Rehabilitation and Therapy Commons^™

Consideration Of Executive Functioning For Physiotherapy Rehabilitation: Studies Of Physiotherapists’ Knowledge, Normative Data, And A Practice Application, Nicole A. Guitar

Electronic Thesis and Dissertation Repository

Executive functioning (EF) refers to cognitive abilities involved in decision-making and self-regulation and can be impaired in many patients referred for physiotherapy, including older adults and people living with chronic pain. This dissertation aimed to determine what physiotherapists understood about EF, to summarize normative data for application in physiotherapy practice, and to provide an assessment of feasibility for studying EF impairments in people living with chronic pain. Study one surveyed what physiotherapists understood about EF as a concept, what EF assessments they used, and if this was influenced by their primary area of practice. Respondents (N = 262) subjectively reported …

Enacting Contextually Responsive Scholarship: Centring Occupation In Participatory Action Research With Children In India, Tanya Elizabeth Benjamin-Thomas, Debbie Laliberte Rudman, David Mark Thomas

Occupational Therapy Publications

Occupation-based scholars are striving to mobilize socially responsive scholarship to address occupational injustices from local to global scales. Moving forward involves expanding beyond Western, Anglophonic, female, able-bodied, adult perspectives on occupation, with critically informed participatory methodologies providing one key means to incorporate diverse perspectives on occupation and occupational justice. Drawing upon a participatory action research project with children with disabilities from rural South India, this paper puts forward an understanding of participatory action research as an occupational process (i.e., embodying a variety of occupations) and an occupation-based process (i.e., informed by an occupational lens). We forefront how ‘occupation’ was centered …

Exploring The Perspectives Of Older Adults And Health Care Providers On Patient Participation In Transitional Care From Hospital To Cardiac Rehabilitation During The Covid-19 Pandemic, Cecilia Flores Sandoval

Electronic Thesis and Dissertation Repository

Older adults who transition from hospital to cardiac rehabilitation settings often are vulnerable and at risk of experiencing adverse health care outcomes. Given the complexities of transitional care, it is crucial to engage older adults in the clinical decision-making process and to promote their active participation in their medical care. Older adults have unique ways of understanding their participation in the transitional care process. Gaining an in-depth understanding of their specific needs during this process can help inform clinical practice and interventions aiming to improve care for older adults living with cardiovascular disease. Focused ethnography methodology was used to explore …

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 …

The Effect Of Dual-Task Testing On The Balance And Gait Of People With Lower Limb Amputations: A Systematic Review, Humberto Omana, Edward Madou, Manuel Montero-Odasso, Michael W. Payne, Ricardo Viana, Susan W. Hunter

Physical Therapy Publications

OBJECTIVE: To systematically review the literature on the effect of dual-task testing on the balance and gait of people with lower limb amputations (PLLA).

LITERATURE SURVEY: Databases MEDLINE, EMBASE, CINAHL, PsycINFO, Web of Science, and Scopus were searched in duplicate (inception to December 1, 2020).

METHODOLOGY: Inclusion criteria: participants were adults with transtibial, knee-disarticulation, transfemoral, or bilateral lower limb amputations; balance or gait was paired with a secondary task; and studies were peer-reviewed and published in English. Two authors independently reviewed articles and consensus was required. A standardized data extraction sheet was used to gather study relevant information in duplicate. …

Troubling Service User Involvement In Health Professional Education: Toward Epistemic Justice, Stephanie Leblanc-Omstead

Electronic Thesis and Dissertation Repository

It has become increasingly popular in health professional education to solicit the contributions and involvement of people who have firsthand or ‘lived’ experiences of using mental health services – a practice hereafter referred to as service user involvement (SUI). SUI is founded on the premise that service users ought to be involved in the development and evaluation of services and systems they experience, which includes the education of future health professionals. Despite the momentum this practice has gained in a range of international contexts, SUI is often conceptualized, organized, and implemented uncritically, and with tremendous inconsistency across health professional education …

Co-Contraction Of Ankle Muscle Activity During Quiet Standing In Individuals With Incomplete Spinal Cord Injury Is Associated With Postural Instability, Kai Lon Fok, Jae W Lee, Janelle Unger, Katherine Chan, Kristin E Musselman, Kei Masani

Physical Therapy Publications

Previous findings indicate that co-contractions of plantarflexors and dorsiflexors during quiet standing increase the ankle mechanical joint stiffness, resulting in increased postural sway. Balance impairments in individuals with incomplete spinal cord injury (iSCI) may be due to co-contractions like in other individuals with reduced balance ability. Here we investigated the effect of co-contraction between plantar- and dorsiflexors on postural balance in individuals with iSCI (iSCI-group) and able-bodied individuals (AB-group). Thirteen able-bodied individuals and 13 individuals with iSCI were asked to perform quiet standing with their eyes open (EO) and eyes closed (EC). Kinetics and electromyograms from the tibialis anterior (TA), …

