Kim Dunleavy | University of Florida (original) (raw)

Papers by Kim Dunleavy

Research paper thumbnail of Author Response

Physical therapy, Jun 1, 2012

Research paper thumbnail of Use of a Group Setting for Respiratory Treatment in Spinal Cord Injury Patients

Research paper thumbnail of Contextual Considerations for Globalized Instructional Design for Healthcare Interventions in Developing Countries

ICERI2009 Proceedings, 2009

Research paper thumbnail of Promoting clinical reasoning using the international classification of function, disability and health (ICF) framework for continuing education development in Rwanda

Physiotherapy, May 1, 2015

The statistical analysis were performed using ANOVA compared with dominant vs. non-dominant leg w... more The statistical analysis were performed using ANOVA compared with dominant vs. non-dominant leg with Knee flexion angle and knee valgus angle. The level of statistical significance was p < 0.05. Results: The result showed bimodal curve of peak knee valgus in both knees. Maximum flexion occurred at stop phase after contacting subjects' leg on floor, and maximum valgus occurred almost simultaneously. In left leg, maximum knee flexion angle was lower by approximately 5 degrees than right leg. On the other hand, knee valgus angle was higher by 2 degrees. There was no significant difference of angular displacement between both knees. However, there was a tendency that smaller maximum flexion and larger valgus were observed in left knee compared with the right leg. Fourteen out of twenty subjects answered that right side step cutting was easier to perform than left one. Further researches are necessary to confirm that right sidestep cutting maneuvers were actually performed more frequently compared with left one. There may be some nature differences of lower extremities between both legs. Conclusion(s): Although there was no significant difference between right and left leg, lower flexion and higher valgus angle were observed in left knee. Implications: Asymmetry of knee joint kinematics during 90 • direction side step cutting (SSC) maneuver, which may cause difference of incidence of ACL injuries should be cautioned. Keywords: ACL injury prevention; Side step cutting; 3D analysis Funding acknowledgements: This study was not funded by any organization that could influence the research results. Ethics approval: Subjects participated in this study after signing informed consent form approved by the institutional review board (Ethics approval No 1335).

Research paper thumbnail of Comparative effectiveness of Pilates and yoga group exercise interventions for chronic mechanical neck pain: quasi-randomised parallel controlled study

Physiotherapy, Sep 1, 2016

Objectives To determine the effectiveness of Pilates and yoga group exercise interventions for in... more Objectives To determine the effectiveness of Pilates and yoga group exercise interventions for individuals with chronic neck pain (CNP). Design Quasi-randomised parallel controlled study. Setting Community, university and private practice settings in four locations. Participants Fifty-six individuals with CNP scoring ≥3/10 on the numeric pain rating scale for >3 months (controls n=19, Pilates n=20, yoga n=19). Interventions Exercise participants completed 12 small-group sessions with modifications and progressions supervised by a physiotherapist. Main outcome measures The primary outcome measure was the Neck Disability Index (NDI). Secondary outcomes were pain ratings, range of movement and postural measurements collected at baseline, 6 weeks and 12 weeks. Follow-up was performed 6 weeks after completion of the exercise classes (Week 18). Results NDI decreased significantly in the Pilates {baseline: 11.1 [standard deviation (SD) 4.3] vs Week 12: 6.8 (SD 4.3); mean difference-4.3 (95% confidence interval-1.64 to-6.7); P<0.001} and yoga groups [baseline: 12.8 (SD 7.4) vs Week 12: 8.1 (SD 5.6); mean difference-4.7 (95% confidence interval-2.1 to-7.4); P<0.00], with no change in the control group. Pain ratings also improved significantly. Moderate-to-large effect sizes (0.7 to 1.8) and low numbers needed to treat were found. There were no differences in outcomes between the exercise groups or associated adverse effects. No improvements in range of movement or posture were found.

