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Elfassy C, Wagner L, Higgins J, Montpetit K, Snider L, Dahan-Oliel N. Stakeholder engagement in the development of an upper extremity outcome measure for children with rare musculoskeletal conditions. Res Involv Engagem 2023; 9:64. [PMID: 37553603 PMCID: PMC10408044 DOI: 10.1186/s40900-023-00479-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 07/28/2023] [Indexed: 08/10/2023]
Abstract
BACKGROUND Upper extremity (UE) involvement is prevalent in 73% of individuals with arthrogryposis multiplex congenita (AMC), yet no AMC-specific outcome measure exists. When developing a measure specific to a population with a rare musculoskeletal condition, clinicians' and patients' perspectives and involvement is a crucial and necessary step. This study sought to determine the most clinically useful items for an outcome measure of UE function for children with AMC as defined by caregivers and clinicians. METHODS To ensure the perspectives and needs of caregivers of children with AMC and clinicians were considered in the development of the UE measure for AMC, a Nominal Group technique (NGT) with caregivers of children with AMC (phase 1) followed by a three-round survey with clinicians (phase 2) were carried out. RESULTS Phase 1: Eleven individuals participated in the nominal group technique and identified 32 items. The most important items were Picking up an object (n = 11), Eating (n = 10), Reaching mouth (n = 10), Getting out of bed (n = 10). Phase 2: Invitations to participate to an online survey was sent to 47 experts in the field of AMC, 20 participants completed round 1, 15 completed round 2 and 13 completed round 3. Throughout the survey, participants were asked about movement required to screen the UE, essential domains to be included in the measure, establishing a scoring guide and identifying tasks associated with joint motion and position. CONCLUSION A preliminary version of an UE AMC-specific outcome measure was developed with the help of caregivers' perspectives and expert opinions.
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Affiliation(s)
- Caroline Elfassy
- Faculty of Medicine, School of Physical and Occupational Therapy, McGill University, Montreal, Canada.
- Clinical Research Department, Shriners Hospital for Children -Canada, 1003 Decarie Boulevard, Montreal, QC, H4A 0A9, Canada.
| | - Lisa Wagner
- Shriners Hospitals for Children, Greenville, USA
| | - Johanne Higgins
- Université de Montréal, École de Réadaptation, Montreal, Canada
| | - Kathleen Montpetit
- Clinical Research Department, Shriners Hospital for Children -Canada, 1003 Decarie Boulevard, Montreal, QC, H4A 0A9, Canada
| | - Laurie Snider
- Faculty of Medicine, School of Physical and Occupational Therapy, McGill University, Montreal, Canada
| | - Noémi Dahan-Oliel
- Faculty of Medicine, School of Physical and Occupational Therapy, McGill University, Montreal, Canada
- Clinical Research Department, Shriners Hospital for Children -Canada, 1003 Decarie Boulevard, Montreal, QC, H4A 0A9, Canada
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Akremi H, Higgins J, Guediri A, Aissaoui R, Nadeau S. Seated postural organization during bilateral upper limb symmetric and asymmetric pushing tasks in individuals after stroke compared to healthy controls. Gait Posture 2023; 104:83-89. [PMID: 37343399 DOI: 10.1016/j.gaitpost.2023.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 06/12/2023] [Accepted: 06/16/2023] [Indexed: 06/23/2023]
Abstract
BACKGROUND Asymmetric weight distribution in sitting has been reported in people after stroke. However, postural strategies used during bilateral symmetric and asymmetric movements performed while seated require more evidence to inform rehabilitation strategies. RESEARCH QUESTIONS How do symmetric and asymmetric effort levels exerted during upper limb (UL) pushing movements affect seated postural organization parameters (weight bearing (WB) between hands and hemibody sides, and forward trunk displacement) of stroke compared to healthy individuals? How are these parameters associated? METHODS Using an instrumented exerciser, 19 post-stroke individuals were compared to 17 healthy individuals when executing four bilateral UL pushing movements in a seated position: symmetrical pushing at 30 % and 15 % of their maximal force (MF) and asymmetrical pushing with 15 % of their MF for one UL vs. 30 % of the MF for the other UL and vice versa. Anterior and vertical forces of the push, as well as vertical forces under each foot and thigh were compared between groups, sides and conditions. Forward trunk displacement was compared between groups and conditions. Correlations were used to determine the association between trunk displacement, hands and hemibody vertical forces. RESULTS Increasing pushing effort caused increased WB on thighs and decreased on WB on feet during the 30 % MF symmetric condition compared to the 15 % MF and asymmetric conditions (p < 0.05). Individuals post-stroke showed WB asymmetry and greater forward trunk displacement when compared to healthy persons (p < 0.05). For both groups, hemibody WB and trunk displacement showed moderate association (r > - 0.5) in the asymmetric condition executed with more resistance on the paretic or non-dominant hand. SIGNIFICANCE Individuals post-stroke presented a similar WB pattern to that of healthy persons during symmetric and asymmetric bilateral UL movements with greater forward trunk displacement and asymmetry. Increased effort and asymmetric force between both UL had effects on seated postural organization strategy.
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Affiliation(s)
- Haifa Akremi
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Canada; Laboratoire de pathokinésiologie, Institut universitaire sur la réadaptation en déficience physique de Montréal-Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR), Canada
| | - Johanne Higgins
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Canada; Laboratoire de pathokinésiologie, Institut universitaire sur la réadaptation en déficience physique de Montréal-Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR), Canada
| | - Amine Guediri
- Laboratoire de pathokinésiologie, Institut universitaire sur la réadaptation en déficience physique de Montréal-Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR), Canada
| | - Rachid Aissaoui
- Laboratoire de pathokinésiologie, Institut universitaire sur la réadaptation en déficience physique de Montréal-Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR), Canada; École de Technologie Supérieure (ETS) and Imaging and Orthopaedics Research Laboratory, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Canada
| | - Sylvie Nadeau
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Canada; Laboratoire de pathokinésiologie, Institut universitaire sur la réadaptation en déficience physique de Montréal-Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR), Canada.
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Proulx CE, Higgins J, Vincent C, Vaughan T, Hewko M, Gagnon DH. User-centered development process of an operating interface to couple a robotic glove with a virtual environment to optimize hand rehabilitation following a stroke. J Rehabil Assist Technol Eng 2023; 10:20556683231166574. [PMID: 37077202 PMCID: PMC10107379 DOI: 10.1177/20556683231166574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 03/14/2023] [Indexed: 04/21/2023] Open
Abstract
Introduction Task-specific neurorehabilitation is crucial to optimize hand recovery shortly after a stroke, but intensive neurorehabilitation remains limited in resource-constrained healthcare systems. This has led to a growing interest in the use of robotic gloves as an adjunct intervention to intensify hand-specific neurorehabilitation. This study aims to develop and assess the usability of an operating interface supporting such a technology coupled with a virtual environment through a user-centered design approach. Methods Fourteen participants with hand hemiparesis following a stroke were invited to don the robotic glove before browsing through the operating interface and its functionalities, and perform two mobility exercises in a virtual environment. Feedback was collected for improving technology usability. Participants completed the System Usability Scale and ABILHAND questionnaires and their recommendations were gathered and prioritized in a Pugh Matrix. Results The System Usability Scale (SUS) score for the operating interface was excellent (M = 87.0 SD = 11.6). A total of 74 recommendations to improve the user interface, calibration process, and exercise usability were identified. Conclusion The application of a full cycle of user-centred design approach confirms the high level of usability of the system which is perceived by end users as acceptable and useful for intensifying neurorehabilitation.
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Affiliation(s)
- CE Proulx
- School of Rehabilitation, Faculty
of Medicine, Université de Montréal, Montreal, QC, Canada
- Center for Interdisciplinary
Research in Rehabilitation of Greater Montreal, Institut Universitaire sur la
Réadaptation en Déficience Physique de Montréal, CIUSSS
Centre-Sud-de-l’Île-de-Montréal, Montreal, QC, Canada
| | - J Higgins
- School of Rehabilitation, Faculty
of Medicine, Université de Montréal, Montreal, QC, Canada
- Center for Interdisciplinary
Research in Rehabilitation of Greater Montreal, Institut Universitaire sur la
Réadaptation en Déficience Physique de Montréal, CIUSSS
Centre-Sud-de-l’Île-de-Montréal, Montreal, QC, Canada
| | - C Vincent
- Department of Rehabilitation, Université Laval, Quebec, QC, Canada
- Center for Interdisciplinary
Research in Rehabilitation and Social Integration, Centre Intégré Universitaire de Santé
et de Services Sociaux de la Capitale-Nationale, Quebec, QC, Canada
| | - T Vaughan
- Simulation and Digital Health,
Medical Devices Research Centre, National Research Council
Canada, Boucherville, QC, Canada
| | - M Hewko
- Simulation and Digital Health,
Medical Devices Research Centre, National Research Council Canada,
Winnipeg, Winnipeg, MB, Canada
| | - DH Gagnon
- School of Rehabilitation, Faculty
of Medicine, Université de Montréal, Montreal, QC, Canada
- Center for Interdisciplinary
Research in Rehabilitation of Greater Montreal, Institut Universitaire sur la
Réadaptation en Déficience Physique de Montréal, CIUSSS
Centre-Sud-de-l’Île-de-Montréal, Montreal, QC, Canada
- DH Gagnon, School of Rehabilitation,
Université de Montréal-Pavillon Ave du Parc, C.P. 6128, succursale Centre-Ville,
Montreal, QC H3C 3J7, Canada.
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Higgins J, Tomaszewska P, Pellny TK, Castiblanco V, Arango J, Tohme J, Schwarzacher T, Mitchell RA, Heslop-Harrison JS, De Vega JJ. Diverged subpopulations in tropical Urochloa (Brachiaria) forage species indicate a role for facultative apomixis and varying ploidy in their population structure and evolution. Ann Bot 2022; 130:657-669. [PMID: 36112370 PMCID: PMC9670755 DOI: 10.1093/aob/mcac115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 09/13/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Urochloa (syn. Brachiaria) is a genus of tropical grasses sown as forage feedstock, particularly in marginal soils. Here we aimed to clarify the genetic diversity and population structure in Urochloa species to understand better how population evolution relates to ploidy level and occurrence of apomictic reproduction. METHODS We explored the genetic diversity of 111 accessions from the five Urochloa species used to develop commercial cultivars. These accessions were conserved from wild materials collected at their centre of origin in Africa, and they tentatively represent the complete Urochloa gene pool used in breeding programmes. We used RNA-sequencing to generate 1.1 million single nucleotide polymorphism loci. We employed genetic admixture, principal component and phylogenetic analyses to define subpopulations. RESULTS We observed three highly differentiated subpopulations in U. brizantha, which were unrelated to ploidy: one intermixed with U. decumbens, and two diverged from the former and the other species in the complex. We also observed two subpopulations in U. humidicola, unrelated to ploidy; one subpopulation had fewer accessions but included the only characterized sexual accession in the species. Our results also supported a division of U. decumbens between diploids and polyploids, and no subpopulations within U. ruziziensis and U. maxima. CONCLUSIONS Polyploid U. decumbens are more closely related to polyploid U. brizantha than to diploid U. decumbens, which supports the divergence of both polyploid groups from a common tetraploid ancestor and provides evidence for the hybridization barrier of ploidy. The three differentiated subpopulations of apomictic polyploid U. brizantha accessions constitute diverged ecotypes, which can probably be utilized in hybrid breeding. Subpopulations were not observed in non-apomictic U. ruziziensis. Sexual Urochloa polyploids were not found (U. brizantha, U. decumbens) or were limited to small subpopulations (U. humidicola). The subpopulation structure observed in the Urochloa sexual-apomictic multiploidy complexes supports geographical parthenogenesis, where the polyploid genotypes exploit the evolutionary advantage of apomixis, i.e. uniparental reproduction and clonality, to occupy extensive geographical areas.