Functional Reach Test, Single-Leg Stance Test, And Tinetti Performance-Oriented Mobility Assessment For The Prediction Of Falls In Older Adults: A Systematic Review, Humberto Omaña, Kari Bezaire, Kyla Brady, Jayme Davies, Nancy Louwagie, Sean Power, Sydney Santin, Susan W. Hunter

Physical Therapy Publications

OBJECTIVE: The authors sought to systematically review the existing literature on the falls-related diagnostic test properties of the Functional Reach Test (FRT), single-leg stance test (SLST), and Tinetti Performance-Oriented Mobility Assessment (POMA) in older adults across settings and patient populations.

METHODS: The PubMed, EMBASE, and CINAHL databases were searched (inception-July 2020). Inclusion criteria were participants aged 60 years or more, prospectively recorded falls, and the reporting of falls-related predictive validity. Manuscripts not published in English were excluded. Methodological quality of reporting was assessed using the Tooth Scale.

RESULTS: Of 1071 studies reviewed, 21 met the inclusion criteria (12 POMA, 8 …

Chronic Pain Following Musculoskeletal Injuries: Where Do Familial Factors, Depression, And Distress Fit In?, Shirin Modarresi

Electronic Thesis and Dissertation Repository

Background: Currently, there is a paucity of effective therapeutic options for chronic pain. A better understanding of the factors that can contribute to chronic pain development and maintenance can lead to more informed prevention and management strategies.

Purpose: The driving force for this thesis comes from the biopsychosocial model of pain. The main purpose was to investigate the contribution of various psychosocial factors to chronic pain with the following objectives: 1) to systematically review the literature on the existence of a familial sub-type of complex regional pain syndrome (fCRPS); 2) CRPS can follow injuries such as distal radius fractures (DRFs), …

The Effect Of First-Time 4-Wheeled Walker Use On The Gait Of Younger And Older Adults, Humberto A. Omana, Edward Madou, Alison Divine, Walter Wittich, Keith D. Hill, Andrew M. Johnson, Jeffrey D. Holmes, Susan W. Hunter

Physical Therapy Publications

INTRODUCTION: The 4-wheeled walker is intended to enhance balance and gait for older adults. Yet, some research suggests that walking aids increase falls risk. An understanding of the influence of age with walker use on gait performance is required.

OBJECTIVE: To examine the effect of initial 4-wheeled walker use on spatiotemporal gait parameters between younger and older adults.

DESIGN: Cross-sectional, repeated-measures.

SETTING: Community-dwelling.

PARTICIPANTS: Twenty-five younger (age: 26.5 ± 4.1 years) and 24 older (age: 68.5 ± 10.5 years) adults participated. Younger adults were aged 18 to 35 years, whereas older adults were 50 years or older. Included were people …

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 …

Exploring Leisure, Social Participation In Older Adults, Zahra Fatina

Undergraduate Student Research Internships Conference

Older adults often face challenges in meaningful occupations in their neighbourhoods, often tied to place-based barriers and changes including neighbourhood decline or gentrification. The objectives of this study are to draw on findings from an ethnographic study exploring older adults’ lives in their neighbourhoods, in order to contextually situate the diverse experiences of older adults as they engage in community occupations, focusing on social participation and leisure. We employed an ethnographic methodology with 38 older adults living in two neighbourhoods in a mid-sized Canadian city. Participants engaged in narrative interviews, photo elicitation interviews, go-along interviews, and activity-space mapping with follow-up …

Exploring The Environmental Factors That Shape The Experiences Of Risk For Older Adults, Bernice Chung

Undergraduate Student Research Internships Conference

When a young adult wants to go mountain climbing, rarely do people think it is “too dangerous”. The same cannot be said for older adults. Although life frequently involves risk-taking, older adults are too often positioned as ‘at risk’ and therefore, in need of protection. The problem lies in the way risk is conceptualized as an individually located phenomenon. This narrow view negates the environmental factors that exist outside the control of older adults and that shape risk in older adulthood. I wanted to address this gap, so my research explored the environmental factors that shape experiences of risk for …

An Evaluation Of The Effectiveness Of Exercise Training-Based Cardiac Rehabilitation To Improve Aerobic Fitness, Rojin Gharaezibaei

Undergraduate Student Research Internships Conference

On intake to exercise-training based cardiac rehabilitation, an incremental CPET is performed to identify V̇O2peak and establish baseline exercise capacity. In individuals who provide a symptom-free and maximal effort, V̇O2peak provides a reasonable estimate of the maximal ability of the body to take up, transport, and utilize O2 and the ceiling of aerobic capacity. However, in those unaccustomed to exhaustive exercise, such an effort is challenging to obtain. In clinical atmospheres, CPET testing is commonly symptom-limited due to breathlessness and fatigue. Thus, many patients voluntarily terminate exercise before reaching their maximal physiological limit of O2 delivery and utilization. As a …

