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Ziyi W, Supo Z, Białas M. Development of a basic evaluation model for manual therapy learning in rehabilitation students based on the Delphi method. BMC MEDICAL EDUCATION 2024; 24:964. [PMID: 39232741 PMCID: PMC11373307 DOI: 10.1186/s12909-024-05932-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Accepted: 08/20/2024] [Indexed: 09/06/2024]
Abstract
OBJECTIVE Manual therapy is a crucial component in rehabilitation education, yet there is a lack of models for evaluating learning in this area. This study aims to develop a foundational evaluation model for manual therapy learning among rehabilitation students, based on the Delphi method, and to analyze the theoretical basis and practical significance of this model. METHODS An initial framework for evaluating the fundamentals of manual therapy learning was constructed through a literature review and theoretical analysis. Using the Delphi method, consultations were conducted with young experts in the field of rehabilitation from January 2024 to March 2024. Fifteen experts completed three rounds of consultation. Each round involved analysis using Dview software, refining and adjusting indicators based on expert opinions, and finally summarizing all retained indicators using Mindmaster. RESULTS The effective response rates for the three rounds of questionnaires were 88%, 100%, and 100%, respectively. Expert familiarity scores were 0.91, 0.95, and 0.95; coefficient of judgment were 0.92, 0.93, and 0.93; authority coefficients were 0.92, 0.94, and 0.94, respectively. Based on three rounds of consultation, the model established includes 3 primary indicators, 10 secondary indicators, 17 tertiary indicators, and 9 quaternary indicators. A total of 24 statistical indicators were finalized, with 8 under the Cognitive Abilities category, 10 under the Practical Skills category, and 6 under the Emotional Competence category. CONCLUSION This study has developed an evaluation model for manual therapy learning among rehabilitation students, based on the Delphi method. The model includes multi-level evaluation indicators covering the key dimensions of Cognitive Abilities, Practical Skills, and Emotional Competence. These indicators provide a preliminary evaluation framework for manual therapy education and a theoretical basis for future research.
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Affiliation(s)
- Wang Ziyi
- Department of Sport, Gdansk University of Physical Education and Sport, Gdansk, 80-336, Poland
- Jiangsu Vocational College of Medicine, Yancheng City, China
| | - Zhou Supo
- Jiangsu College of Nursing, Huaian City, China
| | - Marcin Białas
- Department of Sport, Gdansk University of Physical Education and Sport, Gdansk, 80-336, Poland.
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Jadotte Y, Buchholz B, Carroll W, Frum-Vassallo D, MacPherson J, Cole S. Brief Action Planning in Health and Health Care: A Scoping Review. Med Clin North Am 2023; 107:1047-1096. [PMID: 37806724 DOI: 10.1016/j.mcna.2023.06.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
Achieving maximal health outcomes via health promotion and disease prevention requires the adoption of healthy behaviors. Brief action planning (BAP) is a method for patient self-management, health behavior change, and health coaching with potentially broad implications for and clinical applications in health and health care contexts. This scoping review presents 5 major findings about the literature on BAP: the principal geographic locations and the clinical contexts of its application, the types of research evaluations that it has undergone to date, the theoretic frameworks in which it is grounded, and the fidelity of its use in clinical practice.
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Affiliation(s)
- Yuri Jadotte
- Department of Family, Population, and Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA; Northeast Institute for Evidence Synthesis and Translation, Division of Nursing Science, School of Nursing, Rutgers University, Newark NJ, USA.
