Back Pain At The Aga Khan University Hospital, Nairobi, Stanley Aruyaru Mwenda

Theses & Dissertations

Introduction: Low back pain (LBP) is a common problem world over affecting 60-90% of the population in their lifetime. It is a leading reason for hospital admission, healthcare spending, workplace absenteeism and years lived with disability.

Up to 90% of patients suffering from low back pain do not have a serious pathology warranting imaging or further intervention besides symptom relief. These are categorized as having non- specific low back pain. This has a good prognosis running a short course of 3 to 6 weeks.

The management of non-specific acute LBP entails analgesia and non-pharmacologic interventions (back school and physical therapy). …

Recurring Ankle Injuries In Dancers, Alexis Jawny

Honors Theses

The purpose of this research, obtained from various Journals of Dance Medicine and Science, is to identify the cause of recurring ankle injuries in the dance community. Ankle injuries are the most common type of injury making up 50% of injuries in dancers. The main cause of recurring ankle injuries is improper diagnosing and then leading to the wrong treatment plan. The research focusses on how to prevent these improper diagnoses and what the dancer and specialty care professional (orthopedics, physical therapists, and rehabilitative medicine) can do to decrease the number of ankle injuries occurring and reoccurring in the dance …

The Impact Of Surgical Technique On Coronal Plane Motion In Total Knee Arthroplasty, Kevin I. Perry

Electronic Thesis and Dissertation Repository

There are two predominant techniques used by most surgeons to perform total knee arthroplasty: gap balancing and measured resection. The purpose of the current study was to observe if surgical technique has an effect on post-operative coronal plane balance throughout range of motion and to observe if surgical technique has an effect on tibial and femoral component migration. This was a randomized, prospective controlled trial. Twenty-three patients (24 knees) were enrolled: twelve knees in each group. All knees showed migration of their components from the initial RSA to their RSA at 6 months. Migration was similar for both groups, but …

Anterior Cruciate Ligament Reconstruction: Which Graft Is Best To Prevent Re-Tear?, Katherine Ann Eslinger, Brittany Kapala, Noelle Kreofsky

All Electronic Theses and Dissertations

The three most widely used graft choices currently employed in anterior cruciate ligament (ACL) repair are: patellar tendon autograft, hamstring tendon autograft, and cadaver tendon allograft. The purpose of this study is to examine the efficacy of each of these 3 graft choices (patellar tendon autograft, hamstring tendon autograft and cadaver tendon allograft) and determine which graft is less prone to re-tear. The study was implemented using a quantitative design process. The patient data was obtained and analyzed via Facebook survey. All identifying patient information was removed. Patients were included based on whether or not their ACL reconstruction was performed …

Pelvic Floor Muscle Training In Management Of Postpartum Pelvic Floor Dysfunctions: A Literature Review, Rebecca S. Tanner

Honors Undergraduate Theses

Women can face a wide range of pelvic floor dysfunctions following pregnancy, ranging from urinary incontinence to pelvic pain. Unfortunately, these problems are not routinely checked for in postpartum check-ups and women do not always bring it to the physician’s attention. Strengthening of the pelvic floor muscles may be able to help women prevent these disorders and improve these women’s lifestyles.

The purpose of this thesis was to review and analyze different trials to determine if different pelvic floor dysfunctions (urinary incontinence, sexual dysfunction, and pelvic girdle pain) can be treated using pelvic floor muscle training in the postpartum. After …

The Role Of Simulation-Based Learning Environments In Preparing Undergraduate Health Students For Clinical Practice, Brennen Mills

Theses: Doctorates and Masters

Experiential learning (EL), whereby students are able to integrate theory with practice, is an essential component of learning for health professionals. Traditionally, EL in the health education context has been achieved through clinical placements (CPs) that see students ‘apprentice’ in real clinical settings. The literature suggests there are a number of factors that diminish a student’s ability to learn in such environments, including limited opportunities to practice, being confined primarily to observation roles as opposed to participate in tasks, being exposed to skills/procedures outside their level of learning/understanding, and institutional learning objectives being secondary to workplace goals. Simulation-based learning environments …

Clinical Characteristics Of Active Individuals With Chronic Ankle Instability, Mary Elizabeth Winningham

Electronic Theses and Dissertations

Ankle sprains, specifically to the lateral ligament complex, are one of the most common injuries seen during athletic participation and may lead to chronic ankle instability (CAI).¹ Residual symptoms of CAI can include feelings of giving way and instability as well as, persistent weakness, pain during activity, and self-reported disability, which may affect postural control and functional performance.² The purpose of this study was to determine if there was a relationship between perceived kinesiophobia and dorsiflexion range of motion (DROM), measures of dynamic postural control, and measures of functional performance, within active individuals with CAI. Thirty-seven physically active …