Reliability And Validity Of Two Performance-Based Outcome Measures In Rehabilitation Following Total Knee Arthroplasty, Jennifer L. Van Bussel

Electronic Thesis and Dissertation Repository

Objectives: Performance-based outcome measures (PBOM) are suggested to evaluate change in function during rehabilitation after total knee arthroplasty (TKA). The purpose of this study was to evaluate the measurement properties of the 30-Second Chair Stand Test (30CST) and 10-Metre Walk Test (10MWT) in patients following TKA.

Methods: Eighty-three patients completed two PBOM on three occasions following surgery. Patients also completed the Western Ontario and McMaster Universities Osteoarthritis Index and Global Rating of Change (GRC).

Results: Intraclass correlation coefficients ranged from 0.82 to 0.96. The standard errors of measurement at 6 and 12 weeks postop, respectively, were: 30CST ±0.67 and ±0.79, …

Recovery Following Proximal Humerus Fracture, Azar Varahrami Vigeh

Electronic Thesis and Dissertation Repository

There is currently a glaring gap in the existing knowledge to address individuals’ experiences while recovering from a proximal humeral fracture (PHF). The main objective of this dissertation was to understand better how recovery is perceived by individuals after PHF. This overarching objective aligned well with the broad conceptualization of the issue at hand as those provided by the International Classification of Functioning, Disability and Health (ICF). Three inter-linked studies were conducted to provide a broader picture of recovery after PHF. The first study was a systematic review of prognostic factors predicting recovery after PHF in adults. This review demonstrated …

The Nature And Consistency Of Exercise Reporting In Rehabilitation Following Rotator Cuff Repair, Dinesh Balachandran

Electronic Thesis and Dissertation Repository

Abstract

Purpose:

Rotator cuff repair is conventional surgery, and postoperative rehabilitation programs are routine. Optimization and implementation of evidence-based exercise are dependent on comprehensive reporting of intervention content and dosage. The purpose of this study is to examine the content and consistency of reporting of postoperative exercise programs following arthroscopic rotator cuff repairs.

Methods:

Keyword search of PUBMED, EMBASE, Scopus, SPORTDiscuss, AMED, CINAHL, and Cochrane were performed from January 1950 to March 2019. All the studies that discussed rehabilitation following rotator cuff repairs of human adults were included. A Proforma Consensus on Exercise Reporting Template (CERT) assessment form was used …

Psychometric Properties Of The Brief Pain Inventory-Short Form And Revised Short Mcgill Pain Questionnaire Version-2 In Musculoskeletal Conditions, Samuel Ugochukwu Jumbo

Electronic Thesis and Dissertation Repository

Introduction: Comprehensive pain assessment depends on the use of psychometrically valid patient-reported outcome measures (PROMs). The Brief Pain Inventory-Short Form (BPI-SF) and Revised Short McGill Pain Questionnaire Version-2 (SF-MPQ-2) are general-use multidimensional pain assessment tools commonly used in musculoskeletal conditions. Understanding all relevant measurement properties supports stronger decisions about PROMs.

Thesis Objectives: The overarching objective of this thesis was to determine the sufficiency of measurement evidence backing the use of the BPI-SF and SF-MPQ-2 in musculoskeletal conditions. Specifically, a systematic review was conducted to locate, summarize and compare the quality and content of psychometric evidence backing the BPI-SF and …

Quantifying The Outcomes Of A Virtual Reality (Vr)-Based Gamified Neck Rehabilitation, Shahan Salim

Electronic Thesis and Dissertation Repository

Neck pain is a major global public health concern and adds a significant financial burden to both the healthcare system as well as people suffering from it. Additionally, it presents measurement and evaluation challenges for clinicians as well as adherence challenges and treatment barriers for the patients. We have developed a virtual reality (VR)-based video game that can be used to capture outcomes that may aid in the assessment and treatment of neck pain. We investigated: (i) performance metrics of overall accuracy, accuracy based on movement difficulty, duration, and total envelope of movement; (ii) stability across sessions; (iii) accuracy across …

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 …

Physical, Occupational, And Speech Therapy For Children With Cerebral Palsy., Sarah Westcott Mccoy, Robert Palisano, Lisa Avery, Lynn Jeffries, Alyssa Laforme Fiss, Lisa Chiarello, Steve Hanna

Physical Therapy Publications

AIM: To explore the relationship between rehabilitation therapies and development in children with cerebral palsy (CP).

