Mitigating Risk Factors For Disease Progression In Patients With Varus Gonarthrosis, Angelo Boulougouris

Electronic Thesis and Dissertation Repository

Knee osteoarthritis (OA) is a leading cause of disability worldwide. Its growing burden is related to an aging population, obesity and physical inactivity. The progression of knee OA involves both biomechanical and systemic mechanisms. Known risk factors that might be altered through interventions include lower limb alignment, the distribution of loads across the knee during walking, body composition and muscular strength. The overall purpose of this thesis was to evaluate the effects of multi-modal, rehabilitative and surgical interventions that target different risk factors for disease progression in patients with medial compartment knee OA and varus mal-alignment (varus gonarthrosis). The thesis …

A Pilot Study To Investigate Concerns In Patients Undergoing Neck Dissection Surgery, Daniel Sundar Raj Arulananda Doss

Electronic Thesis and Dissertation Repository

Abstract:

This study investigates concerns in patients undergoing neck dissection surgery. Forty patients were recruited at Pre-surgery, Discharge and 1-month Post-surgery. The Patient Concerns Inventory - Level of Importance questionnaire (PCI-LOI), Shoulder Pain and Disability Index (SPADI), Neck Dissection Impairment Index (NDII) and the University of Washington - Quality of Life questionnaire (UWQOL) were used.

The study identified "Anxiety" at Pre-surgery and "Appearance" at Discharge and 1-month Post-surgery as the important patient concerns. Patients’ concerns were found to change over time. Support for cross-sectional convergent validity of the PCI-LOI was evidenced by significant correlations between the PCI-LOI and the UWQOL …

Examining The Shift In Occupational Identity After A Brain Injury, Mikelle Bryson-Campbell

Electronic Thesis and Dissertation Repository

Occupational identity is defined by Kielhofner (2002) as a sense of who we are as an occupational being, based on our past, current, and future occupational roles. When a life disruption occurs such as a brain injury (BI) and the disruption impacts the ability to conduct an occupation deemed meaningful an important process of transition occurs (Muenchberger, Kendall, & Neal, 2008). In turn occupational identity may shift to reflect the current health and economic status of the individual and what occupations are judged as meaningful.

The current study examined the shift in occupational identity in BI survivors in a two …

Interprofessional Socialization And Dual Identity Development Amongst Cross-Disciplinary Students, Hossein Khalili

Electronic Thesis and Dissertation Repository

The purpose of this study was to develop and test an interprofessional socialization (IPS) framework through assessing the impact of an IPS-based interprofessional education program on interprofessional socialization and dual identity development among health professional students. Although health professional educational programs have been successful in equipping graduates with skills, knowledge and professionalism, the emphasis on specialization and profession-specific education has enhanced the development of a uniprofessional identity, which has been found to be a major barrier towards Interprofessional Person-Centered Collaborative Practice (IPCPCP). Despite the growing acknowledgment of IPS in the current IPE and collaborative practice literature, there is a lack …

Short Term Sensory And Vascular Responses To Physical Agent Modalities And Exercise In Healthy Volunteers And Patients With Distal Radius Fracture., Shaguftha Shaik

Electronic Thesis and Dissertation Repository

Currently, there is weak evidence on the effectiveness of different rehabilitation regimens following distal radius fracture (DRF). This thesis evaluated sensory and vascular effects of exercise, thermal and ultrasound interventions that can be used in the mobilization phase (cast removal) after DRF.

Methods

• This thesis includes 3 studies. The first study compared responses to Immersion in Cold water Evaluation (ICE) in the DRF and uninjured hands. Skin blood flow (Sbf), skin temperature (temp.) and sensory perception thresholds (sPT) at 2000Hz for A –beta fibres and at 5 Hz for C fibres were obtained before, immediately after ICE and 10 min …

Effect Of Fluid Loss Following Hemodialysis On Tibialis Anterior Muscle Strength In People With End-Stage Renal Disease, Anuradha Sawant

Electronic Thesis and Dissertation Repository

ABSTRACT

PURPOSE: The purpose of this study was to evaluate the effect of fluid loss following hemodialysis (HD) on tibialis anterior (TA) strength in participants with end-stage renal disease. Issues concerning measures of skeletal muscle hydration and efficacy of exercise as an anabolic intervention were also addressed.

