Rehabilitation and Therapy Commons^™

“Why Would I Want To Go Out?”: Age-Related Vision Loss And Social Participation, Debbie Rudman, Deborah Gold, Colleen Mcgrath, Biljana Zuvela, Marlee Spafford, Rebecca Renwick

Occupational Therapy Publications

Social participation, a key determinant of healthy aging, is often negatively impacted by age-related vision loss (ARVL). This grounded theory study aimed to understand social participation as a process negotiated in everyday life by older adults with ARVL. Interviews, audio diaries, and life-space maps were used to collect data with 21 older adults in two Ontario cities. Inductive data analysis resulted in a transactional model of the process of negotiating social participation in context. This model depicts how environmental features and resources, skills and abilities, and risks and vulnerabilities transacted with values and priorities to affect if and how social …

Consensus Classifications Of Gross Motor, Manual Ability, And Communication Function Classification Systems Between Therapists And Parents Of Children With Cerebral Palsy., Doreen J Bartlett, Barbara Galuppi, Robert J Palisano, Sarah Westcott Mccoy

Physical Therapy Publications

No abstract provided.

The Child And Adolescent Scale Of Environment (Case): Further Validation With Youth Who Have Chronic Conditions, Gary Bedell, Janette Mcdougal

Occupational Therapy Publications

Objective: To further validate the Child and Adolescent Scale of Environment (CASE).

Methods: Baseline data (n = 430) were analyzed from a longitudinal study on quality of life for youth with chronic conditions ages 11–17 in Ontario, Canada. Internal consistency and structure, and convergent and discriminant validity were examined via Cronbach’s alpha (α), exploratory factor analyses, correlation analyses and ANOVA.

Results: The CASE had high internal consistency (α = 0.89). A three-factor solution was produced with 55% variance explained: (1) Community/Home Resources, (2) School Resources and (3) Physical Design/Access). CASE total and factor …

A Review Of Transcranial Magnetic Stimulation And Multimodal Neuroimaging To Characterize Post-Stroke Neuroplasticity, Angela M. Auriat, Jason L. Neva, Sue Peters, Lara A. Boyd

Physical Therapy Publications

Following stroke, the brain undergoes various stages of recovery where the central nervous system can reorganize neural circuitry (neuroplasticity) both spontaneously and with the aid of behavioral rehabilitation and non-invasive brain stimulation. Multiple neuroimaging techniques can characterize common structural and functional stroke-related deficits, and importantly, help predict recovery of function. Diffusion tensor imaging (DTI) typically reveals increased overall diffusivity throughout the brain following stroke, and is capable of indexing the extent of white matter damage. Magnetic resonance spectroscopy (MRS) provides an index of metabolic changes in surviving neural tissue after stroke, serving as a marker of brain function. The neural …

Motor And Visuospatial Attention And Motor Planning After Stroke: Considerations For The Rehabilitation Of Standing Balance And Gait, Sue Peters, Todd C. Handy, Bimal Lakhani, Lara A. Boyd, S. Jayne Garland

Physical Therapy Publications

Attention and planning can be altered by stroke, which can influence motor performance. Although the influence of these factors on recovery from stroke has been explored for the upper extremity (UE), their impact on balance and gait are unknown. This perspective article presents evidence that altered motor and visuospatial attention influence motor planning of voluntary goal-directed movements poststroke, potentially affecting balance and gait. Additionally, specific strategies for rehabilitation of balance and gait poststroke in the presence of these factors are discussed. Visuospatial attention selects relevant sensory information and supports the preparation of responses to this information. Motor attentional impairments may …

Maternal Factors And The Emotional And Behavioural Functioning Of Adolescents With Chronic Health Conditions, Nicole Etherington, Janette Mcdougall, David Dewit, Virginia Wright

Occupational Therapy Publications

Purpose: This study investigated the association between mothers’ mental health and education and the emotional and behavioural functioning of adolescents with chronic health conditions over time.

Methods: Data were drawn from an ongoing study. Study participants (N¼363) were recruited through eight children’s rehabilitation centres. Logistic regression models were estimated.

