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1. Development and evaluation of Self-Management and Task-Oriented Approach to Rehabilitation Training (START) in the home: case report

Author

Richardson, Julie, DePaul, Vincent, Officer, Alexis, Wilkins, Seanne, Letts, Lori, Bosch, Jackie, and Wishart, Laurie

Subjects
Home care -- Training, Rehabilitation -- Training, Medical personnel -- Training, Physical therapists -- Training, Health
Abstract

Background. The incidence of stroke and subsequent level of disability will increase, as age is the greatest risk factor for stroke and the world's population is aging. Hospital admissions are too brief for patients to regain necessary function. Research to examine therapy delivered within the home environment has the potential to expedite relearning of function and reduce health care expenditures. Purpose. This case report describes the use of the knowledge-to-action cycle (KTA) to develop and evaluate an evidence-based approach for rehabilitation in the home that incorporates self-management and task-oriented functional training (TOFT) for people with stroke. Case Description. The KTA cycle was used to guide adaptation of evidence from self-management and TOFT into an approach titled START (Self-Management and Task-Oriented Approach to Rehabilitation Training). Three stakeholder symposiums identified barriers and supports to implementation. Clinical practice leaders were engaged as partners in the development of the intervention. An online learning management system housed the resources to support therapist training. Therapist focus groups were conducted and stroke outcomes were used to assess patient response. Outcomes. Eight therapists completed 4 workshops and applied the home intervention in 12 people with stroke. A mentoring process for therapists included feedback from peers and experts after viewing treatment videos. Therapist response was determined from the focus groups; patient response was measured by standardized assessments. The therapists noted that the intervention was easier to implement with patients who were motivated and had minimal cognitive impairment. Discussion. The KTA cycle provided a structure for the development of this evidence-based rehabilitation intervention, which was feasible to implement in the home. Further evaluation needs to be undertaken to assess the effectiveness of START., The disability associated with stroke will increase, as age is the strongest predictive risk factor for stroke and the segment of the population ≥ 65 years of age in North [...]

Published
2015
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2. Monitoring physical functioning as the sixth vital sign: evaluating patient and practice engagement in chronic illness care in a primary care setting--a quasi-experimental design

Author

Richardson Julie, Letts Lori, Chan David, Officer Alexis, Wojkowski Sarah, Oliver Doug, Moore Ainsley, McCarthy Lisa, Price David, and Kinzie Sarah

Subjects
Rehabilitation, Primary care, Chronic disease, Physical functioning, Self-management, Self-monitoring, Medicine (General), R5-920
Abstract

Abstract Background In Canada, one in three adults or almost 9 million people report having a chronic condition. Over two thirds of total deaths result from cardiovascular disease, diabetes, cancer and respiratory illness and 77% of persons ≥65 years have at least one chronic condition. Persons with chronic disease are at risk for functional decline; as a result, there is an increased awareness of the significance of functional status as an important health outcome. The purpose of this study was to determine whether patients who receive a multi-component rehabilitation intervention, including online monitoring of function with feedback and self-management workshops, showed less functional decline than case matched controls who did not receive this intervention. In addition, we wanted to determine whether capacity building initiatives within the Family Health Team promote a collaborative approach to Chronic Disease Management. Methods A population-based multi-component rehabilitation intervention delivered to persons with chronic illnesses (≥ 44 yrs) (n = 60) was compared to a group of age and sex matched controls (n = 60) with chronic illnesses receiving usual care within a primary healthcare setting. The population-based intervention consisted of four main components: (1) function-based individual assessment and action planning, (2) rehabilitation self-management workshops, (3) on-line self-assessment of function and (4) organizational capacity building. T-tests and chi-square tests were used for continuous and categorical variables respectively in baseline comparison between groups. Results Two MANOVA showed significant between group differences in patient reported physical functioning (Λ = 0.88, F = (2.86) = 5.97. p = 0.004) and for the physical performance measures collectively as the dependent variable (Λ = 0.80, F = (6.93) = 3.68. p = 0.0025). There were no within group differences for the capacity measures. Conclusion It is feasible to monitor physical functioning as a health outcome for persons with chronic illness in primary care. The timeline for this study was not sufficient to show an increase in the capacity within the team; however there were some differences in patient outcomes. The short timeline was likely not sufficient to build the capacity required to support this approach. Trial registration NCT00859638