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Affiliation(s)
- J Higgins
- Earlham Institute, Norwich Research Park, Norwich NR4 7UZ, UK
| | - P Tomaszewska
- Department of Genetics and Genome Biology, University of Leicester, Leicester LE1 7RH, UK
- Department of Genetics and Cell Physiology, Faculty of Biological Sciences, University of Wroclaw, 50-328 Wroclaw, Poland
| | - T K Pellny
- Rothamsted Research, Harpenden, Hertfordshire AL5 2JQ, UK
| | - V Castiblanco
- International Center for Tropical Agriculture (CIAT), 6713 Cali, Colombia
| | - J Arango
- International Center for Tropical Agriculture (CIAT), 6713 Cali, Colombia
| | - J Tohme
- International Center for Tropical Agriculture (CIAT), 6713 Cali, Colombia
| | - T Schwarzacher
- Department of Genetics and Genome Biology, University of Leicester, Leicester LE1 7RH, UK
| | - R A Mitchell
- Rothamsted Research, Harpenden, Hertfordshire AL5 2JQ, UK
| | - J S Heslop-Harrison
- Department of Genetics and Genome Biology, University of Leicester, Leicester LE1 7RH, UK
- Key Laboratory of Plant Resources Conservation and Sustainable Utilization/Guangdong Provincial, Key Laboratory of Applied Botany, South China Botanical Garden, Chinese Academy of Sciences, Guangzhou, 510650, China
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Sandha P, Higgins J, LeGros Strickler K, Weitzner M. Using Photovoice with Middle and High School Students to Capture Youth Voices on Food Environments and the impact of COVID-19. J Acad Nutr Diet 2022. [DOI: 10.1016/j.jand.2022.08.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Allegue DR, Sweet SN, Higgins J, Archambault PS, Michaud F, Miller WC, Tousignant M, Kairy D. Lessons Learned From Clinicians and Stroke Survivors About Using Telerehabilitation Combined With Exergames: Multiple Case Study. JMIR Rehabil Assist Technol 2022; 9:e31305. [PMID: 36107484 PMCID: PMC9523527 DOI: 10.2196/31305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 01/05/2022] [Accepted: 07/14/2022] [Indexed: 11/17/2022] Open
Abstract
Background In Canada, stroke survivors have difficulty accessing community-based rehabilitation services because of a lack of resources. VirTele, a personalized remote rehabilitation program combining virtual reality exergames and telerehabilitation, was developed to provide stroke survivors an opportunity to pursue rehabilitation of their chronic upper extremity (UE) deficits at home while receiving ongoing follow-up from a clinician. Objective We aimed to identify the behavioral and motivational techniques used by clinicians during the VirTele intervention, explore the indicators of empowerment among stroke survivors, and investigate the determinants of VirTele use among stroke survivors and clinicians. Methods This multiple case study involved 3 stroke survivors with chronic UE deficits and their respective clinicians (physiotherapists) who participated in the VirTele intervention, a 2-month remote rehabilitation intervention that uses nonimmersive virtual reality exergames and telerehabilitation aimed at improving UE deficits in stroke survivors. Study participants had autonomous access to Jintronix exergames and were asked to use them for 30 minutes, 5 times a week. The VirTele intervention included 1-hour videoconference sessions with a clinician 1 to 3 times a week, during which the clinician engaged in motivational interviewing, supervised the stroke survivors’ use of the exergames, and monitored their use of the affected UE through activities of daily living. Semidirected interviews were conducted with the clinicians and stroke survivors 4 to 5 weeks after the end of the VirTele intervention. All interviews were audiorecorded and transcribed verbatim. An abductive thematic analysis was conducted to generate new ideas through a dynamic interaction between data and theory. Results Three stroke survivors (n=2, 67%, women and n=1, 33%, man), with a mean age of 58.8 (SD 19.4) years, and 2 physiotherapists participated in the study. Five major determinants of VirTele use emerged from the qualitative analyses, namely technology performance (usefulness and perception of exergames), effort (ease of use), family support (encouragement), facilitators (considerations of the stroke survivors’ safety as well as trust and understanding of instructions), and challenges (miscommunication and exergame limits). During the VirTele intervention, both clinicians used motivational and behavioral techniques to support autonomy, competence, and connectivity. All these attributes were reflected as empowerment indicators in the stroke survivors. Lessons learned from using telerehabilitation combined with exergames are provided, which will be relevant to other researchers and contexts. Conclusions This multiple case study provides a first glimpse into the impact that motivational interviewing can have on adherence to exergames and changes in behavior in the use of the affected UE in stroke survivors. Lessons learned regarding the supportive role caregivers play and the new responsibilities clinicians have when using the VirTele intervention may inform the use of exergames via telerehabilitation. These lessons will also serve as a model to guide the implementation of similar interventions. International Registered Report Identifier (IRRID) RR2-10.2196/14629
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Affiliation(s)
- Dorra Rakia Allegue
- The Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Institut universitaire sur la réadaptation en déficience physique de Montréal, Montreal, QC, Canada
- School of Rehabilitation, Université de Montréal, Montreal, QC, Canada
| | - Shane Norman Sweet
- The Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Institut universitaire sur la réadaptation en déficience physique de Montréal, Montreal, QC, Canada
- Department of Kinesiology and Physical Education, McGill University, Montreal, QC, Canada
| | - Johanne Higgins
- The Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Institut universitaire sur la réadaptation en déficience physique de Montréal, Montreal, QC, Canada
- School of Rehabilitation, Université de Montréal, Montreal, QC, Canada
| | - Philippe S Archambault
- The Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Institut universitaire sur la réadaptation en déficience physique de Montréal, Montreal, QC, Canada
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
| | - Francois Michaud
- Department of Electrical Engineering and Computer Engineering, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - William C Miller
- Department of Occupational Science & Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Michel Tousignant
- School of Rehabilitation, Université de Sherbrooke, Sherbrooke, QC, Canada
- Research Centre on Aging (CdRV), Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Dahlia Kairy
- The Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Institut universitaire sur la réadaptation en déficience physique de Montréal, Montreal, QC, Canada
- School of Rehabilitation, Université de Montréal, Montreal, QC, Canada
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Kerba J, Demers C, Bélanger V, Napartuk M, Bouchard I, Meloche C, Morel S, Prud’homme N, Gélinas I, Higgins J, Curnier D, Sultan S, Laverdière C, Sinnett D, Marcil V. Needs, Barriers and Facilitators of Adolescents Participating in a Lifestyle Promotion Program in Oncology: Stakeholders, Adolescents and Parents’ Perspective. Children 2022; 9:children9091340. [PMID: 36138649 PMCID: PMC9497682 DOI: 10.3390/children9091340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/17/2022] [Accepted: 08/30/2022] [Indexed: 11/28/2022]
Abstract
Treatments for adolescent cancer can cause debilitating side effects in the short- and long-term such as nausea and malnutrition but also cardiometabolic disturbances. Although the risk for cardiometabolic complications is greater for adolescents with cancer than younger ones, adolescents typically respond poorly to family-oriented health promotion programs. This study aims to assess the needs, barriers and facilitators to healthy lifestyle promotion interventions for adolescents with cancer and how to best adapt these interventions for them. Interviews were held with adolescents treated for cancer (n = 9) and parents (n = 6), focus groups were conducted with stakeholders working in oncology (n = 12) and self-report questionnaires were sent to stakeholders involved in a health promotion intervention (n = 6). At the time of interview, mean age of adolescent participants (40% female) was 17.0 ± 1.9 years (mean age at diagnosis: 14.6 ± 1.6 years). Verbatim and responses to questionnaires were coded and analyzed using qualitative methods. Stakeholder stated that adolescents with cancer need to access activities adapted to their age, to communicate with peers going through a similar experience, and to preserve their schooling and friendships. Barriers to intervention reported by adolescents, parents and stakeholders include lack of motivation, schedule conflicts, fatigue and treatment side effects. Some of the barriers mentioned by adolescents and parents include pain, post-surgery problems, school, physical deconditioning, and lack of time. Facilitators mentioned by adolescents and parents comprise trust in stakeholders’ expertise, personalized approaches, scheduling flexibility. Stakeholders recommended to build trust in the relationship, favoring non-moralizing teachings, adapt interventions to adolescents’ limited attention span and avoiding the use of long-term health benefits as a motivator.
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Affiliation(s)
- Johanne Kerba
- Research Center of the CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
- Department of Nutrition, Université de Montreal, Montreal, QC H3T 1A8, Canada
- Cardiometabolic Health, Diabetes, and Obesity Research Network (CMDO), Montreal, QC J1H 5N4, Canada
| | - Catherine Demers
- Research Center of the CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
- School of Physical and Occupational Therapy, McGill University, Montreal, QC H3G 1Y5, Canada
| | - Véronique Bélanger
- Research Center of the CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
- Department of Nutrition, Université de Montreal, Montreal, QC H3T 1A8, Canada
- Cardiometabolic Health, Diabetes, and Obesity Research Network (CMDO), Montreal, QC J1H 5N4, Canada
- Institute of Nutrition and Functional Food, Quebec City, QC G1V 0A6, Canada
| | - Mélanie Napartuk
- Research Center of the CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
- Department of Nutrition, Université de Montreal, Montreal, QC H3T 1A8, Canada
- Cardiometabolic Health, Diabetes, and Obesity Research Network (CMDO), Montreal, QC J1H 5N4, Canada
- Institute of Nutrition and Functional Food, Quebec City, QC G1V 0A6, Canada
| | - Isabelle Bouchard
- Research Center of the CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
| | - Caroline Meloche
- Research Center of the CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
| | - Sophia Morel
- Research Center of the CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
- Department of Nutrition, Université de Montreal, Montreal, QC H3T 1A8, Canada
- Cardiometabolic Health, Diabetes, and Obesity Research Network (CMDO), Montreal, QC J1H 5N4, Canada
- Institute of Nutrition and Functional Food, Quebec City, QC G1V 0A6, Canada
| | - Nicolas Prud’homme
- Division of Hematology-Oncology, CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
| | - Isabelle Gélinas
- School of Physical and Occupational Therapy, McGill University, Montreal, QC H3G 1Y5, Canada
| | - Johanne Higgins
- School of Rehabilitation, Université de Montréal, Montreal, QC H3N 1X7, Canada
| | - Daniel Curnier
- Research Center of the CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
- School of Kinesiology and Physical Activity Sciences, Université de Montréal, Montreal, QC H3T 1J4, Canada
| | - Serge Sultan
- Research Center of the CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
- Department of Psychology, Université de Montréal, Montreal, QC H3C 3J7, Canada
| | - Caroline Laverdière
- Research Center of the CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
- Department of Pediatrics, Université de Montréal, Montreal, QC H3T 1C5, Canada
| | - Daniel Sinnett
- Research Center of the CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
- Department of Pediatrics, Université de Montréal, Montreal, QC H3T 1C5, Canada
| | - Valérie Marcil
- Research Center of the CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
- Department of Nutrition, Université de Montreal, Montreal, QC H3T 1A8, Canada
- Cardiometabolic Health, Diabetes, and Obesity Research Network (CMDO), Montreal, QC J1H 5N4, Canada
- Institute of Nutrition and Functional Food, Quebec City, QC G1V 0A6, Canada
- Correspondence: ; Tel.: +1-514-345-4931-(3272)
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Auger LP, Masse J, Higgins J. Sexuality in Occupational Therapy: A Call to Action. Br J Occup Ther 2022. [DOI: 10.1177/03080226221107769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Louis-Pierre Auger
- Occupational Therapy Department, School of Rehabilitation, Université de Montréal, Montreal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, QC, Canada
| | - Julie Masse
- Occupational Therapy Department, School of Rehabilitation, Université de Montréal, Montreal, QC, Canada
| | - Johanne Higgins
- Occupational Therapy Department, School of Rehabilitation, Université de Montréal, Montreal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, QC, Canada
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Norgaard Z, Higgins J, Yaplee J, Blake J, Prieve M, Lo FY, Delaney C, Valentine C, Salk J. Process Development and Manufacturing: ULTRA-SENSITIVE DUPLEX SEQUENCING FOR QUANTIFYING MULTI-INDIVIDUAL CELL THERAPY SUB-POPULATION FRACTIONS. Cytotherapy 2022. [DOI: 10.1016/s1465-3249(22)00455-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Proulx CE, Louis Jean MT, Higgins J, Gagnon DH, Dancause N. Somesthetic, Visual, and Auditory Feedback and Their Interactions Applied to Upper Limb Neurorehabilitation Technology: A Narrative Review to Facilitate Contextualization of Knowledge. Front Rehabilit Sci 2022; 3:789479. [PMID: 36188924 PMCID: PMC9397809 DOI: 10.3389/fresc.2022.789479] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 01/14/2022] [Indexed: 11/13/2022]
Abstract
Reduced hand dexterity is a common component of sensorimotor impairments for individuals after stroke. To improve hand function, innovative rehabilitation interventions are constantly developed and tested. In this context, technology-based interventions for hand rehabilitation have been emerging rapidly. This paper offers an overview of basic knowledge on post lesion plasticity and sensorimotor integration processes in the context of augmented feedback and new rehabilitation technologies, in particular virtual reality and soft robotic gloves. We also discuss some factors to consider related to the incorporation of augmented feedback in the development of technology-based interventions in rehabilitation. This includes factors related to feedback delivery parameter design, task complexity and heterogeneity of sensory deficits in individuals affected by a stroke. In spite of the current limitations in our understanding of the mechanisms involved when using new rehabilitation technologies, the multimodal augmented feedback approach appears promising and may provide meaningful ways to optimize recovery after stroke. Moving forward, we argue that comparative studies allowing stratification of the augmented feedback delivery parameters based upon different biomarkers, lesion characteristics or impairments should be advocated (e.g., injured hemisphere, lesion location, lesion volume, sensorimotor impairments). Ultimately, we envision that treatment design should combine augmented feedback of multiple modalities, carefully adapted to the specific condition of the individuals affected by a stroke and that evolves along with recovery. This would better align with the new trend in stroke rehabilitation which challenges the popular idea of the existence of an ultimate good-for-all intervention.
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Affiliation(s)
- Camille E. Proulx
- School of Rehabilitation, Faculty of Medecine, Université de Montréal, Montreal, QC, Canada
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal – Site Institut universitaire sur la réadaptation en déficience physique de Montréal, CIUSSS Centre-Sud-de-l'Île-de-Montréal, Montreal, QC, Canada
- *Correspondence: Camille E. Proulx
| | | | - Johanne Higgins
- School of Rehabilitation, Faculty of Medecine, Université de Montréal, Montreal, QC, Canada
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal – Site Institut universitaire sur la réadaptation en déficience physique de Montréal, CIUSSS Centre-Sud-de-l'Île-de-Montréal, Montreal, QC, Canada
| | - Dany H. Gagnon
- School of Rehabilitation, Faculty of Medecine, Université de Montréal, Montreal, QC, Canada
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal – Site Institut universitaire sur la réadaptation en déficience physique de Montréal, CIUSSS Centre-Sud-de-l'Île-de-Montréal, Montreal, QC, Canada
| | - Numa Dancause
- Department of Neurosciences, Faculty of Medecine, Université de Montréal, Montreal, QC, Canada
- Centre interdisciplinaire de recherche sur le cerveau et l'apprentissage (CIRCA), Université de Montréal, Montreal, QC, Canada
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11
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Hernandez A, Bubyr L, Archambault PS, Higgins J, Levin MF, Kairy D. VR-based rehabilitation as a Feasible and Engaging Tool for the Management of Chronic Post-Stroke Upper Extremity Function Recovery: A Randomized Controlled Trial (Preprint). JMIR Serious Games 2022; 10:e37506. [PMID: 36166289 PMCID: PMC9555337 DOI: 10.2196/37506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 05/27/2022] [Accepted: 07/21/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Alejandro Hernandez
- Centre for Interdisciplinary Research in Rehabilitation, Montreal, QC, Canada
| | | | - Philippe S Archambault
- Centre for Interdisciplinary Research in Rehabilitation, Montreal, QC, Canada
- School of Physical & Occupational Therapy, McGill University, Montreal, QC, Canada
| | - Johanne Higgins
- Centre for Interdisciplinary Research in Rehabilitation, Montreal, QC, Canada
- Ecole de sciences de la réadaptation, Université de Montréal, Montreal, QC, Canada
| | - Mindy F Levin
- Centre for Interdisciplinary Research in Rehabilitation, Montreal, QC, Canada
- School of Physical & Occupational Therapy, McGill University, Montreal, QC, Canada
| | - Dahlia Kairy
- Centre for Interdisciplinary Research in Rehabilitation, Montreal, QC, Canada
- Ecole de sciences de la réadaptation, Université de Montréal, Montreal, QC, Canada
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12
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Holloway GL, Higgins J, Beranek JP. Split staphylectomy to address soft palate thickness in brachycephalic dogs: 75 cases (2016-2018). J Small Anim Pract 2022; 63:460-467. [PMID: 35137415 DOI: 10.1111/jsap.13485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 01/19/2022] [Accepted: 01/19/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Describe the split staphylectomy procedure to address soft palate thickness and assess the complications and long-term outcome of this procedure as a part of multi-level surgery for brachycephalic obstructive airway syndrome. To consider whether same-day discharge following this surgery can be recommended. MATERIALS AND METHODS Medical records of dogs treated for brachycephalic obstructive airway syndrome using the split staphylectomy were reviewed. Owners were contacted to complete a questionnaire assessing initial postoperative concerns, the long-term outcome and the effect of surgery on their dog's quality of life. RESULTS Seventy-five dogs underwent split staphylectomy during the study period. The overall complication rate was 8.3%, of which 2.7% were considered major. No life-threatening complications occurred, and no complications were related to the staphylectomy. The questionnaire was completed by 66.7% of owners (median follow-up 459 days), of which 88% felt that surgery had improved the quality of life for their dog. The majority (88%) of dogs were discharged from hospital on the day of surgery. Of the surveyed owners, 14% sought veterinary attention between their dog leaving the hospital and the scheduled postoperative reassessment 2 weeks after surgery. Four dogs were presented for veterinary intervention during this time period, but no intervention was related to the staphylectomy or for a life-threatening condition. CLINICAL SIGNIFICANCE The split staphylectomy offers a safe, straightforward method of addressing both excess thickness and length of soft palate in dogs with brachycephalic obstructive airway syndrome. Dogs can be discharged on the same day as brachycephalic obstructive airway syndrome surgery including split staphylectomy without an increased risk of complications.
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Affiliation(s)
| | - J Higgins
- Kentdale Referrals, Cumbria, LA7 7NU, UK
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13
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Spencer BF, Church SA, Thompson P, Cant DJH, Maniyarasu S, Theodosiou A, Jones AN, Kappers MJ, Binks DJ, Oliver RA, Higgins J, Thomas AG, Thomson T, Shard AG, Flavell WR. Characterization of buried interfaces using Ga Kα hard X-ray photoelectron spectroscopy (HAXPES). Faraday Discuss 2022; 236:311-337. [DOI: 10.1039/d2fd00021k] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
HAXPES enables the detection of buried interfaces with an increased photo electron sampling depth.