METHODS: Data from published literature were combined in a meta-analysis to establish efficacy of exercise in participants on HD. Three clinical studies were undertaken using data acquired from healthy volunteers and participants on HD. Hydration of the calf muscles was estimated using bioelectrical impedance spectroscopy (BIS) [extracellular (ECF) and intracellular (ICF) fluid] …

A Randomized Controlled Trial Comparing Arthroscopic Surgery To Conservative Management Of Femoroacetabular Impingement, Heather C. Klaus

Electronic Thesis and Dissertation Repository

OBJECTIVE: To determine whether patients with femoroacetabular impingement (FAI) who undergo arthroscopic hip surgery experience similar outcomes at two years post-operative with respect to physical function, pain, and health related quality of life, compared to similar patients who receive conservative management, including medication and physiotherapy. This thesis is an interim analysis of ten participants who are six-months post-randomization. METHODS: Participants were randomized to either operative treatment (6) or conservative treatment (4), and completed general and region specific quality of life questionnaires, including the Hip Outcome Score (HOS), Lower Extremity Functional Scale (LEFS), Modified Harris Hip Score (MHHS), Non-Arthritic Hip Score …

Prognosis And Movement Patterns In Patients After Rotator Cuff Repair, Jayaprakash Raman

Electronic Thesis and Dissertation Repository

Rotator cuff repairs are done in patients who failed to achieve functional improvement with conservative management for rotator cuff tears. This thesis focuses on prognostic factors that predict outcomes after rotator cuff repair (RCR) and change in functional range of motion (ROM) and muscle endurance before and after RCR. A meta-analysis was performed to statistically analyze all available evidence in the literature concerning prognostic factors that determine outcome after RCR. Based on this study, several factors were identified that had significant and moderate effects on outcomes after RCR. Two prospective studies were conducted to analyze change in functional ROM and …

A Model To Reduce The Proportion Of Inappropriate Referrals To Surgery For Patients With Osteoarthritis: A Pilot Study, Laura K. Churchill

Electronic Thesis and Dissertation Repository

A significant proportion of patients referred for total knee arthroplasty are inappropriate candidates for surgery, which warrants remediation of the referral process to reduce wait times for the initial consult. We conducted a prospective feasibility investigation involving 166 patients referred from their general practitioner for a consultation with an orthopaedic surgeon at a joint replacement clinic. The aim of this study was to improve the validity of data collection forms and to improve the feasibility of collecting data in a clinical setting. We also wanted to strengthen our estimate of the sample size to inform the timeline. We were able …

Investigating Immersive Augmented Reality As A Rehabilitation Tool For Parkinson Disease, Danielle M. Bell Boucher

Electronic Thesis and Dissertation Repository

Physical rehabilitation programs are often prescribed in an effort to maintain range of motion, and to adapt strategies for managing the debilitating symptoms of Parkinson disease (PD) in everyday life. An emerging trend to overcome the limitations of traditional rehabilitation is the use of virtual reality technologies. IThe goal of the present study was to determine the feasibility of augmented reality technology (IAR) in a rehabilitative setting. Three IAR environments were designed and a corresponding task was completed in each one. Not surprisingly, the control group generally performed better than the PD group on the tasks. All participants typically performed …

Complex Shoulder Instability: The Role Of The Latarjet Coracoid Transfer, Ryan Degen

Electronic Thesis and Dissertation Repository

Recurrent anterior shoulder instability is a common clinical entity often requiring surgical stabilization. Recurrence rates following soft-tissue stabilization procedures are moderately high and have been attributed to associated bony defects of either the glenoid or humeral head. Complex shoulder instability, defined as instability associated with bony defects around the shoulder, is a challenging clinical problem. The Latarjet coracoid transfer has been proposed as a treatment option and its resultant stabilizing effects have been explored in this biomechanical cadaver-based study.

For both glenoid and humeral head defects, the Latarjet coracoid transfer adequately stabilized the shoulder, outperforming other procedures often utilized for …

The Effects Of Virtual Rehabilitation Following Acquired Brain Injury: A Feasibility Study, Taylor L. Randall

Electronic Thesis and Dissertation Repository

Increasingly the Nintendo Wii has been cited as an adjunctive tool for physical rehabilitation among healthy young and older adults, and among diverse range of patient populations (e.g., Parkinson’s disease, Cerebral Palsy, and Down syndrome) in clinical settings. However, evidence supporting the implementation of Wii-habilitation in community settings remains limited. The present study evaluates the feasibility of a 4-week community based exercise program using the Nintendo Wii™; as a tool for improving balance in individuals with Acquired Brain Injury (ABI) several years post injury. This study also evaluates whether use of the Wii™ in this context may lead to clinically …

Short Term Treatment Effectiveness And Long Term Prognosis In Patients With Lateral Epicondylosis/Tennis Elbow, Pritika Gogia

