Rehabilitation and Therapy Commons^™

Association Of Fall-Related Injuries And Different Diagnoses In Older Adults Of Ontario: A Machine Learning Approach, Sorour Rostampour

Electronic Thesis and Dissertation Repository

Falls are the leading cause of injury-related hospitalizations among older adults in Canada. This study aimed to identify the most informative diagnostic categories associated with fall-related injuries (FRIs) using three machine learning algorithms: decision tree, random forest, and extreme gradient boosting tree (XGBoost). Secondary data from two Ontario health administrative databases (NACRS, DAD) covering the period 2006-2015 were analyzed. Older adults (aged ≥ 65 years) who sought treatment for FRIs in emergency departments (ED) or hospitals, as indicated by Canadian version of the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10-CA) codes for falls …

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 …

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

Electronic Thesis and Dissertation Repository

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 …

Reframing Childhood Disability: Pushing Boundaries In The Rehabilitation Sciences, Emily J. Cox

Electronic Thesis and Dissertation Repository

The purpose of this study was to critically examine the ways that dominant discourses surrounding childhood disability, as constructed in the neoliberal context, shape knowledge and practice in children’s rehabilitation. I carried out a critical discourse analysis of text within the rehabilitation sciences, including peer-reviewed research, websites, and qualitative interview transcripts. Drawing on disability studies scholarship as well as my Foucauldian conceptual framework, I called attention to complex interactions between discourse, power, and knowledge that shape thought and action in the rehabilitation sciences. My findings suggest that despite a growing recognition of the harms associated with deficit-based understandings of disability, …

The Genetics Of Pain: An Exploration Of Gene-By-Environment Interactions And Their Effects On Pain, Mohamad F. Fakhereddin

Electronic Thesis and Dissertation Repository

The findings presented in this dissertation are part of the bigger SYMBIOME project which aims to use the biopsychosocial model of pain to develop a prognostic clinical phenotype for people that experience musculoskeletal (MSK) trauma. Chapter 2 presents an exploratory analysis to assess the relationships between genetic polymorphisms and pain severity and interference. Early childhood trauma was also explored as a moderator between genetic polymorphisms and pain outcomes. For pain severity, major allele carriers (A/A and G/A) of FKBP5 rs9394314 reported significantly higher scores than minor allele carriers (G/G). Further, major allele carriers who had at least one adverse childhood …

Femoroacetabular Impingement Syndrome: Evaluating Postoperative Rehabilitation Progress And Return To Sport Readiness, Trevor A. Day

Electronic Thesis and Dissertation Repository

Femoroacetabular impingement syndrome (FAIS) is a common cause of non-arthritic hip pain and reduced physical activity in active young adults. It is defined as a motion-related disorder of the hip with a triad of symptoms, clinical signs, and imaging findings that represents symptomatic premature contact between the proximal femur and the acetabulum. There are two anatomical morphologies that can cause FAIS, cam, and pincer, and is a challenging clinical pathology. Patients typically undergo hip arthroscopy to repair damage to the joint and recess the bone causing the impingement. These procedures can result in positive outcomes for the patient, like reduced …

A Transformative Journey: The Lived Experience Of Healthcare Learners Participating In Pain Management Education, Zoe A. Leyland

Electronic Thesis and Dissertation Repository

There is little emphasis on pain management education for healthcare providers. In September 2019, the Master of Clinical Science (MClSc) program in Advanced Healthcare Practice at Western University in London, Ontario introduced a new, “Interprofessional Pain Management” (IPM) field. The program follows a competency-based framework, and the learners are all practicing healthcare providers with a special interest in pain. Part of the purpose of this thesis is to describe the process of development and implementation. The objective is to provide educators and healthcare providers an in-depth look at how the pain education is experienced. This includes exploring the lived experience …

Investigating Physiological Determinants Of Mental Health In Children With Cerebral Palsy, Daniela A. Testani

Electronic Thesis and Dissertation Repository

Background

Fifty-seven percent of children with cerebral palsy (CP) experience mental health symptoms including symptoms of anxiety and depression. Although CP is non progressive, secondary conditions can have progressive effects on an individuals’ functional abilities. Particularly, untreated mental health symptoms can negatively affect a child’s quality of life. Children with CP also experience fatigue, pain, poor physical activity, and sleep disturbances. The presence of these physiological symptoms, separate and in combination, may impact mental health; however, it has not been systematically examined. Identifying factors that contribute to mental health symptoms may prevent the maintenance of these issues into adulthood.