| | - Benjamin Buchholz
- Sickle Cell Center of Excellence, College of Medicine, Howard University, Washington, DC, USA
| | - William Carroll
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles CA, USA
| | - Deirdra Frum-Vassallo
- Health Promotion Disease Prevention, Northport VA Medical Center, Northport, NY, USA
| | | | - Steven Cole
- BAP Professional Network, US; Department of Psychiatry, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA; Department of Scientific Education, Zucker SOM at Hofstra/Northwell, Hempstead, NY, USA; Department of Psychiatry, Zucker SOM at Hofstra/Northwell, Hempstead, NY, USA
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Lee WY, Park HJ. Toxicity of cerium oxide nanoparticles on neonatal testicular development in mouse organ culture. Reprod Toxicol 2022; 111:120-128. [DOI: 10.1016/j.reprotox.2022.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 05/18/2022] [Accepted: 05/25/2022] [Indexed: 10/18/2022]
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Eilayyan O, Thomas A, Hallé MC, Tibbles AC, Jacobs C, Ahmed S, Schneider MJ, Al Zoubi F, Lee J, Myrtos D, Long CR, Bussieres A. Promoting the use of a self-management strategy among novice chiropractors treating individuals with spine pain: A mixed methods pilot clustered-clinical trial. PLoS One 2022; 17:e0262825. [PMID: 35061845 PMCID: PMC8782363 DOI: 10.1371/journal.pone.0262825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 01/02/2022] [Indexed: 11/19/2022] Open
Abstract
Background The uptake of Self-Management Support (SMS) among clinicians is suboptimal. To date, few studies have tested knowledge translation (KT) interventions to increase the application of SMS in chiropractic teaching clinics. Study objective Evaluate the feasibility of implementing a KT intervention to promote the use of a SMS strategy among chiropractic interns, their supervisors, and individuals with spine pain compared to controls. Methods Mixed methods pilot clustered-clinical trial. Clusters of 16 Patient Management Teams were allocated to a complex KT intervention (online and workshop training). Primary feasibility outcomes for clinicians, interns and patients were rates of recruitment, retention, and adherence to protocol. A nominal group technique and interviews were used to seek end-users’ views on the implementation process, and generate possible solutions. Results In total, 16 (84%) clinicians, 65 (26%) interns and 42 patients agreed to participate. All clinicians in the intervention group completed all KT intervention components, 23 interns (85%) completed the online training and 14 interns (51.8%) attended the workshop training. All clinicians in the intervention and seven (78%) in the control group completed all outcome measures at baseline and 6-month follow-up, while 15 (55.6%) and 23 (60.5%) interns in the intervention and control groups completed the questionnaires at baseline and 6-month follow-up, respectively. Among patients, 10 (52.6%) and 12 (52.2%) in the intervention and control groups respectively completed the questionnaires at the end of the study. Based on interview findings, solutions to improve the feasibility of conducting a full trial include: making SMS a part of the internship, changing the time of introducing the study to the interns, and having more training on SMS. Conclusion Recruitment and retention of chiropractic interns and patients for a larger implementation trial in a single outpatient teaching clinic may be challenging.
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Affiliation(s)
- Owis Eilayyan
- School of Physical and Occupational Therapy, McGill University, Quebec, Canada
- Physical Therapy and Rehabilitation Department, College of Applied Medical Sciences, Jouf University, Sakaka, Jouf, Saudi Arabia
- * E-mail: ,
| | - Aliki Thomas
- School of Physical and Occupational Therapy, McGill University, Quebec, Canada
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Quebec, Canada
| | - Marie-Christine Hallé
- School of Physical and Occupational Therapy, McGill University, Quebec, Canada
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Quebec, Canada