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Affiliation(s)
- B. F. Spencer
- Henry Royce Institute, Photon Science Institute, Department of Materials, School of Natural Sciences, The University of Manchester, Manchester, M13 9PL, UK
| | - S. A. Church
- Henry Royce Institute, Photon Science Institute, Department of Physics and Astronomy, School of Natural Sciences, The University of Manchester, Manchester, M13 9PL, UK
| | - P. Thompson
- Department of Computer Science, School of Engineering, The University of Manchester, Manchester, M13 9PL, UK
| | - D. J. H. Cant
- Surface Technologies, Chemical and Biological Sciences Department, National Physical Laboratory, Hampton Road, Teddington, TW11 0LW, UK
| | - S. Maniyarasu
- Henry Royce Institute, Photon Science Institute, Department of Physics and Astronomy, School of Natural Sciences, The University of Manchester, Manchester, M13 9PL, UK
| | - A. Theodosiou
- The Nuclear Graphite Research Group, The University of Manchester, Oxford Road, Manchester, M13 9PL, UK
| | - A. N. Jones
- The Nuclear Graphite Research Group, The University of Manchester, Oxford Road, Manchester, M13 9PL, UK
| | - M. J. Kappers
- Department of Materials Science & Metallurgy, University of Cambridge, 27 Charles Babbage Road, Cambridge, CB3 0FS, UK
| | - D. J. Binks
- Henry Royce Institute, Photon Science Institute, Department of Physics and Astronomy, School of Natural Sciences, The University of Manchester, Manchester, M13 9PL, UK
| | - R. A. Oliver
- Department of Materials Science & Metallurgy, University of Cambridge, 27 Charles Babbage Road, Cambridge, CB3 0FS, UK
| | | | - A. G. Thomas
- Henry Royce Institute, Photon Science Institute, Department of Materials, School of Natural Sciences, The University of Manchester, Manchester, M13 9PL, UK
| | - T. Thomson
- Department of Computer Science, School of Engineering, The University of Manchester, Manchester, M13 9PL, UK
| | - A. G. Shard
- Surface Technologies, Chemical and Biological Sciences Department, National Physical Laboratory, Hampton Road, Teddington, TW11 0LW, UK
| | - W. R. Flavell
- Henry Royce Institute, Photon Science Institute, Department of Physics and Astronomy, School of Natural Sciences, The University of Manchester, Manchester, M13 9PL, UK
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14
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Kechichian A, Lafrance S, Matifat E, Dubé F, Lussier D, Benhaim P, Perreault K, Filiatrault J, Rainville P, Higgins J, Rousseau J, Masse J, Desmeules F. Multimodal Interventions Including Rehabilitation Exercise for Older Adults With Chronic Musculoskeletal Pain: A Systematic Review and Meta-analyses of Randomized Controlled Trials. J Geriatr Phys Ther 2021; 45:34-49. [PMID: 34928239 DOI: 10.1519/jpt.0000000000000279] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND AND PURPOSE Musculoskeletal disorders (MSKDs) are the most common causes of disabilities for older adults. The aim of this systematic review and meta-analysis is to assess the effectiveness of multimodal interventions including exercise rehabilitation for older adults with chronic MSKDs. METHODS A literature search was conducted up to February 2019 in 5 bibliographical databases to identify randomized controlled trials (RCTs) that compared multimodal interventions including exercise rehabilitation with usual medical care or no intervention. Randomized controlled trials were assessed with the Cochrane risk-of-bias tool. Meta-analyses were performed and pooled mean differences (MDs) or standardized mean differences (SMDs) were calculated. RESULTS Sixteen RCTs (n = 2322 participants) were included. One RCT was considered at low risk of bias, 8 had some concerns of bias, and 7 had a high risk of bias. Participants suffered from hip or knee osteoarthritis (OA) (n = 12 RCTs), low back pain (LBP) (n = 2 RCTs) and generalized chronic pain (GCP) (n = 2 RCTs). Multimodal interventions were significantly more effective than usual care to decrease pain (visual analog scale, out of 10 points) in the short term, MD: -0.71 (95% confidence interval [CI] -1.08 to -0.34, n = 900), and in the long term: MD: -0.52 (95% CI -0.98 to -0.05, n = 575), but these differences are not considered clinically important. In terms of disabilities, multimodal interventions were also significantly more effective than usual care. The SMDs were -0.47 (95% CI -0.61 to -0.34, n = 903) and -0.29 (95% CI -0.46 to -0.13, n = 568) for OA trials in the short and long terms, respectively, and -0.47 (95% CI -0.81 to -0.12, n = 211) for LBP and GCP trials in the short term. The magnitude of these effects may be considered as small to moderate. CONCLUSION Multimodal intervention including exercise rehabilitation combined with usual medical care is an efficacious therapeutic option to reduce disabilities in older adults with chronic MSKDs. A significant but not clinically important effect was observed for pain. The most beneficial component of the multimodal interventions in terms of education, exercises, or medication remains to be determined.
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Affiliation(s)
- Amélie Kechichian
- Maisonneuve-Rosemont Hospital Research Center, University of Montreal Affiliated Research Center, Montreal, Quebec, Canada.,Pierre and Marie Curie University, Sorbonne University, Paris, France
| | - Simon Lafrance
- Maisonneuve-Rosemont Hospital Research Center, University of Montreal Affiliated Research Center, Montreal, Quebec, Canada.,School of Rehabilitation, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Eveline Matifat
- Maisonneuve-Rosemont Hospital Research Center, University of Montreal Affiliated Research Center, Montreal, Quebec, Canada
| | - François Dubé
- School of Rehabilitation, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada.,Institut Universitaire de Gériatrie de Montréal, CIUSSS Centre-Sud-de-l'Ile-de-Montréal, Montreal, Quebec, Canada
| | - David Lussier
- Institut Universitaire de Gériatrie de Montréal, CIUSSS Centre-Sud-de-l'Ile-de-Montréal, Montreal, Quebec, Canada.,Department of Medicine, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Patrick Benhaim
- Institut Universitaire de Gériatrie de Montréal, CIUSSS Centre-Sud-de-l'Ile-de-Montréal, Montreal, Quebec, Canada.,Department of Medicine, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Kadija Perreault
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec City, Quebec, Canada.,Department of Rehabilitation, Faculty of Medicine, University of Laval, Quebec, Canada
| | - Johanne Filiatrault
- School of Rehabilitation, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada.,Institut Universitaire de Gériatrie de Montréal, CIUSSS Centre-Sud-de-l'Ile-de-Montréal, Montreal, Quebec, Canada
| | - Pierre Rainville
- Institut Universitaire de Gériatrie de Montréal, CIUSSS Centre-Sud-de-l'Ile-de-Montréal, Montreal, Quebec, Canada.,Departement of Stomatology, Faculty of Dental Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Johanne Higgins
- School of Rehabilitation, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada.,Center for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Quebec, Canada
| | - Jacqueline Rousseau
- School of Rehabilitation, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada.,Institut Universitaire de Gériatrie de Montréal, CIUSSS Centre-Sud-de-l'Ile-de-Montréal, Montreal, Quebec, Canada
| | - Julie Masse
- School of Rehabilitation, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada
| | - François Desmeules
- Maisonneuve-Rosemont Hospital Research Center, University of Montreal Affiliated Research Center, Montreal, Quebec, Canada.,School of Rehabilitation, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada
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15
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Akremi H, Higgins J, Aissaoui R, Nadeau S. Bilateral motor coordination during upper limb symmetric pushing movements at two levels of force resistance in healthy and post-stroke individuals. Hum Mov Sci 2021; 81:102913. [PMID: 34952321 DOI: 10.1016/j.humov.2021.102913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 12/06/2021] [Accepted: 12/07/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Impairments of the upper limb (UL) are common after a stroke and may affect bilateral coordination. A better understanding of UL bilateral coordination is required for designing innovative rehabilitation strategies. OBJECTIVE To assess bilateral coordination after stroke using time-distance, velocity and force parameters during an UL bilateral task performed by simultaneously pushing handles on a bilateral exerciser at two levels of force. METHODS Two groups were included to assess bilateral coordination on a newly designed bimanual exerciser- One group of individuals at least 3 months post-stroke (n = 19) with moderate impairment and one group of healthy individuals (n = 20). Participants performed linear movements by pushing simultaneously with both hands on instrumented handles. The task consisted of two one-minute trials performed in sitting at two levels of participants' maximum force (MF): 30% and 15%, with visual feedback. Time-distance parameters, spatial, velocity and force profiles were compared between groups, between levels of resistance and the first part (0-50%) and entire duration of the pushing cycles (0-100%). RESULTS The mean pushing time was longer at 30% MF compared to 15% MF in the stroke group. Spatial profiles, represented by hand positions on the rail, revealed that the paretic hand lagged slightly behind throughout the cycle. For velocity, both groups displayed good coordination. It was less coupled at 30% than 15% MF and a trend was observed toward more lag occurrence in the stroke group. Except for lower forces on the paretic side in the stroke group, the shape of the force profiles was similar between groups, sides and levels of resistance. For all parameters, the coordination was good up to 75% of the pushing cycle and decreased toward the end of the cycle. CONCLUSIONS Individuals after stroke presented with overall spatial and temporal coupling of the UL during bilateral pushing movements. The relay of information at different levels of the nervous system might explain the coordinated pushing movements and might be interesting for training UL coordination.
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Affiliation(s)
- Haifa Akremi
- École de réadaptation, Faculté de médecine, Université de Montréal, C.P.6128 Succ. Centre-ville, Montréal, QC H3C 3J7, Canada; Laboratoire de pathokinésiologie, Institut universitaire sur la réadaptation en déficience physique de Montréal-Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR), Montreal, Canada
| | - Johanne Higgins
- École de réadaptation, Faculté de médecine, Université de Montréal, C.P.6128 Succ. Centre-ville, Montréal, QC H3C 3J7, Canada; Laboratoire de pathokinésiologie, Institut universitaire sur la réadaptation en déficience physique de Montréal-Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR), Montreal, Canada
| | - Rachid Aissaoui
- Laboratoire de pathokinésiologie, Institut universitaire sur la réadaptation en déficience physique de Montréal-Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR), Montreal, Canada; École de Technologie Supérieure (ETS) and Imaging and Orthopaedics Research Laboratory, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Canada
| | - Sylvie Nadeau
- École de réadaptation, Faculté de médecine, Université de Montréal, C.P.6128 Succ. Centre-ville, Montréal, QC H3C 3J7, Canada; Laboratoire de pathokinésiologie, Institut universitaire sur la réadaptation en déficience physique de Montréal-Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR), Montreal, Canada.
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16
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Bernaerts S, De Witte NAJ, Van der Auwera V, Bonroy B, Muraru L, Bamidis P, Frantzidis C, Kourtidou-Papadeli C, Azevedo N, Garatea J, Muñoz I, Almeida R, Losada R, Fung J, Kehayia E, Lamontagne A, de Guise E, Duclos C, Higgins J, Nadeau S, Beaudry L, Konstantinidis E. Rehabilitation supported by technology: Protocol for an international co-creation and user experience study (Preprint). JMIR Res Protoc 2021; 11:e34537. [PMID: 35266874 PMCID: PMC8949709 DOI: 10.2196/34537] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 12/21/2021] [Accepted: 12/22/2021] [Indexed: 12/24/2022] Open
Abstract
Background Living labs in the health and well-being domain have become increasingly common over the past decade but vary in available infrastructure, implemented study designs, and outcome measures. The Horizon 2020 Project Virtual Health and Wellbeing Living Lab Infrastructure aims to harmonize living lab procedures and open living lab infrastructures to facilitate and promote research activities in the health and well-being domain in Europe and beyond. This protocol will describe the design of a joint research activity, focusing on the use of innovative technology for both rehabilitation interventions and data collection in a rehabilitation context. Objective With this joint research activity, this study primarily aims to gain insight into each living lab’s infrastructure and procedures to harmonize health and well-being living lab procedures and infrastructures in Europe and beyond, particularly in the context of rehabilitation. Secondarily, this study aims to investigate the potential of innovative technologies for rehabilitation through living lab methodologies. Methods This study has a mixed methods design comprising multiple phases. There are two main phases of data collection: cocreation (phase 1) and small-scale pilot studies (phase 2), which are preceded by a preliminary harmonization of procedures among the different international living labs. An intermediate phase further allows the implementation of minor adjustments to the intervention or protocol depending on the input that was obtained in the cocreation phase. A total of 6 small-scale pilot studies using innovative technologies for intervention or data collection will be performed across 4 countries. The target study sample comprises patients with stroke and older adults with mild cognitive impairment. The third and final phases involve Delphi procedures to reach a consensus on harmonized procedures and protocols. Results Phase 1 data collection will begin in March 2022, and phase 2 data collection will begin in June 2022. Results will include the output of the cocreation sessions, small-scale pilot studies, and advice on harmonizing procedures and protocols for health and well-being living labs focusing on rehabilitation. Conclusions The knowledge gained by the execution of this research will lead to harmonized procedures and protocols in a rehabilitation context for health and well-being living labs in Europe and beyond. In addition to the harmonized procedures and protocols in rehabilitation, we will also be able to provide new insights for improving the implementation of innovative technologies in rehabilitation. International Registered Report Identifier (IRRID) PRR1-10.2196/34537
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Affiliation(s)
- Sylvie Bernaerts
- LiCalab, Thomas More University of Applied Sciences, Geel, Belgium
- Expertise Unit Psychology, Technology & Society, Thomas More University of Applied Sciences, Antwerpen, Belgium
| | - Nele A J De Witte
- LiCalab, Thomas More University of Applied Sciences, Geel, Belgium
- Expertise Unit Psychology, Technology & Society, Thomas More University of Applied Sciences, Antwerpen, Belgium
| | | | - Bert Bonroy
- Mobilab & Care, Thomas More University of Applied Sciences, Geel, Belgium
| | - Luiza Muraru
- Mobilab & Care, Thomas More University of Applied Sciences, Geel, Belgium
| | - Panagiotis Bamidis
- Medical Physics and Digital Innovation Laboratory, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Christos Frantzidis
- Medical Physics and Digital Innovation Laboratory, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Chrysoula Kourtidou-Papadeli
- Medical Physics and Digital Innovation Laboratory, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Greek Aerospace Medical Association and Space Research, Thessaloniki, Greece
| | - Nancy Azevedo
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain, Institut Universitaire sur la réadaptation en déficience physique de Montréal, Montreal, QC, Canada
| | - Jokin Garatea
- GAIA, Asociación de Industrias de Conocimiento y Tecnologías Aplicadas, San Sebastian, Spain
| | - Idoia Muñoz
- GAIA, Asociación de Industrias de Conocimiento y Tecnologías Aplicadas, San Sebastian, Spain
| | - Rosa Almeida
- Fundación INTRAS, Research, Development and Innovation Department, Valladolid, Spain
| | - Raquel Losada
- Fundación INTRAS, Research, Development and Innovation Department, Valladolid, Spain
| | - Joyce Fung
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain, Institut Universitaire sur la réadaptation en déficience physique de Montréal, Montreal, QC, Canada
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
| | - Eva Kehayia
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain, Institut Universitaire sur la réadaptation en déficience physique de Montréal, Montreal, QC, Canada
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
| | - Anouk Lamontagne
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain, Institut Universitaire sur la réadaptation en déficience physique de Montréal, Montreal, QC, Canada
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
| | - Elaine de Guise
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain, Institut Universitaire sur la réadaptation en déficience physique de Montréal, Montreal, QC, Canada
- Université de Montreal, Montreal, QC, Canada
| | - Cyril Duclos
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain, Institut Universitaire sur la réadaptation en déficience physique de Montréal, Montreal, QC, Canada
- Université de Montreal, Montreal, QC, Canada
| | - Johanne Higgins
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain, Institut Universitaire sur la réadaptation en déficience physique de Montréal, Montreal, QC, Canada
- Université de Montreal, Montreal, QC, Canada
| | - Sylvie Nadeau
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain, Institut Universitaire sur la réadaptation en déficience physique de Montréal, Montreal, QC, Canada
- Université de Montreal, Montreal, QC, Canada
| | - Lucie Beaudry
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain, Institut Universitaire sur la réadaptation en déficience physique de Montréal, Montreal, QC, Canada
- Dance Department, Université du Québec à Montréal, Montreal, QC, Canada
| | - Evdokimos Konstantinidis
- Medical Physics and Digital Innovation Laboratory, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