Objectives …

Collaborative Coaching In Pediatric Rehabilitation: An Effectiveness-Implementation Study Of The Applied Coaching Model, Zoe Daviault

Electronic Thesis and Dissertation Repository

Learner-centered models have become more prevalent within early childhood interventions. However, it is still unclear which components are being implemented in clinical practice and if therapists are receiving the proper training to implement these strategies (Ward et al., 2020). The primary objective of this study is to evaluate the implementation outcomes of appropriateness, adoption, acceptability, and fidelity of a novel coaching intervention, the Applied Coaching Model (ACM), and practice support tool, the Applied Coaching Tool (ACT). An effectiveness-implementation Hybrid Type 1 design was used to gather information on the ACM and ACT delivery and implementation at the Early Childhood Rehabilitation …

“I Am The Expert” : The Process Of Adolescent Transition In The Self-Management Of Hearing Healthcare. A Constructivist Grounded Theory Study, Christine N. Meston

Electronic Thesis and Dissertation Repository

Adolescence is a time when adult behaviours become established and adolescents are more able to manage aspects of their healthcare. Research has examined adolescent transitions to self-manage their personal healthcare needs associated with chronic diseases. Providing children and adolescents with information about their health is an ongoing process and, as they mature, they should be allowed to take on more responsibility for their healthcare management. The purpose of this study was to explore the transition for adolescents who are deaf and hard of hearing toward the self-management of their hearing healthcare. A constructivist grounded theory approach was used to develop …

Exploring The Mental Health Experiences Of African, Caribbean, And Black Youth In London, Ontario, Lily Yosieph

Electronic Thesis and Dissertation Repository

This qualitative study explores the mental health experiences of African, Caribbean, and Black (ACB) youth in London, Ontario, investigating how the factors of race, gender, culture, and place have shaped their perceptions and experiences of mental health. The data collection and analysis were conducted using a phenomenological approach and a critical lens informed by feminist, intersectionality, and critical race theories. These data illuminate the ways in which these young people’s attitudes toward mental health and help-seeking strategies are impacted by broader social constructs and community expectations, which they navigate and often resist in their everyday lives. Their insights can provide …

Predicting Dissatisfaction With Total Knee Arthroplasty, Joseph S. Munn

Electronic Thesis and Dissertation Repository

Total knee arthroplasty (TKA) is a common and effective treatment for end-stage osteoarthritis. However, approximately 20% of patients are consistently found to be dissatisfied or unsure of their satisfaction with their TKA at 1-year post-surgery. Two strategies for reducing dissatisfaction have appeared in the literature. The first aims to reduce the number of dissatisfied patients who will undergo surgery by identifying patients likely to be dissatisfied pre-surgery. The second aims to implement interventions that improve patient satisfaction by generating realistic expectations for outcomes and by association improving met expectations scores. It may be possible to improve the performance of these …

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 …

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 …

Psychometric Properties Of The Brief Pain Inventory-Short Form And Revised Short Mcgill Pain Questionnaire Version-2 In Musculoskeletal Conditions, Samuel Ugochukwu Jumbo

Electronic Thesis and Dissertation Repository

Introduction: Comprehensive pain assessment depends on the use of psychometrically valid patient-reported outcome measures (PROMs). The Brief Pain Inventory-Short Form (BPI-SF) and Revised Short McGill Pain Questionnaire Version-2 (SF-MPQ-2) are general-use multidimensional pain assessment tools commonly used in musculoskeletal conditions. Understanding all relevant measurement properties supports stronger decisions about PROMs.

