Medicine and Health Sciences Commons^™

Assessment Of Interprofessional Team Collaboration Scale (Aitcs): Further Testing And Instrument Revision., Carole Orchard, Linda L Pederson, Emily Read, Cornelia Mahler, Heather Laschinger

Nursing Publications

INTRODUCTION: The need to be able to assess collaborative practice in health care teams has been recognized in response to the direction for team-based care in a number of policy documents. The purpose of this study is to report on further refinement of such a measurement instrument, the Assessment of Interprofessional Team Collaboration Scale (AITCS) first published in 2012. To support this refinement, two objectives were set: Objective 1: to determine whether the items from the data collected in 2016 load on the same factors as found for the 2012 version of the 37-item AITCS. Objective 2: to determine whether …

Working Towards The Promise Of Participatory Action Research: Learning From Ageing Research Exemplars, Colleen E. Mcgrath

Occupational Therapy Publications

Within research addressing issues of social justice, there is a growing uptake of participatory action research (PAR) approaches that are ideally committed to equitable participation of community members in all phases of the research process in order to collaboratively enact social transformation. However, the utilization of such approaches has not always matched the ideal, with inconsistencies in how participation and action are incorporated. “Participation” within various research processes is displayed differently, with the involvement of community members varying from full participation to their involvement as simply participants for data collection. Similarly, “action” is varyingly enacted from researchers proposing research implications …

Evaluation Of The Construct Validity Of The Questionnaire To Identify Knee Symptoms Among Individuals Across Canada With Chronic Knee Pain, James Young

Electronic Thesis and Dissertation Repository

The primary purpose of this study was to evaluate the construct validity of the Questionnaire to Identify Knee Symptoms (QuIKS) measurement scale among individuals with chronic knee symptoms consistent with osteoarthritis. Construct validity was assessed using tests of convergent and discriminative validity on 15 pre-specified hypotheses. The secondary objective was to determine the internal consistency reliability of the QuIKS. One hundred and five individuals recruited in select physiotherapy clinics from across Canada were mailed the QuIKS and five other health questionnaires. Fifty-five individuals completed the questionnaire package. While none of the pre-specified construct validity hypotheses were met, nine of the …

Fatigue In Adults With Cerebral Palsy: A Three-Year Follow-Up Study., Irene L B Oude Lansink, Patrick G Mcphee, Laura Kristine Brunton, Jan Willem Gorter

Physical Therapy Publications

OBJECTIVES: To describe the course of fatigue over a 3-year follow-up period in adults with cerebral palsy and to investigate the association of known determinants of fatigue (i.e. demographic characteristics and/or body composition) with change in fatigue.

METHODS: Forty-one adults with cerebral palsy from a previous study of fatigue were invited to participate in a follow-up study. Twenty-three adults with cerebral palsy (Gross Motor Function Classification System (GMFCS) levels I-V; mean age 38 years 2 months, standard deviation (SD) 14 years 1 month)) agreed to participate (convenience sample). Fatigue was measured with the Fatigue Impact and Severity Self-Assessment (FISSA, range …

Understanding The Process Of Recovery From Critical Illness From The Patient Perspective: A Constructivist Grounded Theory, Tania Larsen

Electronic Thesis and Dissertation Repository

Critical illness creates long-term physical, psychological and cognitive deficits that negatively impact quality of life, persisting well beyond hospital discharge. The purpose of this constructivist grounded theory study is to understand and develop theoretical propositions on factors that patient’s perceive influence the process of recovery from critical illness in order to inform more comprehensive patient care management strategies.

