Medicine and Health Sciences Commons^™

Combined Interdisciplinary Rehabilitation For Persisting Symptoms Following A Mild Traumatic Brain Injury, Marquise Morrissey

Electronic Thesis and Dissertation Repository

Mild traumatic brain injuries (mTBI’s) are the most frequently experienced form of traumatic brain injury. Certain demographic characteristics, including older age, female sex, and pre-existing mental health conditions, increase the risk of experiencing persisting symptoms beyond the acute injury phase. Care for individuals with an mTBI is limited by geography, non-standardized trajectories of care, and gaps in healthcare provider knowledge. An interdisciplinary outpatient intervention has been created to address these issues, but has not been evaluated. Accordingly, the overall purpose of this thesis was to investigate treatment outcomes of individuals with persisting symptoms following an mTBI after completing a combined …

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 …

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

Electronic Thesis and Dissertation Repository

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 …

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

Electronic Thesis and Dissertation Repository

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. …

Troubling Service User Involvement In Health Professional Education: Toward Epistemic Justice, Stephanie Leblanc-Omstead

Electronic Thesis and Dissertation Repository

It has become increasingly popular in health professional education to solicit the contributions and involvement of people who have firsthand or ‘lived’ experiences of using mental health services – a practice hereafter referred to as service user involvement (SUI). SUI is founded on the premise that service users ought to be involved in the development and evaluation of services and systems they experience, which includes the education of future health professionals. Despite the momentum this practice has gained in a range of international contexts, SUI is often conceptualized, organized, and implemented uncritically, and with tremendous inconsistency across health professional education …

Optimizing Gait Outcomes In Parkinson's Disease With Auditory Cues: The Effects Of Synchronization, Groove, And Beat Perception Ability, Emily A. Ready

Electronic Thesis and Dissertation Repository

This dissertation explores a common, rehabilitative strategy for mitigating gait impairments in Parkinson’s disease (PD) called Rhythmic Auditory Stimulation (RAS). The effects of this intervention on gait in PD are well documented but highly variable, which poses difficulty for appropriate therapeutic application. Part of this variability may be related to individual musical abilities, such as beat perception accuracy, as most RAS interventions involve synchronizing with a beat. However, music is complex and variable. Therefore, factors inherent in the music itself may play a role in these differences, such as how much the music makes you want to move (groove), or …

Resting State Functional Magnetic Resonance And Diffusion Tensor Imaging Of Hemiplegic Cerebral Palsy Patients Treated With Constraint-Induced Movement Therapy: Predictors And Clinically Correlated Evidence Of Neuroplasticity, Kathryn Y. Manning

Electronic Thesis and Dissertation Repository

Hemiplegic cerebral palsy is characterized by unilateral upper limb impairment and patients often compensate by performing most tasks with their unaffected arm. Constraint-induced movement therapy (CIMT) directly combats this learned non-use by casting the unaffected arm and forcing the patient to repetitively practice skills with the hemiplegic limb. Subjects with hemiplegic cerebral palsy were recruited from Holland Bloorview Kids Rehabilitation Hospital, Thames Valley Children’s Centre and McMaster Children’s Hospital. MRI acquisitions and clinical evaluations were collected at baseline, 1 and 6-months later. The case group participated in a CIMT camp after baseline evaluations and was compared to an untreated control …

Examining The Shift In Occupational Identity After A Brain Injury, Mikelle Bryson-Campbell

Electronic Thesis and Dissertation Repository

Occupational identity is defined by Kielhofner (2002) as a sense of who we are as an occupational being, based on our past, current, and future occupational roles. When a life disruption occurs such as a brain injury (BI) and the disruption impacts the ability to conduct an occupation deemed meaningful an important process of transition occurs (Muenchberger, Kendall, & Neal, 2008). In turn occupational identity may shift to reflect the current health and economic status of the individual and what occupations are judged as meaningful.

The current study examined the shift in occupational identity in BI survivors in a two …

Properties And Applications Of Sensory Outcome Measures In Carpal Tunnel Syndrome, Derek Km Cheung

Electronic Thesis and Dissertation Repository

This thesis aimed to determine the psychometric properties and applications of sensory threshold tools and outcome measures in patients with Carpal Tunnel Syndrome (CTS). The first chapter is a psychometric study that defines clinically important difference (CID), construct validity and responsiveness of touch and vibration threshold tools and in the Symptoms Severity Scale (SSS). The study found the CID for the PSSD and for the SSS was 0.15g/mm² and 0.50 respectively. The study also found that the Vibrometer was more representative of hand function and responsive compared PSSD. The second objective of this thesis was to determine the feasibility …

A Stakeholder Generated Conceptualization For Successful Return To Work Outcome Evaluation: A Concept Mapping Approach, Rhysa Leyshon

Electronic Thesis and Dissertation Repository

Measurement of return to work (RTW) lacks attention to outcomes of relevance to all stakeholders. The objective of this thesis was to define what constitutes a successful RTW outcome from a stakeholder perspective and determine how to best measure it. A concept mapping method was used to create a conceptualization of successful RTW outcome based on indicators of interest and importance to various stakeholders. RTW researchers were questioned and the literature was searched for measures that mapped to the conceptualization and concepts. Stakeholders, made up of RTW consumers and providers, generated 48 indicators of successful RTW which were subsequently grouped …