Research paper thumbnail of A narrative review of ergonomic problems, principles, and potential solutions in surgical operations

Research paper thumbnail of Barriers and facilitators to initiating and sustaining interprofessional pain education

Journal of Interprofessional Education & Practice

Research paper thumbnail of Use of Group Treatments for Scapulothoracic Strengthening in Spinal Cord Injury Patients

Research paper thumbnail of Therapeutic Exercise Prescription

Research paper thumbnail of The Differing Effects of Nociception and Pain Memory on Pain Thresholds in Participants with and without a History of Injury: A Pretest-Posttest Quasi Experimental Study

Journal of Behavioral and Brain Science

Purpose: Memory has been identified as an important protective feature to prevent future injury, ... more Purpose: Memory has been identified as an important protective feature to prevent future injury, but its role has yet to be ascertained. The current study aimed to determine whether there was a difference in pressure pain threshold (PPT) responses between participants with a prior history of injury of lower extremity injury (PSI) and those without (NPSI) when exposed to 1) experimental mechanical pain, 2) short-term memory recall of a painful stimulus, or 3) long-term memory of the pain associated with a prior injury. Subjects and Methods: The study used a pretest-posttest quasi-experimental design. A convenience sample of 59 pain-free participants was recruited from an urban university. Twenty-nine PSI and 30 NPSI were stratified into two groups based on their injury history with PPT values measured at baseline and immediately following each of the three experimental conditions. A repeated measure ANCOVA analysis was conducted for each condition to determine whether there was a difference in PPT responses between the two groups. Results: There was a statistically significant difference in PPT values between the two groups when exposed to experimental pain, F(1,57) = 6.010, p = 0.017, partial η 2 = 0.095 and with long-term pain memory, F(1,57) = 4.886, p = 0.031, partial η 2 = 0.079. There was no statistically significant difference between groups with short-term pain memory, F(1,57) = 3.925, p = 0.

Research paper thumbnail of Interprofessional pain management: Educational models and exemplars across the learning and practice continuum

Journal of Interprofessional Education & Practice

Research paper thumbnail of Chronic lower back pain in aquaculture clam farmers: adoption and feasibility of self-management strategies introduced using a rapid prototype participatory ergonomic approach

International Journal of Occupational Safety and Ergonomics

Background: Lower back pain (LBP) is extremely prevalent in seafood harvesters who often have lim... more Background: Lower back pain (LBP) is extremely prevalent in seafood harvesters who often have limited or no access to ergonomic consultation, occupational health support and rehabilitation services.Purpose: This pilot study aimed to describe a participatory ergonomic approach and determine feasibility and extent of adoption of self-management strategies in clam farmers with LBP.Methods: A rapid prototype participatory ergonomic approach was used to develop context-specific self-management strategies. Options to adjust lifting and repetitive stress were introduced using video clips, demonstrations and discussions in the workplace. Workers chose and implemented 3 strategies for 8 weeks with weekly reminders. Survey and qualitative data from focus groups were analyzed.Results: Team strategies were the most popular, but individual options were used more often. Strategies were considered feasible, acceptable and relatively easy to use. Strategies were implemented relatively consistently, and most improved productivity with decreased pain. Challenges for uptake included changing habit, culture and team dynamics.Discussion/Conclusions: Participatory rapid prototyping provided a feasible and efficient option to introduce strategies for clam farmers with small teams, variable work processes and workloads, and time restrictions. Strategies were considered acceptable, easy to use and most increased productivity. These methods show potential for future research.

Research paper thumbnail of Assessing professionalism in health profession degree programs: A scoping review

Currents in Pharmacy Teaching and Learning, 2021

BACKGROUND To identify and classify methods for assessing professionalism across health professio... more BACKGROUND To identify and classify methods for assessing professionalism across health profession degree programs and identify gaps in the literature regarding types of assessments. METHODS The authors conducted a scoping review of articles published from database inception through 24 January 2020. Included articles described an assessment approach for professionalism in health profession degree programs available in full-text in the English language. Articles were classified based on profession, timing of assessment, feedback type, assessment type, professionalism dimension, and Barr's modified Kirkpatrick hierarchy. RESULTS Authors classified 277 articles meeting inclusion criteria. Most articles were from medical education (62.5%) conducted during didactic (62.1%) or experiential/clinical curriculum (49.8%). Few articles (15.5%) described longitudinal assessment. Feedback type was formative (32.2%) or summative (35%), with only 8.3% using both. Assessment types frequently reported included self-administered rating scales (30%), reflections (18.8%), observed clinical encounters (17.3%), and knowledge-based tests (13.4%). Ethical practice principles (65%) and effective interactions with patients (48.4%) were the most frequently assessed dimensions of professionalism. Authors observed balanced distribution among Barr's modified Kirkpatrick model at levels of reaction (38.3%), modification of perceptions and attitudes (33.6%), acquisition of knowledge and skills (39%), and behavioral change (36.1%). IMPLICATIONS The classification scheme identified in current literature on professionalism assessment does not align with International Ottawa Conference Working Group on the Assessment of Professionalism recommendations. Gaps identified were limited description of professionalism assessment during admissions, infrequent longitudinal assessment, limited use of methods for both formative and summative assessment, and limited reports of assessments applicable to interprofessional education settings.