Published
2012
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3. A032 – Health, lifestyle and aging with Multiple Sclerosis: A qualitative study

Author

Arnold, Catherine M., Faulkner, Robert A., Ploughman, Michelle, Austin, Mark, Kearney, Anne, Murdoch, Michelle, Stefanelli, Mark, Godwin, Marshall, Muir, Susan W, Speechley, Mark, Borrie, Michael, Montero-Odasso, Manuel, MacKay-Lyons, M, Creaser, G, Macdonald, A, McKenna, J, Murphy, S, O'Neill, VR, Nilsson, T, Begley, L, Ikert, Kathy M., Long, Kristin M., Bittner, Darren R., Birmingham, Trevor B., Bryant, Dianne M., Richardson, Julie, Letts, Lori, Chan, David, Stratford, Paul, Hand, Carri, Price, David, Hilts, Linda, Coman, Liliana, Edwards, Mary, Baptiste, Sue, Law, Mary, Alexander, Elliot, Rosenthal, Stephanie, Guilcher, Sara, Evans, Cathy, Gattey, M, Hydomako, R, McLean, B, O'Leary, J, Shkopich, K, Klassen, L, Laprade, Judi, Roy, Marla, Laing, M, Di Nicolantonio, L, Goncharova, K, Pui, M, Vas, H, House, R, Switzer-McIntyre, S, Cheifetz, O, Serediuk, F, Park Dorsay, J, Hladysh, G, Woodhouse, L, Dalzell, MA, Shallwani, S, Preuss, RA, Patterson, Debbie, Ptak, Janice, Howe, JA, Brunton, K, Salisbury, K, Sharma, SK, Childerhose, DE, Sharma, S, WalkerJohnston, JA, Barnes, JL, Fisher, Megan E., Aristone, Martha N., Young, Katrina K., Waechter, Laurie E., Landry, Michel D., Taylor, Leslie A., Cooper, Nicole S., Wong, S, Hébert, Luc J., Rowe, Peter, Debouter, Kelly, Lai, Denise, Winn, CS, Chisholm, BA, Hummelbrunner, JA, Wasson, Pamela, Passalent, L, Soever, L, Kennedy, C, Warmington, K, Shupak, R, Thomas, R, Linekar, S, Lundon, K, Morgan, Dale, Kelly, Larry, Hastie, Robyn, Deber, Raisa B., Verrier, Molly C., O'Callaghan, L, Alexander, E, Titus, D, MacDougall, P, Hoens, AM, Garland, SJ, Tunnacliffe, R, Lineker, S, Varatharasan, N, Schneider, R, MacKay, C, Murphy, SM, Wu, Kenneth, Fox, Patricia, Tullis, Elizabeth, Stephenson, Anne L., Davis, AM, Mahomed, N, Badley, EM, Scott, Lisa, Carpenter, Christine, Brander, Rosemary R., Paterson, Margo L., Chan, Yolande E., Reinikka, KJE, French, E, Huijbregts, M, Cleaver, SR, Paulenko, T, Hebert, D, Creaser, GA, MacKenzie, D, Barkhouse-McKeen, C, Shrier, Ian, Freeman, K, Davidson, L, Pelland, L, Wilson, Nicole, Hopkins-Rosseel, Diana, Fraser, M, Wainwright, G, MacCormack, B, Basque Godin, C, Mori, B, Evans, C, Gibson, BE, Thornton, M, Dutton, T, King, J, Lawrence, PJ, Duggan, M, Hoens, A, Geddes, E Lynne, Gill, Caroline, Fong-Lee, Dianna, Lindsay, Jane, McPhail, Stacey, McIntosh, Karen, Marken, Suri L., Dutton, Tanya, Hopkins-Rosseel, DH, Kasdan, P, Fong-Lee, D., Marken, Siri, Moreside, JM, McGill, SM, Juma, S, Winter Di Cola, JL, Kennedy, DM, Dickson, P, Denis, S, Robarts, S, Gollish, J, Salbach, NM, Veinot, P, Jaglal, SB, Bayley, M, Rolfe, D, Dogra, M, Woodhouse, LJ, Spadoni, GF, Stratford, PW, Fox, P, Sessford, J, Beaton, D, Harniman, E, Inrig, T, Baxter, K, Portanova, A, Smuck, L, Connelly, DM, Shaw, J, Adkin, A, Jog, M, Hollway, D, Earl, M, Murphy, A, MacDonald, E, Overend, TJ, Brooks, D, Anderson, CM, Cicutto, L, Keim, M, McAuslan, D, Nonoyama, M, Levac, D., Pierrynowski, M., MacPherson, M, Glassman, L, Jadan, P, MacArthur, L, Landry, M, Frenette, J, Dumont, N, Moreland, JD, DePaul, VG, DeHueck, AL, Musselman, KE, Yang, JF, Tousignant, M, Moffet, H, Boissy, P, Corriveau, H, Cabana, F, Marquis, F, Towns, Megan, Barrett, Lauren, Darling, Catherine, Lee, Michelle, Aganon, Isabel, Hill, Kylie, Brooks, Dina, Robbins, Shawn, Alcock, Greg, Maly, Monica, Jones, Gareth, Birmingham, Trevor, Glazebrook, Cheryl