The Development And Testing Of A Gyroscope-Based Neck Strengthening Rehabilitation Device, Nicole D. Devos

Electronic Thesis and Dissertation Repository

Neck pain can be debilitating, and is experienced by the majority of people at some point over the course of their life. Resistance training has been shown to have significant improvement in pain or disability for patients. There are few options available for telerehabilitation, and the use of gyroscope stabilizers is proposed for this use. A biomechanics model of a head--neck--gyroscope system was created. In order to also model the dynamics of such a system, this work proposes a blended method using the Denavit--Hartenberg (DH) convention, popular in the field of robotics, with the Lagrangian mechanics approach to analyze an …

The Signs And Symptoms Of Discogenic Low Back Pain, Joe J. Putos

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The signs and symptoms of low back pain (LBP) associated with disc herniation (DLBP) and its underlying mechanism(s) are not well supported. One theory proposes that some low back pain (LBP) is the result of a disc herniation compressing adjacent tissues innervated with nociceptors. The theory proposes that spinal manipulation (SM) and/or mobilizations (SMOB) can reduce the size and position of the herniation, and relieve pain and improve range of motion. There is no research to support or negate the theory even though clinical evidence supports its plausibility.

In this three-part study we examined clinical practices that have an anecdotal …

Physiotherapists Description Of Patient-Centered Care, And Barriers And Facilitators Experienced To Implementation, Maclean Jordan

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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

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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 …

The Role Of Patient And Rehabilitation Factors In The Recovery Of Home And Family Work Roles Following Distal Radius Fracture, Sheena Saju Philip Ms.

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Background: Distal radius fracture (DRF) is a common upper extremity fracture that causes significant impairment and leads to difficulties in fulfilling important life roles such as indoor and outdoor cleaning, meal preparation, grocery shopping, caring for others, and earning and managing family income. However, clinicians do not routinely address home and family life roles after a DRF. Patient and rehabilitation factors are crucial in addressing home and family work roles (HFWRs). The HFWR questionnaire consists of tasks that are typically performed at home.

Objective: The overarching objective of this thesis is to explore the role of patient and rehabilitation …

The Lived Experience Of Persons With Parkinson's Disease In Non-Contact Boxing Programs, Laura Mulder

Electronic Thesis and Dissertation Repository

We conducted a scoping review to identify articles examining non-contact boxing programs for persons with Parkinson’s disease (PwP). Results suggested that gait, mobility, balance, and quality-of-life were the most-studied outcomes. Many qualitative articles explored the experience within in-person boxing programs, but no articles explored experiences within virtual boxing programs. We followed this review with an interpretative phenomenological analysis aimed at addressing this research gap and interviewed six PwP who had engaged with both virtual and in-person Rock Steady Boxing programming. Results suggested that although the virtual setting improved elements of the individual experience, the physical and social aspects were better …

Exploring The Experience Of Sexuality And Gender During The Healthcare Transition Of The Youth With Cerebral Palsy, Umma Salma

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Background: Transition from the pediatric to adult health care system is an important phase of healthcare for youth with cerebral palsy (CP). Sexuality and gender are two very important components of health that are mostly ignored in the healthcare transition process. It is possible that health care providers only see a client’s disability, and therefore, key aspects of sexuality and gender diversity may be ignored, or deemed irrelevant as a result of their disability status. Therefore, the purpose of our study is to explore how gender and sexuality may influence the experience of health care transition for youth with cerebral …

The Shared Contributions Of The Capsule, Labrum, And Bone On The Suction Seal Of The Hip, Alexander J. Hoffer

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The hip capsule, labrum, and bone contribute to hip stability. Abnormalities in these structures are associated with pain and microinstability. Previous studies have quantified the individual stabilizing roles of the capsule and labrum and have associated cam over-resection with decreased hip stability.

The first objective of this thesis was to identify the relative biomechanical contributions of the capsule, labrum, and bone to the hip suction seal, as a representation of hip stability. The second objective was to assess the effectiveness of a labral reconstruction in restoring the suction seal after a cam over-resection.

Ten human cadaveric hips were tested in …

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

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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 …

Systemic, Institutional, And Teaching Factors In The Delivery Of Interprofessional Education Curriculum In Canada, Mohammad B. Azzam

Electronic Thesis and Dissertation Repository

The Canadian federal and several provincial governments are currently collaborating to establish ‘team-based’ primary healthcare—or interprofessional collaborative practice (IPCP), which can be effectively accomplished when interprofessional education (IPE) is sustainably delivered by health and social care (HASC) professional education programs. Indeed, achieving the intended patient/client-oriented outcomes of IPE and subsequent IPCP requires deliberate and purposeful considerations of several systemic, institutional, and teaching factors. Regrettably, the analyses of the extent to which these factors have influenced effective IPCP is currently under-researched. In this integrated-article dissertation, we took a purposeful and systematic approach to explore the extent to which these multi-tiered factors …