METHOD: We conducted a prospective, longitudinal study involving 656 children with CP (mean age [SD] 6y [2y 8mo] at study entry; 1y 6mo-11y 11mo; 287 females, 369 males), and their parents. Children were assessed two to five times over 2 years by therapists using standardized measures of balance and walking endurance. Parents completed questionnaires on demographics, rehabilitation therapies, and their children's performance in self-care and participation in recreation. Therapists and parents collaboratively classified children's Gross Motor Function Classification System (GMFCS) levels. We created longitudinal …

Self-Management As A Means To Achieving Client-Centred Care For The Care Partnership Living With Parkinson’S Disease, Danielle M. Hudson

Electronic Thesis and Dissertation Repository

Parkinson’s disease (PD) is a chronic condition that manifests through many changing symptoms over time. A person diagnosed with PD is typically supported by a spouse or other family member as their primary care partner, who experiences a host of biopsychosocial challenges associated with their care partner role. The best approach to supporting a care partnership, consisting of the person diagnosed with PD and the primary care partner, through their individualized journey with PD remains to be defined. The aim of this research was to identify clinical insights for providing client-centred care for both members of the PD care partnership. …

Interpreting Patient Reported Outcomes In Orthopaedic Surgery: A Systematic Review, Shgufta Docter, Zina Fathalla, Michael Lukacs, Michaela Khan, Morgan Jennings, Shu-Hsuan Liu, Dong Zi, Dianne Bryant

Western Research Forum

Background: Reporting methods of patient reported outcome measures (PROMs) vary in orthopaedic surgery literature. While most studies report statistical significance, the interpretation of results would be improved if authors reported confidence intervals (CIs), the minimally clinically important difference (MCID), and number needed to treat (NNT).

Objective: To assess the quality and interpretability of reporting the results of PROMs. To evaluate reporting, we will assess the proportion of studies that reported (1) 95% CIs, (2) MCID, and (3) NNT. To evaluate interpretation, we will assess the proportion of studies that discussed results using the MCID or the effect sizes and how …

Does Improved Physical Function Following A Nustep® Seated All Extremity Exercise Intervention Reduce The Fear Of Falling And Improve Quality Of Life In Older Adults With Fear Of Falling Living In Community Care Homes?, Navjot Gill, Denise Connelly

Western Research Forum

Background:

Decreased physical activity associated with fear of falling invokes a dangerous cycle of more fear, reduced activity and falls. NuStep is a seated all-extremity recumbent cross trainer which provides safe and efficient exercise training.

Hypotheses/Objectives:

The objectives of this study are to:

i. improve physical function and mobility of older adults living with a fear of falling with a NuStep;

ii. assess change in self-reported fear of falling and quality of life before and after the exercise intervention; and

iii. determine whether there is a relationship between exercise-related improved physical function/mobility with change in fear of falling and/or quality …

Psychometric Properties Of Standardized Balance Confidence, Fear Of Falling, And Falls-Efficacy Measures In People With Lower Limb Amputations, Jack Y. Wang, Susan W. Hunter, Ricardo Viana, Jeffrey D. Holmes, Michael Payne

Western Research Forum

Background:

In Canada, >50% of community-dwelling lower limb amputees (LLA) fall at least once each year, a rate that is almost twice that of community-dwelling older adults. While the physical consequences of falls may be readily apparent, psychological sequelae that follow may be just as, if not more, detrimental than an actual fall itself. Current measures of balance confidence show no change in LLA following discharge from rehabilitation. The limited detectable change may be due to content validity challenges of the measures as they were not developed for the unique challenges faced by LLA.