M., Wright, F. Virginia, Martin, MBA, Norton, B, Ramsaran, KD, Street, ME, Syed, SN, Dang, MT, Barclay-Goddard, R, Stratford, P, Miller, P, Karam, J., Zettel, M., Green, K., Carter, D., Lam, F., Evans, C., Yeung, E., Lindquist, NJ, Magis, TF, Rispin, JE, Walton, PE, Kirby, RL, Manns, PJ, Haller, MK, Marler, K, Lore, S, Sottana, B, Crowley, A, Beaudin, V, Sloan, C, Landry, SC, Nigg, BM, Tecante, KE, Albers, Pamela, Devon, Heidi, Nairn, Lacey, Olenick, Betsy, Roach, Stephanie, Arnold, Cathy, Watts, Cathy, Wieler, M, Jones, CA, Allen, J, Haennel, R, Shaw, JA, Zecevic, A, Dal Bello-Haas, V, Harrision, L, Kanthan, R, Lawson, S, Zaluski, N, Petrie, A, Rohs, J, Parker, R, Roy, JS, MacDermid, JC, Roth, JH, Grewal, R, Officer, Alexis, DePaul, Vincent, Bosch, Jackie, Wilkins, Seanne, Wishart, Laurie, Inness, EL, Mansfield, A, Biasin, L, Prajapati, S, Lakhani, B, Mileris, R, McIlroy, WE, Henderson, RJ, Vanik, J, Alyoshkina, N, Diamond, C, Lee, J, Martinov, K, O'Brien, KK, Alexander, R, King, K, Murray, J, Tebeje, M, Bayoumi, AM, Bereket, T, Swinton, M, Norman, G, Solomon, P, Anstey, S, Bethune, M, Thomas, A, Wood-Salomon, E, Curwin, S, D'Amboise, SN, Héroux, ME, Pari, G, Norman, KE, Lee, Linda-Joy, Coppieters, Michel W., Hodges, Paul W., Perreault, Audrey, Tremblay, Louis E., Thibault-Gagnon, S, Gentilcore-Saulnier, E, McLean, L, Kay, JL, McNeely, ML, Campbell, KL, Peddle, CJ, Courneya, KS, Subramanian, SK, Levin, MF, Dechman, G, Tupper, SM, Levesque, L, Reese, H, Nailer, T, Walton, D, Schachter, CL, Stalker, CA, Teram, E, Lasiuk, G, Bartlett, Doreen, Chiarello, Lisa, Jacobs, Diane, Busch, Angela, Novak, Christine B., Anastakis, Dimitri J., Beaton, Dorcas E., Mackinnon, Susan E., Katz, Joel, Figueiredo, S, Finch, L, Jiali, M, Ahmed, S, Huang, A, Mayo, NE, Lochhead, Lois, MacMillan, Peter, DePaul, V, Burridge, H, Kwok, C, Rosario, J, Stogios, C, McKay, E, Moyer, E, Wishart, L, Holly, J, DYER, Joseph-Omer, MAUPAS, Éric, de ANDRADE MELO, Sibele, BOURBONNAIS, Daniel, FORGET, Robert, Shrier, I, Boudier-Reveret, M, Feldman, D, Mazer, B, Rege, SS, Soever, LJ, Fenety, Anne, Hoens, Alison, Harman, Katherine, Bassett, Raewyn, Byrne, Jeannette M., Prentice, Stephen D., Carlesso, Lisa, Cairney, John, Hoogenes, Jennifer, Gabison, S, Nussbaum, EL, Taillon-Hobson, A., McLean, L., Aaron, S., Bilodeau, M., Taillon-Hobson, Anne, McLean, Linda, Aaron, Shawn, Bilodeau, Martin, Zbarsky, Kathryn, Parsley, Dana, Clegg, Heather, Welch, Tyler, Fernandes, Catherine, Jaglal, Susan, Inness, Liz, Williams, Josh, McIlroy, William, Howe, Jo-Anne, Yardley, D, Benoit, M, Blake, T, Gillies, G, Ho, R, MacKinnon, M, Chesworth, BM, Busch, AJ, Dooley, A, Coons, S, Crockett, K, Mucha, J, Kean, CO, Birmingham, TB, King, LK, Giffin, JR, Lourenço, Christiane B., Subramanian, Sandeep, Sveistrup, Heidi, Levin, Mindy F., DESMEULES, FRANÇOIS, DIONNE, CLERMONT E., BELZILE, ÉTIENNE L., BOURBONNAIS, RENÉE, FRÉMONT, PIERRE, Richards, CL, Schneider, GM, Smith, AD, Bath, B, Bourassa, R, Lovo Grona, S, Schneider, KJ, Emery, Carolyn, Norman, Kathleen, Pearson, Neil, Woodhouse, Linda, Pelland, Lucie, Werstine, Rob, and Schneider, Kathryn