Semi-structured interviews were conducted with 17 participants admitted to an ICU. All interviews were audio-recorded and transcribed verbatim. Data collection and analysis occurred concurrently using the constant comparative method. Data were analysed initially with line-by-line coding, then focused coding. Initial codes were …

Exploring The Relationship Between Locomotor Training And Bowel And Bladder Outcomes In Individuals With Spinal Cord Injury: A Scoping Review And Feasibility Study., Anna Rudkovska

Electronic Thesis and Dissertation Repository

This thesis explored the relationship between locomotor training and bowel and bladder function in individuals with Spinal Cord Injury (SCI). Study 1 was a scoping review that identified and summarized literature describing the relationship between locomotor training and bowel/ bladder outcomes in individuals with SCI and identified research gaps in the existing literature on bowel/bladder outcomes during locomotor training. Results of the scoping review suggested there is evidence of a positive relationship between locomotor training and bowel/bladder outcomes, however, most of that evidence was not collected using clinical outcome measures. Study 2 evaluated the feasibility of using the Spinal Cord …

Stability Of The Gross Motor Function Classification System, Manual Ability Classification System, And Communication Function Classification System., Robert J Palisano, Lisa Avery, Jan Willem Gorter, Barbara Galuppi, Sarah Westcott Mccoy

Physical Therapy Publications

AIM: To determine the stability of the Gross Motor Function Classification System (GMFCS), Manual Ability Classification System (MACS), and Communication Function Classification System (CFCS) over 1-year and 2-year intervals using a process for consensus classification between parents and therapists.

METHOD: Participants were 664 children with cerebral palsy (CP), 18 months to 12 years of age, one of their parents, and 90 therapists. Consensus between parents and therapists on level of function was ≥92% for the GMFCS, MACS, and CFCS. A linearly weighted kappa coefficient of ≥0.75 was the criterion for stability.

RESULTS: Kappa coefficients varied from 0.76 to 0.88 for …

A Collaborative Approach To Decision Making Through Developmental Monitoring To Provide Individualized Services For Children With Cerebral Palsy., Doreen J Bartlett, Sarah W Mccoy, Lisa A Chiarello, Lisa Avery, Barbara Galuppi, On Track Study Team

Physical Therapy Publications

In this Perspective, we suggest a process to improve physical and occupational therapists’ and families’ collaboration to provide appropriate, efficient, and effective evidence-based services to improve motor function, self-care performance, and participation in family and recreation activities for children with cerebral palsy (CP). This process is informed by 2 multisite prospective cohort studies (Move & PLAY and On Track). The heterogeneity of children with CP is described, limiting the utility of evidence from randomized controlled trials and systematic reviews to inform service planning for children with CP. An evidence-based alternative using prospective cohort studies that produce knowledge of determinants of …

Operant Conditioning Of Human Upper-Limb Stretch Reflexes, Ehsan Abolhasani

Electronic Thesis and Dissertation Repository

Operant conditioning of short-latency reflex (SLR) and H-reflex have been investigated in animals and humans. We modified previously established protocols for conditioning lower limb H-reflexes to up-condition the SLR in brachioradialis muscle and to investigate the effect of such conditioning on the long-latency response (LLR) of synergistic muscles. Our study included 12 healthy participants. Each participant took part in 3 baseline and 27 conditioning sessions in 6 weeks, followed by two additional sessions one month and two months after the last conditioning session. We found an increase in SLR magnitude in 50% of participants (by 15%±2.50). However, there was no …

A Framework For Secondary Cognitive And Motor Tasks In Dual-Task Gait Testing In People With Mild Cognitive Impairment., Susan W Hunter, Alison Divine, Courtney Frengopoulos, Manuel Montero Odasso

Physical Therapy Publications

BACKGROUND: Cognition is a key factor in the regulation of normal walking and dual-task gait assessment is an accepted method to evaluate the relationship. The objective of this study was to create a framework for task complexity of concurrent motor and cognitive tasks with gait in people with mild cognitive impairment (MCI).