Research paper thumbnail of Patellar Clunk Syndrome—A Complication After Total Knee Arthroplasty: A Case Report

JOSPT Cases, May 14, 2021

Research paper thumbnail of Becoming an anti-racist interprofessional healthcare organization: Our journey

Journal of Interprofessional Education & Practice, 2022

The COVID-19 pandemic amplified the egregious disproportionate burden of disease based on race, e... more The COVID-19 pandemic amplified the egregious disproportionate burden of disease based on race, ethnicity, and failure of organizations to address structural racism. This paper describes a journey by members of the National Academies of Practice (NAP) who came together to address diversity, equity, and inclusion (DEI). Through collaborative efforts, a virtual, interactive workshop was designed and delivered at NAP's 2021 Virtual Forum to facilitate discussions about DEI priorities across professions and to initiate a sustainable action plan toward achieving inclusive excellence. Resulting discoveries and reflections led us to the essential question: can we truly become an anti-racist interprofessional healthcare organization?

Research paper thumbnail of Teaching and Learning Concepts for Exercise

Therapeutic Exercise Prescription, 2019

Research paper thumbnail of Comparative effectiveness of Pilates and yoga group exercise interventions for chronic mechanical neck pain: quasi-randomised parallel controlled study

Physiotherapy, 2016

Objectives To determine the effectiveness of Pilates and yoga group exercise interventions for in... more Objectives To determine the effectiveness of Pilates and yoga group exercise interventions for individuals with chronic neck pain (CNP). Design Quasi-randomised parallel controlled study. Setting Community, university and private practice settings in four locations. Participants Fifty-six individuals with CNP scoring ≥3/10 on the numeric pain rating scale for >3 months (controls n=19, Pilates n=20, yoga n=19). Interventions Exercise participants completed 12 small-group sessions with modifications and progressions supervised by a physiotherapist. Main outcome measures The primary outcome measure was the Neck Disability Index (NDI). Secondary outcomes were pain ratings, range of movement and postural measurements collected at baseline, 6 weeks and 12 weeks. Follow-up was performed 6 weeks after completion of the exercise classes (Week 18). Results NDI decreased significantly in the Pilates {baseline: 11.1 [standard deviation (SD) 4.3] vs Week 12: 6.8 (SD 4.3); mean difference-4.3 (95% confidence interval-1.64 to-6.7); P<0.001} and yoga groups [baseline: 12.8 (SD 7.4) vs Week 12: 8.1 (SD 5.6); mean difference-4.7 (95% confidence interval-2.1 to-7.4); P<0.00], with no change in the control group. Pain ratings also improved significantly. Moderate-to-large effect sizes (0.7 to 1.8) and low numbers needed to treat were found. There were no differences in outcomes between the exercise groups or associated adverse effects. No improvements in range of movement or posture were found.

Research paper thumbnail of Outcomes of hip resurfacing in a professional dancer: A case report

Physiotherapy Theory and Practice, 2011

A new surgical option (hip resurfacing arthroplasty) is now available for younger patients with h... more A new surgical option (hip resurfacing arthroplasty) is now available for younger patients with hip osteoarthritis. A more aggressive rehabilitation program than the typical total hip arthroplasty protocol is needed for active individuals. This case report describes interventions used to maximize function in a 46-year-old professional dancer after hip resurfacing with a progressive therapeutic exercise program. Exercise choices were selected to address dance-specific requirements while respecting healing of the posterior capsular incision. Strengthening focused on hip abduction, extension, and external rotation. Precautions included avoiding gluteal stretching until 6 months. Pelvic alignment and weight-bearing distribution were emphasized. The patient was able to return to rehearsal by 7 months, at which time strength was equivalent to the unaffected leg. Range of motion reached unaffected side values at week 8 for internal rotation, week 11 for extension, week 13 for adduction, and week 28 for flexion. External rotation and abduction were still limited at 1 year, which influenced pelvic alignment with resultant pain on the unaffected side. Functional and impairment outcomes are presented with timelines to provide a basis for postoperative benchmarks for active clients after hip resurfacing. Although this case report presents a dance-specific program, exercise progressions for other active individuals may benefit from similar exercise intensity and sports-specific focus. Future rehabilitation programs should take into account possible flexion and external rotation range limitations and the need for gluteal muscle strengthening along with symmetry and pelvic alignment correction. Long-term studies investigating intensity of rehabilitation are warranted for patients intending to participate in higher level athletic activity.