Results: There were significantly reduced odds that girls would display clinical signs of hyperactivity/inattention one year later compared to boys when a maternal mental health condition was present (OR¼0.10; p50.01). Where low maternal education was present, girls were more likely to display peer relationship problems one year later (OR¼3.72; …

Prevalence And Influences Of Preschoolers’ Sedentary Behaviors In Early Learning Centers: A Cross-Sectional Study, Patricia Tucker, Leigh M. Vanderloo, Shauna M. Burke, Jennifer D. Irwin, Andrew M. Johnson

Occupational Therapy Publications

Background

Recent research has highlighted the need for increased evidence regarding the sedentary activity levels of preschoolers. Given the large proportion of time this population spends in various early learning facilities, the exploration of sedentary behaviors within this particular environment should be a priority. The purpose of the study was two-fold: (1) to compare sedentary time of preschoolers in three different early learning environments (i.e., full-day kindergarten [FDK], center-, and home-based childcare); and (2) to assess which characteristics (i.e., staff behaviors, sedentary environment, fixed play environment, portable play environment, sedentary opportunities) of these early learning environments influence preschoolers’ sedentary time. …

Mobility And Cognition In Seniors. Report From The 2008 Institute Of Aging (Cihr) Mobility And Cognition Workshop, Manuel Montero-Odasso, Louis Bherer, Stephanie Studenski, Karen Gopaul, Afua Oteng-Amoako, Sarah Woolmore-Goodwin, Paul Stoole, Jennie Wells, Timothy Doherty, Aleksandra A. Zecevic, David Galinsky, R. Jane Rylett, Jeffrey Jutai, Susan W. Muir-Hunter, Mark Speechley, Richard Camicioli

Physical Therapy Publications

Background

The annual Scientific Meeting of the Canadian Association on Gerontology was held on October 24 and 25, 2008 in London, Ontario. Prior to the annual meeting, mobility and cognition experts met on October 23, 2008 to engage in a pre-conference workshop.

Methods

Discussions during the workshop addressed novel areas of research and knowledge and research gaps pertaining to the interaction between mobility and cognition in seniors.

Results

Workshop presenters moved from the neuromuscular, biomechanics, and neurology of gait impairments, and falls through the role of cognition and mood on mobility regulation to the whole person in the environment. Research …

Reliability Of The Berg Balance Scale As A Clinical Measure Of Balance In Community-Dwelling Older Adults With Mild To Moderate Alzheimer Disease: A Pilot Study, Susan W Muir-Hunter, Laura J. Graham, Manuel Montero Odasso

Physical Therapy Publications

Purpose : To measure test-retest and interrater reliability of the Berg Balance Scale (BBS) in community-dwelling adults with mild to moderate Alzheimer disease (AD).

Method : A sample of 15 adults (mean age 80.20 [SD 5.03] years) with AD performed three balance tests: the BBS, timed up-and-go test (TUG), and Functional Reach Test (FRT). Both relative reliability, using the intra-class correlation coefficient (ICC), and absolute reliability, using standard error of measurement (SEM) and minimal detectable change (MDC95) values, were calculated; Bland-Altman plots were constructed to evaluate inter-tester agreement. The test-retest interval was 1 week.

Results : For the BBS, relative …

The Healthy Mind, Healthy Mobility Trial: A Novel Exercise Program For Older Adults, Dawn P. Gill, Michael A. Gregory, Guangyong Zou, Teresa Liu-Ambrose, Ryosuke Shigematsu, Vladimir Hachinski, Clara Fitzgerald, Robert Petrella

Lifestyle Research Team

BACKGROUND:

More evidence is needed to conclude that a specific program of exercise and/or cognitive training warrants prescription for the prevention of cognitive decline. We examined the effect of a group-based standard exercise program for older adults, with and without dual-task training, on cognitive function in older adults without dementia.

