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 …

Investigating The Effects Of Custom Made Orthotics On Brain Forms: A Pilot Study, Lindsay Carey

Electronic Thesis and Dissertation Repository

OBJECTIVES: To determine (1) the feasibility of this novel approach and technique of recording brain activity, wirelessly and continuously, during human gait, and (2) if custom made orthotics will alter the brain activity patterns recorded. METHODS: Gait trials were performed on 16 participants walking with and without orthotic devices in their shoes while simultaneously collecting EEG data through the Emotiv wireless neuroheadset. RESULTS: The Emotiv neuroheadset was capable of detecting changes in brain activity between the two gait trials. The differences in brain activity identified between conditions were not statistically significant. CONCLUSION: The findings suggest the Emotiv EEG device is …

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 …

Re-Cognizing Power In The Culture Of Dementia Care Knowledge, Ryan T. Deforge

Electronic Thesis and Dissertation Repository

In light of increasing system demands, system regulations, and constrained resources, those living and working with dementia in the long-term care sector are vulnerable to oppressive care practices. This is true so long as our understanding of how social power affects the ways in which dementia care knowledge is created, shared, and enacted remains limited. Based on prolonged field observations and on informal and formal interviews with care recipients, family members, and staff, the aim of this critical qualitative research was to examine the culture of dementia care knowledge in two sites: a specialized dementia care unit in a long-term …

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 …

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 …

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 …

How Power Tilt Is Used In Daily Life To Manage Sitting Pressure: Perspectives Of Adults Who Use Power Tilt And Therapists Who Prescribe This Technology, Laura C. Titus

Electronic Thesis and Dissertation Repository

Recent research studies have identified that use of large amplitudes of power tilt as a pressure management strategy used by adults who use wheelchairs and are at risk of developing pressure ulcers, was low. While the reason for low use was not identified, a lack of fit between using large amplitudes of tilt and daily life function was speculated as a main reason across studies. Using a post-positivist grounded theory approach, this study explored how power tilt was used in daily life particularly for managing sitting pressures, from the perspectives of five people experienced with using power tilt and six …

Causes Of Post Stroke Falls Along The Care Continuum: Implications For Improving Patient Safety, Mona Madady

Electronic Thesis and Dissertation Repository

In Western countries stroke is responsible for 10-12% of all deaths. In 2000, strokes cost $3.6 billion for the Canadian healthcare system and lost productivity due to premature death and long-term disability. Falls are a frequent occurrence at all stages of post-stroke recovery and can have significant negative impacts. While information about the incidence and risk factors of falling among stroke survivors is available, considerably less is known about the specific factors contributing to falls and the circumstances surrounding these adverse events. The purpose of this project was to identify similarities between systemic factors of falls in stroke survivors across …

Effect Of Congenital Versus Acquired Varus On Patient-Reported Outcomes After High Tibial Osteotomy, Sherelle T. Solomon

Electronic Thesis and Dissertation Repository

ABSTRACT

Objectives: 1) To determine the inter-rater reliability of tibial bone varus angle (TBVA) measurements. 2) To compare patient-reported outcomes after medial opening wedge high tibial osteotomy (HTO) in patients with congenital versus acquired varus.

Methods: Two raters measured TBVA from preoperative whole-limb standing anteroposterior radiographs (n=74). Patients completed Knee Osteoarthritis Outcome Scores (KOOS) before and 5 years after surgery. The sample was first divided into two groups based on preoperative congenital (TBVA>5°) or acquired (TBVA≤5°) varus, then three groups based on tertiles for TBVA.

Results: Intraclass correlation coefficients (ICC) suggested excellent inter-rater reliability (ICC2,1=0.78; ICC2,2=0.88). Repeated measures analysis …

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 …

Community Integration After In-Patient Rehabilitation For Lower Extremity Musculoskeletal Disorders: A Pilot Study, Chandni Chadha

Electronic Thesis and Dissertation Repository

Purpose: To investigate change in community integration (CI) and functional status following discharge from in-patient musculoskeletal (MSK) rehabilitation, and to explore the concordance between the Reintegration to Normal Living Index (RNLI) and patient interviews. Participants: Twenty-five individuals with lower extremity MSK disorders discharged home after rehabilitation. Methods: For all outcome measures, categories of change between successive time points were created using the minimal detectable change. Change patterns were evaluated at the group and individual level across four time intervals. Percent agreement quantified concordance between interview and RNLI data. Results: Change over time was confirmed at the group level. However, individual-level …

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 …

"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.