Medicine and Health Sciences Commons^™

Multiple-Modality Exercise And Mind-Motor Training To Improve Mobility In Older Adults: A Randomized Controlled Trial, Narlon Cassio Boa Sorte Silva, Dawn P. Gill, Michael A. Gregory, John Bocti, Robert Petrella

Lifestyle Research Team

Objective:

To investigate the effects of multiple-modality exercise with or without additional mind-motor training on mobility outcomes in older adults with subjective cognitive complaints.

Methods:

This was a 24-week randomized controlled trial with a 28-week no-contact follow-up. Community-dwelling older adults underwent a thrice -weekly, Multiple-Modality exercise and Mind-Motor (M4) training or Multiple-Modality (M2) exercise with an active control intervention (balance, range of motion and breathing exercises). Study outcomes included differences between groups at 24 weeks and after the no-contact follow-up (i.e., 52 weeks) in usual and dual-task (DT, i.e., serial sevens [S7] and phonemic verbal fluency [VF] tasks) gait velocity, …

The Effect Of Light Touch On Balance Control During Overground Walking In Healthy Young Adults., A R Oates, Janelle Unger, C M Arnold, J Fung, J L Lanovaz

Physical Therapy Publications

Balance control is essential for safe walking. Adding haptic input through light touch may improve walking balance; however, evidence is limited. This research investigated the effect of added haptic input through light touch in healthy young adults during challenging walking conditions. Sixteen individuals walked normally, in tandem, and on a compliant, low-lying balance beam with and without light touch on a railing. Three-dimensional kinematic data were captured to compute stride velocity (m/s), relative time spent in double support (%DS), a medial-lateral margin of stability (MOS_ML) and its variance (MOS_MLCV), as well as a symmetry index (SI) …

Optimization Of The Hockey Fans In Training (Hockey Fit) Weight Loss And Healthy Lifestyle Program For Male Hockey Fans, Wendy Blunt, Dawn P. Gill, Shannon Sibbald, Brendan Riggin, Roseanne Pulford, Ryan Scott, Karen Danylchuk, Cindy M. Gray, Sally Wyke, Christopher Bunn, Robert Petrella

Lifestyle Research Team

BACKGROUND:

The health outcomes of men continue to be poorer than women globally. Challenges in addressing this problem include difficulties engaging men in weight loss programs as they tend to view these programs as contrary to the masculine narrative of independence and self-reliance. Researchers have been turning towards sports fans to engage men in health promotion programs as sports fans are typically male, and tend to have poor health habits.

METHODS:

Developed from the highly successful gender-sensitized Football Fans in Training program, Hockey Fans in Training (Hockey FIT) recruited 80 male hockey fans of the London Knights and Sarnia Sting …

E-Visits For Early Post-Operative Visits Following Orthopaedic Surgery Can They Add Efficiency Without Sacrificing Effectiveness, William G. Jeffery

Electronic Thesis and Dissertation Repository

We asked 217 sport surgery and 135 total knee arthroplasty (TKA) patients to complete a questionnaire (e-Visit) before attending their two and six-week post-operative appointment. Our primary objective was to use the questions asked of patients prior to their appointment to develop a model that could be used as web-based e-Visit to predict early post-operative adverse events. Gold standard comparison was the surgeon’s opinion as to the presence or absence of an event at follow-up. Secondary objective was evaluation of a simplified model. We found good area under the curve (AUC) statistics (0.76 (95% CI 0.69 - 0.84) and 0.80 …

The Effect Of High Baseline Pain On Impairment Outcomes One Year After Distal Radius Fracture, Farrukh Riaz

Electronic Thesis and Dissertation Repository

Objective

The purpose of this study is to evaluate whether high baseline pain predicts impairment outcomes in grip strength or wrist range of motion (ROM) at one year after a distal radius fracture (DRF). Impairments occur for less than 15% of patients.