Thesis Objectives: The overarching objective of this thesis was to determine the sufficiency of measurement evidence backing the use of the BPI-SF and SF-MPQ-2 in musculoskeletal conditions. Specifically, a systematic review was conducted to locate, summarize and compare the quality and content of psychometric evidence backing the BPI-SF and …

Self-Management As A Means To Achieving Client-Centred Care For The Care Partnership Living With Parkinson’S Disease, Danielle M. Hudson

Electronic Thesis and Dissertation Repository

Parkinson’s disease (PD) is a chronic condition that manifests through many changing symptoms over time. A person diagnosed with PD is typically supported by a spouse or other family member as their primary care partner, who experiences a host of biopsychosocial challenges associated with their care partner role. The best approach to supporting a care partnership, consisting of the person diagnosed with PD and the primary care partner, through their individualized journey with PD remains to be defined. The aim of this research was to identify clinical insights for providing client-centred care for both members of the PD care partnership. …

Relationship Between Exercise Training Adherence And Improvement In Functional Capacity Among Transient Ischemic Attack And Mild Non-Disabling Stroke Survivors In Cardiac Rehabilitation, Melissa Majoni

Electronic Thesis and Dissertation Repository

Introduction: Transient ischemic attack (TIA) is characterized by temporary neurological dysfunction and carries a short-term risk of stroke, hospitalization, and death. Cardiac rehabilitation and secondary prevention (CRSP) involving behavior change and exercise reduces morbidity and mortality among heart patients but is typically not offered after TIA, despite similarities in risk factors between coronary artery disease and stroke. Current stroke secondary prevention strategies are suboptimal.

Objectives: To quantify the relationship between exercise adherence and functional capacity at CRSP exit among exercise-trained TIA and mild non-disabling stroke (MNDS) patients and to determine if CRSP improves physical and psychological outcomes.

Methods: From 2004 …

Dance As A Protective Measure Against The Cognitive And Physical Declines Associated With Aging: A Proposed Study, Sarah M. Schwanz, Jeffrey Holmes, Jessica Grahn

Western Research Forum

Background:

Dance is considered a multimodal activity in that it requires both physical and cognitive engagement. Combining physical activity with music may have a synergistic effect, enabling dance to enhance physical and cognitive functions more than music and physical activity alone. The positive changes attributed to dance training such as improved visuospatial and motor ability, high coordination, greater balance, and increased cognitive ability may also benefit individuals as they age.

Methods:

This proposed study will examine whether dance training has the potential to protect against age-related cognitive and physical decline by assessing the cognitive and physical domains that show decline …

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 …

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 …

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 …

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 …

E-Visits For Early Post-Operative Visits Following Orthopaedic Surgery Can They Add Efficiency Without Sacrificing Effectiveness, William G. Jeffery

Electronic Thesis and Dissertation Repository

We asked 217 sport surgery and 135 total knee arthroplasty (TKA) patients to complete a questionnaire (e-Visit) before attending their two and six-week post-operative appointment. Our primary objective was to use the questions asked of patients prior to their appointment to develop a model that could be used as web-based e-Visit to predict early post-operative adverse events. Gold standard comparison was the surgeon’s opinion as to the presence or absence of an event at follow-up. Secondary objective was evaluation of a simplified model. We found good area under the curve (AUC) statistics (0.76 (95% CI 0.69 - 0.84) and 0.80 …

Assessing The Impact Of Caregiver Outcomes On Function And Reintegration Of Stroke Survivors Participating In A Community Stroke Rehabilitation Program., Spencer R. Thompson