| | | | - Craig Jacobs
- Canadian Memorial Chiropractic College, Ontario, Canada
| | - Sara Ahmed
- School of Physical and Occupational Therapy, McGill University, Quebec, Canada
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Quebec, Canada
| | - Michael J. Schneider
- School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Fadi Al Zoubi
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Joyce Lee
- Canadian Memorial Chiropractic College, Ontario, Canada
| | - Danny Myrtos
- Canadian Memorial Chiropractic College, Ontario, Canada
| | - Cynthia R. Long
- Palmer College of Chiropractic, Davenport, Iowa, United States of America
| | - Andre Bussieres
- School of Physical and Occupational Therapy, McGill University, Quebec, Canada
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Quebec, Canada
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Weisberg J, Connell G, Verville L, Cancelliere C. Brief action planning to facilitate the management of acute low back pain with radiculopathy and yellow flags: a case report. THE JOURNAL OF THE CANADIAN CHIROPRACTIC ASSOCIATION 2021; 65:212-218. [PMID: 34658393 PMCID: PMC8480372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Brief action planning (BAP) is a collaborative tool to support patients' self-management goal setting and action planning. BAP facilitates patient self-reflection, and provides opportunity to establish goals of their own priority. CASE PRESENTATION A 55 year-old female with recentonset low back pain with L5 nerve root distribution, described severe pain in the low back and sharp pain and tingle-sensations down to her right foot. Pain worsened with sitting, coughing, and bending. She was diagnosed with lumbar and other intervertebral disc disorder with radiculopathy (ICD 10: M51.1). TREATMENT Initial treatment included reassurance, education, promotion of movement, and manual therapies. Symptoms worsened at the eighth visit (five weeks) where she also demonstrated pain-catastrophizing behaviours and an over-reliance on passive treatment strategies (i.e., psychosocial factors or yellow flags). BAP was introduced into her treatment plan to set achievable goals for her care. OUTCOME Decreased pain and disability were reported after incorporating BAP into care. Reduced pain-catastrophizing and reduced over-dependence on passive strategies were also demonstrated. Clinical gains were sustained at the 10-week follow-up assessment. KEY CLINICAL MESSAGE We describe the utilization of brief action planning as a technique for improving adherence to evidence-based clinical practice guideline recommendations in a patient with acute low back pain and radiculopathy, and late-onset psychosocial factors.
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Affiliation(s)
| | - Gaelan Connell
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada
- Institute for Disability and Rehabilitation Research, Ontario Tech University and Canadian Memorial Chiropractic College, Toronto, Ontario, Canada
| | - Leslie Verville
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada
- Institute for Disability and Rehabilitation Research, Ontario Tech University and Canadian Memorial Chiropractic College, Toronto, Ontario, Canada
| | - Carol Cancelliere
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada
- Institute for Disability and Rehabilitation Research, Ontario Tech University and Canadian Memorial Chiropractic College, Toronto, Ontario, Canada
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Connell G, Verville L, Cancelliere C, Wong JJ, Yu H, Shearer HM. Brief action planning targeting prognostic factors for an adult with persistent low back pain without radiculopathy: A case report. Clin Case Rep 2020; 8:2777-2781. [PMID: 33363821 PMCID: PMC7752451 DOI: 10.1002/ccr3.3280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 07/10/2020] [Accepted: 07/30/2020] [Indexed: 11/26/2022] Open
Abstract
We describe the implementation of brief action planning in conjunction with evidence-based clinical practice guideline recommendations to improve self-efficacy in a patient with psychosocial barriers and persistent nonspecific low back pain.
