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, …

Does An Acute Achilles Tendon Rupture Become A Patient's Achilles Heel In The Long-Term?, Michaela Cm Khan

Electronic Thesis and Dissertation Repository

It is unknown if deficits in the involved limb following acute Achilles tendon rupture (AATR) persist in the long-term, or differ between patients treated operatively or non-operatively. This study investigated 43 patients 15±1 years post-AATR from a previous randomized controlled trial (RCT) that compared operative and non-operative treatment. Structural characteristics in the Achilles tendon and surrounding musculature were assessed using magnetic resonance imaging. We also performed physical examinations and evaluated performance-based and patient-reported outcomes. Overall, there were substantial differences between the involved and uninvolved limbs in most outcomes. Some outcomes improved over time from the initial RCT to the final …

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 …

Exploration Of Knowledge And Skills Development Among Community Health Workers In Rwanda, Schadrack Ngabonziza

Electronic Thesis and Dissertation Repository

Community Health Workers (CHWs) are individuals who are selected and trained to provide healthcare services in the community. To be effective, they need ongoing training opportunities to gain knowledge and skills to perform their tasks. This study used descriptive qualitative methods to explore how Animatrice de Santé Maternelle (ASM)-CHWs working in select regions of Rwanda gained and enhanced their knowledge and skills to support maternal and newborn health care. Thematic analysis was used to analyze data from 110 ASM-CHWs and ten supervisors of CHWs. The analysis yielded two main themes. 1) Formalized training among CHWs, which included the subthemes of …

Characterization Of Wilms' Tumour 1 (Wt1) As A Biomarker For Fibrosis In Duchenne Muscular Dystrophy, Patrick Murphy

Electronic Thesis and Dissertation Repository

Duchenne muscular dystrophy (DMD) is the most common inherited pediatric muscle dystrophy. It is characterized by muscle degeneration, resulting in fibrosis that is a significant impediment to both endogenous muscle repair and any potential regenerative strategy. At present, there are few therapies that specifically address fibrosis and microenvironment improvement, but one possibility rests in targeting the Wilms’ tumour 1 (Wt1) protein. Wt1 is a zinc finger transcription factor, recently shown to be expressed in fibrotic conditions such as Dupuytren’s disease and pulmonary fibrosis. This thesis examines the expression pattern of Wt1 in several mouse models of DMD, through both histological …

Exploring Current Topics And Trends In Anatomy Education: A Scoping Review, Alex Wolf

Electronic Thesis and Dissertation Repository

Within the field of health professional education, one finds that anatomy often presents students with a great deal of difficulty. The literature in this area is piecemeal and there is limited work available examining the whole of this topic. A scoping review was conducted to determine how students are taught anatomy across multiple disciplines (medicine, dentistry, rehabilitation sciences, and undergraduate education) and to assess for any notable differences between these populations. The results found that scholarship on anatomy instruction varies based on educational context, and medical students are the most frequently targeted student population. It also found that the use …

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 …

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. …

Post-Operative Analgesia Following Total Knee Arthroplasty: A Randomized Controlled Trial Comparing Regional Techniques, James H. Allen

Electronic Thesis and Dissertation Repository

Regional anaesthetic techniques for the management of post-operative pain following total knee arthroplasty (TKA) are becoming increasingly popular. The purpose of this randomized control trial was to assess whether periarticular infiltration and infusion (LIA and infusion) had a comparable time-to-discharge and analgesic quality to a motor-sparing nerve block (MSNB) technique in patients who have undergone TKA. The study arms included continuous MSNB (n=35, control) and LIA and infusion (n=35, experimental). Continuous anaesthetic infusion of 0.2% Ropivacaine was delivered at a rate of 8ml/hr post-operatively. The primary outcome was time to discharge. Secondary objectives included pain scores at rest and activity, …

Academic Center Tiered Operating Room Strategy (Action): Comparing A High Efficiency Or To The Conventional Or, Moaz Bin Yunus Chohan

Electronic Thesis and Dissertation Repository

Canadian healthcare system is under immense economic pressure. In an attempt to resolve the problem, outpatient surgical services were offered to patients presenting with orthopaedic surgical complaints. An observational cohort study was carried out, comparing the conventional surgical setup to the newly designed high-efficiency setup that provided similar care, with a significantly lower operating cost. A total of 200 patients were enrolled in the study. Standardized and unstandardized questionnaires were used to evaluate pre-operative and post-operative patient data that reflected quality of life outcomes. Data was collected at enrolment and during post-operative follow-ups of up to 6 months. Results indicate …

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 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 …