Staff-Family Communication Methods In Long-Term Care Homes: An Integrative Review, Alexander Stephen, Denise Connelly, Lillian Hung, Janelle Unger

Physical Therapy Publications

Context: Communication methods have been trialled to promote staff-family relations and facilitate person-centred care for residents living in long-term care homes. A review and synthesis of the common methods will inform the development of stafffamily communication methods, policy and best practice guidelines.

Objectives: 1) synthesise and summarise common communication methods, and types(s) of delivery, used for staff-family communication in long-term care homes; and 2) identify any challenges that impacted the implementation of the communication method(s).

Methods: An integrative review was employed to incorporate papers with diverse research designs. It involved a comprehensive database and grey literature search, and study selection …

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 …

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 …

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 …

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 …

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

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 …

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 …

Usability Evaluation Of A Self-Management Mobile Application For Individuals With A Mild Traumatic Brain Injury, Marquise M Bonn, Laura J. Graham, Stephanie Marrocco, Samantha Jeske, Becky Moran, Dalton L Wolfe

Physical Therapy Publications

OBJECTIVE: Mild traumatic brain injuries (mTBIs) are common and may result in persisting symptoms. Mobile health (mHealth) applications enhance treatment access and rehabilitation. However, there is limited evidence to support mHealth applications for individuals with an mTBI. The primary purpose of this study was to evaluate user experiences and perceptions of the Parkwood Pacing and Planning™ application, an mHealth application developed to help individuals manage their symptoms following an mTBI. The secondary purpose of this study was to identify strategies to improve the application. This study was conducted as part of the development process for this application.

METHODS: A mixed …

Implementation Of Increased Physical Therapy Intensity For Improving Walking After Stroke: Walk 'N Watch Protocol For A Multisite Stepped-Wedge Cluster-Randomized Controlled Trial, Sue Peters, Shannon B Lim, Mark T Bayley, Krista Best, Louise A Connell, Hélène Corriveau, Sarah J Donkers, Sean P Dukelow, Tara D Klassen, Marie-Hélène Milot, Brodie M Sakakibara, Lisa Sheehy, Hubert Wong, Jennifer Yao, Janice J Eng

Physical Therapy Publications

RATIONALE: Clinical practice guidelines support structured, progressive protocols for improving walking after stroke. Yet, practice is slow to change, evidenced by the little amount of walking activity in stroke rehabilitation units. Our recent study (n = 75) found that a structured, progressive protocol integrated with typical daily physical therapy improved walking and quality-of-life measures over usual care. Research therapists progressed the intensity of exercise by using heart rate and step counters worn by the participants with stroke during therapy. To have the greatest impact, our next step is to undertake an implementation trial to change practice across stroke units where …

Higher Intensity Walking Improves Global Cognition During Inpatient Rehabilitation: A Secondary Analysis Of A Randomized Control Trial, Sue Peters, Keith R Lohse, Tara D Klassen, Teresa Liu-Ambrose, Sean P Dukelow, Mark T Bayley, Michael D Hill, Sepideh Pooyania, Jennifer Yao, Janice J Eng

Physical Therapy Publications

Cognitive deficits are common poststroke. Cognitive rehabilitation is typically used to improve cognitive deficits. It is unknown whether higher doses of exercise to promote motor recovery influence cognitive outcomes. Our recent trial, Determining Optimal Post-Stroke Exercise (DOSE), shows more than double the steps and aerobic minutes can be achieved during inpatient rehabilitation versus usual care, and translates to improved long-term walking outcomes. Thus, the secondary analysis aim was to determine the effect of the DOSE protocol on cognitive outcomes over 1-year poststroke. The DOSE protocol progressively increased step number and aerobic minutes during inpatient stroke rehabilitation over 20 sessions. The …

The Traumatic Injuries Distress Scale: Manual And Questionnaire, David Walton

Physical Therapy Publications

No abstract provided.

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

Electronic Thesis and Dissertation Repository

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 …

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 …

Kinematic And Kinetic Gait Characteristics In People With Patellofemoral Pain: A Systematic Review And Meta-Analysis, Harvi Hart Dr.

Physical Therapy Publications

Abstract

Background

Patellofemoral pain (PFP) is a prevalent knee condition with many proposed biomechanically orientated etiological factors and treatments.

Objective

We aimed to systematically review and synthesize the evidence for biomechanical variables (spatiotemporal, kinematic, kinetic) during walking and running in people with PFP compared with pain-free controls, and determine if biomechanical variables contribute to the development of PFP.

Design

Systematic review and meta-analysis.

Data sources

We searched Medline, CINAHL, SPORTDiscus, Embase, and Web of Science from inception to October 2021.

Eligibility criteria for selecting studies

All study designs (prospective, case–control [± interventional component, provided pre-intervention data were reported for both …

Quantifying Physical Resilience In Ageing Using Measurement Instruments: A Scoping Review, Sue Peters, Theodore D Cosco, Dawn C Mackey, Gurkaran S Sarohia, Jeffrey Leong, Andrew Wister

Physical Therapy Publications

Purpose: The capacity to recover motor function with pathology or age-related decline is termed physical resilience. It is unknown what outcome domains are captured with existing measurement instruments. Thus, this scoping review aimed to identify measurement instruments for physical resilience, identify research gaps, and make recommendations for future research. Methods: Articles were included from the search when their subject matter included the term resilience in relation to the physical health of older adults. Data on physical resilience measurement instruments were extracted using the outcome domains: body function or structure, activity and participation, and societal impact. Results: The majority of the …

The Effects On Gait Of 4-Wheeled Walker Use In People With Alzheimer's Disease Dementia And Gait Impairment: A Pilot Study, Humberto Omaña, Edward Madou, Susan W. Hunter

Physical Therapy Publications

In people with dementia, provision of mobility aids is standard treatment for those with impaired gait. However, mobility aid use is independently associated with increased falls risk. In this short communication, gait velocity and stride time variability were recorded in eleven adults with Alzheimer's disease dementia. Three conditions were tested: single-task (no aid), walking with a walker, and dual-task (walker use and counting backwards) under both a straight path and Figure-of-8 walking configuration. Gait velocity increased when using a walker compared to no aid in the Figure-of-8 walking configuration. Walker use improved gait in simple walking, but benefits diminished upon …