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Affiliation(s)
- Gaelan Connell
- Faculty of Health SciencesOntario Tech UniversityOshawaONCanada
- Centre for Disability Prevention and RehabilitationCanadian Memorial Chiropractic CollegeOntario Tech UniversityTorontoONCanada
- Rehabilitation SciencesFaculty of MedicineUniversity of British ColumbiaVancouverBCCanada
| | - Leslie Verville
- Faculty of Health SciencesOntario Tech UniversityOshawaONCanada
- Centre for Disability Prevention and RehabilitationCanadian Memorial Chiropractic CollegeOntario Tech UniversityTorontoONCanada
| | - Carol Cancelliere
- Faculty of Health SciencesOntario Tech UniversityOshawaONCanada
- Centre for Disability Prevention and RehabilitationCanadian Memorial Chiropractic CollegeOntario Tech UniversityTorontoONCanada
| | - Jessica J. Wong
- Faculty of Health SciencesOntario Tech UniversityOshawaONCanada
- Centre for Disability Prevention and RehabilitationCanadian Memorial Chiropractic CollegeOntario Tech UniversityTorontoONCanada
- Epidemiology DivisionDalla Lana School of Public HealthUniversity of TorontoTorontoONCanada
| | - Hainan Yu
- Faculty of Health SciencesOntario Tech UniversityOshawaONCanada
- Centre for Disability Prevention and RehabilitationCanadian Memorial Chiropractic CollegeOntario Tech UniversityTorontoONCanada
| | - Heather M. Shearer
- Faculty of Health SciencesOntario Tech UniversityOshawaONCanada
- Centre for Disability Prevention and RehabilitationCanadian Memorial Chiropractic CollegeOntario Tech UniversityTorontoONCanada
- Institute of Health Policy, Management and EvaluationUniversity of TorontoTorontoONCanada
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Eilayyan O, Visca R, Zidarov D, Ware P, Bussières A, Ahmed S. Developing theory-informed knowledge translation strategies to facilitate the use of patient-reported outcome measures in interdisciplinary low back pain clinical practices in Quebec: mixed methods study. BMC Health Serv Res 2020; 20:789. [PMID: 32843032 PMCID: PMC7445906 DOI: 10.1186/s12913-020-05616-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Accepted: 08/02/2020] [Indexed: 01/23/2023] Open
Abstract
Background There is a growing interest among healthcare providers (HCPs) to use Patient Reported Outcome Measures (PROMs) in clinical care. PROMs can help improve patient-care provider communication and may be used to inform the need for interdisciplinary care for Low Back Pain (LBP). However, PROM implementation to support clinical decision-making is complex and requires knowledge translation (KT) interventions that will overcome barriers to using PROMs in interdisciplinary clinical settings. Objectives to 1) identify potential barriers and enablers to using PROMs in primary care LBP clinical practice from the perspective of healthcare team members, and 2) develop a theory-based tailored KT intervention to facilitate the use of PROMs in interdisciplinary clinical practice. Methods We invited 25 HCPs working in an interdisciplinary team to complete a self-administered survey designed based on the Theoretical Domain Framework (TDF) to identify the barriers and enablers to using PROM scores in LBP clinical practice. The questionnaire consisted of 30 questions rated on a 5-point Likert scale (quantitative) and included open-ended questions (qualitative). Quantitative and qualitative data were analysed to estimate the frequency of barriers and enablers. Findings were then reviewed by a panel of four KT experts who mapped behaviour change techniques to barriers identified that informed the design of a KT intervention. Results Eighteen HCPs responded to the survey. Factors identified as likely to restrict the use of PROM scores included knowledge, skills, social/professional role and identity, goals, decision processes, beliefs about consequences, environmental context and resources, behavioural regulation, and social influence. A multi-component evidence-based KT intervention was proposed by the panel of experts to address these barriers: a training workshop; educational materials; and use of PROM score reports to HCPs that were all delivered by an opinion leader. Conclusion The routine use of PROMs in clinical practice may optimize the quality of LBP care and improve patients’ outcomes. The proposed multi-component KT intervention is expected to be an effective strategy to increase HCPs’ ability to integrate PROMs into clinical decision-making and to engage patients in their care.