Methods:

In this cohort study patients with a DRF were recruited from a hand clinic in London, Ontario. This data was collected at two evaluation time points: at baseline (within the first 10 days after fracture) and at one year after fracture. Baseline pain was assessed using the pain subscale of the Patient-Rated Wrist Evaluation (PRWE) and classified …

Moving From Parent "Consultant" To Parent "Collaborator": One Pediatric Research Team's Experience., Doreen Bartlett, Lisa A Chiarello, Tina Hjorngaard, Barbara Sieck Taylor

Physical Therapy Publications

We share our experiences as academic physical therapists and parents of young people with cerebral palsy working together as a research team, describe and critically review how our working relationship has evolved and propose further enhancements to realize our shared vision. This manuscript is informed by a call for “family-centered research,” transcripts of face-to-face meetings held over a period of 11/2 days, the INVOLVE document and our experiences over almost a decade, as well as other related literature. Authentic collaborative research partnerships between academic researchers and parents embodying trust, mutual respect and shared social responsibility take time and effort to …

Understanding Participation Of Children With Cerebral Palsy In Family And Recreational Activities., Mohammed S Alghamdi, Lisa A Chiarello, Robert J Palisano, Sarah W Mccoy

Physical Therapy Publications

AIMS: The primary aim of this study was to determine the effect of age, sex, gross motor, manual ability, and communication functions on the frequency and enjoyment of children's participation in family and recreational activities. The secondary aim was to determine the relationships between motor and communication functions and participation.

METHODS: Participants were 694 children, 1.5-12 years old, with cerebral palsy (CP) and their parents across the US and Canada. Parents rated children's frequency and enjoyment of participation using the Child Engagement in Daily Life measure. Parents and therapists identified children's level of function using Gross Motor Function Classification System …

Advancing Social Transformation Through Occupation: A Critical Examination Of Epistemological Foundations, Discourses And Contextual Factors Shaping Research And Practice, Lisette Farias Vera

Electronic Thesis and Dissertation Repository

Widespread appeals to advance a social justice agenda have emerged within health-related fields. However, expressing a commitment to social justice has created tensions within occupational science and therapy as scholars attempt to enact social transformative scholarship while at the same time having roots within health sciences, a field largely dominated by positivist/postpositivist thinking. The broader intent of this thesis is to inform further development of occupation-based social transformative scholarship aligned with the critical paradigm.

This doctoral dissertation is comprised of five integrated manuscripts, in addition to introduction and discussion chapters. Chapter two examines the increasing use of critical perspectives and …

Using A Deliberative Dialogue To Facilitate The Uptake Of Research Evidence In Rehabilitation For Children With Cerebral Palsy, Alisiyah Daya

Electronic Thesis and Dissertation Repository

This study explores how to facilitate the use of research evidence to optimize outcomes for children with cerebral palsy (CP) in practice. Findings from two studies were used as the basis for exploring how to comprehensively assess developmental trajectories of children with CP and plan individualized interventions. Seventeen affiliated stakeholders (e.g. physicians, senior leadership, frontline clinicians, families and youth with CP) participated in this study.

Data from a deliberative dialogue and interviews were analyzed using grounded theory methods with a pragmatic perspective. The results highlighted that all areas of practice must engage in knowledge translation to be effective. Stakeholders outlined …

Dynamic Loading And Pain In Knee Osteoarthritis: Effects Of Limb Realignment And Ligament Reconstruction Surgeries, Kendal Marriott

Electronic Thesis and Dissertation Repository

Painful loading of the knee during walking is a key feature of knee osteoarthritis (OA). The external knee moments derived from three-dimensional gait analysis represent dynamic knee loads and may help evaluate surgical interventions. However, the relationships between knee moments and pain and the effects of surgery remain unclear. The overall purpose of this thesis was to investigate knee moments and pain during walking in patients with moderate medial knee OA, including the effects of limb realignment and ligament reconstruction surgeries. This thesis includes three studies investigating knee moments in patients with medial compartment tibiofemoral OA.

Chapter 2 describes a …

A Cross- Sectional Study Of Stress Biomarkers And Their Associations With Post-Trauma Complaints, And How Those Associations Are Moderated By Early Life Adversity, Sadia Siraj

Electronic Thesis and Dissertation Repository

Chronic musculoskeletal pain results in significant personal, economic, and social burden. Early identification and intervention in those people with acute pain that are likely to transition into a state of chronicity can prevent the onset of chronic pain before it emerges and becomes resistant to treatment. This study investigated the potential stress biomarkers associated with acute pain and disability and how those associations are influenced by early life adversities.