Objectives:

1) Review items from standardized …

The Feasibility Of Gathering Patient-Reported Outcome Measures On Individuals With Acute Ankle Sprains In A Busy Clinic Environment, Ryan Reeson

Electronic Thesis and Dissertation Repository

Ankle sprains are the most common sports injury and can lead to long-term deficits. Patient-reported outcome measures (PROMs) may assist clinicians in evaluating the recovery trajectory of patients with ankle sprains. However, before a large-scale study can be performed, it is necessary to determine whether it is feasible to collect PROMs in a busy clinic environment. This study had a narrow recruitment window but the consent rate was 100%. Ten patients at Fowler Kennedy Sport Medicine Clinic were followed for up to six visits. Three PROMs that characterized lower extremity function were measured. The measurement completion rate decreased from 100% …

The Experiences Of Physical Rehabilitation In Individuals With Spinal Cord Injuries: A Qualitative Thematic Synthesis., Janelle Unger, Hardeep Singh, Avril Mansfield, Sander L Hitzig, Erica Lenton, Kristin E Musselman

Physical Therapy Publications

PURPOSE: The purpose of this thematic synthesis review was to identify and synthesise published qualitative research on the perspectives of individuals with spinal cord injuries with respect to physical rehabilitation interventions.

MATERIALS AND METHODS: The peer-reviewed literature was searched across seven databases and identified abstracts were independently screened by two reviewers. A thematic synthesis methodology was used to code and synthesise the results from the included studies.

RESULTS: In total, 7233 abstracts were identified; 31 articles were selected for inclusion, representing 26 physical rehabilitation interventions. The methodological quality of studies was moderate (Standards for Reporting Qualitative Research mean ± standard …

Effect Of Learning To Use A Mobility Aid On Gait And Cognitive Demands In People With Mild To Moderate Alzheimer's Disease: Part I - Cane, Susan W. Hunter, Alison Divine, Humberto Omana, Walter Wittich, Keith D Hill, Andrew M Johnson, Jeffrey D Holmes

Physical Therapy Publications

BACKGROUND: People with Alzheimer's disease (AD) exhibit balance and walking impairments that increase falls risk. Prescription of a mobility aid is done to improve stability, yet also requires increased cognitive resources. Single-point canes require unique motor sequencing for safe use. The effect of learning to use a single-point cane has not been evaluated in people with AD.

OBJECTIVES: In people with AD and healthy adult controls: 1) examine changes in gait while using a cane under various walking conditions; and 2) determine the cognitive and gait costs associated with concurrent cane walking while multi-tasking.

METHODS: Seventeen participants with AD (age …

The Facilitators And Barriers Of Physical Activity Engagement For Youth And Young Adults With Childhood Onset Physical Disabilities, Matt Downs

Electronic Thesis and Dissertation Repository

This thesis explored the motivators, experiences and challenges of youth and young adults (hereafter referred to as youth) with childhood-onset physical disabilities with respect to engaging in and sustaining physical activity. A focus group was conducted with youth (n= 6) who were current or past clients of recreational programs offered through a pediatric rehabilitation centre. Youth also completed a Personalized Exercise Questionnaire. A separate focus group was conducted with centre clinicians (n= 7). Data were analyzed through an interpretive description approach. A positive outlook towards physical activity was found among all participants. Youth recognized the physical, …

The Development And Evaluation Of Resources To Improve The Quality Of Care For Patients With Knee Osteoarthritis, Laura K. Churchill

Electronic Thesis and Dissertation Repository

Purpose: The non-operative management of patients with knee osteoarthritis (OA) is often considered suboptimal. Sub-optimal management includes inadequate use of non-surgical treatments, misuse of diagnostic imaging, and non-operative referrals to surgeons in consideration of total knee replacement (TKR). These inefficiencies result from an interplay of factors involving primary care physicians, patients, and the systems in which they function. The overall purpose of this thesis is to develop a means to optimize the management of patients with knee OA, and the timing and quality of referrals to TKR.