Electronic Thesis and Dissertation Repository

This thesis investigated the short term and long term outcomes of patients who underwent treatment for lateral epicondylosis (LE). The first manuscript compared the immediate effects of counterforce brace versus kinesiotaping on pain free grip during a repetitive upper extremity reaching task in thirty patients (n=30) with LE. The study found kinesiotape to be superior over bracing as it not only improved immediate pain free grip strength by 17.5% but also maintained this during activity as compared to brace which had a smaller improvement of 9.3%. The second manuscript determined the extent of work disability/limitations experienced by patients (n=32) following …

Describing The Falls Prevention Program At An Acute Care Hospital In Ontario Using Leveson’S Systems Model, Mahboubeh Mehrjoo

Electronic Thesis and Dissertation Repository

Falls are the most frequent adverse event in acute care hospitals. Although a large number of studies have addressed the patients’ risk factors for falls and best practices in fall prevention, patients falls still remain a major problem. This study applied a systemic methodology (Causal Analysis based on STAMP (CAST)) to depict Ontario’s acute care hospital structure related to patient fall prevention. The system’s component behaviours and interactions were described and deficits and inappropriate control mechanisms among the system’s controllers were identified. As a result of the CAST analysis, the complexity of the health care system, lack of a consistent …

Gait Retraining In Parkinson’S Disease: A Cognitive Cueing Approach, Stephanie J. Morrison

Electronic Thesis and Dissertation Repository

Parkinson’s disease (PD) is characterized by resting tremor, bradykinesia, rigidity, and postural instability. These cardinal symptoms commonly affect gait performance and therefore researchers have been investigating techniques to manage and treat gait impairment in individuals with PD. This thesis explores a progressive approach to gait rehabilitation using a novel intervention that combines traditional gait cueing techniques with motor learning approaches to facilitate self-cued gait improvement. Five participants with PD-related gait impairment completed the home-based gait training intervention. This intervention included video footage of each individual participant walking with and without verbal instructional cues, audio coaching, and practice periods. Participants were …

Relationships Amongst Osteoarthritis Biomarkers, Dynamic Knee Joint Load, And Exercise: Results From A Randomized Controlled Pilot Study, Michael A. Hunt, Courtney L. Pollock, Virginia Byers Kraus, Tore Saxne, Sue Peters, Janet L. Huebner, Eric C. Sayre, Jolanda Cibere

Physical Therapy Publications

Background

Little is known about the relationships of circulating levels of biomarkers of cartilage degradation with biomechanical outcomes relevant to knee osteoarthritis (OA) or biomarker changes following non-pharmacological interventions. The objectives of this exploratory, pilot study were to: 1) examine relationships between biomarkers of articular cartilage degradation and synthesis with measures of knee joint load during walking, and 2) examine changes in these biomarkers following 10 weeks of strengthening exercises.

Methods

Seventeen (8 male, 9 female; 66.1 +/- 11.3 years of age) individuals with radiographically-confirmed medial tibiofemoral OA participated. All participants underwent a baseline testing session where serum and urine …

Hospital-Based Nurse Practitioner Practice: An Exploration Of Interprofessional Teams., Christina J. Hurlock-Chorostecki

Electronic Thesis and Dissertation Repository

Nurse practitioner (NP) roles within hospital teams are evolving worldwide. However, understanding of their practice within the context of interprofessional (IP) teamwork remains limited. This two-phase study undertaken within Ontario, Canada provides a new multi-perspective understanding of the value of NP practice within IP hospital teams. Constructivist grounded theory, a modification of the classic methodology, guided an interpretive approach based in exploration of process and meaning construction, privilege and power exposure, and juxtaposition with extant theory. A conceptual rendering of NP practice was determined through supplemental analysis of 30 team member focus groups. This new perspective emerged as three practice …

University Campus Accessibility Measure, Lea E. Klinger

Occupational Therapy Publications

No abstract provided.

"Any Movement At All Is Exercise": A Focused Ethnography Of Rural Community-Dwelling Older Adults' Perceptions And Experiences Of Exercise As Self-Care, Laura J. Graham, Denise M Connelly

Physical Therapy Publications

PURPOSE: To understand rural community-dwelling older adult participants' shared values, beliefs, and behaviours related to exercise as self-care.

METHODS: We conducted a constructivist-focused ethnography involving semi-structured interviews and participant observation with 17 individuals 65 years and older. Interviews were transcribed and inductively coded to develop themes related to exercise, self-care, and exercise as self-care. Field notes were triangulated with follow-up interviews and dialogue between authors to enhance interpretation.

RESULTS: Participants described exercise broadly as movement and not as a central self-care behaviour. However, awareness of the importance and health-related benefits of exercise increased after a significant personal health-related event. Participants …

Physical Accessibility Measure For Schools, Lea E. Klinger

Occupational Therapy Publications

No abstract provided.