- European Network of Living Labs, Brussels, Belgium
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17
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Allegue DR, Higgins J, Sweet SN, Archambault PS, Michaud F, Miller W, Tousignant M, Kairy D. Rehabilitation of upper extremity by telerehabilitation combined with exergames in chronic stroke survivors: Preliminary findings from a feasibility clinical trial (Preprint). JMIR Rehabil Assist Technol 2021; 9:e33745. [PMID: 35731560 PMCID: PMC9260524 DOI: 10.2196/33745] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 02/09/2022] [Accepted: 04/29/2022] [Indexed: 02/02/2023] Open
Abstract
Background Exergames are increasingly being used among survivors of stroke with chronic upper extremity (UE) sequelae to continue exercising at home after discharge and maintain activity levels. The use of virtual reality exergames combined with a telerehabilitation app (VirTele) may be an interesting alternative to rehabilitate the UE sequelae in survivors of chronic stroke while allowing for ongoing monitoring with a clinician. Objective This study aimed to determine the feasibility of using VirTele in survivors of chronic stroke at home and explore the impact of VirTele on UE motor function, quantity and quality of use, quality of life, and motivation in survivors of chronic stroke compared with conventional therapy. Methods This study was a 2-arm feasibility clinical trial. Eligible participants were randomly allocated to an experimental group (receiving VirTele for 8 weeks) or a control group (receiving conventional therapy for 8 weeks). Feasibility was measured from the exergame and intervention logs completed by the clinician. Outcome measurements included the Fugl-Meyer Assessment-UE, Motor Activity Log-30, Stroke Impact Scale-16, and Treatment Self-Regulation Questionnaire-15, which were administered to both groups at four time points: time point 1 (T1; before starting the intervention), time point 2 (after the intervention), time point 3 (1 month after the intervention), and time point 4 (T4; 2 months after the intervention). Results A total of 11 survivors of stroke were randomized and allocated to an experimental or a control group. At the onset of the COVID-19 pandemic, participants pursued the allocated treatment for 3 months instead of 8 weeks. VirTele intervention dose was captured in terms of time spent on exergames, frequency of use of exergames, total number of successful repetitions, and frequency of videoconference sessions. Technical issues included the loss of passwords, internet issues, updates of the system, and problems with the avatar. Overall, most survivors of stroke found the technology easy to use and useful, except for 9% (1/11) of participants. For the Fugl-Meyer Assessment-UE and Motor Activity Log-30, both groups exhibited an improvement in >50% of the participants, which was maintained over time (from time point 3 to T4). Regarding Stroke Impact Scale-16 scores, the control group reported improvement in activities of daily life (3/5, 60%), hand function (5/5, 100%), and mobility (2/5, 40%), whereas the experimental group reported varied and inconclusive results (from T1 to T4). For the Treatment Self-Regulation Questionnaire-15, 75% (3/4) of the experimental group demonstrated an increase in the autonomous motivation score (from T1 to time point 2), whereas, in the control group, this improvement was observed in only 9% (1/11) of participants. Conclusions The VirTele intervention constitutes another therapeutic alternative, in addition to conventional therapy, to deliver an intense personalized rehabilitation program for survivors of chronic stroke with UE sequelae. International Registered Report Identifier (IRRID) RR2-10.2196/14629
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Affiliation(s)
- Dorra Rakia Allegue
- School of Rehabilitation, Université de Montréal, Montreal, QC, Canada
- The Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Institut universitaire sur la réadaptation en déficience physique de Montréal, Montreal, QC, Canada
- Mission Universitaire de Tunisie, Montreal, QC, Canada
| | - Johanne Higgins
- School of Rehabilitation, Université de Montréal, Montreal, QC, Canada
- The Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Institut universitaire sur la réadaptation en déficience physique de Montréal, Montreal, QC, Canada
| | - Shane N Sweet
- The Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Institut universitaire sur la réadaptation en déficience physique de Montréal, Montreal, QC, Canada
- Department of Kinesiology and Physical Education, McGill University, Montreal, QC, Canada
| | - Philippe S Archambault
- The Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Institut universitaire sur la réadaptation en déficience physique de Montréal, Montreal, QC, Canada
- School of Physical & Occupational Therapy, McGill University, Montreal, QC, Canada
| | - Francois Michaud
- Department of Electrical Engineering and Computer Engineering, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - William Miller
- Department of Occupational Science & Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Michel Tousignant
- Faculty of Medicine and Health Sciences, School of Rehabilitation, Université de Sherbrooke, Sherbrooke, QC, Canada
- Center of research on Aging, Sherbrooke, QC, Canada
| | - Dahlia Kairy
- School of Rehabilitation, Université de Montréal, Montreal, QC, Canada
- The Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Institut universitaire sur la réadaptation en déficience physique de Montréal, Montreal, QC, Canada
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18
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Weil S, Jung E, Domínguez Azorín D, Higgins J, Reckless J, Ramsden N, Keller P, Grainger D, Wick W, Winkler F. P10.02 Combined methods of a micropump system and a chronic cranial window allows tumor observation with multi photon laser scanning microscopy under continuous treatment. Neuro Oncol 2021. [DOI: 10.1093/neuonc/noab180.095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
BACKGROUND
Glioblastomas are notoriously therapy resistant tumors. As opposed to other tumor entities, no major advances in therapeutic success have been made in the past decades. This has been calling for a deeper biological understanding of the tumor, its growth and resistance patterns. We have been using a xenograft glioma model, where human glioblastoma cells are implanted under chronic cranial windows and studied longitudinally over many weeks and months using multi photon laser scanning microscopy (MPLSM). To test the effect of (new) drugs, a stable and direct delivery system avoiding the blood-brain-barrier has come into our interest.
MATERIAL AND METHODS
We implanted cranial windows and fluorescently labeled human glioblastoma stem-like cells into NMRI nude mice to follow up on the tumor development in our MPLSM model. After tumor establishment, an Alzet® micropump was implanted to directly deliver agents via a catheter system continuously over 28 days directly under the cranial window onto the brain surface. Using the MPLSM technique, the continuous delivery and infusion of drugs onto the brain and into the tumor was measured over many weeks in detail using MPLSM.
RESULTS
The establishment of the combined methods allowed reliable concurrent drug delivery over 28 days bypassing the blood-brain-barrier. Individual regions and tumor cells could be measured and followed up before, and after the beginning of the treatment, as well as after the end of the pump activity. Fluorescently labelled drugs were detectable in the MPLSM and its distribution into the brain parenchyma could be quantified. After the end of the micropump activity, further MPLSM measurements offer the possibility to observe long term effects of the applied drug on the tumor.
CONCLUSION
The combination of tumor observation in the MPSLM and concurrent continuous drug delivery is a feasible and reliable method for the investigation of (novel) anti-tumor agents, especially drugs that are not blood-brain-barrier penetrant. Morphological or even functional changes of individual tumor cells can be measured under and after treatment. These techniques can be used to test new drugs targeting the tumor, its tumor microtubes and tumor cells networks, and measure the effects longitudinally.
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Affiliation(s)
- S Weil
- Neurology Clinic and National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - E Jung
- Neurology Clinic and National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - D Domínguez Azorín
- Neurology Clinic and National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - J Higgins
- Divide & Conquer, Cambridge, United Kingdom
| | - J Reckless
- Divide & Conquer, Cambridge, United Kingdom
| | - N Ramsden
- Divide & Conquer, Cambridge, United Kingdom
| | - P Keller
- Divide & Conquer, Cambridge, United Kingdom
| | - D Grainger
- Divide & Conquer, Cambridge, United Kingdom
| | - W Wick
- Neurology Clinic and National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - F Winkler
- Neurology Clinic and National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
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19
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Forget NJ, Higgins J, Rivard M, Harris PG. Going beyond Activity and Participation: Development of the DIF-CHUM-A patient-reported outcome measure for individuals with Dupuytren's contracture. J Hand Ther 2021; 33:305-313. [PMID: 31492480 DOI: 10.1016/j.jht.2019.03.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 03/27/2019] [Accepted: 03/28/2019] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN This is a cross-sectional clinical measurement. INTRODUCTION There are currently no Dupuytren's contracture (DC)-specific, patient-reported outcomes (PROs) that can provide a thorough clinical portrait of the patients' perceptions with regard to the execution of regular activities. PURPOSE OF THE STUDY The purpose of this study was to present the development of the Dupuytren's contracture Impact on Function-Centre Hospitalier de l'Université de Montréal (DIF-CHUM), a DC-specific PRO. METHODS The development process involved consultation of 45 individuals with DC and 7 health professionals, existing literature, and DC-specific PRO. RESULTS The DIF-CHUM is composed of 2 sections: section 1, Activity and Participation includes 8 items per hand, scored on Difficulty and Change scales; section 2, General Impact includes up to 18 items, scored on Difficulty, Importance, Change and Satisfaction scales. Preliminary evidence suggests that the DIF-CHUM demonstrates good content validity. DISCUSSION The DIF-CHUM is designed to be a patient-centered measure of Activity and Participation and Functional Competence for individuals with DC that will provide hand therapists with a unique perspective of the impact of DC on patients' lives. CONCLUSION Further validation of the DIF-CHUM, including its scoring, is under way.
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Affiliation(s)
- Nancy J Forget
- Public Health PhD Program, School of Public Health, University of Montreal, Montreal, Quebec, Canada.
| | - Johanne Higgins
- School of Rehabilitation, University of Montreal, Montreal, Quebec, Canada; Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Quebec, Canada
| | - Michèle Rivard
- Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, Quebec, Canada; Public Health Research Institute, University of Montreal, Montreal, Quebec, Canada
| | - Patrick G Harris
- Plastic Surgery Service, Department of Surgery, University of Montreal Hospital Center (CHUM), Montreal, Quebec, Canada
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20
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Allegue DR, Kairy D, Higgins J, Archambault PS, Michaud F, Miller WC, Sweet SN, Tousignant M. A Personalized Home-Based Rehabilitation Program Using Exergames Combined With a Telerehabilitation App in a Chronic Stroke Survivor: Mixed Methods Case Study. JMIR Serious Games 2021; 9:e26153. [PMID: 34132649 PMCID: PMC8441601 DOI: 10.2196/26153] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 04/08/2021] [Accepted: 05/29/2021] [Indexed: 02/01/2023] Open
Abstract
Background In Canada, only 11% of stroke survivors have access to outpatient and community-based rehabilitation after discharge from inpatient rehabilitation. Hence, innovative community-based strategies are needed to provide adequate postrehabilitation services. The VirTele program, which combines virtual reality exergames and a telerehabilitation app, was developed to provide stroke survivors with residual upper extremity deficits, the opportunity to participate in a personalized home rehabilitation program. Objective This study aims to determine the feasibility of VirTele for remote upper extremity rehabilitation in a chronic stroke survivor; explore the preliminary efficacy of VirTele on upper extremity motor function, the amount and quality of upper extremity use, and impact on quality of life and motivation; and explore the determinants of behavioral intention and use behavior of VirTele along with indicators of empowerment. Methods A 63-year-old male stroke survivor (3 years) with moderate upper extremity impairment participated in a 2-month VirTele intervention. He was instructed to use exergames (5 games for upper extremity) for 30 minutes, 5 times per week, and conduct videoconference sessions with a clinician at least once per week. Motivational interviewing was incorporated into VirTele to empower the participant to continue exercising and use his upper extremities in everyday activities. Upper extremity motor function (Fugl-Meyer Assessment–upper extremity), amount and quality of upper extremity use (Motor Activity Log-30), and impact on quality of life (Stroke Impact Scale-16) and motivation (Treatment Self-Regulation Questionnaire-15) were measured before (T1), after (T2) VirTele intervention, and during a 1- (T3) and 2-month (T4) follow-up period. Qualitative data were collected through logs and semistructured interviews. Feasibility data (eg, number and duration of videoconference sessions and adherence) were documented at the end of each week. Results The participant completed 48 exergame sessions (33 hours) and 8 videoconference sessions. Results suggest that the VirTele intervention and the study protocol could be feasible for stroke survivors. The participant exhibited clinically meaningful improvements at T2 on the Fugl-Meyer and Stroke Impact Scale-16 and maintained these gains at T3 and T4. During the follow-up periods, the amount and quality of upper extremity use showed meaningful changes, suggesting more involvement of the affected upper extremity in daily activities. The participant demonstrated a high level of autonomous motivation, which may explain his adherence. Performance, effort, and social influence have meaningful weights in the behavioral intention of using VirTele. However, the lack of control of technical and organizational infrastructures may influence the long-term use of technology. At the end of the intervention, the participant demonstrated considerable empowerment at both the behavioral and capacity levels. Conclusions VirTele was shown to be feasible for use in chronic stroke survivors for remote upper extremity rehabilitation. Meaningful determinants of behavioral intention and use behavior of VirTele were identified, and preliminary efficacy results are promising. International Registered Report Identifier (IRRID) RR2-10.2196/14629
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Affiliation(s)
- Dorra Rakia Allegue
- School of Rehabilitation, Université de Montréal, Montreal, QC, Canada.,The Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Institut universitaire sur la réadaptation en déficience physique de Montréal, Montreal, QC, Canada.,Mission Universitaire de Tunisie, Montreal, QC, Canada
| | - Dahlia Kairy
- School of Rehabilitation, Université de Montréal, Montreal, QC, Canada.,The Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Institut universitaire sur la réadaptation en déficience physique de Montréal, Montreal, QC, Canada
| | - Johanne Higgins
- School of Rehabilitation, Université de Montréal, Montreal, QC, Canada.,The Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Institut universitaire sur la réadaptation en déficience physique de Montréal, Montreal, QC, Canada
| | - Philippe S Archambault
- The Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Institut universitaire sur la réadaptation en déficience physique de Montréal, Montreal, QC, Canada.,School of Physical & Occupational Therapy, McGill University, Montreal, QC, Canada
| | - Francois Michaud
- Department of Electrical Engineering and Computer Engineering, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - William C Miller
- Department of Occupational Science & Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Shane N Sweet
- The Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Institut universitaire sur la réadaptation en déficience physique de Montréal, Montreal, QC, Canada.,Department of Kinesiology and Physical Education, McGill University, Montreal, QC, Canada
| | - Michel Tousignant
- Faculty of Medicine and Health Sciences, School of Rehabilitation, Université de Sherbrooke, Sherbrooke, QC, Canada.,Center of research on Aging, Sherbrooke, QC, Canada
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21
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Demers C, Brochu A, Higgins J, Gélinas I. Complex behavioral interventions targeting physical activity and dietary behaviors in pediatric oncology: A scoping review. Pediatr Blood Cancer 2021; 68:e29090. [PMID: 33991403 DOI: 10.1002/pbc.29090] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 03/10/2021] [Accepted: 04/12/2021] [Indexed: 11/11/2022]
Abstract
As cancer and its treatment negatively impacts the long-term health and quality of life of survivors, there is a need to explore new avenues to prevent or minimize the impact of adverse effects in children with cancer and cancer survivors. Therefore, this scoping review aimed to report on the state of the evidence on the use and effects of complex behavioral interventions (CBI) targeting physical activity and/or dietary behaviors in pediatric oncology. Fourteen quantitative studies were included, evaluating interventions that used a combination of two or three different treatment modalities. Overall, studies demonstrated that it is feasible to implement CBI and that they can potentially improve physical activity and dietary behaviors as well as patient outcomes such as physical and psychological health. Unfortunately, due to a paucity of studies and the heterogeneity of the studies included in this review, no conclusive evidence favoring specific interventions were identified.