Valued Strategies In The Development And Implementation Of Interprofessional Education Placements, Olajumoke Akintomide

Electronic Thesis and Dissertation Repository

Background: Interprofessional education (IPE) is increasingly being recognized as an essential component of training future healthcare providers. IPE allows students to learn collaboratively preparing them for future collaborative practice. Purpose: This study aimed to identify strategies valued by rehabilitation therapy students and clinical instructors in the development and implementation of IPE placements. Method: Through interviews and focus groups, this study explored the experiences and perspectives of students and clinical instructors regarding IPE placements for students in rehabilitation therapy programs. Results: Four major themes emerged from the findings of this study relating to the development and implementation of IPE placements. Themes …

A Biomechanical Comparison Of A Subacromial Balloon Spacer, Superior Capsular Reconstruction, And A Rigid Subacromial Spacer In A Massive Irreparable Rotator Cuff Cadaveric Model, Devin Ferguson

Electronic Thesis and Dissertation Repository

Massive irreparable rotator cuff tears are a common cause of pain and disability. Several different treatments exist; however, they are associated with poor clinical outcomes and survivorship in younger patients without glenohumeral arthritis. The purpose of this thesis was to compare the impact of a subacromial balloon spacer, superior capsular reconstruction, and a rigid subacromial implant on the glenohumeral kinematics and mechanical efficiency of a massive rotator cuff deficient shoulder. The results indicate that each surgical state improves the glenohumeral kinematics of a massive irreparable rotator cuff tear. The subacromial implant leads to mild overcorrection of humeral head translation. No …

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 …

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 …

Mindfulness With Children And Youth: A Hermeneutic Phenomenological Inquiry Into Paediatric Therapists' Experiences, Kirsten S. Smith

Electronic Thesis and Dissertation Repository

Background: Mindfulness has become popular as a treatment approach for many health conditions and has been taken up by diverse health practitioners in recent years. While research into mindfulness-based interventions is on the rise, much of this research originates in the field of psychology and is aimed toward adult populations. Occupational therapists, including those working with children and youth, have begun to take up mindfulness to support their clients to participate in daily activities, and there is evidence that clinical uptake has outpaced research in this area.

Method: A scoping review was undertaken to understand the breadth of literature regarding …

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 …

Total Hip Arthroplasty In Young Patients, Aaron G. Chen

Electronic Thesis and Dissertation Repository

Total hip arthroplasty (THA) is the gold standard in treatment of hip arthritis yet is often avoided in young patients due to concerns of inferior survivorship. We aim to explore the role of THA in young patients and assess whether these historical concerns are valid in contemporary THA by presenting the results of: (1) a systematic review and meta-analysis of the current literature, (2) a retrospective database review, and (3) a retrospective population-based study. We found excellent long-term survivorship with modern THA in young patients, demonstrating greater than 90% revision-free survival up to 15 years. Factors that may increase risk …

The Lived Experiences Of Pain And Fatigue In Persons Living With Neurological Conditions: A Phenomenological Study, Lauren L. Kane

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Purpose: The aim of the study was to understand the experiences and impact of pain and fatigue and to further explore the relationship between participants' descriptions of their lived experiences with these phenomena within and across multiple sclerosis, Parkinson's disease, and cerebral palsy. Methods: Semi-structured interviews were used to interview nine participants about their experiences of living with pain and fatigue in their respective conditions. A new phenomenological approach was adopted, and data was analyzed inductively using interpretive phenomenological analysis. Results: Three final themes including a lack of understanding, negative perceptions of pain and fatigue, and coping strategies used to …

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. …

Biomechanical Characterization Of Semi-Rigid Constructs And The Potential Effect On Proximal Junctional Kyphosis In The Thoracic Spine, Chloe Cadieux

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Long spinal fusions are the mainstay of treatment in adult spinal deformity; however, proximal junctional kyphosis (PJK) is a common and potentially catastrophic complication that can occur following this procedure. It has been hypothesized that using semi-rigid constructs at the superior aspect of the instrumentation may decrease this complication. The objective of this thesis was to determine if there is a biomechanical advantage between various semi-rigid constructs utilized in long spinal fusions to help decrease the risk of PJK. Nine human cadaveric spines (T1 – T12) instrumented with the standard all-pedicle-screw construct (APS) were compared to various semi-rigid constructs including …

Exploring The Inter-Relationship Between Cognitive And Motor Function In People With Lower Limb Amputations, Humberto Adolfo Omaña Moreno