Stress level was determined according to the plasma level of stress biomarkers (cortisol, BDNF, TGFB1) and self-report measures of stress following musculoskeletal traumatic events. The magnitude and direction of associations of …

Parents' Experiences And Perceptions When Classifying Their Children With Cerebral Palsy: Recommendations For Service Providers., Natalie V Scime, Doreen J Bartlett, Laura K Brunton, Robert J Palisano

Physical Therapy Publications

AIMS: This study investigated the experiences and perceptions of parents of children with cerebral palsy (CP) when classifying their children using the Gross Motor Function Classification System (GMFCS), the Manual Ability Classification System (MACS), and the Communication Function Classification System (CFCS). The second aim was to collate parents' recommendations for service providers on how to interact and communicate with families.

METHODS: A purposive sample of seven parents participating in the On Track study was recruited. Semi-structured interviews were conducted orally and were audiotaped, transcribed, and coded openly. A descriptive interpretive approach within a pragmatic perspective was used during analysis.

RESULTS: …

Reliability And Validity Of The Star Excursion Balance Test In Patients With Knee Osteoarthritis, Lauren Kanko

Electronic Thesis and Dissertation Repository

The purpose of this study was to investigate the measurement properties of the star excursion balance test (SEBT) in patients with knee osteoarthritis (OA). Specific objectives were to estimate: 1) test-retest reliability, 2) concurrent validity of observer measurements compared to a 3D motion capture system, and 3) longitudinal validity in response to 12 weeks of neuromuscular exercises. Thirty-eight patients diagnosed with knee OA participated. They performed the SEBT on three test occasions. The first two test sessions were completed within one week and the third was 12 weeks later. Participants performed exercises at home over the 12-week period. Intraclass correlation …

Investigating The Enabling Factors Influencing Occupational Therapists’ Adoption Of Assisted Living Technology, Colleen E. Mcgrath

Occupational Therapy Publications

Method

This qualitative study utilized semi-structured interviews and focus groups with 20 occupational therapists in England and Scotland. The goal was to identify those enabling factors necessary for occupational therapists to adopt assisted living technology.

Results

Five themes emerged regarding the enablers needed to support the adoption of assisted living technology by occupational therapists, including: (1) a positive client–therapist relationship; (2) affordability; (3) time; (4) increased awareness, education, and training; and (5) usability features of the assisted living technology.

Conclusion

With an aging population and the increasing role that technology is playing globally in older adults’ lives, it has never …

Construction And Validation Of The Fatigue Impact And Severity Self-Assessment For Youth And Young Adults With Cerebral Palsy., Laura K Brunton, Doreen J Bartlett

Physical Therapy Publications

Purpose: The Fatigue Impact and Severity Self-Assessment (FISSA) was created to assess the impact, severity and self-management of fatigue for individuals with cerebral palsy (CP) aged 14-31.

Methods Used: Items were generated from a review of measures and interviews with individuals with CP. Focus groups with healthcare professionals were used for item reduction. A mailed survey was conducted (n=163/367) to assess the factor structure, known-groups validity and test-retest reliability.

Results Obtained: The final measure contained 31-items in two factors and discriminated between individuals expected to have different levels of fatigue. Individuals with more functional abilities reported less fatigue (p< 0.002) and those with higher pain reported higher fatigue (p< 0.001). The FISSA was shown to have adequate test-retest reliability, ICC(3,1)=0.74 (95% CI 0.53-0.87).

Conclusions …

How Do Individuals With Cerebral Palsy And Their Families Prefer To Receive And Use Evidence-Based Information To Individualize Services To Optimize Outcomes?, Tianna D. B. Deluzio

Electronic Thesis and Dissertation Repository

The main objectives of this study were to: (1) describe the format in which children with cerebral palsy (CP) and their parents prefer to receive information pertaining to development; (2) understand how children with CP and their parents intend to use this information; and (3) gain insight on how children with CP wish to be represented in the information in terms of being both comprehensive and respectful. Ten children with CP and their parent(s) or guardian(s) participated. Semi-structured interviews were conducted and analyzed using constant comparative analysis. Eight themes were created related to the type and format of information preferred …