METHODS: Community-dwelling people with MCI (n = 41, mean age = 76.20 ± 7.65 years) and cognitively normal controls (n = 41, mean age = 72.10 ± 3.80 years) participated in this study. Gait velocity was collected using an instrumented walkway under one single task and six combined …

"We Were Meant To Go Down One Road, But Now We Have Rerouted": A Phenomenological Inquiry Into The Experience Of Aging Out-Of-Place, Sachindri Wijekoon

Electronic Thesis and Dissertation Repository

In an age of globalization, the experience of aging in a foreign land is part of the late-life experience of many older adults. However, studies of aging and migration have largely failed to conceptualize the unique resettlement experiences of immigrants entering North America as older adults. This dissertation asked, “What is the experience of aging out-of-place?” Specifically, this research question aimed to understand how late-life immigrants relate to, and connect and engage with places through aging processes, and the essentiality of daily occupations within such engagement. An interpretive paradigm and a hermeneutic phenomenological methodology guided this inquiry. The hermeneutic phenomenological …

Validity And Reliability Of The Clinician Rated Drop Vertical Jump Scale In Patients Following Anterior Cruciate Ligament Reconstruction, Morgan Jennings

Electronic Thesis and Dissertation Repository

The purpose of this study was to evaluate the validity and reliability of the Clinician Rated Drop Vertical Jump Scale (CR-DVJS) in a population of patients following anterior cruciate ligament reconstruction (ACLR). Patients completed two drop vertical jump tasks at 6 and/or 12-months post-operative. One task was recorded using a motion capture system. Four individuals of varying clinical experience served as raters for the CR-DVJS. Rater scores of valgus collapse did not correlate strongly with motion capture measures of knee abduction moment or angle. However, CR-DVJS scores of trunk and knee flexion did demonstrate an association with 3D measures of …

Electrical Stimulation For Treating Pressure Injuries: Evaluation Of A Knowledge Mobilization Project, Lyndsay Orr

Electronic Thesis and Dissertation Repository

Pressure ulcers (PrU) are a secondary health complication that cause increased morbidity, mortality and decreased quality of life. PrUs have also been shown to have a significant financial burden on the healthcare system. Current best practice guidelines strongly recommend the use of Electrical Stimulation (E-Stim) to increase healing rates of PrUs. Unfortunately, there has been lack of uptake for the use of E-Stim in clinical practice. To address this gap in practice, a knowledge mobilization project called the E-Stim Collaboration Project was developed. The aim of this dissertation was to 1) determine if an education program can change knowledge, attitudes …

How Do Health Care Providers Identify And Address Lifestyle Factors With Community Dwelling Adults Who Have Chronic Wounds?, Linda Norton

Electronic Thesis and Dissertation Repository

Wound prevention and management best practice guidelines and literature contain recommendations that treatment plans need to consider the client’s lifestyle but offer little guidance about the specific lifestyle factors to be considered, nor how to address these. A post positivist constructivist grounded theory study was used to explore this gap Participants were health care providers with at least 5 years of experience working with community dwelling adults with chronic wounds. Data were transcripts of two semi structured individual interviews, a reflective journal, relevant documents identified by participants and transcripts of focus groups.

A common understanding of lifestyle factors was not …

Impact Of Feeding Tube Status On Health Outcomes For Individuals With Oropharyngeal Cancer, Nedeljko Jovanovic

Electronic Thesis and Dissertation Repository

Abstract

This study investigated differences in outcomes related to health, swallowing, and quality of life (QoL) for individuals with oropharyngeal squamous cell carcinoma (OPSCC) receiving either radiotherapy (RT) alone, or concomitant chemoradiotherapy (CRT). Differences were assessed based on whether patients received a feeding tube (FT group) or not (NFT group). Measures including the Functional Oral Intake Scale (FOIS), Performance Status Scale for Head and Neck Cancer (PSS-HN), M.D. Anderson Dysphagia Inventory (MDADI), and weight were collected for 126 individuals at baseline, and at 3, 6, and 12 months post-treatment. Data were analyzed to identify potential prognostic differences between the groups, …