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The main objective of the present dissertation was to expand our understanding of the inter-relationship between cognition and mobility in people with lower limb amputations (PLLA). Study 1 systematically reviewed the literature to assess the effects of dual-task testing on the balance and gait of PLLA. A total of twenty-two studies were included. Overall, PLLA demonstrated a disproportionately greater dual-task effect than controls, characterized by increased sway velocity and reduced pace and rhythm, and increased asymmetry when balance or walking was paired with a secondary task. Additionally, the dual-task effect was not influenced by differences in etiology, level of amputation, …

Advancing Type 2 Diabetes As A Condition For Primary Referral To Physiotherapy In Canada, Sarah M. Janssen

Electronic Thesis and Dissertation Repository

Obesity and sedentary lifestyle are increasingly prevalent risk factors for type 2 diabetes (T2D), characterized by high blood glucose levels. Adoption and maintenance of healthy eating, physical activity, and exercise is recommended for lowering blood glucose and weight management. Physiotherapists are experts in prescribing safe, effective exercise to optimize health for people with co-morbid health conditions. However, T2D is not a primary condition for referral to physiotherapy services in Canada. The overall question guiding a series of three related studies was, What is the current education and perspectives of Canadian physiotherapists about their role in managing T2D? Study one surveyed …

Perception And Attitudes Of Canadians Living With Parkinson’S Disease Towards Using Advanced Driver Assistance Systems (Adas), Anupradi Sultania

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Advanced driver assistance systems (ADAS) are becoming increasingly prevalent commercially and have potential to increase road safety for at risk populations, such as those with Parkinson’s disease (PD). This thesis presents the results of a survey study (n= 153) exploring the perception and attitudes of Canadians living with PD towards using ADAS. Most participants had a favourable perception of perceived usefulness and perceived ease of use towards ADAS. Most participants found ADAS slightly, quite or extremely beneficial, good, rewarding and pleasant. Perceived ease of use and previous experience were determinants for intention to use ADAS in the next year. Perceived …

To Develop A Clinically Friendly Multi-Segment Kinematic And Kinetic Foot Model And Test It On Pre-/Post-Hto Patients With Medial Knee Osteoarthritis And Knee Varus, Songlin Zhu

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This study aims to develop a clinically useful multi-segment foot model that will enable the analysis of foot kinematics and kinetics in an optical motion capture laboratory setting. This study will also test the new multi-segment foot model on patients with knee osteoarthritis and varus knee alignment that is corrected by high tibial osteotomy (HTO). The multi-segment foot model divides the foot into four functional segments: the hindfoot, midfoot, forefoot and hallux. An X-Z-Y-Cardan angle rotation convention was used to determine intersegmental dorsi/plantar flexion, inversion/eversion, and internal/external rotation. Joint moments, joint powers and medio-longitudinal arch (MLA) height/length ratio were also …

Caregiver Experience With The Applied Coaching Model On Supporting Adherence To Home Exercise Programs For Children With Developmental Delays: A Mixed Methods Research Study, Mackenzie Cheng

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Home exercise programs (HEP) are a form of treatment for children with delayed motor, sensory, cognitive, or speech skills. Studies show improvement in developmental and barriers that affect adherence, there is still a lack of standardized rehabilitation models that can address this issue. This interpretive phenomenology study explores the lived experiences of caregivers of children with developmental delays regarding adherence to HEPs. Participating caregivers interacted with therapists using an Applied Coaching Model (ACM), a model of multiple theories focusing on holistic rehabilitative care. Qualitative results of this mixed-methods study identified specific factors that affect adherence to HEPs. Quantitative results found …

Describing Healthcare Concerns Of Young People And Adults With Cerebral Palsy, Christina M. Winger

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The purpose of this study was to identify healthcare concerns of young people and adults with cerebral palsy (CP) in the Transitional and Lifelong Care (TLC) program, and determine whether there were patient factors associated with the number of healthcare concerns. A retrospective chart review of initial TLC consultations was completed (n = 241). Descriptive and inferential statistics were used to explore and explain patterns in the sample population. The participants reported a high number of concerns of varied nature that were not easily predicted by condition-specific or demographic variables. This study may better healthcare delivery for young people …

Searching For The 'Good' In Physiotherapist Practice: Toward An Ethic Of Care, Michelle J. Kleiner

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The qualities and practices of a ‘good’ physiotherapist have not been systematically reviewed nor have practitioners’ perspectives been empirically investigated. Understanding what constitutes a ‘good’ physiotherapist has potentially profound implications that may inform professional priorities including education curricula, professional practices, competency profiles, and patient interactions. The research purpose was to examine perceptions of what constitutes a ‘good’ physiotherapist. This dissertation includes four integrated manuscripts. The first is an integrative review to critically examine how physiotherapists and patients describe the qualities of a ‘good’ MSK physiotherapist as depicted in peer-reviewed literature. Six qualities were identified as: responsive, ethical, communicative, caring, competent, …