Methods: This thesis includes three studies. In study 1, we identified and cross-validated …

The Process Of Exercise Participation In The Community For Functional Recovery Post Formal Rehabilitation Among Survivors Of Stroke: A Grounded Theory Study, Nicole M. Evans

Electronic Thesis and Dissertation Repository

The effects of stroke pose a challenge on independence and community participation, which are common goals among survivors of stroke during recovery. Exercises are implemented during rehabilitation services and have a profound effect on functional recovery; however, services are limited, where adherence levels to exercise post discharge are less than ideal. The aim of this research was to understand the process of exercise participation for functional recovery among community living survivors of stroke following discharge from formal rehabilitation. Findings of this constructivist grounded theory study provided insight into the phases leading to exercise commitment –contact with a healthcare provider, desire …

Evaluating Knowledge Of Falls Risk Factors And Falls Prevention Strategies Among Lower Extremity Amputees After Inpatient Prosthetic Rehabilitation: A Prospective Study, Susan W. Hunter, Jordan Higa, Courtney Frengopoulos, Ricardo Viana, Michael Payne

Physical Therapy Publications

Purpose: Falls are prevalent among people with lower extremity amputations. A knowledge of risk factors is important in preventing falls, though no research has evaluated patient understanding of falls in this population. The study objective was to evaluate knowledge of falls risk factors and falls prevention strategies at discharge and 4-months after inpatient prosthetic rehabilitation.

Methods: Participants completed a falls questionnaires with four sections: (1) falls during rehabilitation and after discharge, (2) falls self-efficacy using the Activities-specific Balance Confidence scale, (3) knowledge of falls risk factors, and (4) falls prevention strategies. Questionnaire responses were quantified using means and standard deviations …

Effect Of Learning To Use A Mobility Aid On Gait And Cognitive Demands In People With Mild To Moderate Alzheimer's Disease: Part Ii - 4-Wheeled Walker., Susan W. Hunter, Alison Divine, Humberto Omana, Walter Wittich, Keith D Hill, Andrew M Johnson, Jeffrey D Holmes

Physical Therapy Publications

BACKGROUND: Cognitive deficits and gait problems are common and progressive in Alzheimer's disease (AD). Prescription of a 4-wheeled walker is a common intervention to improve stability and independence, yet can be associated with an increased falls risk.

OBJECTIVES: 1) To examine changes in spatial-temporal gait parameters while using a 4-wheeled walker under different walking conditions, and 2) to determine the cognitive and gait task costs of walking with the aid in adults with AD and healthy older adults.

METHODS: Twenty participants with AD (age 79.1±7.1 years) and 22 controls (age 68.5±10.7 years) walked using a 4-wheeled walker in a straight …

Physiotherapy Students’ Attitudes Toward Working With People With Dementia: A Cross-Sectional Survey, Susan W. Hunter, Jessica Armstrong, Mark Silva, Alison Devine

Physical Therapy Publications

Aims: To understand personal, educational and clinical experiences and the attitudes of physiotherapy students towards people with dementia.

Methods: Online survey questionnaire. Physiotherapy students in the last year of a two-year Masters of Physical Therapy (MPT) entry-to-practice degree program (n = 59) were surveyed. Descriptive statistics were used to analyze the data.

Results: Fifty-five students participated (93%). The majority of students (n = 52/55, 77%) had at least one clinical placement working with people with dementia. Overall, 53% (n = 29/55) felt their academic training was sufficient to effectively work with people with dementia. Moreover, …

Reliability, Validity, And Agreement Of The Short-Form Activities-Specific Balance Confidence Scale In People With Lower Extremity Amputations., Katherine Fuller, Humberto Adolfo Omaña Moreno, Courtney Frengopoulos, Michael W Payne, Ricardo Viana, Susan W. Hunter

Physical Therapy Publications

BACKGROUND: Clinicians use the Activities-specific Balance Confidence Scale to understand balance confidence. A short-form Activities-specific Balance Confidence scale, was developed using the six most difficult tasks from the original Activities-specific Balance Confidence scale; however, short-form the short-form scale psychometrics and agreement with the original scale have yet to be explored in people with lower extremity amputations.

OBJECTIVE: To determine the relative and absolute reliability, construct validity, and agreement of the short-form Activities-specific Balance Confidence scale.

STUDY DESIGN: Test-retest with a 2-week interval.

METHODS: Analysis for relative reliability and internal consistency was intraclass correlation coefficient and Cronbach's

RESULTS: The short-form Activities-specific …