METHODS:

We conducted a proof-of-concept, single-blinded, 26-wk randomized controlled trial whereby participants recruited from preexisting exercise classes at the Canadian Centre for Activity and Aging in London, Ontario, were randomized to the intervention group (exercise + dual-task [EDT]) or the control group (exercise only [EO]). Each week (2 or 3 …

The Physical Activity Levels And Sedentary Behaviors Of Latino Children In London (Ontario, Canada), Gillian E. Mandich, Shauna Burke, Anca Gaston, Patricia Tucker

Health and Rehabilitation Sciences Publications

OBJECTIVE: To assess the physical activity and sedentary behaviors of a sample of Latino children in London, Ontario, Canada.

METHODS: Seventy-four Latino children (54.1% male; mean age = 11.4) completed self-report questionnaires related to physical activity and sedentary behaviors. A subset of children (n = 64) wore Actical (Mini Mitter, Respironics) accelerometers for a maximum of four days.

RESULTS: Latino children self-reported moderate levels of physical activity (i.e., mean score of 2.8 on 5-point scale). Accelerometer data revealed that children spent an average of 50.0 min in moderate-to-vigorous physical activity (MVPA; 59.2 min on weekdays and 50.6 min on weekend …

Reliability Of Three Landmarking Methods For Dual Inclinometry Measurements Of Lumbar Flexion And Extension, Joy C. Macdermid, Vanitha Arumugam, Joshua I. Vincent, Kimberly L. Payne, Aubrey K. So

Health and Rehabilitation Sciences Publications

Background

To examine the intra and inter-rater reliability of lumbar flexion and extension measurements attained using three landmarking methods for dual inclinometry.

Methods

This was a repeated measures reliability study. Convenience sampling was used to obtain forty volunteer subjects. Two assessors measured a series of lumbar flexion and extension movements using the J-Tech™ dual inclinometer. Three different landmarking methods were used: 1) straight palpation of PSIS and L1, 2) palpation of PSIS and the site of the nearest 5 cm interval point closest to L1 and 3) location of PSIS and 15 cm cephalad. Upon landmarking, adhesive tape was used …

Short-Term Cortical Plasticity Associated With Feedback-Error Learning After Locomotor Training In A Patient With Incomplete Spinal Cord Injury, Amanda E. Chisholm, Sue Peters, Michael R. Borich, Lara A. Boyd, Tania Lam

Physical Therapy Publications

Background and purpose: For rehabilitation strategies to be effective, training should be based on principles of motor learning, such as feedback-error learning, that facilitate adaptive processes in the nervous system by inducing errors and recalibration of sensory and motor systems. This case report suggests that locomotor resistance training can enhance somatosensory and corticospinal excitability and modulate resting-state brain functional connectivity in a patient with motor-incomplete spinal cord injury (SCI).

Case description: The short-term cortical plasticity of a 31-year-old man who had sustained an incomplete SCI 9.5 years previously was explored in response to body-weight-supported treadmill training with velocity-dependent resistance applied …

Reverse Innovation: An Opportunity For Strengthening Health Systems, Anne W Snowdon, Harpreet Bassi, Andrew D. Scarffe, Alexander D Smith

Health and Rehabilitation Sciences Publications

BACKGROUND: Canada, when compared to other OECD countries, ranks poorly with respect to innovation and innovation adoption while struggling with increasing health system costs. As a result of its failure to innovate, the Canadian health system will struggle to meet the needs and demands of both current and future populations. The purpose of this initiative was to explore if a competition-based reverse innovation challenge could mobilize and stimulate current and future leaders to identify and lead potential reverse innovation projects that address health system challenges in Canada.

METHODS: An open call for applications took place over a 4-month period. Applicants …

Youth With Disabilities Talk About Spirituality: A Qualitative Descriptive Study, Patricia J. Baldwin, Jan Evans, Nicole Etherington, Megan Nichols, Viginia Wright, Janette Mcdougall

Occupational Therapy Publications

There is little known about what spirituality means for youth with disability or about the potential relevance of youths’ spirituality in pediatric rehabilitation. This study explored perceptions of spirituality for youth with disabilities. Using a qualitative descriptive methodology, we examined the lived experiences of eighteen youth ages 11-20 years with disabilities including cerebral palsy, central nervous system disorder or autism spectrum disorder. In individual interviews, followed by a focus group, youth identified key spiritual themes – the importance of their beliefs, personal sources of comfort and strength, finding purpose in helping others, significance of personal connections, and strengths-based perspectives on …