The Effectiveness Of Neurofeedback And Heart Rate Variability Biofeedback For Individuals With Long-Term Post-Concussive Symptoms, Marquise Bonn

Electronic Thesis and Dissertation Repository

Case studies have shown that low resolution electromagnetic tomography (LoRETA) neurofeedback is effective for many psychological disorders, but it’s effectiveness for individuals experiencing persistent post-concussive symptoms (PPCS) is uncertain. Individuals with PPCS (n = 7) received an eight-week LoRETA neurofeedback and heart rate variability biofeedback intervention. Change in symptoms, driving simulation performance, electroencephalographic z-score deviations, and heart rate variability were compared to PPCS (n = 9) and healthy (n = 8) control groups. Statistical analyses revealed that the intervention significantly reduced electroencephalographic z-score deviations (p < 0.005) compared to PPCS controls. Additionally, headache, nausea, and dizziness symptoms were reduced in the intervention group (p = 0.003) and the PPCS controls (p = 0.001) compared to healthy …

The Listening Shift: Evaluating A Communication-Strategies Training Program For Telepractice Nurses Experiencing Hearing Challenges, Raphaelle Koerber

Electronic Thesis and Dissertation Repository

Workers who wish to remain employed should be supported in doing so, even if they are experiencing age-related disabilities, such as hearing loss. I aimed to better understand the strategies from which workers with hearing loss might benefit, and how they can be supported in adopting these strategies. To collect rich data, I recruited telepractice nurses who rely on listening to make critical decisions about triaging and health care recommendations. My first research question was: What strategies exist for making telephone speech more intelligible for health care providers and patients with hearing challenges? I performed a scoping review following the …

Immature Auditory Evoked Potentials In Children With Moderate-Severe Developmental Language Disorder., Elaine Yuen Ling Kwok, Marc F Joanisse, Lisa Archibald, Janis Oram Cardy

Health and Rehabilitation Sciences Publications

Purpose: Immature auditory processing has been proposed to underlie language impairments in children with developmental language disorder (DLD; also known as specific language impairment). Using newly available normative auditory evoked potential (AEP) waveforms, we estimated AEP maturity in individual children with DLD and explored whether this maturational index was related to their language abilities.

Method: AEPs were elicited by 225 trials of a 490-Hz pure tone. Using intraclass correlation and our previously established normative AEP waveforms of 7- to 10-year-old children with typical development, we estimated the age equivalent of the AEPs (AEP-age) from 21 children with DLD. The relation …

Assessing The Risk Of Falling In Adults One-Year After Total Hip Arthroplasty, William Janes

Electronic Thesis and Dissertation Repository

The purpose of this study was to examine falls prevalence, falls risk factors and knowledge of falls in individuals who have undergone a total hip arthroplasty. There were 135 patients examined at their one-year follow-up appointment for total hip arthroplasty. Our primary outcome, falls prevalence and falls circumstances, found a falls prevalence of 21.5% with identical circumstances to that of average community-dwelling older adults. Female sex, number of prescription medications and multiple joint replacements were found to be significantly associated with the occurrence of falls in the previous year. The Falls Risk for Older People in a Community Setting Questionnaire …

An Analysis Of The Relationship Between Humor Styles And Depression, Marisa L. Kfrerer

Electronic Thesis and Dissertation Repository

The present study examined the relationship between humor styles and depression using two methods of examination: (1) the mean humor style differences between individuals who reported that they had been diagnosed with depression versus those who did not report being depressed; and (2) a short scale assessing depressed affect. Participants were 878 adult Australians. With respect to mean differences, depressed individuals were found to use self-defeating humor more, and self-enhancing humor less than non-depressed adults. When the depressed affect scale score was analyzed, negative correlations were found between depressed affect and both positive styles of humor, affiliative and self-enhancing. Additionally, …