Discovering The Brain Activation Patterns Associated With Somatosensory Stimulation In The Lower Extremity In Healthy Adults At Rest: Preliminary Results For A Systematic Review, Siying Luan

Undergraduate Student Research Internships Conference

Stroke, which is the leading cause of disability and the third leading cause of death in adults in North America, burdens millions of people as they age. When people experience the long-lasting consequences of stroke, such as limited mobility, the rehabilitation process becomes critical. The mechanism behind walking is supported by a complex system, the somatosensory nervous system. This system transmits information that is essential for one to complete daily tasks, which means the relationship between the somatosensory system and walking is critical to understand for future innovative rehabilitation interventions. Thus, we are investigating the brain activation patterns associated with …

Development Of A Low-Cost Algometer, Thomas D. Naish, Ana Luisa Trejos, Dave M. Walton

Undergraduate Student Research Internships Conference

Many people suffer from chronic pain, the reasons for which are not always well understood. Algometers are instruments that can help clinicians understand the nature of pain by determining the force at which pain becomes noticeable or unbearable. Algometers can also be used to determine the effects that external influences can have on pain tolerance in healthy people.

The goal of this project was to develop an algometer that can measure the normal range of pain thresholds and tolerances of most patients, which ranges up to 35 lbs. Also, the result needed to be accurate to about 1% and made …

Investigating Adherence To Screening Guidelines For Cardiometabolic Disease In Persons With Spinal Cord Injury At The Parkwood Institute Outpatient Clinic, Luxshmi Nageswaran

Undergraduate Student Research Internships Conference

Persons with spinal cord injury (SCI) are at an increased risk of developing cardiometabolic disease (CMD) and related complications. To address this, the Paralyzed Veterans of America released a set of clinical practice guidelines with screening recommendations for CMD risk factors such as dyslipidemia, hypertension, obesity, and diabetes.

Clinical data indicated that 25 patients out of a total of 48 (52%) are at an increased risk of developing cardiometabolic disease, as defined as having three or more risk factors present. In addition, a review of 30 intake forms from the Parkwood Institute Outpatient Clinic showed that hypertension and weight screenings …

Understanding The Impact Of Covid-19 On Physical And Mental Fatigue In Youth With Cerebral Palsy, Nathan Wc Yang Mr.

Undergraduate Student Research Internships Conference

This explorative study examined the impact of the COVID-19 pandemic, lockdowns, and social distancing on mental and physical fatigue and life role participation of youth with CP. Quantitative data included results from the Fatigue Impact and Severity Self-Assessment (FISSA), Child & Adolescent Scale of Participation (CASP) and the Participation and Environment Measure for Children and Youth (PEM-CY).

Creation Of A Virtual Interface For Stress-Trauma Investigations Through Open World Navigation: An Exploration Of Tolerability And Physiological Reactions, Michael J. Lukacs

Electronic Thesis and Dissertation Repository

It is estimated that as many as 50% of people suffering from Whiplash Associated Disorders (WAD) may experience chronic alterations of their activities of daily living as much as 1-year post injury. Despite their burden, there is little to evidence to suggest why some people may be more likely to acquire WAD or develop chronic symptomology. Additionally, the link between biomechanical forces at the time of impact and symptom development or recovery is poor. As a result, interest in alternative theories such as stress system reactivity have received interest in recent literature, but empirical methods to test them has been …

Evaluating A Concern For Falling Among People With A Lower Extremity Amputation, Kristin Elizabeth Nugent

Electronic Thesis and Dissertation Repository

The purpose of these studies was to evaluate a concern for falling (CFF) among people with a lower extremity amputation (PLEA). Study 1 evaluated relative and absolute test-retest reliability of five standardized scales which have not been previously evaluated among PLEA. Twenty-two participants completed Study 1, an online survey that was administered twice. Study 2 assessed the inter-relationship of the multiple dimensions in a CFF using nine standardized scales of measurement and open-ended questions, and the association on quality of life (QOL). Forty-eight participants completed Study 2, a onetime online survey. Study 1 provided support for the reliable use of …

The Psychosocial And Physical Effects Of Therapeutic Horseback Riding For Children With Cerebral Palsy, Karen M. Pratt

Electronic Thesis and Dissertation Repository

Background: Participation in specialized adapted activities such as therapeutic horseback riding (THR) is critical for children with cerebral palsy (CP) as they are at increased risk for lower habitual physical activity levels, social exclusion and mental health conditions. The benefits of THR for children CP are unclear despite positive anecdotal evidence. Purpose: The aim of the study is to explore the effects of THR participation for children with CP across multiple domains of health (psychological, social and physical) from the children themselves. Specifically, this study explored overall wellbeing including mental health, perceived independence, social inclusion and presence of fatigue and …