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Affiliation(s)
- Catherine Demers
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada.,Division of Haematology-Oncology, CHU Ste-Justine, Montreal, Quebec, Canada.,Montreal Center for Interdisciplinary Research in Rehabilitation (CRIR), Jewish Rehabilitation Hospital Research Site, Laval, Quebec, Canada
| | - Annie Brochu
- Division of Haematology-Oncology, CHU Ste-Justine, Montreal, Quebec, Canada.,School of rehabilitation, University of Montreal, Montreal, Quebec, Canada
| | - Johanne Higgins
- Montreal Center for Interdisciplinary Research in Rehabilitation (CRIR), Jewish Rehabilitation Hospital Research Site, Laval, Quebec, Canada.,School of rehabilitation, University of Montreal, Montreal, Quebec, Canada
| | - Isabelle Gélinas
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada.,Montreal Center for Interdisciplinary Research in Rehabilitation (CRIR), Jewish Rehabilitation Hospital Research Site, Laval, Quebec, Canada
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22
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Proulx CE, Higgins J, Gagnon DH. Occupational therapists' evaluation of the perceived usability and utility of wearable soft robotic exoskeleton gloves for hand function rehabilitation following a stroke. Disabil Rehabil Assist Technol 2021:1-10. [PMID: 34190657 DOI: 10.1080/17483107.2021.1938710] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE To evaluate the perceived usability and utility of using a soft robotic glove to rehabilitate hand function following a stroke. METHODS A convergent parallel mixed-methods design was used to consult a convenience sample of 14 experienced occupational therapists (OTs) practicing within a specialised stroke rehabilitation program. All OTs participated in one 60-to-90-minute individual consultation during which the attributes of a recently-developed soft robotic glove (ExoGlove) were presented before they could test it on themselves. After this consultation, OTs completed the System Usability Scale (SUS) questionnaire and answered open-ended questions focussing on the usability and utility of soft robotic gloves framed according to the Unified Theory of Acceptance and Use of Technology (UTAUT). RESULTS The OTs perceived the glove's usability as being moderate-to-good on the SUS (median score= 63.75 on a scale of 100). Thematic analysis revealed the importance of specifically considering elements such as ease of use (e.g. simplicity and speed), cost, movement precision, durability, and safety, when developing soft robotic gloves such as the ExoGlove. CONCLUSIONS Engagement in a continuous improvement process is essential to maximise the perceived usability and utility of soft robotic gloves, particularly of the ExoGlove, through their final development phase before pilot testing their effects and effectiveness for post-stroke hand rehabilitation.Implications for rehabilitationAll occupational therapists anticipate that a soft robotic glove such as the ExoGlove will allow them to increase treatment intensity and best aligns with principles of neuroplasticity.The clinical judgement and guidance of OTs, developed through practice, experience, and knowledge, remain essential to safely and efficiently exercise with a soft robotic glove.Achieving a balance between effort and performance expectancies is essential in developing and improving the functionality of soft robotic gloves, as with each additional functionality comes new challenges that impact its successful transition to a clinical setting.
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Affiliation(s)
- Camille E Proulx
- School of Rehabilitation, Université de Montréal, Montreal, Canada.,Center for Interdisciplinary Research in Rehabilitation of Greater Montreal, Institut universitaire sur la réadaptation en déficience physique de Montréal, CIUSSS Centre-Sud-de-l'Île-de-Montréal, Montreal, Canada
| | - Johanne Higgins
- School of Rehabilitation, Université de Montréal, Montreal, Canada.,Center for Interdisciplinary Research in Rehabilitation of Greater Montreal, Institut universitaire sur la réadaptation en déficience physique de Montréal, CIUSSS Centre-Sud-de-l'Île-de-Montréal, Montreal, Canada
| | - Dany H Gagnon
- School of Rehabilitation, Université de Montréal, Montreal, Canada.,Center for Interdisciplinary Research in Rehabilitation of Greater Montreal, Institut universitaire sur la réadaptation en déficience physique de Montréal, CIUSSS Centre-Sud-de-l'Île-de-Montréal, Montreal, Canada
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23
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Bruyneel AV, Higgins J, Akremi H, Aissaoui R, Nadeau S. Postural organization and inter-limb coordination are altered after stroke when an isometric maximum bilateral pushing effort of the upper limbs is performed. Clin Biomech (Bristol, Avon) 2021; 86:105388. [PMID: 34052694 DOI: 10.1016/j.clinbiomech.2021.105388] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 05/17/2021] [Accepted: 05/18/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Postural strategies of the trunk and the lower limbs are linked to upper limb motor activities. The objective was to analyze the postural organization at the lower limbs as well as the inter-limb coordination during isometric maximal bilateral pushing of upper limbs. METHODS Fifteen individuals after stroke and 17 healthy participants were assessed with an instrumented exerciser paired with an instrumented sitting surface while they executed isometric bilateral pushes with the upper limbs. The anteroposterior, vertical and mediolateral forces were recorded at the handles, the thighs and the feet. Force values at maximal bilateral pushing efforts at each segment and inter-limb coordination between sides were compared. FINDINGS During the isometric pushes, the paretic maximal forces at the handles for stroke participants were lower than the nonparetic side and lower than both sides of the control participants (p < 0.036). The control and stroke participants had moderate to good coordination for the anteroposterior forces (hands and thighs). While they used similar postural strategies to the controls except for a decreased weight on the paretic foot, vertical forces were less coordinated at the handles and feet in the stroke group (p < 0.050). The inter-trial variability was also higher in the stroke group. INTERPRETATION Bilateral pushing with gradual efforts induces impaired postural strategies and coordination between limbs in individuals after stroke. It may reveal to be a promising strategy to assess and train post-stroke individuals in a clinical setting. Also, providing feedback would help better control symmetry during efforts.
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Affiliation(s)
- Anne-Violette Bruyneel
- Department of Physiotherapy, School of Health Sciences, HES-SO//University of Applied Sciences and Arts Western Switzerland, Geneva, Switzerland.
| | - Johanne Higgins
- École de réadaptation, Faculté de médecine, Université de Montréal, Pavillon du Parc, Bureau 402-18, C.P.6128 Succ. Centre-ville, Montréal, QC H3C 3J7, Canada; Laboratoire de pathokinésiologie, Institut universitaire sur la réadaptation en déficience physique de Montréal-Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain, 6300 avenue Darlington, Montréal, QC H3S 2J4, Canada.
| | - Haifa Akremi
- École de réadaptation, Faculté de médecine, Université de Montréal, Pavillon du Parc, Bureau 402-18, C.P.6128 Succ. Centre-ville, Montréal, QC H3C 3J7, Canada; Laboratoire de pathokinésiologie, Institut universitaire sur la réadaptation en déficience physique de Montréal-Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain, 6300 avenue Darlington, Montréal, QC H3S 2J4, Canada.
| | - Rachid Aissaoui
- École de Technologie Supérieure, Montreal, Canada; Centre for Interdisciplinary Research in Rehabilitation (CRIR) of Greater Montreal, Montreal, Canada; Imaging and Orthopaedics Research Laboratory, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Canada.
| | - Sylvie Nadeau
- École de réadaptation, Faculté de médecine, Université de Montréal, Pavillon du Parc, Bureau 402-18, C.P.6128 Succ. Centre-ville, Montréal, QC H3C 3J7, Canada; Laboratoire de pathokinésiologie, Institut universitaire sur la réadaptation en déficience physique de Montréal-Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain, 6300 avenue Darlington, Montréal, QC H3S 2J4, Canada.
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Boissonnault È, Higgins J, LaGarde G, Barthélemy D, Lamarre C, H Dagher J. Brain stimulation in attention deficits after traumatic brain injury: a literature review and feasibility study. Pilot Feasibility Stud 2021; 7:115. [PMID: 34059152 PMCID: PMC8165970 DOI: 10.1186/s40814-021-00859-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 05/21/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND After a traumatic brain injury, disturbances in the attentional processes have a direct negative effect on functional recovery and on return to complex activities. To date, there is no good attention remediation treatment available. The primary objective of this review and pilot study is to provide an overview of the research evidence and to evaluate the feasibility of implementing a tDCS protocol to improve attention disorders in patients with mild complicated to severe subacute TBI, hospitalized in an inpatient rehabilitation facility. Our secondary objective is to extract preliminary data and observational information on participants' response to treatment. METHODS Participants were recruited from a consecutive series of patients admitted to the TBI unit of a subspecialized regional rehabilitation center. They received a 20-min tDCS stimulation 3 times a week for 3 weeks. A neuropsychological evaluation was performed before and after the intervention. We collected participants' sociodemographic and clinical characteristics as well as information about satisfaction, tolerability, and adverse effects. RESULTS One hundred sixty-four patients were admitted between September 2018 and January 2020. One hundred fifty-eight were excluded, and 6 patients with presumed attentional deficits were enrolled. None completed the protocol as intended. No major side effects occurred. CONCLUSION Non-invasive brain neurostimulation is promising to enhance attention deficits in patients with TBI. Implementation of a tDCS protocol to fulfill this purpose in an intensive inpatient rehabilitation center has its limitations. We made recommendations to facilitate the implementation of similar projects in the future. TRIAL REGISTRATION ISRCTN, ISRCTN55243064 . Registered 14 October 2020-retrospectively registered.
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Affiliation(s)
- Ève Boissonnault
- Physical Medicine and Rehabilitation Service, Université de Montréal, Montreal, QC, Canada. .,Institut universitaire sur la réadaptation en déficience physique de Montréal (IURDPM), 6300, avenue de Darlington (Pavillon Gingras), Montréal, QC, H3S 2J4, Canada. .,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, QC, Canada.
| | - Johanne Higgins
- Institut universitaire sur la réadaptation en déficience physique de Montréal (IURDPM), 6300, avenue de Darlington (Pavillon Gingras), Montréal, QC, H3S 2J4, Canada.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, QC, Canada.,School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Geneviève LaGarde
- Institut universitaire sur la réadaptation en déficience physique de Montréal (IURDPM), 6300, avenue de Darlington (Pavillon Gingras), Montréal, QC, H3S 2J4, Canada.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, QC, Canada
| | - Dorothy Barthélemy
- Institut universitaire sur la réadaptation en déficience physique de Montréal (IURDPM), 6300, avenue de Darlington (Pavillon Gingras), Montréal, QC, H3S 2J4, Canada.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, QC, Canada.,School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Céline Lamarre
- Physical Medicine and Rehabilitation Service, Université de Montréal, Montreal, QC, Canada.,Institut universitaire sur la réadaptation en déficience physique de Montréal (IURDPM), 6300, avenue de Darlington (Pavillon Gingras), Montréal, QC, H3S 2J4, Canada.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, QC, Canada
| | - Jehane H Dagher
- Physical Medicine and Rehabilitation Service, Université de Montréal, Montreal, QC, Canada.,Institut universitaire sur la réadaptation en déficience physique de Montréal (IURDPM), 6300, avenue de Darlington (Pavillon Gingras), Montréal, QC, H3S 2J4, Canada.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, QC, Canada
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Norgaard Z, Higgins J, Yaplee J, Valentine C, Williams L, Salk J. Ultra-sensitive duplex sequencing for tracking of allogeneic cell therapies. Cytotherapy 2021. [DOI: 10.1016/s1465324921005478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Proulx C, Gagnon D, Higgins J. Perceived Usability and Acceptability of a Soft Robotic Glove for Rehabilitation of Adults With Hand Hemiparesis: A Mixed-Method Study Among Occupational Therapists in Stroke Rehabilitation. Arch Phys Med Rehabil 2020. [DOI: 10.1016/j.apmr.2020.09.308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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27
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Higgins J, Schmuhl N, Wautlet C, Rice L. P32 The silent majority: Physicians’ knowledge of and attitudes toward restrictive abortion policies in a battleground state. Contraception 2020. [DOI: 10.1016/j.contraception.2020.07.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Paquette P, Higgins J, Gagnon DH. Peripheral and Central Adaptations After a Median Nerve Neuromobilization Program Completed by Individuals With Carpal Tunnel Syndrome: An Exploratory Mechanistic Study Using Musculoskeletal Ultrasound Imaging and Transcranial Magnetic Stimulation. J Manipulative Physiol Ther 2020; 43:566-578. [PMID: 32861518 DOI: 10.1016/j.jmpt.2019.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Revised: 10/11/2019] [Accepted: 10/22/2019] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Neuromobilization exercises are increasingly advocated in the conservative management of individuals with carpal tunnel syndrome (CTS), as they may mitigate CTS-related signs and symptoms via potential peripheral (ie, musculoskeletal) and central (ie, neurophysiological) adaptations. However, the mechanisms underlying these adaptations have not been studied extensively. Hence, this exploratory and mechanistic study aims to evaluate the potential peripheral and central adaptations that may result in individuals with CTS who have completed a neuromobilization program. METHODS Fourteen individuals with CTS were evaluated before and 1 week after the completion of a 4-week neuromobilization program that incorporated median nerve sliding exercises. Pain and upper limb functional abilities were assessed using standardized questionnaires. The biological integrity and mechanical properties of the median nerve and the corticospinal excitability were quantified using musculoskeletal ultrasound imaging and transcranial magnetic stimulation, respectively. RESULTS Upon completion of the program, participants reported both large and moderate improvements in pain (P ≤ .03) and upper limb functional abilities (P = .02), respectively. The biological integrity and mechanical properties of the median nerve remained unchanged (P ≥ .22), whereas a small significant increase in corticospinal excitability (P = .04) was observed. CONCLUSION The proposed neuromobilization program appears promising to improve pain and upper limb functional abilities in individuals with CTS. These improvements may be preferentially mediated via central, rather than peripheral, adaptations. Future studies, especially with a larger sample size, longer intervention duration, and additional measurement times, are needed to strengthen current evidence.
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Affiliation(s)
- Philippe Paquette
- School of Rehabilitation, Université de Montréal, Montréal, Québec, Canada.
| | - Johanne Higgins
- School of Rehabilitation, Université de Montréal, Montréal, Québec, Canada
| | - Dany H Gagnon
- School of Rehabilitation, Université de Montréal, Montréal, Québec, Canada
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Withrow D, Depner CM, Boland EM, Birks BR, Melanson EL, Higgins J, Eckel RH, Perreault L, Bergman BC, Wright KP. 0132 Sex Differences in Evening Food Intake and Associated Weight Gain During Insufficient Sleep. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Timing of food intake has emerged as a novel risk factor for weight gain and obesity. Higher evening food intake, especially during insufficient sleep, is associated with weight gain. We aimed to explore initial changes in evening food intake and the respiratory quotient (RQ) during insufficient sleep and subsequent weight gain. We also explored sex differences.
Methods
28 healthy adults (14F) aged 26.3±4.5y completed a 14–16 daylong laboratory protocol. In their home environment participants maintained one week of ~9h/night sleep schedules and consumed energy balanced diets for 3 days prior to completing the laboratory protocol. The laboratory protocol consisted of 3 baseline days of 9h/night scheduled sleep with energy balanced diets followed by 10 days of 5h/night scheduled sleep with ad-libitum food intake, with (n=14) and without (n=14) weekend recovery sleep. RQ was assessed on days 3 and 5 in a whole room calorimeter. Evening (dinner and after-dinner snacks) energy intake and body weight were assessed daily.
Results
A significant sex by condition effect was observed for evening food intake such that men and women were similar at baseline, but men ate more than women during insufficient sleep, when controlling for body mass (p<0.05). A significant sex by condition effect was also observed for RQ with women showing similar RQ during baseline and insufficient sleep and men showing a higher RQ during insufficient sleep versus baseline (p<0.05). Linear regression with food intake and RQ as predictors of weight gain showed that increased evening food intake, but not RQ, on the second day of sleep restriction was associated with weight gain in men, but not women, at the end of the study eight days later (p<0.05).