Dual-Task Gait Assessment In Lower Extremity Amputees, Courtney A. Frengopoulos

Electronic Thesis and Dissertation Repository

The purpose of these studies was to develop a reliable dual-task functional mobility protocol and investigate changes in dual-task performance over time in lower extremity amputees. Relative and absolute test-retest reliability of the protocol were evaluated across the population in a study consisting of three groups, with 20 participants per group. A pilot study of 16 participants investigated change in dual-task performance between discharge from rehabilitation and follow-up for both cognitively normal and cognitively impaired individuals. Gait was assessed by the developed protocol as well as an electronic walkway (GaitRITE®). All three groups in Study 1 had excellent relative test-retest …

The Attentional Demands Of Ambulating With An Assistive Device In Older Adults With Alzheimer's Disease, Susan W. Hunter, M Montero-Odasso

Physical Therapy Publications

Ambulation with a mobility aid is a unique real-life situation of multi-tasking. These simultaneous motor tasks place increased demands on executive function in healthy young and older adults, but the demands have not been evaluated in people with Alzheimer's disease (AD). Mobility problems are common among adults with AD, leading to provision of a mobility aid to optimize independent activity. The study objectives were: (i) to determine the dual-task cost (DTC) associated with the use of a mobility aid in straight and complex path walking, and (ii) to evaluate the association between executive function and ambulation with a mobility aid …

Assessing The Impact Of Caregiver Outcomes On Function And Reintegration Of Stroke Survivors Participating In A Community Stroke Rehabilitation Program., Spencer R. Thompson

Electronic Thesis and Dissertation Repository

There is a limited amount of literature evaluating the relationship between caregivers, and the stroke survivors’ function and reintegration. The objectives were to evaluate the association between caregivers’ lifestyle changes on function and the role of functioning as a moderator between caregiving and reintegration among stroke survivors receiving community-based rehabilitation. Data were collected from January 2011 to January 2016. A one-way repeated measures analysis of variance and multivariable linear regression were performed on Functional Independence Measure, Bakas Caregiving Outcomes Scale, Reintegration to Normal Living Index across admission, discharge, and follow-up. Mean age was 70.2±13.17 years with 58% males (n=200). A …

Links Between Physical And Mental Health: Assessment Of Therapeutic Riding’S Effect On Children With Special Needs, Sabah I. Hasan

Brescia Psychology Undergraduate Honours Theses

This observational study examined the effect of therapeutic riding (TR) on four domains, physical skills, positive values, social skills, and self-identity in children with special needs. Participants were recruited from SARI Therapeutic Riding and were divided, based on observation, into more or less severe diagnosis categories. It was predicted that children with less severe diagnosis would show more of an increase on the four domains, especially physical skills due to TR. Participants were observed using an observational checklist at pre- and post-riding lessons. Results showed non-significant differences in all four domains, however, there was a tendency for scores to increase …

P19. Head Impacts In Youth Soccer Are Comparable To American Football, Alexandra B. Harriss, Aakash Naik, Dave Walton, James P. Dickey

Western Research Forum

Head Impacts in youth soccer are comparable to American Football

Alexandra Harriss¹, Aakash Naik¹, David M. Walton², James P. Dickey¹

School of Kinesiology¹, School of Physical Therapy², Western University, London, Canada

Background: Research has unequivocally demonstrated that females and youth soccer players are at a significant high risk of concussion. Recently, concerns for “heading” have been raised due to possible adverse neurological effects. While head impact accelerations and rotations have been investigated in American football, head impacts in youth soccer have not been rigorously studied. The purpose is to …

Predicting Response To Medial Branch Blocks: A Clinical Decision Making Tool, Swati Mehta

Electronic Thesis and Dissertation Repository

Chronic neck pain can lead to long-term disability and socio-economic burden. Several demographic, clinical, and psychosocial factors have been implicated in the development of neck pain disability. These factors may also influence management of neck pain. Optimal treatment often requires targeting interventions based on specific diagnosis. One of the most common cause of neck pain is cervical facet joint injury. Currently, the gold standard for diagnosing facetogenic injury is through the medial branch block (MBB) procedure. Though the procedure is relatively safe, it is still invasive and may result in adverse effects. In Canada, access to this procedure is limited …

Discerning The Social In Individual Stories Of Occupation Through Critical Narrative Inquiry., Debbie Rudman, Rebecca Aldrich