Research paper thumbnail of Physical therapy education and provision in Cambodia: A framework for choice of systems for development projects

Disability and Rehabilitation, 2007

Rehabilitation agencies, policy makers and donors are faced with the choice of the level of rehab... more Rehabilitation agencies, policy makers and donors are faced with the choice of the level of rehabilitation provider to promote in developing countries. This is particularly the case after conflict when new systems are considered and the need for rehabilitation becomes a priority. The complete decimation of medical services in Cambodia highlights the effects of both social change and development agency impact on the establishment of rehabilitation services. This paper discusses the factors that led to the development of four types of physical therapy provider levels in Cambodia with the goal of providing a framework for these decisions. Case study analysis utilizing interviews, site analysis and literature review. There are four levels of physical therapy provider systems that were initiated at different stages of the rebuilding of the country. Rehabilitation workers were trained during the war in refugee camps and afterwards in rehabilitation centers, professional physical therapists were trained in a university programme after the conflict ceased and community follow-up workers and community-based rehabilitation workers were trained to address some of the geographic accessibility issues. Factors that affected the different systems include the post-conflict development agency philosophy, instructor availability and training, financial support, high school education standards, geographic and rural/urban distribution and cost and time for training. The community-based rehabilitation and community follow-up models also address referral systems and social and vocational support. The comparison of the different types of provider and the initiating or driving forces that led to development of these systems are discussed in order to provide agencies which are planning to implement training of rehabilitation providers in developing countries with a decision-making framework. A combined system is the optimal approach; however, the choice of which type of provider level to promote will differ according to political stability, stage of development, presence of trained educators, rural vs. urban need, funding agency philosophy and educational standards in the country.

Research paper thumbnail of Proximal Tibial Fracture Following Total Knee Arthoplasty

Journal of Orthopaedic & Sports Physical Therapy, 2011

The patient was a 74-year-old man, with a history of total knee arthoplasty 14 years earlier, aft... more The patient was a 74-year-old man, with a history of total knee arthoplasty 14 years earlier, after having sustained a pathological fracture of the proximal diaphysis of the left tibia following a fall. Given the unstable nature of the fracture and the severe osteolysis noted below the total knee arthroplasty, surgical management 1 day after the fall entailed packing cancellous bone graft into the defect and realigning the fracture.

Research paper thumbnail of Author Response

Physical therapy, Jun 1, 2012

Research paper thumbnail of Use of a Group Setting for Respiratory Treatment in Spinal Cord Injury Patients

Research paper thumbnail of Contextual Considerations for Globalized Instructional Design for Healthcare Interventions in Developing Countries

ICERI2009 Proceedings, 2009

Research paper thumbnail of Promoting clinical reasoning using the international classification of function, disability and health (ICF) framework for continuing education development in Rwanda

Physiotherapy, May 1, 2015

The statistical analysis were performed using ANOVA compared with dominant vs. non-dominant leg w... more The statistical analysis were performed using ANOVA compared with dominant vs. non-dominant leg with Knee flexion angle and knee valgus angle. The level of statistical significance was p < 0.05. Results: The result showed bimodal curve of peak knee valgus in both knees. Maximum flexion occurred at stop phase after contacting subjects' leg on floor, and maximum valgus occurred almost simultaneously. In left leg, maximum knee flexion angle was lower by approximately 5 degrees than right leg. On the other hand, knee valgus angle was higher by 2 degrees. There was no significant difference of angular displacement between both knees. However, there was a tendency that smaller maximum flexion and larger valgus were observed in left knee compared with the right leg. Fourteen out of twenty subjects answered that right side step cutting was easier to perform than left one. Further researches are necessary to confirm that right sidestep cutting maneuvers were actually performed more frequently compared with left one. There may be some nature differences of lower extremities between both legs. Conclusion(s): Although there was no significant difference between right and left leg, lower flexion and higher valgus angle were observed in left knee. Implications: Asymmetry of knee joint kinematics during 90 • direction side step cutting (SSC) maneuver, which may cause difference of incidence of ACL injuries should be cautioned. Keywords: ACL injury prevention; Side step cutting; 3D analysis Funding acknowledgements: This study was not funded by any organization that could influence the research results. Ethics approval: Subjects participated in this study after signing informed consent form approved by the institutional review board (Ethics approval No 1335).