Conclusion
Findings suggest that rapid changes in evening food intake during insufficient sleep contributes to subsequent weight gain during sustained insufficient sleep, especially in men.
Support
NIH HL109706, DK111161, TR001082, DK048520, Sleep Research Society Foundation grant 011-JP-16 and Office of Naval Research MURI (N00014-15-1-2809).
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Affiliation(s)
- D Withrow
- Sleep and Chronobiology Laboratory, Department of Integrative Physiology, University of Colorado, Boulder, CO
| | - C M Depner
- Sleep and Chronobiology Laboratory, Department of Integrative Physiology, University of Colorado, Boulder, CO
| | - E M Boland
- Sleep and Chronobiology Laboratory, Department of Integrative Physiology, University of Colorado, Boulder, CO
| | - B R Birks
- Sleep and Chronobiology Laboratory, Department of Integrative Physiology, University of Colorado, Boulder, CO
| | - E L Melanson
- Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO
- Division of Geriatric Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - J Higgins
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - R H Eckel
- Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - L Perreault
- Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - B C Bergman
- Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - K P Wright
- Sleep and Chronobiology Laboratory, Department of Integrative Physiology, University of Colorado, Boulder, CO
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Allegue DR, Kairy D, Higgins J, Archambault P, Michaud F, Miller W, Sweet SN, Tousignant M. Optimization of Upper Extremity Rehabilitation by Combining Telerehabilitation With an Exergame in People With Chronic Stroke: Protocol for a Mixed Methods Study. JMIR Res Protoc 2020; 9:e14629. [PMID: 32097119 PMCID: PMC7273231 DOI: 10.2196/14629] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 11/28/2019] [Accepted: 02/07/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Exergames have the potential to provide an accessible, remote approach for poststroke upper extremity (UE) rehabilitation. However, the use of exergames without any follow-up by a health professional could lead to compensatory movements during the exercises, inadequate choice of difficulty level, exercises not being completed, and lack of motivation to pursue exercise programs, thereby decreasing their benefits. Combining telerehabilitation with exergames could allow continuous adjustment of the exercises and monitoring of the participant's completion and adherence. At present, there is limited evidence regarding the feasibility or efficacy of combining telerehabilitation and exergames for stroke rehabilitation. OBJECTIVE This study aims to (1) determine the preliminary efficacy of using telerehabilitation combined with exergames on UE motor recovery, function, quality of life, and motivation in participants with chronic stroke, compared with conventional therapy (the graded repetitive arm supplementary program; GRASP); (2) examine the feasibility of using the technology with participants diagnosed with stroke at home; and (3) identify the obstacles and facilitators for its use by participants diagnosed with stroke and stroke therapists and understand the shared decision-making process. METHODS A mixed methods study protocol is proposed, including a randomized, blinded feasibility trial with an embedded multiple case study. The intervention consists of the provision of a remote rehabilitation program, during which participants will use the Jintronix exergame for UE training and the Reacts Application to conduct videoconferenced sessions with the therapists (physical or occupational therapists). We plan to recruit 52 participants diagnosed with stroke, randomly assigned to a control group (n=26; 2-month on-paper home exercise program: the GRASP with no supervision) and an experimental group (n=26; 2-month home program using the technology). The primary outcome is the Fugl-Meyer UE Assessment, a performance-based measure of UE impairment. The secondary outcomes are self-reported questionnaires and include the Motor Activity Log-28 (quality and frequency of use of the UE), Stroke Impact Scale-16 (the quality of life), and Treatment Self-Regulation Questionnaire (motivation). Feasibility data include process, resources, management, and scientific outcomes. Qualitative data will be collected by interviews with both participants and therapists. RESULTS At present, data collection was ongoing with one participant who had completed the exergame- telerehabilitation based intervention. We expect to collect preliminary efficacy data of this technology on the functional and motor recovery of the UE, following a stroke; collect feasibility data with users at home (adherence, safety, and technical difficulties); and identify the obstacles and facilitators for the technology use and understand the shared decision-making process. CONCLUSIONS This paper describes the protocol underlying the study of a telerehabilitation-exergame technology to contribute to understanding its feasibility and preliminary efficacy for UE stroke rehabilitation. TRIAL REGISTRATION ClinicalTrials.gov NCT03759106; http://clinicaltrials.gov/show/NCT03759106. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/14629.
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Affiliation(s)
- Dorra Rakia Allegue
- School of Rehabilitation, Université de Montréal, Montreal, QC, Canada
- The Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Institut universitaire sur la réadaptation en déficience physique de Montréal, Montreal, QC, Canada
- Mission Universitaire de Tunisie, Montreal, QC, Canada
| | - Dahlia Kairy
- School of Rehabilitation, Université de Montréal, Montreal, QC, Canada
- The Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Institut universitaire sur la réadaptation en déficience physique de Montréal, Montreal, QC, Canada
| | - Johanne Higgins
- School of Rehabilitation, Université de Montréal, Montreal, QC, Canada
- The Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Institut universitaire sur la réadaptation en déficience physique de Montréal, Montreal, QC, Canada
| | | | | | | | - Shane Norman Sweet
- The Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Institut universitaire sur la réadaptation en déficience physique de Montréal, Montreal, QC, Canada
- McGill University, Montreal, QC, Canada
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Proulx CE, Beaulac M, David M, Deguire C, Haché C, Klug F, Kupnik M, Higgins J, Gagnon DH. Review of the effects of soft robotic gloves for activity-based rehabilitation in individuals with reduced hand function and manual dexterity following a neurological event. J Rehabil Assist Technol Eng 2020; 7:2055668320918130. [PMID: 32435506 PMCID: PMC7223210 DOI: 10.1177/2055668320918130] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 03/17/2020] [Indexed: 12/20/2022] Open
Abstract
Despite limited scientific evidence, there is an increasing interest in soft robotic gloves to optimize hand- and finger-related functional abilities following a neurological event. This review maps evidence on the effects and effectiveness of soft robotic gloves for hand rehabilitation and, whenever possible, patients' satisfaction. A systematized search of the literature was conducted using keywords structured around three areas: technology attributes, anatomy, and rehabilitation. A total of 272 titles, abstracts, and keywords were initially retrieved, and data were extracted out of 13 articles. Six articles investigated the effects of wearing a soft robotic glove and eight studied the effect or effectiveness of an intervention with it. Some statistically significant and meaningful beneficial effects were confirmed with the 29 outcome measures used. Finally, 11 articles also confirmed users' satisfaction with regard to the soft robotic glove, while some articles also noticed an increased engagement in the rehabilitation program with this technology. Despite the heterogeneity across studies, soft robotic gloves stand out as a safe and promising technology to improve hand- and finger-related dexterity and functional performance. However, strengthened evidence of the effects or effectiveness of such devices is needed before their transition from laboratory to clinical practice.
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Affiliation(s)
- Camille E Proulx
- School of Rehabilitation, Université de Montréal, Montréal, Canada.,Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Institut universitaire sur la réadaptation en déficience physique de Montréal, CIUSSS Centre-Sud-de-l'Île-de-Montréal, Montreal, QC, Canada
| | - Myrka Beaulac
- School of Rehabilitation, Université de Montréal, Montréal, Canada
| | - Mélissa David
- School of Rehabilitation, Université de Montréal, Montréal, Canada
| | - Catryne Deguire
- School of Rehabilitation, Université de Montréal, Montréal, Canada
| | - Catherine Haché
- School of Rehabilitation, Université de Montréal, Montréal, Canada
| | - Florian Klug
- Technischen Universität Darmstadt, Darmstaadt, Germany
| | - Mario Kupnik
- Technischen Universität Darmstadt, Darmstaadt, Germany
| | - Johanne Higgins
- School of Rehabilitation, Université de Montréal, Montréal, Canada.,Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Institut universitaire sur la réadaptation en déficience physique de Montréal, CIUSSS Centre-Sud-de-l'Île-de-Montréal, Montreal, QC, Canada
| | - Dany H Gagnon
- School of Rehabilitation, Université de Montréal, Montréal, Canada.,Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Institut universitaire sur la réadaptation en déficience physique de Montréal, CIUSSS Centre-Sud-de-l'Île-de-Montréal, Montreal, QC, Canada
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Paquette P, Higgins J, Danino MA, Harris P, Lamontagne M, Gagnon DH. Effects of a preoperative neuromobilization program offered to individuals with carpal tunnel syndrome awaiting carpal tunnel decompression surgery: A pilot randomized controlled study. J Hand Ther 2020. [PMID: 32151500 DOI: 10.1016/b978-0-12-815499-1.00003-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
STUDY DESIGN Pilot randomized controlled trial with parallel groups. INTRODUCTION Engaging individuals with carpal tunnel syndrome (CTS) awaiting carpal tunnel decompression surgery in a preoperative rehabilitation program may mitigate pain and sensorimotor impairments, enhance functional abilities before surgery, and improve postoperative outcomes. PURPOSE OF THE STUDY To assess the feasibility and the efficacy of a novel preoperative neuromobilization exercise program (NEP). METHODS Thirty individuals with CTS were randomly allocated into a four-week home-based neuromobilization exercise group or a standard care group while awaiting surgery. Outcome measures included feasibility (ie, recruitment, attrition, adherence, satisfaction, and safety) and efficacy metrics (ie, median nerve integrity and neurodynamics, tip pinch grip, pain, and upper limb functional abilities) collected before (ie, at the baseline and about four weeks later) and four weeks after surgery. RESULTS Thirty individuals with CTS were recruited (recruitment rate = 11.8%) and 25 completed the study (attrition rate = 16.7%). Adherence (94%) and satisfaction with the program (eg, enjoy the exercises and likeliness to repeat the NEP (≥4.2/5) were high and no serious adverse event was reported. NEP-related immediate pre- and post-surgery beneficial effects on pain interference were documented (P = .05, η2 = .10), whereas an overall increased neurodynamics (P = .04, η2 = .11) and decreased pain severity (P = .01, η2 = .21) were observed. DISCUSSION Engaging in the proposed NEP has limited beneficial effect as a stand-alone intervention on pre- and post-surgery outcomes for individuals with CTS. Expanding the program's content and attribute by adding other components including desensitization maneuvers and novel therapies promoting corticospinal plasticity is recommended. CONCLUSION A preoperative NEP completed by individuals with CTS awaiting surgery is feasible, acceptable, and safe. However, given the limited beneficial effectsof the program, revision of its content and attributes is recommended before proceeding to large-scale trials.
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Affiliation(s)
- Philippe Paquette
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Institut universitaire sur la réadaptation en déficience physique de Montréal, Centre intégré universitaire de santé et de services sociaux (CIUSSS) du Centre-Sud-de-l'Île-de-Montréal, Montreal, Canada; School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - Johanne Higgins
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Institut universitaire sur la réadaptation en déficience physique de Montréal, Centre intégré universitaire de santé et de services sociaux (CIUSSS) du Centre-Sud-de-l'Île-de-Montréal, Montreal, Canada; School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - Michel Alain Danino
- Department of Surgery, Centre Hospitalier de l'Université de Montréal, Montreal, Canada
| | - Patrick Harris
- Department of Surgery, Centre Hospitalier de l'Université de Montréal, Montreal, Canada
| | - Martin Lamontagne
- Department of Physical Medicine and Rehabilitation, Centre Hospitalier de l'Université de Montréal, Montreal, Canada
| | - Dany H Gagnon
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Institut universitaire sur la réadaptation en déficience physique de Montréal, Centre intégré universitaire de santé et de services sociaux (CIUSSS) du Centre-Sud-de-l'Île-de-Montréal, Montreal, Canada; School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Canada.
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Veras M, Stewart J, Deonandan R, Tatmatsu-Rocha JC, Higgins J, Poissant L, Kairy D. Cost Analysis of a Home-Based Virtual Reality Rehabilitation to Improve Upper Limb Function in Stroke Survivors. Glob J Health Sci 2020. [DOI: 10.5539/gjhs.v12n2p98] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Loss of arm function occurs in up to 85% of stroke survivors. Home-based telerehabilitation is a viable approach for upper limb training post-stroke when rehabilitation services are not available. Method: A costing analysis of a telerehabilitation program was conducted under several scenarios, alongside a single-blind two-arm randomized controlled trial with participants randomly allocated to control (N=25) or intervention group (N=26). Detailed analysis of the cost for two different scenarios for providing telerehabilitation were conducted. The fixed costs of the telerehabilitation are an important determinant of the total costs of the program. The detailed breakdown of the costs allows for costs of future proposed telerehabilitation programs to be easily estimated. The costs analysis found that a program supplying all required technology costs between CAD$475 per patient and CAD$482 per patient, while a program supplying only a camera would have total costs between CAD$242 per patient and $245 per patient. The findings of this study support the potential implementation of telerehabilitation for stroke survivors for improving accessibility to rehabilitation services. This cost-analysis study will facilitate the implementation and future research on cost-effectiveness of such interventions.
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Norouzi-Gheidari N, Hernandez A, Archambault PS, Higgins J, Poissant L, Kairy D. Feasibility, Safety and Efficacy of a Virtual Reality Exergame System to Supplement Upper Extremity Rehabilitation Post-Stroke: A Pilot Randomized Clinical Trial and Proof of Principle. Int J Environ Res Public Health 2019; 17:E113. [PMID: 31877910 PMCID: PMC6981843 DOI: 10.3390/ijerph17010113] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Revised: 12/13/2019] [Accepted: 12/20/2019] [Indexed: 11/16/2022]
Abstract
(1) Background: Increasing the amount of therapy time has been shown to improve motor function in stroke survivors. However, it is often not possible to increase the amount of therapy time provided in the current one-on-one therapy models. Rehabilitation-based virtual reality exergame systems, such as Jintronix, can be offered to stroke survivors as an adjunct to traditional therapy. The goal of this study was to examine the safety and feasibility of providing additional therapy using an exergame system and assess its preliminary clinical efficacy. (2) Methods: Stroke survivors receiving outpatient rehabilitation services participated in this pilot randomized control trial in which the intervention group received 4 weeks of exergaming sessions in addition to traditional therapy sessions. (3) Results: Nine subjects in the intervention and nine subjects in the control group completed the study. The intervention group had at least two extra sessions per week, with an average duration of 44 min per session and no serious adverse events (falls, dizziness, or pain). The efficacy measures showed statistically meaningful improvements in the activities of daily living measures (i.e., MAL-QOM (motor activity log-quality of movement) and both mobility and physical domains of the SIS (stroke impact scale) with mean difference of 1.0%, 5.5%, and 6.7% between the intervention and control group, respectively) at post-intervention. (4) Conclusion: Using virtual reality exergaming technology as an adjunct to traditional therapy is feasible and safe in post-stroke rehabilitation and may be beneficial to upper extremity functional recovery.
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Affiliation(s)
- Nahid Norouzi-Gheidari
- School of Physical and Occupational Therapy, McGill University, Montreal, QC H3G 1Y5, Canada;
- Feil/Oberfeld/CRIR Research Centre, Jewish Rehabilitation Hospital site of CISSS-Laval, Laval, QC H7V 1R2, Canada
| | - Alejandro Hernandez
- CRIR Research Centre, IURDPM site of CIUSSS-Montreal, Montreal, QC H3S 2J4, Canada; (A.H.); (J.H.); (L.P.); (D.K.)
| | - Philippe S. Archambault
- School of Physical and Occupational Therapy, McGill University, Montreal, QC H3G 1Y5, Canada;
- Feil/Oberfeld/CRIR Research Centre, Jewish Rehabilitation Hospital site of CISSS-Laval, Laval, QC H7V 1R2, Canada
| | - Johanne Higgins
- CRIR Research Centre, IURDPM site of CIUSSS-Montreal, Montreal, QC H3S 2J4, Canada; (A.H.); (J.H.); (L.P.); (D.K.)