Electronic Thesis and Dissertation Repository

There is a limited amount of literature evaluating the relationship between caregivers, and the stroke survivors’ function and reintegration. The objectives were to evaluate the association between caregivers’ lifestyle changes on function and the role of functioning as a moderator between caregiving and reintegration among stroke survivors receiving community-based rehabilitation. Data were collected from January 2011 to January 2016. A one-way repeated measures analysis of variance and multivariable linear regression were performed on Functional Independence Measure, Bakas Caregiving Outcomes Scale, Reintegration to Normal Living Index across admission, discharge, and follow-up. Mean age was 70.2±13.17 years with 58% males (n=200). A …

Links Between Physical And Mental Health: Assessment Of Therapeutic Riding’S Effect On Children With Special Needs, Sabah I. Hasan

Brescia Psychology Undergraduate Honours Theses

This observational study examined the effect of therapeutic riding (TR) on four domains, physical skills, positive values, social skills, and self-identity in children with special needs. Participants were recruited from SARI Therapeutic Riding and were divided, based on observation, into more or less severe diagnosis categories. It was predicted that children with less severe diagnosis would show more of an increase on the four domains, especially physical skills due to TR. Participants were observed using an observational checklist at pre- and post-riding lessons. Results showed non-significant differences in all four domains, however, there was a tendency for scores to increase …

Predicting Response To Medial Branch Blocks: A Clinical Decision Making Tool, Swati Mehta

Electronic Thesis and Dissertation Repository

Chronic neck pain can lead to long-term disability and socio-economic burden. Several demographic, clinical, and psychosocial factors have been implicated in the development of neck pain disability. These factors may also influence management of neck pain. Optimal treatment often requires targeting interventions based on specific diagnosis. One of the most common cause of neck pain is cervical facet joint injury. Currently, the gold standard for diagnosing facetogenic injury is through the medial branch block (MBB) procedure. Though the procedure is relatively safe, it is still invasive and may result in adverse effects. In Canada, access to this procedure is limited …

Fitness-To-Drive Screening Measure© : Constructing And Validating The Short Form, Shabnam Medhizadah

Electronic Thesis and Dissertation Repository

The valid and reliable Fitness-to-Drive Screening Measure^© (FTDS) is a free online proxy measure that screens for at-risk older drivers using 54 driving-related items. This secondary data analysis aims to construct and validate a short form FTDS, using 200 caregiver FTDS response sets and 200 older driver on-road assessment pass/fail outcomes. To construct the short form, exploratory factor analysis and classical test theory techniques were employed to determine the most interpretable factor model and the minimum number of items that might be used to predict fitness to drive. Next, receiver operating characteristics curves were generated to evaluate the concurrent …

Longitudinal Evaluation Of Patient Concerns After Surgery For Head And Neck Cancer, Isabel Wozniczka

Electronic Thesis and Dissertation Repository

The primary purpose of this study was to investigate and describe the longitudinal effects of shoulder and neck mobility, strength, and quality of life (QOL) following neck dissection (ND) surgery and identify the concerns of head and neck cancer (HNC) patients. ND is one of the standard procedures for treating HNC, which results in many complications and dysfunctions that can have an effect on a patient’s QOL.

The study had 27 eligible HNC participants who underwent ND, of which eight participated in the shoulder range of motion (ROM) and strength and 12 participated in the QOL patient-reported outcomes analysis. The …

An Evaluation Of The Effectiveness Of A Simulated Classroom-Based Intervention On Concussion Rehabilitation Among Individuals With Persistent Post-Concussion Symptoms, Bedoor Alqenai

Electronic Thesis and Dissertation Repository

Although recent clinical and scientific effort has focused on the development of guidelines for post-concussion return to play/work/learn, there is still relatively little literature that addresses specific treatment methods by which this can be accomplished. Accordingly, this study investigated the effect of a 7-week simulated classroom-based intervention on the self-reporting of symptom scores among 71 individuals with persistent concussion symptoms (26 men and 45 women). All participants were provided with novel strategies for reading, writing, study skills, social communication and technology use. Self-assessment of symptoms were obtained weekly, both before and after each session of the treatment program, in an …