Quality Of Life And Self-Determination: Youth With Chronic Health Conditions Make The Connection, Janette Mcdougall, Patricia Baldwin, Jan Evans, Megan Nichols, Nicole Ehterington, Virginia Wright

Occupational Therapy Publications

While optimizing quality of life(QOL) is a key goal of rehabilitation care,no previous study has reported on what ‘QOL’ means to youth with chronic health conditions. In addition, no qualitative studies have explored the relationship between QOL and self-determination(SD). Objectives of this qualitative study were to examine: what the terms ‘quality of life’ and ‘self-determination’ mean to youth with chronic conditions; the factors these youth think are linked with these concepts; the relationship they see between concepts, the types of future goals youth have and how they view the connection between their SD and these goals. A descriptive methodology was …

Situating Occupation In Social Relations Of Power: Occupational Possibilities, Ageism And The Retirement ‘Choice’, Debbie Laliberte Rudman

Occupational Therapy Publications

Introduction: Research attending to social relations of power can enhance understanding of the mechanisms through which occupational injustices occur and inform socially transformative practice. This study explored how power operates through ageism in ways that shape what people come to take for granted regarding occupation in relation to age, and what occupations are supported through socio- political conditions.

Methods: Narratives were collected using a two-stage interview process with 17 retired Canadians. A critical narrative analysis approach was employed to examine how these narratives revealed the complex ways occupations are negotiated within broader discourses and age relations.

Findings: Ageism mattered for …

The Manual Ability Classification System: A Scoping Review, Deepa Jeevanantham, Emily Dyszuk, Doreen Bartlett

Physical Therapy Publications

PURPOSE: To examine the use of the Manual Ability Classification System (MACS) and to identify gaps in the literature by conducting a thorough search of existing publications from 2006 to March 2013.

METHODS: An extensive literature search included 15 databases, using the search terms "Manual Ability Classification System" or "MACS" to retrieve relevant abstracts.

RESULTS: A total of 161 articles were identified for final inclusion. The review identified literature that supports the reliability, validity, and stability of the MACS.

CONCLUSIONS: The MACS could be considered as a standard classification for children with cerebral palsy on the basis of manual abilities. …

A Modified Evidence-Based Practice- Knowledge, Attitudes, Behaviour And Decisions/Outcomes Questionnaire Is Valid Across Multiple Professions Involved In Pain Management, Qiyun Shi, Bert M Chesworth, Mary Law, R Brian Haynes, Joy C Macdermid

Health and Rehabilitation Sciences Publications

BACKGROUND: A validated and reliable instrument was developed to knowledge, attitudes and behaviours with respect to evidence-based practice (EBB-KABQ) in medical trainees but requires further adaptation and validation to be applied across different health professionals.

METHODS: A modified 33-item evidence-based practice scale (EBP-KABQ) was developed to evaluate EBP perceptions and behaviors in clinicians. An international sample of 673 clinicians interested in treatment of pain (mean age = 45 years, 48% occupational therapists/physical therapists, 25% had more than 5 years of clinical training) completed an online English version of the questionnaire and demographics. Scaling properties (internal consistency, floor/ceiling effects) and construct …

Motoric Cognitive Risk Syndrome: Multicountry Prevalence And Dementia Risk, Joe Verghese, Cedric Annweiler, Emmeline Ayers, Nir Barzilai, Olivier Beauchet, David A Bennett, Stephanie A Bridenbaugh, Aron S Buchman, Michele L Callisaya, Richard Camicioli, Benjamin Capistrant, Somnath Chatterji, Anne-Marie De Cock, Luigi Ferrucci, Nir Giladi, Jack M Guralnik, Jeffrey M Hausdorff, Roee Holtzer, Ki Woong Kim, Paul Kowal, Reto W Kressig, Jae-Young Lim, Susan Lord, Kenichi Meguro, Manuel Montero-Odasso, Susan W. Hunter, Mohan L Noone, Lynn Rochester, Velandai Srikanth, Cuiling Wang

Physical Therapy Publications

OBJECTIVES: Our objective is to report prevalence of motoric cognitive risk syndrome (MCR), a newly described predementia syndrome characterized by slow gait and cognitive complaints, in multiple countries, and its association with dementia risk.