- School of Rehabilitation, Université de Montréal, Montreal, QC H3N 1X7, Canada
| | - Lise Poissant
- CRIR Research Centre, IURDPM site of CIUSSS-Montreal, Montreal, QC H3S 2J4, Canada; (A.H.); (J.H.); (L.P.); (D.K.)
- School of Rehabilitation, Université de Montréal, Montreal, QC H3N 1X7, Canada
| | - Dahlia Kairy
- CRIR Research Centre, IURDPM site of CIUSSS-Montreal, Montreal, QC H3S 2J4, Canada; (A.H.); (J.H.); (L.P.); (D.K.)
- School of Rehabilitation, Université de Montréal, Montreal, QC H3N 1X7, Canada
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Ingo C, Lin C, Higgins J, Arevalo YA, Prabhakaran S. Diffusion Properties of Normal-Appearing White Matter Microstructure and Severity of Motor Impairment in Acute Ischemic Stroke. AJNR Am J Neuroradiol 2019; 41:71-78. [PMID: 31831465 DOI: 10.3174/ajnr.a6357] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 10/30/2019] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The effect of white matter hyperintensities as measured by FLAIR MR imaging on functional impairment and recovery after ischemic stroke has been investigated thoroughly. However, there has been growing interest in investigating normal-appearing white matter microstructural integrity following ischemic stroke onset with techniques such as DTI. MATERIALS AND METHODS Fifty-two patients with acute ischemic stroke and 36 without stroke were evaluated with a DTI and FLAIR imaging protocol and clinically assessed for the severity of motor impairment using the Motricity Index within 72 hours of suspected symptom onset. RESULTS There were widespread decreases in fractional anisotropy and increases in mean diffusivity and radial diffusivity for the acute stroke group compared with the nonstroke group. There was a significant positive association between fractional anisotropy and motor function and a significant negative association between mean diffusivity/radial diffusivity and motor function. The normal-appearing white matter ROIs that were most sensitive to the Motricity Index were the anterior/posterior limb of the internal capsule in the infarcted hemisphere and the splenium of the corpus callosum, external capsule, posterior limb/retrolenticular part of the internal capsule, superior longitudinal fasciculus, and cingulum (hippocampus) of the intrahemisphere/contralateral hemisphere. CONCLUSIONS The microstructural integrity of normal-appearing white matter is a significant parameter to identify neural differences not only between those individuals with and without acute ischemic stroke but also correlated with the severity of acute motor impairment.
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Affiliation(s)
- C Ingo
- From the Departments of Neurology (C.I., Y.A.A.) .,Physical Therapy and Human Movement Sciences (C.I.)
| | - C Lin
- Department of Neurology (C.L.), University of Alabama at Birmingham, Birmingham, Alabama
| | - J Higgins
- Radiology (J.H.), Northwestern University, Chicago, Illinois
| | - Y A Arevalo
- From the Departments of Neurology (C.I., Y.A.A.)
| | - S Prabhakaran
- Department of Neurology (S.P.), University of Chicago Medical Center, Chicago, Illinois
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de Guise E, Higgins J, Kehayia E, Poldma T, Saj A, Beauchet O, Bastien T, Azevedo N, Nadeau S. Caractériser l’interaction environnement – personne lors d’une visite muséale : une étude de faisabilité de collectes de données multiples et ponctuelles de la mobilité dans l’espace public. Neurophysiol Clin 2019. [DOI: 10.1016/j.neucli.2019.10.153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Bruyneel AV, Akremi H, Higgins J, Nadeau S. La coordination inter-membres des forces diffèrent entre les sujets sains et post-AVC lors de poussées bilatérales maximales des membres supérieurs. Neurophysiol Clin 2019. [DOI: 10.1016/j.neucli.2019.10.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Pelletier R, Paquette É, Bourbonnais D, Higgins J, Harris PG, Danino MA. Bilateral sensory and motor as well as cognitive differences between persons with and without musculoskeletal disorders of the wrist and hand. Musculoskelet Sci Pract 2019; 44:102058. [PMID: 31542683 DOI: 10.1016/j.msksp.2019.102058] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Revised: 08/11/2019] [Accepted: 09/12/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND Sensory and motor disturbances are characteristic of musculoskeletal injuries and conditions. Rehabilitation interventions aimed at remediating these disturbances are traditionally exclusively targeted to the affected area. However, there is some evidence of bilateral changes in sensory and motor function associated with unilateral injuries and conditions suggesting central changes. Deficits on specific cognitive tasks have also been documented in persons with chronic pain. PURPOSE The purpose of the present study was to determine if participants with unilateral pain arising from heterogeneous wrist/hand injuries and conditions demonstrate bilateral changes in sensory and motor functions as well as cognitive deficits. DESIGN/METHODS Sensory (Pressure Pain Thresholds, Two Point Orientation Discrimination), Motor (grip strength and Purdue Pegboard), and Cognitive function (Stroop test and mental rotation task) were measured in 30 participants with wrist/hand pain and 30 healthy control participants in an observational cross-sectional study. RESULTS Participants with unilateral wrist/hand pain demonstrated differences in cognitive function measured with the Stroop test (p = 0.03). They also demonstrated bilateral sensorimotor differences in pressure pain thresholds (p = 0.03), grip strength (p = 0.00) and Purdue pegboard test (p = 0.03) results compared to healthy control participants. CONCLUSION Cognitive as well as bilateral alterations in sensory and motor function in participants with musculoskeletal injuries and conditions suggest central changes are involved in their pathophysiology. These findings in persons with heterogeneous injuries/conditions suggest that these changes are not specific to an injury/condition. Bilateral sensorimotor changes have important implications with regards to the pathophysiology of musculoskeletal disorders of the wrist/hand, for rehabilitative interventions and research.
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Affiliation(s)
- René Pelletier
- Sciences de la réadaptation, École de réadaptation, Faculté de Médecine, Université de Montréal, Montréal, Québec, H3C 3J7, Canada.
| | - Élyssa Paquette
- Sciences de la réadaptation, École de réadaptation, Faculté de Médecine, Université de Montréal, Montréal, Québec, H3C 3J7, Canada.
| | - Daniel Bourbonnais
- École de réadaptation, Faculté de médecine, Université de Montréal, C.P. 6128, succursale Centre-ville, Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, H3C 3J7, Québec, Canada.
| | - Johanne Higgins
- École de réadaptation, Faculté de médecine, Université de Montréal, C.P. 6128, succursale Centre-ville, Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, H3C 3J7, Québec, Canada.
| | - Patrick G Harris
- Département de chirurgie Université de Montréal, Chef département de chirurgie du Centre Hospitalier de l'Université de Montréal (CHUM), 1000, rue Saint-Denisx, H2X 0C1, Québec, Canada.
| | - Michel Alain Danino
- Université de Montréal, Chef du service de chirurgie plastique du Centre Hospitalier Université de Montréal (CHUM), 850, rue St-Denis Pav. S - local S02-128, H2X 0A9, Montréal, Québec, Canada.
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da Silva RL, Santos FF, Mendes IMG, Caromano FA, Higgins J, Frak V. Contributions of the Left and the Right Hemispheres on Language-Induced Grip Force Modulation of the Left Hand in Unimanual Tasks. ACTA ACUST UNITED AC 2019; 55:medicina55100674. [PMID: 31590447 PMCID: PMC6843471 DOI: 10.3390/medicina55100674] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 09/30/2019] [Accepted: 10/03/2019] [Indexed: 11/16/2022]
Abstract
Background and Objectives: Language-induced grip force modulation (LGFM) can be used to better understand the link between language and motor functions as an expression of embodied language. However, the contribution of each brain hemisphere to LGFM is still unclear. Using six different action verbs as stimuli, this study evaluated the grip force modulation of the left hand in a unimanual task to characterize the left and right hemispheres' contributions. Materials and Methods: Left-hand LGFM of 20 healthy and consistently right-handed subjects was evaluated using the verbs "to write", "to hold", "to pull" (left-lateralized central processing actions), "to draw", "to tie", and "to drive" (bihemispheric central processing actions) as linguistic stimuli. The time between the word onset and the first interval of statistical significance regarding the baseline (here as reaction time, RT) was also measured. Results: The six verbs produced LGFM. The modulation intensity was similar for the six verbs, but the RT was variable. The verbs "to draw", "to tie", and "to drive", whose central processing of the described action is bihemispheric, showed a longer RT compared to the other verbs. Conclusions: The possibility of a given manual action being performed by the left hand in consistent right-handers does not interfere with the occurrence of LGFM when the descriptor verb of this action is used as a linguistic stimulus, even if the possibility is remote. Therefore, LGFM seems to mainly rely on the left hemisphere, while a greater activation of the right hemisphere in action processing appears to slow the increase in LGFM intensity.
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Affiliation(s)
- Ronaldo Luis da Silva
- Faculté des Sciences, Université du Québec à Montréal - 141 Avenue du Président-Kennedy, Montréal, QC H2X 1Y4, Canada.
- Centre de recherche interdisciplinaire en réadaptation (CRIR), Institut universitaire sur la réadaptation en déficience physique de Montréal (IURDPM) - 6300 Avenue de Darlington, Montréal, QC H3S 2J4, Canada.
| | - Francielly Ferreira Santos
- Centro Estadual de Reabilitação e de Readaptação Dr Henrique Santillo - CRER - Av. Ver. José Monteiro, 1655 - Setor Negrão de Lima, Goiânia, GO 74653-230, Brazil.
| | - Isabella Maria Gonçalves Mendes
- Centro Estadual de Reabilitação e de Readaptação Dr Henrique Santillo - CRER - Av. Ver. José Monteiro, 1655 - Setor Negrão de Lima, Goiânia, GO 74653-230, Brazil.
| | - Fátima Aparecida Caromano
- Laboratory of Physical Therapy and Behaviour, Department of Physical Therapy, Speech and Occupational Therapy, University of São Paulo Medical School - Rua Cipotânea, 51 - Cidade Universitária, São Paulo, SP 05360-000, Brazil.
| | - Johanne Higgins
- Centre de recherche interdisciplinaire en réadaptation (CRIR), Institut universitaire sur la réadaptation en déficience physique de Montréal (IURDPM) - 6300 Avenue de Darlington, Montréal, QC H3S 2J4, Canada.
- École de Réadaptation, Faculté de Médecine, Université de Montréal - 7077 Avenue du Parc, Montréal, QC H3N, Canada.
| | - Victor Frak
- Faculté des Sciences, Université du Québec à Montréal - 141 Avenue du Président-Kennedy, Montréal, QC H2X 1Y4, Canada.
- Centre de recherche interdisciplinaire en réadaptation (CRIR), Institut universitaire sur la réadaptation en déficience physique de Montréal (IURDPM) - 6300 Avenue de Darlington, Montréal, QC H3S 2J4, Canada.
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Hehir MP, Burke N, Burke G, Turner MJ, Breathnach FM, Mcauliffe FM, Morrison JJ, Dornan S, Higgins J, Cotter A, Geary MP, Mcparland P, Daly S, Cody F, Dicker P, Tully E, Malone FD. Sonographic markers of fetal adiposity and risk of Cesarean delivery. Ultrasound Obstet Gynecol 2019; 54:338-343. [PMID: 30887629 DOI: 10.1002/uog.20263] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Revised: 03/10/2019] [Accepted: 03/12/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE Increased fetal size is associated with shoulder dystocia during labor and subsequent need for assisted delivery. We sought to investigate if increased fetal adiposity diagnosed sonographically in late pregnancy is associated with increased risk of operative delivery. METHODS This secondary analysis of the Genesis Study recruited 2392 nulliparous women with singleton pregnancy in cephalic presentation, in a prospective, multicenter study, to examine prenatal and intrapartum predictors of Cesarean delivery. Participants underwent ultrasound and clinical evaluation between 39 + 0 and 40 + 6 weeks' gestation. Data on fetal biometry were not revealed to patients or to their managing clinicians. A fetal adiposity composite of fetal thigh adiposity and fetal abdominal wall thickness was compiled for each infant in order to determine whether fetal adiposity > 90th centile was associated with an increased risk of Cesarean or operative vaginal delivery. RESULTS After exclusions, data were available for 2330 patients. Patients with a fetal adiposity composite > 90th centile had a higher maternal body mass index (BMI) (25 ± 5 kg/m2 vs 24 ± 4 kg/m2 ; P = 0.005), birth weight (3872 ± 417 g vs 3585 ± 401 g; P < 0.0001) and rate of induction of labor (47% (108/232) vs 40% (834/2098); P = 0.048) than did those with an adiposity composite ≤ 90th centile. Fetuses with adiposity composite > 90th centile were more likely to require Cesarean delivery than were those with adiposity composite ≤ 90th centile (P < 0.0001). After adjusting for birth weight, maternal BMI and need for induction of labor, fetal adiposity > 90th centile remained a risk factor for Cesarean delivery (P < 0.0001). A fetal adiposity composite > 90th centile was more predictive of the need for unplanned Cesarean delivery than was an estimated fetal weight > 90th centile (odds ratio, 2.20 (95% CI, 1.65-2.94; P < 0.001) vs 1.74 (95% CI, 1.29-2.35; P < 0.001). Having an adiposity composite > 90th centile was not associated with an increased likelihood of operative vaginal delivery when compared with having an adiposity composite ≤ 90th centile (P = 0.37). CONCLUSIONS Fetuses with increased adipose deposition are more likely to require Cesarean delivery than are those without increased adiposity. Consideration should, therefore, be given to adding fetal thigh adiposity and abdominal wall thickness to fetal sonographic assessment in late pregnancy. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- M P Hehir
- Royal College of Surgeons in Ireland, Rotunda Hospital, Dublin, Ireland
| | - N Burke
- Rotunda Hospital, Dublin, Ireland
| | - G Burke
- Department of Obstetrics and Gynaecology, Graduate Entry Medical School, University of Limerick, Limerick, Ireland
| | - M J Turner
- University College Dublin Centre for Human Reproduction, School of Medicine and Medical Science, Coombe Women and Infants Maternity Hospital, Dublin, Ireland
| | - F M Breathnach
- Royal College of Surgeons in Ireland, Rotunda Hospital, Dublin, Ireland
| | - F M Mcauliffe
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - J J Morrison
- Department of Obstetrics and Gynaecology, National University of Ireland, Galway, Ireland
| | - S Dornan
- Royal Jubilee Maternity Hospital, Belfast, Ireland
| | - J Higgins
- University College Cork, Cork University Maternity Hospital, Cork, Ireland
| | - A Cotter
- Department of Obstetrics and Gynaecology, Graduate Entry Medical School, University of Limerick, Limerick, Ireland
| | | | - P Mcparland
- National Maternity Hospital, Dublin, Ireland
| | - S Daly
- Coombe Women and Infants Maternity Hospital, Dublin, Ireland
| | - F Cody
- Rotunda Hospital, Dublin, Ireland
| | - P Dicker
- Epidemiology & Public Health, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - E Tully
- Rotunda Hospital, Dublin, Ireland
| | - F D Malone
- Royal College of Surgeons in Ireland, Rotunda Hospital, Dublin, Ireland
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Roy A, Higgins J, Nadeau S. Reliability and minimal detectable change of the mini-BESTest in adults with spinal cord injury in a rehabilitation setting. Physiother Theory Pract 2019; 37:126-134. [PMID: 31156010 DOI: 10.1080/09593985.2019.1622161] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: The mini-Balance Evaluation Systems Test (mini-BESTest) is a valid tool for assessing standing balance in people with spinal cord injury (SCI). Its reliability has not yet been investigated with this population. Objective: To assess the test-retest and inter-rater reliability of the mini-BESTest in adults with SCI in a rehabilitation setting. Methods: Twenty-three participants admitted in a rehabilitation center following an SCI (mean age = 52.2 years, SD = 14.5; 13/23 tetraplegia; 14/23 traumatic injury) and able to stand 30 seconds without help were recruited. They were evaluated twice with the mini-BESTest to establish the test-retest reliability (interval of 1 to 2 days). One of the two sessions was video-recorded to establish the inter-rater reliability (3 physiotherapists). Intraclass correlation coefficients (ICC2,1), weighted kappa (Kw) and Kendall's W were used to determine reliability of total score and individual items. Minimal detectable changes (MDC) were computed. Results. The mini-BESTest total scores showed excellent test-retest (ICC = 0.94) and inter-rater (ICC = 0.96) reliability. Reliability of 50% of the individual items was acceptable to excellent (Κw and W = 0.35-1.00). The MDC of the mini-BESTest total score was 4 points. Conclusion: The mini-BESTest is a reliable tool to assess standing balance in adults with an SCI. A minimal change of 4 points on the total scale is needed to be confident that the change is not a measurement error between two sessions or two raters.