Subjects
active transfer strategies for informing clinical practice through information technologies, injury prevention, health human resources management strategies, Merging Research and Practice, implementation and management strategies, Abstracts, clinical experience, clinical skills and clinical reasoning modules in orthopaedic practice, Special Sessions, evolving physiotherapist roles, chronic disease prevention, neurological, basic science or clinically focused research on targeted physiotherapy interventions, Scientific sessions, fundamental scientific research, mobility, Newfoundland, Canadian Physiotherapy Association Congress 2010, population health services, advances in research related to neuromusculoskeletal practice, health system reform, patient and client preference, clinical research and the reciprocal transfer of knowledge between clinical practice and research, innovative service delivery models, post-operative management of acute care patients, promotion of research, practice and patient/client care in the neuromusculoskeletal area, Canada, assessment and treatment of disability that arises from both spinal and peripheral pathologies, Abstracts, CPA Congress 2010, role of physiotherapists in primary health care, exercise prescription, Physical Therapy, Sports Therapy and Rehabilitation, Health Promotion, clinical decision making, St. John's, evidence based practice model, informing the development of clinical research questions, determinants of health, innovative models of practice, physiotherapy leadership development, Physio10, Leadership in Action, public and patient education, musculoskeletal, benchmarking areas of practice, inter-professional collaboration and education strategies, Neuromusculoskeletal Practice, public, private and independent practice management of physiotherapy services, Merging Research with Practice, cardio-respiratory
Published
2010

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