Type-2 Diabetes Mellitus Reduces Cortical Thickness And Decreases Oxidative Metabolism In Sensorimotor Regions After Stroke., Jennifer K Ferris, Sue Peters, Katlyn E Brown, Katherine Tourigny, Lara A Boyd

Physical Therapy Publications

Individuals with type-2 diabetes mellitus experience poor motor outcomes after ischemic stroke. Recent research suggests that type-2 diabetes adversely impacts neuronal integrity and function, yet little work has considered how these neuronal changes affect sensorimotor outcomes after stroke. Here, we considered how type-2 diabetes impacted the structural and metabolic function of the sensorimotor cortex after stroke using volumetric magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS). We hypothesized that the combination of chronic stroke and type-2 diabetes would negatively impact the integrity of sensorimotor cortex as compared to individuals with chronic stroke alone. Compared to stroke alone, individuals with …

Efficacy Of Rhythmic Acquisition On Gait Performance Among Individuals With Parkinson’S Disease, Demian L. Kogutek

Electronic Thesis and Dissertation Repository

The purpose of this study was to identify the ability of individuals with Parkinson’s disease (PD) to acquire different rhythmic complexity levels through individual home-based Improvised Active Music Therapy (IAMT) sessions. The study aimed to identify whether higher acquisition of rhythmic complexity levels improved gait performance, as well as beat perception and production abilities. In this single subject multiple baseline design, the study measured the ability of four right-handed participants with PD to acquire greater density of syncopation, as a measure of rhythmic complexity levels, while playing uninterrupted improvised music on a simplified electronic drum-set. An accredited music therapist led …

The Impact Of Blood Pressure Dipping Status On Cognition, Mobility And Cardiovascular Health In Older Adults Following An Exercise Program, Narlon Cassio Boa Sorte Silva, Michael A. Greagory, Dawn P. Gill, Cheri L. Mcgowan, Robert Petrella

Lifestyle Research Team

Objectives: To determine whether a dual-task gait and aerobic exercise intervention differentially impacted older adults with normal blood pressure (BP) dipping status (dippers) compared to those with nondipping status (nondippers).

Methods: This study was a secondary analysis involving participants (mean age = 70.3 years, 61% women) who attended a laboratory-based exercise intervention over a 6-month period (40 min/day and 3 days/week). Participants were assessed in measures of cognition, mobility, and cardiovascular health at baseline, 3, 6, and 12 months (after a 6-month no-contact follow-up).

Results: We observed improvements in cognition in both groups at 6 and 12 months, although no …

Descriptive Report Of The Impact Of Fatigue And Current Management Strategies In Cerebral Palsy., Laura K Brunton

Physical Therapy Publications

Purpose: Describe the impact of fatigue and self-management practices for adolescents and young adults with cerebral palsy (CP).

Methods: Survey of 124 people with CP with the Fatigue Impact and Severity Self-Assessment (FISSA).

Results: People in GMFCS Level I experienced little impact of fatigue with high proportions of this group disagreeing to statements about fatigue impacting their general activities, mobility and social activities. People in GMFCS Levels II-V reported impact of fatigue on activities. Differences between groups were evident in questions related to fatigue interference with length of time for physical activity and with motivations to participate in social …

Application Of The Mckenzie System Of Mechanical Diagnosis And Therapy In Patients With Shoulder Disorders, Afshin Heidar Abady

Electronic Thesis and Dissertation Repository

Shoulder pain is one of the leading causes of referrals to physiotherapy clinics. The annual prevalence of shoulder complaints is about 100 to 160 per 1000 patients in general population. Complexity of shoulder joint, and lack of uniformity of diagnostic labeling commonly used in clinical practice, makes it difficult to make a precise diagnosis. In addition, issues with reliability and validity exist for the shoulder Orthopedic Special Tests (OSTs), making accurate diagnoses challenging.

