Medicine and Health Sciences Commons^™

Assessment Of Landing Biomechanics And Rehabilitation After Anterior Cruciate Ligament Reconstruction, Sheila S. Gagnon

Electronic Thesis and Dissertation Repository

Aberrant landing biomechanics increase the risk of anterior cruciate ligament (ACL) injury and are a focus of rehabilitation after ACL reconstruction. The purpose of the present thesis was to develop and evaluate methods of assessing landing mechanics and investigate the effects of different rehabilitation strategies after ACL reconstruction. Three studies were conducted. The first study used a Delphi process to develop the content of a Clinician-Rated Drop Vertical Jump Scale to evaluate jump landing mechanics during rehabilitation after ACL reconstruction. Twenty experts participated in four rounds of questioning, resulting in 92% agreement for knee valgus collapse, lateral trunk lean, insufficient …

Impact Of Graded Passive Cycling On Hemodynamics, Cerebral Blood Flow, And Heart Function In Healthy Adults And Septic Icu Patients, Jennifer Chen

Electronic Thesis and Dissertation Repository

Sepsis is a life-threatening dysregulation of host response to an infectious insult, which often leads to multi-organ failure. Sepsis survivors suffer from post-intensive care syndrome in part due to their prolonged bed rest and lack of mobility. Although early mobilization has been championed as a mechanism to counter the adverse effects associated with ICU immobility, due to sedation and mechanical ventilation, active early mobilization is not often administered in septic patients due to worries of hemodynamic instability and potential for inducing adverse events. Passive exercise is a mobilization modality that circumvents the need for patients to be conscious and participatory …

Cardiovascular Effects Of Exercise And Use Of Abdominal Binder In Patients Of Parkinson’S Disease With Orthostatic Hypotension, Faizan Ahmed

Electronic Thesis and Dissertation Repository

Orthostatic hypotension (OH) is a common manifestation of autonomic dysfunction in Parkinson’s Disease. It can adversely affect a patient’s functional capacity, exercise tolerance and quality of life, while increasing the risk of falls, cerebrovascular disease and overall mortality. Use of an abdominal binder (AB) can help counter OH; however, this has not been sufficiently studied in patients with Parkinson’s Disease (PwPD). Moreover, the hemodynamic effects of upper and lower extremity exercise are unclear in PwPD with OH. Although OH can impair the cerebral circulation, the consequences on the cerebral hemodynamics of wearing an AB or performing exercise are unknown in …

Joint Protection Programs For People With Hand Arthritis, Pavlos Bobos

Electronic Thesis and Dissertation Repository

The fact that Joint Protection Programs (JPP) can reduce pain and improve function is based on small, but definitive Randomized Controlled Trials (RCTs), conducted in the 1980s. However, changes over time in the nature of hand use, the rapid expansion of technology, and improvements in our understanding of health literacy mean that these programs are now outdated. Further, problems with adherence to JPP are well documented. The purpose of this thesis was 1) to conduct a scoping review to map all the available evidence around joint protection programs in published and unpublished studies 2) to evaluate the effectiveness of joint …

Exploring The Effects Of The Cycling Without Age Program On Older Adults Living In Long-Term Care, Victoria Cotnam

Electronic Thesis and Dissertation Repository

The Cycling Without Age program, offered in long-term care homes around the world, allows residents to experience the feeling of a bike ride in the trishaw as a volunteer pedals the electrical bike. The purpose of this pragmatic observational study was to measure the effects of an existing program in a Canadian long-term care home on residents’ happiness, quality of life, pain and functional status (using Resident-Assessment Instrument Minimum Data Set 2.0). A convenience sample of 39 residents participated in two groups, a biking group (n=23) and a strolls group (n=16) over the period of 12 weeks. Findings show that …

Navigating The “Blind World”: The Psychosocial And Occupational Experiences Of Parents Of Adolescents With Visual Impairments, Peiwen Cao

Electronic Thesis and Dissertation Repository

Using a constructivist narrative inquiry approach, this research study sought to explore how parents of adolescents with visual impairments story their psychosocial and occupational experiences. Participants of the study consisted of four parents who were currently raising adolescents with visual impairments between the ages of 14 to 17. Participants took part in two in-depth narrative interviews, in which they answered several open-ended questions about their experiences of raising their adolescent children who were visually impaired. Participants also participated in a brief concluding interview session, in which they provided feedback on the narrative that I constructed based on their interview responses. …

Clinical Predictors Of Driving Simulator Performance In Drivers With Multiple Sclerosis, Sarah Krasniuk

Electronic Thesis and Dissertation Repository

Drivers with Multiple Sclerosis (MS) experience visual-cognitive impairment that may impact their fitness to drive. Fitness to drive is the ability to control a motor vehicle, as determined via a comprehensive driving evaluation, with in-clinic and on-road driving assessments. However, the on-road driving assessment may pose a crash risk to medically at-risk drivers. Instead, a driving simulator assessment that targets the driving performance deficits of drivers may inform fitness to drive decisions. However, utilizing clinical tests to indicate driving simulator performance in drivers with MS is not fully understood.