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Affiliation(s)
- Owis Eilayyan
- School of Physical & Occupational Therapy, Faculty of Medicine, McGill University, 3654 Prom Sir-William-Osler, Montréal, QC, H3G 1Y5, Canada.,College of Applied Medical Sciences, Physical Therapy and Rehabilitation Department, Jouf University, Sakaka, Jouf, Saudi Arabia.,Center for outcome research and evaluation, Clinical Epidemiology, McGill University Health Center, McGill University, Montréal, QC, Canada.,Centre de recherche interdisciplinaire en réadaptation (CRIR), Constance Lethbridge Rehabilitation Center, Montréal, QC, Canada
| | - Regina Visca
- RUISSS McGill Centre of Expertise in Chronic Pain, Montréal, QC, Canada.,Family Medicine, Faculty of Medicine, McGill University, Montréal, QC, Canada
| | - Diana Zidarov
- Faculté de Médecine, École de réadaptation, Université de Montréal, Montréal, QC, Canada.,Institut universitaire sur la réadaptation en déficience physique de Montréal, Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l'Île-de-Montréal, Montreal, QC, Canada.,Centre de recherche interdisciplinaire en réadaptation (CRIR), Institut de réadaptation Gingras-Lindsay-de-Montréal, Montréal, QC, Canada
| | - Patrick Ware
- Centre for Global eHealth InnovationCentre for Global eHealth Innovation, University Health Network, Toronto, ON, Canada
| | - André Bussières
- School of Physical & Occupational Therapy, Faculty of Medicine, McGill University, 3654 Prom Sir-William-Osler, Montréal, QC, H3G 1Y5, Canada.,Centre de recherche interdisciplinaire en réadaptation (CRIR), Constance Lethbridge Rehabilitation Center, Montréal, QC, Canada.,Département chiropratique, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Sara Ahmed
- School of Physical & Occupational Therapy, Faculty of Medicine, McGill University, 3654 Prom Sir-William-Osler, Montréal, QC, H3G 1Y5, Canada. .,Center for outcome research and evaluation, Clinical Epidemiology, McGill University Health Center, McGill University, Montréal, QC, Canada. .,Centre de recherche interdisciplinaire en réadaptation (CRIR), Constance Lethbridge Rehabilitation Center, Montréal, QC, Canada. .,Centre de recherche interdisciplinaire en réadaptation (CRIR), Institut de réadaptation Gingras-Lindsay-de-Montréal, Montréal, QC, Canada.
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Eilayyan O, Thomas A, Hallé MC, Ahmed S, Tibbles AC, Jacobs C, Mior S, Davis C, Evans R, Schneider MJ, Owens H, Zoubi FA, Barnsley J, Long CR, Bussières A. Promoting the use of self-management in patients with spine pain managed by chiropractors and chiropractic interns: barriers and design of a theory-based knowledge translation intervention. Chiropr Man Therap 2019; 27:44. [PMID: 31636895 PMCID: PMC6794734 DOI: 10.1186/s12998-019-0267-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 07/05/2019] [Indexed: 12/29/2022] Open
Abstract
Background The literature supports the effectiveness of self-management support (SMS) to improve health outcomes of patients with chronic spine pain. However, patient engagement in SMS programs is suboptimal. The objectives of this study were to: 1) assess participation in self-care (i.e. activation) among patients with spine pain, 2) identify patients’ barriers and enablers to using SMS, and 3) map behaviour change techniques (BCTs) to key barriers to inform the design of a knowledge translation (KT) intervention aimed to increase the use of SMS. Methods In summer 2016, we invited 250 patients with spine pain seeking care at the Canadian Memorial Chiropractic College in Ontario, Canada to complete the Patient Activation Measure (PAM) survey to assess the level of participation in self-care. We subsequently conducted individual interviews, in summer 2017, based on the Theoretical Domains Framework (TDF) in a subset of patients to identify potential challenges to using SMS. The interview guide included 20 open-ended questions and accompanying probes. Findings were deductively analysed guided by the TDF. A panel of 7 experts mapped key barriers to BCTs, designed a KT intervention, and selected the modes of