The primary aim of this thesis was to investigate usefulness of the McKenzie system of Mechanical Diagnosis and Therapy (MDT) in classifying and treating patients with shoulder …

Lived Experience And Process Of Engagement In Physical Exercise For Older Adults With Chronic Back Pain, Melissa E. Hay

Electronic Thesis and Dissertation Repository

For older adults, physical exercise is especially important in maintaining functional independence, extending quality of life, and optimizing personal health resources. For patients with chronic pain conditions, exercise participation can significantly improve patient-reported symptoms. Older adults are the most sedentary age group with the majority not meeting the recommended duration and intensity of weekly exercise. Although nonadherence with exercise guidelines may result for a variety of reasons, adverse health conditions including chronic pain are likely of particular concern for older adults. The aim of this research, consisting of two studies employing interpretive phenomenology and constructivist grounded theory, was to understand …

Mathematical Abilities In Children With Developmental Language Disorder, Alexandra M. Cross, Lisa M.D. Archibald, Marc F. Joanisse

Health and Rehabilitation Sciences Publications

Purpose. The present paper provides a scoping review of the literature on mathematical abilities in developmental language disorder (DLD). Children with DLD typically struggle with learning in school, however the mechanism by which DLD impacts academic success is unclear. Mathematics involves demands in the multiple domains, and therefore holds potential for examining the relationship between language and academic performance on tasks mediated by verbal and non-verbal demands.

Methods. A scoping review was performed via computerized database searching to examine literature on mathematics and DLD. The 21 papers meeting inclusion criteria compared children with typical development or DLD on various tasks …

Interrelationships Of Functional Status And Health Conditions In Children With Cerebral Palsy: A Descriptive Study., Doreen Bartlett, Emily Dyszuk, Barbara Galuppi, Jan Willem Gorter

Physical Therapy Publications

PURPOSE: To examine the relationship among the Gross Motor Function Classification System (GMFCS), the Manual Ability Classification System (MACS), and the Communication Function Classification System (CFCS) in children with cerebral palsy (CP) and to determine the average number and effect of health conditions.

METHODS: Participants were 671 children with CP aged 2 to 12 years from Canada and the United States. Cross-tabulation of functional classifications and averages were computed for the number and impact of health conditions and comparisons among groups.

RESULTS: A total of 78 of the 125 possible classification combinations were recorded. Most frequent were GMFCS I, MACS …

Physical Rehabilitation Interventions In The Intensive Care Unit: A Scoping Review Of 117 Studies., Julie C Reid, Janelle Unger, Devin Mccaskell, Laura Childerhose, David J Zorko, Michelle E Kho

Physical Therapy Publications

BACKGROUND: Physical rehabilitation (PR) interventions in the intensive care unit (ICU) can improve patients' functional outcomes, yet systematic reviews identified discordant effects and poor reporting. We conducted a scoping review to determine the extent of ICU PR interventions and how they were reported and measured.

METHODS: We searched five databases from inception to December 2016 for prospective studies evaluating adult ICU PR interventions. Two independent reviewers screened titles, abstracts, and full texts for inclusion. We assessed completeness of reporting using the Consolidated Standards of Reporting Trials, Strengthening the Reporting of Observational Studies in Epidemiology, or Standards for Quality Improvement Reporting …

Understanding Parkinson’S Through Visual Narratives: “I’M Not Mrs. Parkinson’S”, S. G. Lutz, Jeffrey D. Holmes, D. Rudman, A. M. Johnson, K. Ladonna, M. E. Jenkins

Occupational Therapy Publications

Although it is accepted that individuals with Parkinson’s disease (PD) must navigate challenges such as receiving their diagnosis, and changing daily occupations, little is known about how they navigate. The purpose of this study is to deepen the current understanding of the experience of living with PD and its implications for occupation through a narrative visual methodology (photo-elicitation). Methods: Six individuals with PD were asked to take photographs and share verbal narrative accounts to illustrate their experience of living with PD. Findings: Results highlight the interrelationship between occupation and identity, as many of the participants stories were interpreted as foregrounding …