METHODS: Pooled MCR prevalence analysis of individual data from 26,802 adults without dementia and disability aged 60 years and older from 22 cohorts from 17 countries. We also examined risk of incident cognitive impairment (Mini-Mental State Examination decline ≥4 points) and dementia associated with MCR in 4,812 individuals without dementia with baseline Mini-Mental State Examination scores ≥25 from 4 prospective cohort studies using Cox models adjusted …

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. …

Scoping Review - Physical Accessibility & Post-Secondary Education, Lea E. Klinger

Occupational Therapy Publications

No abstract provided.

Icf-Based Functional Components And Contextual Factors As Correlates Of Perceived Quality Of Life For Youth With Chronic Conditions, Janette Mcdougall, Virginia Wright, David Dewit, Linda Miller

Occupational Therapy Publications

Purpose: To explore International Classification of Functioning, Disability and Health (ICF)-based functional components and contextual factors associated with perceived quality of life (QOL) for youth with chronic conditions from the perspective of youth and parents.

Method: Baseline data were obtained from a longitudinal study examining predictors of changes in perceived QOL for youth with chronic conditions. 439 youth aged 11–17 (and one of their parents) completed a questionnaire. Standardized tools were used to measure youth functioning, contextual factors and perceived QOL. Multivariate linear regression analyses, controlling for socio-demographic and health information, were conducted to explore correlations among youth functioning/contextual factors …

Embracing And Enacting An ‘Occupational Imagination’: Occupational Science As Transformative, Debbie Rudman

Occupational Therapy Publications

This paper addresses the question of how occupational science can move forward in its development as a socially and politically engaged discipline. It is argued that a transformative approach to scholarship needs to be embraced, and that enacting such an approach requires a radical reconfiguration of the sensibility underpinning occupational science. After reviewing the key defining characteristics of a transformative paradigmatic approach, key insights regarding how to foster a radical sensibility in occupational science are drawn from C. Wright Mills (1959) conceptualization of ‘the sociological imagination’. Embracing an occupational imagination premised on these key insights would foster the transformative potential …

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 …

"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.

University Campus Accessibility Measure, Lea E. Klinger

Occupational Therapy Publications

No abstract provided.

The Youth Report Version Of The Child And Adolescent Scale Of Participation (Casp): Assessment Of Psychometric Properties And Comparison With Parent Report, Janette Mcdougall, Gary Bedell, Virginia Wright

Occupational Therapy Publications

Objective The Child and Adolescent Scale of Participation (CASP) parent report is a brief and valid measure for use with children and youth with chronic conditions/disabilities that has been shown to have good coverage at the chapter level of the‘Activities and Participation’component of the International Classification of Functioning,Disability and Health.The purpose of this research was to assess the psychometric properties of a CASP youth self-report version,to further validate the parent report,and to compare parent and youth reports of youths’ activity and participation.

Methods Baseline data from a longitudinal study examining predictors of changes in quality of life for youth with …

The Bodily Experience Of Cerebral Palsy: A Journey To Self-Awareness., Laura K Brunton, Doreen J Bartlett

Physical Therapy Publications

PURPOSE: The aim of the study was to describe the lived bodily experience of cerebral palsy (CP).

METHOD: This was a descriptive phenomenological inquiry. Ten participants were interviewed about their bodily experiences of living with CP. Interviews were semi-structured around pain and fatigue. Inductive thematic analysis was used to identify themes.

RESULTS: The bodily experience of CP centered on issues of fatigue and pain as a feeling of muscle soreness. An overwhelming amount of the discussion on fatigue emphasized the fatigue that occurs with walking and prolonged activity. Self-awareness of the individuals' own bodies and adapting activity to continue to …