delivery. Results Two hundred and twenty-three patients completed the PAM. Approximately 24% of respondents were not actively involved in their care. Interview findings from 13 spine pain patients suggested that the potential barriers to using SMS corresponded to four TDF domains: Environmental Context and Resources; Emotion; Memory, Attention & Decision-Making; and Behavioural Regulation. The proposed theory-based KT intervention includes paper-based educational materials, webinars and videos, summarising and demonstrating the therapeutic recommendations including exercises and other lifestyle changes. In addition, the KT intervention includes Brief Action Planning, a SMS strategy based on motivational interviewing, along with a SMART plan and reminders. Conclusions Almost one quarter of study participants were not actively engaged in their spine care. Key barriers likely to influence uptake of SMS among patients were identified and used to inform the design of a theory-based KT intervention to increase their participation level. The proposed multi-component KT intervention may be an effective strategy to optimize the quality of spine pain care and improve patients’ health-outcomes. Electronic supplementary material The online version of this article (10.1186/s12998-019-0267-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Owis Eilayyan
- 1School of Physical and Occupational Therapy, McGill University, 3654 Promenade Sir-William-Osler, Montreal, Quebec H3G 1Y5 Canada.,2Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), 6363, Hudson Road, office 061, Lindsay Pavilion of the IURDPM, Montreal, QC H3S 1M9 Canada
| | - Aliki Thomas
- 1School of Physical and Occupational Therapy, McGill University, 3654 Promenade Sir-William-Osler, Montreal, Quebec H3G 1Y5 Canada.,2Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), 6363, Hudson Road, office 061, Lindsay Pavilion of the IURDPM, Montreal, QC H3S 1M9 Canada
| | - Marie-Christine Hallé
- 1School of Physical and Occupational Therapy, McGill University, 3654 Promenade Sir-William-Osler, Montreal, Quebec H3G 1Y5 Canada.,2Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), 6363, Hudson Road, office 061, Lindsay Pavilion of the IURDPM, Montreal, QC H3S 1M9 Canada
| | - Sara Ahmed
- 1School of Physical and Occupational Therapy, McGill University, 3654 Promenade Sir-William-Osler, Montreal, Quebec H3G 1Y5 Canada.,2Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), 6363, Hudson Road, office 061, Lindsay Pavilion of the IURDPM, Montreal, QC H3S 1M9 Canada
| | - Anthony C Tibbles
- 3Canadian Memorial Chiropractic College, 6100 Leslie St, North York, ON M2H 3J1 Canada
| | - Craig Jacobs
- 3Canadian Memorial Chiropractic College, 6100 Leslie St, North York, ON M2H 3J1 Canada
| | - Silvano Mior
- 3Canadian Memorial Chiropractic College, 6100 Leslie St, North York, ON M2H 3J1 Canada
| | - Connie Davis
- 4University of British Columbia, 2329 West Mall, Vancouver, BC V6T 1Z4 Canada.,Centre for Collaboration, Motivation and Innovation, PO Box 1343, Vernon, BC V1T 6N6 Canada
| | - Roni Evans
- 6University of Minnesota, Minneapolis, MN 55455 USA
| | | | - Heather Owens
- 1School of Physical and Occupational Therapy, McGill University, 3654 Promenade Sir-William-Osler, Montreal, Quebec H3G 1Y5 Canada
| | - Fadi Al Zoubi
- 1School of Physical and Occupational Therapy, McGill University, 3654 Promenade Sir-William-Osler, Montreal, Quebec H3G 1Y5 Canada.,2Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), 6363, Hudson Road, office 061, Lindsay Pavilion of the IURDPM, Montreal, QC H3S 1M9 Canada
| | - Jan Barnsley
- 8University of Toronto, 27 King's College Cir, Toronto, ON M5S Canada
| | - Cynthia R Long
- 9Palmer College, Davenport, 1000 Brady St, Davenport, IA 52803 USA
| | - Andre Bussières
- 1School of Physical and Occupational Therapy, McGill University, 3654 Promenade Sir-William-Osler, Montreal, Quebec H3G 1Y5 Canada.,2Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), 6363, Hudson Road, office 061, Lindsay Pavilion of the IURDPM, Montreal, QC H3S 1M9 Canada
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