Medicine and Health Sciences Commons^™

The Relationship Of Plantar Sensation With Standing Balance And Gait Post-Stroke, Stephen Parsons

Electronic Thesis and Dissertation Repository

Gait and balance dysfunction after stroke limit independence and quality of life. Numerous contributing factors have been investigated but the role of sensation deficits has received little attention. This thesis investigated the relationship between plantar cutaneous sensation and 1) standing balance, 2) gait, and 3) use of vision to compensate for sensory loss with a secondary analysis of data from individuals with subacute stroke. Associations between standing balance, gait and sensation were investigated with Spearman correlations. Individuals classified as impaired or intact sensation were compared on gait and standing balance measures. This thesis found plantar sensation is related to standing …

Psychometric Evaluation Of Self-Report Pain And Disability Measures For Elbow Disorders, Joshua Vincent

Electronic Thesis and Dissertation Repository

Elbow disorders are one of the commonest musculoskeletal problems with a prevalence of 9% in men and 8.1% in women. Patient centered care is the goal of current healthcare delivery models; but optimizing treatment outcome and clinical research is hampered by a lack of outcome measures. Since pain and disability resulting from elbow disorders are experienced differently across individuals, they are best captured by patient reported outcome measures (PROM).

PROMs like the Patient-rated Elbow Evaluation (PREE); American Shoulder and Elbow surgeons – Elbow form (pASES-e) have been developed for use in elbow disorders, but important questions remain about their measurement …

Investigation Of Sox9 Ablation On Neuroplasticity And Recovery After Ischemic Stroke, Bethany Robin Lenore Bass

Electronic Thesis and Dissertation Repository

Neuroplasticity is a key factor in post-stroke functional recovery. A chief inhibitor of post-stroke neuroplasticity is the expression of chondroitin sulfate proteoglycans (CSPGs). Recent research has shown that the transcription factor SOX9 is responsible for upregulating the expression of CSPGs in the injured central nervous system. Accordingly, CSPG levels are significantly lower in mice with the Sox9 gene conditionally knocked out. The purpose of this study was to determine how Sox9 ablation affects neuroplasticity and recovery after stroke. Behavioural test results revealed that Sox9 KO mice exhibited significantly improved functional recovery after stroke compared to controls. This correlated with increased …

Characterizing Spoken Discourse In Individuals With Parkinson Disease Without Dementia, Angela C. Roberts

Electronic Thesis and Dissertation Repository

Background: The effects of disease (PD) on cognition, word retrieval, syntax, and speech/voice processes may interact to manifest uniquely in spoken language tasks. A handful of studies have explored spoken discourse production in PD and, while not ubiquitously, have reported a number of impairments including: reduced words per minute, reduced grammatical complexity, reduced informativeness, and increased verbal disruption. Methodological differences have impeded cross-study comparisons. As such, the profile of spoken language impairments in PD remains ambiguous.

Method: A cross-genre, multi-level discourse analysis, prospective, cross-sectional between groups study design was conducted with 19 PD participants (M_age = 70.74, M …

The Waiting Game: A Primary Care Intervention To Improve Access To Specialist Care To Patients With Osteoarthritis, Laura K. Churchill, Dianne Bryant

Health and Rehabilitation Sciences Publications

Osteoarthritis (OA) commonly presents in the knee, contributing to pain and impairment in those affected. Given appropriate candidacy, surgical treatment for end-stage knee OA such as total knee replacement (TKR) and high tibial osteotomy (HTO) are highly successful with negligible risk. Just as the population has aged over the past decade, so too has the demand for surgical treatment of OA increasing wait times across Canada. Cipriano et al. identified that wait times for TKR in Ontario are longer than clinically appropriate. Several North American studies have demonstrated that general practitioner referrals to specialists do not result in subsequent surgery. …

Measuring Fatigue In Adolescents And Young Adults With Cerebral Palsy, Laura K. Brunton

Electronic Thesis and Dissertation Repository

Fatigue is a significant issue and has been estimated to affect between 30-50% of individuals with cerebral palsy (CP) in various studies; however, there is no validated measure of fatigue for this population. A systematic review revealed no one single measure with adequate psychometric properties for use with individuals with CP. As a result a new tool was created: the Fatigue Impact and Severity Self-Assessment (FISSA). Interviews were conducted with youth and young adults with CP to understand the bodily experience of living with CP and as a client-centered approach to item creation for the FISSA. Focus groups with healthcare …