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Affiliation(s)
- Audrey Roy
- School of Rehabilitation, Faculté de Médecine, Université de Montréal, Pavillon du Parc , Montréal, QC, Canada.,Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, QC, Canada.,Spinal Cord Injury Unit, Institut universitaire sur la réadaptation en déficience physique de Montréal (IURDPM) du Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l'Ile-de-Montréal (CCSMTL) , Montréal, QC, Canada
| | - Johanne Higgins
- School of Rehabilitation, Faculté de Médecine, Université de Montréal, Pavillon du Parc , Montréal, QC, Canada.,Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, QC, Canada.,Spinal Cord Injury Unit, Institut universitaire sur la réadaptation en déficience physique de Montréal (IURDPM) du Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l'Ile-de-Montréal (CCSMTL) , Montréal, QC, Canada
| | - Sylvie Nadeau
- School of Rehabilitation, Faculté de Médecine, Université de Montréal, Pavillon du Parc , Montréal, QC, Canada.,Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, QC, Canada.,Spinal Cord Injury Unit, Institut universitaire sur la réadaptation en déficience physique de Montréal (IURDPM) du Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l'Ile-de-Montréal (CCSMTL) , Montréal, QC, Canada
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Burnett C, Hamlin P, Dabovic K, Higgins J, Persky D. A PHASE 1/2 STUDY OF MT-3724 TO EVALUATE SAFETY, PHARMACODYNAMICS AND EFFICACY OF MT-3724 FOR THE TREATMENT OF PATIENTS WITH RELAPSED OR REFRACTORY DIFFUSE LARGE B CELL LYMPHOMA. Hematol Oncol 2019. [DOI: 10.1002/hon.13_2632] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- C.A. Burnett
- Clinical Development; Molecular Templates, Inc.; Jersey City NJ United States
| | - P. Hamlin
- Division of Hematologic Malignancies; Memorial Sloan Kettering Cancer Center; New York NY United States
| | - K. Dabovic
- Clinical Development; Molecular Templates, Inc.; Jersey City NJ United States
| | - J. Higgins
- Manufacturing; Molecular Templates, Inc.; Austin TX United States
| | - D.O. Persky
- Division of Hematology and Oncology; University of Arizona Cancer Center; Tucson AZ United States
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Higgins J, Laramée MT, Harrison KR, Delparte JJ, Scovil CY, Flett HM, Burns AS. The Spinal Cord Injury Pressure Ulcer Scale (SCIPUS): an assessment of validity using Rasch analysis. Spinal Cord 2019; 57:874-880. [PMID: 31053776 DOI: 10.1038/s41393-019-0287-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Revised: 04/23/2019] [Accepted: 04/24/2019] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Secondary analysis of retrospective data. OBJECTIVE The aim of this study was to further validate the Spinal Cord Injury Pressure Ulcer Scale (SCIPUS) using Rasch analysis. SETTING Two rehabilitation centers in Canada. METHOD Data were collected as part of the Spinal Cord Injury Knowledge Mobilization Network (SCI KMN) initiative. The SCIPUS was completed within 72 h of inpatient admission. Persons admitted for initial rehabilitation in two inpatient spinal cord rehabilitation programs were included in the project. RESULTS Data from 886 participants were analyzed, approximately 60% of whom were males. Rasch analyses demonstrated that the SCIPUS, in its current format did not meet criteria required for true measurement. A transformed version of the SCIPUS obtained by deletion of misfitting items and modification of the response scales improved fit to the model and showed preliminary evidence of unidimensionality. The person separation index, however indicated that the scale requires further adjustments of its scoring options. CONCLUSIONS In its original form, the SCIPUS does not meet the requirements of the Rasch model and its total score should be used cautiously. However, following some adjustments to the items such as addressing DIF between sites to insure a standardized assessment across sites and adding response options to some of the items, interval-scale measurement should be possible.
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Affiliation(s)
- Johanne Higgins
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Canada. .,Institut universitaire sur la réadaptation en déficience physique de Montréal (IURDPM) of the Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l'Ile-de-Montréal, Montreal, QC, Canada. .,School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada.
| | - Marie-Thérèse Laramée
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Canada.,Institut universitaire sur la réadaptation en déficience physique de Montréal (IURDPM) of the Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l'Ile-de-Montréal, Montreal, QC, Canada
| | - Kate Rousseau Harrison
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Canada.,Institut universitaire sur la réadaptation en déficience physique de Montréal (IURDPM) of the Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l'Ile-de-Montréal, Montreal, QC, Canada
| | - Jude J Delparte
- Brain and Spinal Cord Rehabilitation Program, Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada
| | - Carol Y Scovil
- Brain and Spinal Cord Rehabilitation Program, Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada.,Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
| | - Heather M Flett
- Brain and Spinal Cord Rehabilitation Program, Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada.,Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
| | - Anthony S Burns
- Brain and Spinal Cord Rehabilitation Program, Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada.,Division of Physiatry, Department of Medicine, University of Toronto, Toronto, ON, Canada
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Flett HM, Delparte JJ, Scovil CY, Higgins J, Laramée MT, Burns AS. Determining Pressure Injury Risk on Admission to Inpatient Spinal Cord Injury Rehabilitation: A Comparison of the FIM, Spinal Cord Injury Pressure Ulcer Scale, and Braden Scale. Arch Phys Med Rehabil 2019; 100:1881-1887. [PMID: 31054293 DOI: 10.1016/j.apmr.2019.04.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 03/27/2019] [Accepted: 04/04/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Assess the utility of the admission Spinal Cord Injury Pressure Ulcer Scale (SCIPUS), Braden Scale, and the FIM for identifying individuals at risk for developing pressure injury during inpatient spinal cord injury (SCI) rehabilitation. DESIGN Retrospective cohort. SETTING Two tertiary rehabilitation centers. PARTICIPANTS Individuals (N=754) participating in inpatient SCI rehabilitation. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Logistic regression analysis was performed to determine the utility of the SCIPUS, Braden Scale, and FIM for identifying individuals at risk for developing pressure injury (PI) during inpatient SCI rehabilitation. Sensitivity, specificity, positive predictive value, negative predictive value, false negative rate, odds ratio, likelihood ratio, and area under the curve (AUC) are reported. RESULTS The SCIPUS total score and its individual items did not demonstrate acceptable accuracy (AUC≥0.7) whereas the Braden Scale (0.73) and the FIM score (0.74) did. Once items were dichotomized into high and low risk categories, 1 Braden item (friction and shear), 5 FIM items (bathing, toileting, bed/chair transfer, tub/shower transfer, toilet transfer), the FIM transfers subscale, FIM Motor subscale, and the FIM instrument as a whole, maintained AUCs ≥0.7 and negative predictive values ≥0.95. The FIM bed/chair transfer score demonstrated the highest likelihood ratio (2.62) and overall was the most promising measure for determining PI risk. CONCLUSION Study findings suggest that a simple measure of mobility, admission FIM bed/chair transfer score of 1 (total assist), can identify at-risk individuals with greater accuracy than both an SCI specific instrument (SCIPUS) and a PI specific instrument (Braden). The FIM bed/chair transfer score can be readily determined at rehabilitation admission with minimal administrative and clinical burden.
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Affiliation(s)
- Heather M Flett
- Brain and Spinal Cord Rehabilitation Program, Lyndhurst Centre, Toronto Rehabilitation Institute, University Health Network, Toronto, ON; Department of Physical Therapy, University of Toronto, Toronto, ON.
| | - Jude J Delparte
- Brain and Spinal Cord Rehabilitation Program, Lyndhurst Centre, Toronto Rehabilitation Institute, University Health Network, Toronto, ON
| | - Carol Y Scovil
- Brain and Spinal Cord Rehabilitation Program, Lyndhurst Centre, Toronto Rehabilitation Institute, University Health Network, Toronto, ON; Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON
| | - Johanne Higgins
- Research Unit, Integrated University Centre for Health and Social Services for South Central Island of Montreal-Institute of Rehabilitation Gingras-Lindsay-de-Montréal, Montreal, QC; School of Rehabilitation Faculty of Medicine, University of Montreal, Montreal, QC; Center for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, QC
| | - Marie-Thérèse Laramée
- Research Unit, Integrated University Centre for Health and Social Services for South Central Island of Montreal-Institute of Rehabilitation Gingras-Lindsay-de-Montréal, Montreal, QC; Center for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, QC; Spinal Cord Injury Program, CCSMTL, - Institute of Rehabilitation Gingras-Lindsay-de-Montréal, Montreal, QC
| | - Anthony S Burns
- Brain and Spinal Cord Rehabilitation Program, Lyndhurst Centre, Toronto Rehabilitation Institute, University Health Network, Toronto, ON; Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Toronto, Toronto, ON, Canada
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Rau JG, Wu LS, May AF, Taylor AE, Liu IL, Higgins J, Butch NP, Ross KA, Nair HS, Lumsden MD, Gingras MJP, Christianson AD. Behavior of the breathing pyrochlore lattice Ba 3Yb 2Zn 5O 11 in applied magnetic field. J Phys Condens Matter 2018; 30:455801. [PMID: 30256218 DOI: 10.1088/1361-648x/aae45a] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The breathing pyrochlore lattice material Ba3Yb2Zn5O11 exists in the nearly decoupled limit, in contrast to most other well-studied breathing pyrochlore compounds. As a result, it constitutes a useful platform to benchmark theoretical calculations of exchange interactions in insulating Yb3+ magnets. Here we study Ba3Yb2Zn5O11 at low temperatures in applied magnetic fields as a further probe of the physics of this model system. Experimentally, we consider the behavior of polycrystalline samples of Ba3Yb2Zn5O11 with a combination of inelastic neutron scattering and heat capacity measurements down to 75 mK and up to fields of 10 T. Consistent with previous work, inelastic neutron scattering finds a level crossing near 3 T, but no significant dispersion of the spin excitations is detected up to the highest applied fields. Refinement of the theoretical model previously determined at zero field can reproduce much of the inelastic neutron scattering spectra and specific heat data. A notable exception is a low temperature peak in the specific heat at ∼0.1 K. This may indicate the scale of interactions between tetrahedra or may reflect undetected disorder in Ba3Yb2Zn5O11.
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Affiliation(s)
- J G Rau
- Department of Physics and Astronomy, University of Waterloo, Waterloo, Ontario, N2L 3G1, Canada. Max-Planck-Institut für Physik komplexer Systeme, 01187 Dresden, Germany
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Scrimgeour D, Higgins J, Bucknall V, Arnett R, Featherstone C, Cleland J, Lee A, Brennan P. Do surgeon interviewers have human factor-related issues during the long day UK National Trauma and Orthopaedic specialty recruitment process? Surgeon 2018. [DOI: 10.1016/j.surge.2018.01.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Higgins J, Carpenter E, Christianson L, Everett B, Greene M, Haider S, Hendrick CE, Powell J. “Will taking the pill make me less gay?”: contraceptive norms, contexts and conflicts among sexual minority women from three cities. Contraception 2018. [DOI: 10.1016/j.contraception.2018.07.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Siegel S, Fan L, Goldman A, Higgins J, Goates S, Partridge J. The Impact of Hospital Quality Improvement Initiatives on Health Outcomes. J Acad Nutr Diet 2018. [DOI: 10.1016/j.jand.2018.06.252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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49
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Pelletier R, Bourbonnais D, Higgins J, Mireault M, Danino MA, Harris PG. Left Right Judgement Task and Sensory, Motor, and Cognitive Assessment in Participants with Wrist/Hand Pain. Rehabil Res Pract 2018; 2018:1530245. [PMID: 30225144 PMCID: PMC6129336 DOI: 10.1155/2018/1530245] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 07/20/2018] [Accepted: 08/02/2018] [Indexed: 01/01/2023] Open
Abstract
The Left Right Judgement Task (LRJT) involves determining if an image of the body part is of the left or right side. The LRJT has been utilized as part of rehabilitation treatment programs for persons with pain associated with musculoskeletal injuries and conditions. Although studies often attribute changes and improvement in LRJT performance to an altered body schema, imaging studies suggest that the LRJT implicates other cortical regions. We hypothesized that cognitive factors would be related to LRJT performance of hands and feet and that sensory, motor, and pain related factors would be related to LRJT in the affected hand of participants with wrist/hand pain. In an observational cross-sectional study, sixty-one participants with wrist/hand pain participated in a study assessing motor imagery ability, cognitive (Stroop test), sensory (Two-Point Orientation Discrimination, pressure pain thresholds), motor (grip strength, Purdue Pegboard Test), and pain related measures (West Haven Yale Multidimensional Pain Inventory) as well as disability (Disability of the Arm, Shoulder and Hand). Multiple linear regression found Stroop test time and motor imagery ability to be related to LRJT performance. Tactile acuity, motor performance, participation in general activities, and the taking of pain medications were predictors of LRJT accuracy in the affected hand. Participants who took pain medications performed poorly in both LRJT accuracy (p=0.001) and reaction time of the affected hand (p=0.009). These participants had poorer cognitive (p=0.013) and motor function (p=0.002), and higher pain severity scores (p=0.010). The results suggest that the LRJT is a complex mental task that involves cognitive, sensory, motor, and behavioural processes. Differences between persons with and without pain and improvement in LRJT performance may be attributed to any of these factors and should be considered in rehabilitation research and practice utilizing this task.
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Affiliation(s)
- René Pelletier
- Sciences de la Réadaptation, École de Réadaptation, Faculté de Médecine, Université de Montréal, Montréal (Québec), Canada H3C 3J7
| | - Daniel Bourbonnais
- École de Réadaptation, Faculté de Médecine, Université de Montréal, C.P. 6128, Succursale Centre-Ville, Montréal (Québec), Canada H3C 3J7
- Researcher, Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Canada
| | - Johanne Higgins
- École de Réadaptation, Faculté de Médecine, Université de Montréal, C.P. 6128, Succursale Centre-Ville, Montréal (Québec), Canada H3C 3J7
- Researcher, Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Canada
| | - Maxime Mireault
- Sciences de la Réadaptation, École de Réadaptation, Faculté de Médecine, Université de Montréal, Montréal (Québec), Canada H3C 3J7
| | - Michel Alain Danino
- Professeur Agrégé Université de Montréal, Chef du Service de Chirurgie Plastique du Centre Hospitalier Université de Montréal (CHUM), 850 rue St-Denis Pav. S-Local S02-128 Montréal (Québec), Canada H2X 0A9
| | - Patrick G. Harris
- Service de Chirurgie Plastique, Département de Chirurgie du Centre Hospitalier de l'Université de Montréal (CHUM), 1000 rue Saint-Denis (Québec), Canada H2X 0C1
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Higgins J, Nadeau S, Emeraux B, Akremi H, Aissaoui R. Effects of asymmetrical resistance imposed during repeated bilateral upper limb pushing movements on bilateral coordination post-stroke. Ann Phys Rehabil Med 2018. [DOI: 10.1016/j.rehab.2018.05.1136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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