Through three aims, this dissertation will examine the clinical utility of …

Intimate Partner Violence (Ipv): Clinical And Societal Perspectives, Marudan Sivagurunathan

Electronic Thesis and Dissertation Repository

Intimate Partner Violence (IPV) can have a lasting impact on survivors’ emotional, physical, and psychological wellbeing. IPV is multifaceted and can influence survivors’ interactions across various institutions, including healthcare settings. This PhD project consists of both qualitative and quantitative studies aimed at exploring the clinical and societal perspectives around IPV.

Study #1 sought to explore the discourses around male IPV drawn from a social networking site (Reddit.com). While some areas related to IPV are well researched, studies on male intimate partner violence survivors are limited. The results from study #1 show that male IPV disclosure is a complex process. While …

The Experiences Of Female Adolescents Who Have Sustained A Concussion Through Sport Participation: A Consideration Of An Occupational Perspective During Recovery, Annalise Michelle Tichenoff

Electronic Thesis and Dissertation Repository

Adolescence is a time of rapid and tumultuous development in the physical, cognitive and psychosocial domains. Sustaining a concussion during this time period may complicate this development, particularly when symptoms are prolonged. Of particular importance is the study of adolescent females, as this population has been under-evaluated within the literature. This is especially troubling due to the number of concussions that occur among adolescent females, as concussions within this population reportedly occur at twice the frequency of adolescent males. This dissertation presents a qualitative case study investigation that explores the recovery experiences of adolescent female athletes who have sustained a …

Communicative Participation Outcomes Of Preschool Speech-Language Services: Opportunities, Challenges, And Solutions, Elaine Yuen Ling Kwok

Electronic Thesis and Dissertation Repository

It has been estimated that speech and language disorders impact as many as 15-22% of preschoolers. In Ontario, Canada, families who are concerned about their children’s speech, language, or communication skills can access publicly funded services through Ontario’s Preschool Speech and Language Program. In this program, speech-language pathologists provide assessments and early interventions to improve children’s communication skills and lessen the negative effect of communication delays on development. Since 2012, the Program mandated the use of an outcome measure, the Focus on the Outcomes of Communication Under Six® (FOCUS), but there has been inconsistent uptake among speech-language pathologists. Using a …

Therapeutic Interventions For Managing Diabetic Shoulder, Sanaa A. Alsubheen

Electronic Thesis and Dissertation Repository

Shoulder pain is a common complaint of diabetic patients that causes motion limitations and functional disability. Adhesive capsulitis (AC) is the most common disabling shoulder disorder. There is no optimal non-surgical treatment for managing AC in diabetic patients. Furthermore, the impact of diabetes on shoulder recovery and factors predicting shoulder function following shoulder arthroplasty is not well investigated.

Purpose and Methods

The main purpose of this thesis was to inform clinical practice about the best intervention for managing AC in diabetic patients, and to assess the impact of diabetes on functional outcomes after shoulder arthroplasty, with the following objectives: 1) …

The Symbiome Project: An Exploratory Investigation Of The Biological, Psychological, And Social Mechanisms That Contribute To The Transition From Acute To Chronic Musculoskeletal Pain, Joshua Y. Lee

Electronic Thesis and Dissertation Repository

This dissertation presents the initial findings of the SYMBIOME project; which attempts to combine the objective and subjective aspects of musculoskeletal pain to develop a prognostic clinical phenotype. Chapter 2 presents a moderator analysis of functional outcomes (pain interference and pain severity). Psychosocial moderators can affect the relationship between biomarkers and pain. For pain severity, TNF-α, TGF-β1, and CRP were moderated by employment status, pre-existing psychopathology, and sex. For pain interference, IL-1β, cortisol, TGF-β1, CRP, and IL-6 were moderated by pre-existing pain, peri-traumatic fear, region of injury, and peri-traumatic stress. Chapter 3 presents a latent growth curve analysis in determining …

Assessment Of Intrinsic Hand Neuromuscular Physiology, Philemon Tsang

Electronic Thesis and Dissertation Repository

Alterations to the peripheral nervous system and neuromuscular physiology may impact hand function in a typical or clinical population, such as individuals with ulnar neuropathy. The mechanisms that influence these positive and negative changes are still not well understood. The three studies within my thesis aim to validate the reliability of decomposition-based quantitative electromyography (DQEMG) measurements and explore the changes in intrinsic hand neuromuscular physiology in a typical aging population and individuals recovering from a surgical intervention for severe ulnar neuropathy.

The purpose of the first study was to determine the test-retest reliability of near-fibre (NF) jiggle, a measure of …

Exploring Gender Equity Through Occupation: A Critical Decolonizing Ethnography In Tanzania, Stephanie Huff

Electronic Thesis and Dissertation Repository

Within the discipline of occupational science, scholars of increasingly diverse geographical spaces have highlighted the necessity of diversity and epistemological expansion to enact transformative scholarship. In response, this dissertation enacted a critical decolonizing ethnographic project with 5 women from Tanzania to explore their experiences of gender inequities.

This thesis is composed of four integrated manuscripts, as well as introduction and conclusion chapters. Manuscript two examines past perspectives and approaches to research which examined gender equity and inequity in Tanzania, illuminating gaps and recommendations for future gendered research in Tanzania. Manuscript three presents an argument for the uptake of Africana Womanism …