Reflective Practice And Professional Knowledge: A Grounded Theory Study Of Speech-Language Pathologists Working In Head And Neck Cancer Rehabilitation, Marie-Eve Caty

Electronic Thesis and Dissertation Repository

Reflective practice is defined in this dissertation as a process of thinking 'about' and 'through' one's doings, such that practitioners become more skillful, and aware of the nature and impact of their performance within their professional practices. Because it is presumed to enable healthcare delivery practices that are more sensitive to patient needs and more in-line with evidence- based practices, RP is frequently noted as an essential attribute of competent clinical practice. Yet, little is known about the processes by which RP contributes to the professional learning of health-care practitioners in general, and Speech- Language Pathologists (SLPs) in particular.

This …

The Role Of Rotator Interval Closure In Bankart Lesion Repair, Lauren L. Rainsford

Electronic Thesis and Dissertation Repository

Twenty-nine patients who had sustained an anterior shoulder dislocation were randomly assigned to receive Bankart lesion repair, or Bankart lesion repair with rotator interval closure. External rotation range of motion with 90° of abduction external rotation range of motion with no abduction, and forward flexion range of motion were measured preoperatively, and at three and six months postoperatively. Quality of life, function, and pain were measured preoperatively, and at three, six, 12 and 24 weeks postoperatively. We found no significant differences between groups for any outcome but the confidence intervals were wide and definitive conclusions could not be made. This …

Resting State Functional Magnetic Resonance And Diffusion Tensor Imaging Of Hemiplegic Cerebral Palsy Patients Treated With Constraint-Induced Movement Therapy: Predictors And Clinically Correlated Evidence Of Neuroplasticity, Kathryn Y. Manning

Electronic Thesis and Dissertation Repository

Hemiplegic cerebral palsy is characterized by unilateral upper limb impairment and patients often compensate by performing most tasks with their unaffected arm. Constraint-induced movement therapy (CIMT) directly combats this learned non-use by casting the unaffected arm and forcing the patient to repetitively practice skills with the hemiplegic limb. Subjects with hemiplegic cerebral palsy were recruited from Holland Bloorview Kids Rehabilitation Hospital, Thames Valley Children’s Centre and McMaster Children’s Hospital. MRI acquisitions and clinical evaluations were collected at baseline, 1 and 6-months later. The case group participated in a CIMT camp after baseline evaluations and was compared to an untreated control …

Community Physiotherapy And Chronic Disease Self-Management For Rural Community-Dwelling Older Adults, Laura J. Graham

Electronic Thesis and Dissertation Repository

Research problem: The majority of older Canadians live with at least one chronic disease. Exercise has been shown to be an effective means to reducing symptoms, and to improving physical dysfunction in chronically ill populations; and self-management is a nationally advocated approach to dealing with the growing health care issue of chronic disease. Physiotherapists are experts in prescribing therapeutic exercise and promoting chronic disease self-management.

Methods: This two-study dissertation explored older adults’ perceptions of exercise as a self-care activity within a chronic disease self-management strategy using focused ethnography; and physiotherapists’ experiences in promoting exercise as a means to chronic disease …

Short-Term Sensory And Cutaneous Vascular Responses To Therapeutic Ultrasound In The Forearms Of Healthy Volunteers, Shaguftha S. Shaik, Joy C. Macdermid, Trevor Birmingham, Ruby Grewal, Baseer Farooq

Bone and Joint Institute

© 2014 Shaik et al. Background: Therapeutic ultrasound (US) is used for a variety of clinical pathologies and is thought to accelerate tissue repair and help with pain reduction via its thermal and nonthermal effects. The evidence on physiological effects of US on both sensory and vascular functions in humans is incomplete. Hence, the purpose of this study was to determine the short-term impact of two doses of US (3 MHz, 1:4, 0.25 W/cm2, 5 min; 1 MHz, continuous, 0.8 W/cm2, 3 min), on sensory and vascular responses in the healthy forearms. Methods: Twenty healthy subjects were recruited (mean age, …