Occupational Therapy Publications

Calls to ‘transcend the individual’ in occupational science have emerged in recognition of the boundaries of individualistic perspectives and the drive to develop a socially responsive science. In this article, we contend that transcending the individual does not equate to neglecting how individuals make sense of and experience occupation; rather, it requires looking at individual constructions of experiences and occupations in critically informed ways that highlight the socio-political influences on those constructions. This discussion article considers how critical narrative inquiry can be taken up as a methodological approach to interpretively link individual ‘stories’ with social ‘stories’ or discourses, enabling further …

Resource Seeking As Occupation: A Critical And Empirical Exploration., Rebecca M Aldrich, Debbie Rudman, Virginia A Dickie

Occupational Therapy Publications

Occupational therapists and occupational scientists are committed to generating and using knowledge about occupation, but Western middle-class social norms regarding particular ways of doing have limited explorations of survival occupations. This article provides empirical evidence of the ways in which resource seeking constitutes an occupational response to situations of uncertain survival. Resource seeking includes a range of activities outside formal employment that aim to meet basic needs. On the basis of findings from 2 ethnographic studies, we critique the presumption of survival in guiding occupational therapy documents and the accompanying failure to recognize occupations that seem at odds with self-sufficiency. …

Development, Implementation, And Outcomes Of An Acute Care Clinician Scientist Clinical Placement: Case Report., Sarah Wojkowski, Janelle Unger, Magda Mccaughan, Beverley Cole, Michelle E Kho

Physical Therapy Publications

Purpose: This article presents the development, implementation, and outcomes of an innovative clinician scientist (CS) placement for a 2nd-year, entry-level MSc(PT) student at McMaster University. Client Description: All physiotherapy students participating in the third 6-week clinical placement at McMaster University were eligible to apply for one CS placement. A placement description and expectations were developed collaboratively by the clinical site and the MSc(PT) programme before placement matching. Intervention: A shared supervisory model between one acute care physiotherapist and a critical care CS was developed to provide supervision in both clinical and research-related activities during the placement. Measures and Outcomes: The …

Interhemispheric Pathways Are Important For Motor Outcome In Individuals With Chronic And Severe Upper Limb Impairment Post Stroke, Kathryn S. Hayward, Jason L. Neva, Cameron S. Mang, Sue Peters, Katie P. Wadden, Jennifer K. Ferris, Lara A. Boyd

Physical Therapy Publications

Background: Severity of arm impairment alone does not explain motor outcomes in people with severe impairment post stroke.

Objective: Define the contribution of brain biomarkers to upper limb motor outcomes in people with severe arm impairment post stroke.

Methods: Paretic arm impairment (Fugl-Meyer upper limb, FM-UL) and function (Wolf Motor Function Test rate, WMFT-rate) were measured in 15 individuals with severe (FM-UL ≤ 30/66) and 14 with mild-moderate (FM-UL > 40/66) impairment. Transcranial magnetic stimulation and diffusion weight imaging indexed structure and function of the corticospinal tract and corpus callosum. Separate models of the relationship between possible biomarkers and motor outcomes …

Precarity In The Nonprofit Employment Services Sector, Carlo Fanelli, Debbie Rudman, Rebecca Aldrich

Occupational Therapy Publications

Drawing on interview and focus group data, this article explores research undertaken as part of a larger research project exploring precarity in the nonprofit employment services sector in a mid-sized Canadian city. We critically survey major legislative changes to Canadian employment and income security policies and programs, including the restructuring of work and labor relations, growth of performance-based contracting-out, erosion of intergovernmental transfers, worker stress, and emotional tolls. Our study’s results demonstrate how employment precarity in the nonprofit employment services sector is amplified by top-down and centralized relationships with funding partners and policymaking divorced from the employment experiences of frontline …

“You Got To Make The Numbers Work”: Negotiating Managerial Reforms In The Provision Of Employment Support Service., Debbie Rudman, Rebecca Aldrich, John Grundy, Melanie Stone, Suzanne Huot, Awish Aslam

Occupational Therapy Publications

No abstract provided.

The Comprehensive Professional Behaviours Development Log, Deb Lucy, Doreen J. Bartlett, Tianna D. B. Deluzio

Physical Therapy Publications

No abstract provided.

Clinician's Commentary On Patterson Et Al., Sue Peters

Physical Therapy Publications

No abstract provided.