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 …

Health Concerns Of Adolescents And Adults With Spina Bifida, Jessica A. Starowicz

Electronic Thesis and Dissertation Repository

The Transitional and Lifelong Care (TLC) program is a multidisciplinary clinical service providing comprehensive, coordinated care to adolescents and adults with spina bifida (SB). This study sought to identify the most common health concerns among this population at initial consultation and identify patient factors related to these concerns to ultimately improve health care delivery. A retrospective chart review was performed. Descriptive analyses were completed and associations between concerns and patient factors were determined using Spearman’s rho correlation coefficients. A multiple linear regression was performed to estimate the relationship between patient factors and total number of concerns reported. Ninety-four patient charts …

The Problem Of Operational Stress Injuries In An Ontario Fire & Rescue Organization, Megan Edgelow

The Dissertation-in-Practice at Western University

The purpose of this Organizational Improvement Plan (OIP) is to assist public safety leaders in understanding the human and financial costs of operational stress injuries (OSIs) and possible solutions to this issue. OSIs, including posttraumatic stress disorder (PTSD), are a growing problem for public safety organizations, requiring new and innovative solutions. This OIP is applied to a fire and rescue organization in a small urban centre in Ontario that faces similar OSI challenges to many other public safety organizations. The Problem of Practice (PoP) is a lack of implementation of effective practices to mitigate the impact of OSIs. The foundation …

Nature, Nurture, Or Both? Study Of Sex And Gender And Their Effects On Pain, Maryam Ghodrati

Electronic Thesis and Dissertation Repository

As a pain researcher, in order to have a better understanding of pain, we should adopt a multidimensional view, such as the biopsychosocial (BPS) model and consider physical, psychological, and social elements altogether. The studies in this dissertation are part of the bigger project of SYMBIOME in which the aim is to help to create and develop a prognostic clinical phenotype in people post musculoskeletal (MSK) trauma. Chapter 2 presents a Confirmatory Factor Analysis (CFA) in order to assess the structural validity of the first section of the new Gender Pain and Expectation Scale (GPES). Our analysis indicated a 3-factor …

Functional Performance Testing In Ice Hockey: The Role Of The Single Leg, Medial Countermovement Jump, Anthony S. Donskov

Electronic Thesis and Dissertation Repository

Due to the physical nature of the game, injuries are common in ice hockey. Injury rates have been difficult to interpret due to the inconsistencies in the definitions of injury and athlete exposure. Consensus statements on injury definitions have been developed for sports such as soccer and rugby but have not been established in ice hockey. Furthermore, many different off-ice tests are performed, but a hockey-specific performance test has not been promoted. Accordingly, the objective for this thesis was to investigate injury rates, injury definition, athlete exposure and injury type in men’s ice hockey, and providing information on a practical …

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 …

Development And Feasibility Of A Modified Fugl-Meyer Lower Extremity Assessment For Telerehabilitation: A Pilot Study., Sue Peters, Marcela Botero, Allison Evers, Brianna Fong, Botond Jakab, Emily Petter, Janice J Eng

Physical Therapy Publications

BACKGROUND: The majority of stroke survivors experience motor impairment which benefits from rehabilitation treatment. Telerehabilitation, remote delivery of rehabilitation services, is a possible solution providing access to rehabilitation for stroke survivors living in rural areas or in situations like the COVID-19 pandemic where face-to-face treatment may be risky. However, valid and reliable motor impairment measures have not yet been established over a telerehabilitation platform. The Fugl-Meyer (FM) lower extremity assessment is widely used clinically and in research. Thus, the aim was to develop a modified FM for telerehabilitation (FM-tele) and assess the feasibility and preliminary agreement of FM-tele scores with …

The Time For Translation Of Mobile Brain And Body Imaging To People With Stroke Is Now, Brian Greeley, Grant Hanada, Lara A Boyd, Sue Peters

Physical Therapy Publications

No abstract provided.

Producing Precarity: The Individualization Of Later Life Unemployment Within Employment Support Provision, Debbie Rudman, Rebecca Aldrich

Occupational Therapy Publications

There have been marked policy shifts within many nations towards ‘extended work lives’, with such shifts often underpinned by an assumption that individual aging citizens can make the responsible choice to prolong work and thereby avoid dependency on the state. However, possibilities for extended work lives are inequitably distributed, and older workers who become unemployed often face prolonged unemployment and barriers to obtaining sustainable employment. Drawing on findings from an ethnographic study addressing the negotiation of long-term unemployment in two North American cities, this article attends to how jobseekers aged 50 and older, employment support service providers, and organizational stakeholders …