Research paper thumbnail of Comparative effectiveness of Pilates and yoga group exercise interventions for chronic mechanical neck pain: quasi-randomised parallel controlled study

Physiotherapy, Sep 1, 2016

Objectives To determine the effectiveness of Pilates and yoga group exercise interventions for in... more Objectives To determine the effectiveness of Pilates and yoga group exercise interventions for individuals with chronic neck pain (CNP). Design Quasi-randomised parallel controlled study. Setting Community, university and private practice settings in four locations. Participants Fifty-six individuals with CNP scoring ≥3/10 on the numeric pain rating scale for >3 months (controls n=19, Pilates n=20, yoga n=19). Interventions Exercise participants completed 12 small-group sessions with modifications and progressions supervised by a physiotherapist. Main outcome measures The primary outcome measure was the Neck Disability Index (NDI). Secondary outcomes were pain ratings, range of movement and postural measurements collected at baseline, 6 weeks and 12 weeks. Follow-up was performed 6 weeks after completion of the exercise classes (Week 18). Results NDI decreased significantly in the Pilates {baseline: 11.1 [standard deviation (SD) 4.3] vs Week 12: 6.8 (SD 4.3); mean difference-4.3 (95% confidence interval-1.64 to-6.7); P<0.001} and yoga groups [baseline: 12.8 (SD 7.4) vs Week 12: 8.1 (SD 5.6); mean difference-4.7 (95% confidence interval-2.1 to-7.4); P<0.00], with no change in the control group. Pain ratings also improved significantly. Moderate-to-large effect sizes (0.7 to 1.8) and low numbers needed to treat were found. There were no differences in outcomes between the exercise groups or associated adverse effects. No improvements in range of movement or posture were found.

Research paper thumbnail of A narrative review of ergonomic problems, principles, and potential solutions in surgical operations

Research paper thumbnail of Barriers and facilitators to initiating and sustaining interprofessional pain education

Journal of Interprofessional Education & Practice

Research paper thumbnail of Use of Group Treatments for Scapulothoracic Strengthening in Spinal Cord Injury Patients

Research paper thumbnail of Therapeutic Exercise Prescription

Research paper thumbnail of The Differing Effects of Nociception and Pain Memory on Pain Thresholds in Participants with and without a History of Injury: A Pretest-Posttest Quasi Experimental Study

Journal of Behavioral and Brain Science

Purpose: Memory has been identified as an important protective feature to prevent future injury, ... more Purpose: Memory has been identified as an important protective feature to prevent future injury, but its role has yet to be ascertained. The current study aimed to determine whether there was a difference in pressure pain threshold (PPT) responses between participants with a prior history of injury of lower extremity injury (PSI) and those without (NPSI) when exposed to 1) experimental mechanical pain, 2) short-term memory recall of a painful stimulus, or 3) long-term memory of the pain associated with a prior injury. Subjects and Methods: The study used a pretest-posttest quasi-experimental design. A convenience sample of 59 pain-free participants was recruited from an urban university. Twenty-nine PSI and 30 NPSI were stratified into two groups based on their injury history with PPT values measured at baseline and immediately following each of the three experimental conditions. A repeated measure ANCOVA analysis was conducted for each condition to determine whether there was a difference in PPT responses between the two groups. Results: There was a statistically significant difference in PPT values between the two groups when exposed to experimental pain, F(1,57) = 6.010, p = 0.017, partial η 2 = 0.095 and with long-term pain memory, F(1,57) = 4.886, p = 0.031, partial η 2 = 0.079. There was no statistically significant difference between groups with short-term pain memory, F(1,57) = 3.925, p = 0.

Research paper thumbnail of Interprofessional pain management: Educational models and exemplars across the learning and practice continuum

Journal of Interprofessional Education & Practice

Research paper thumbnail of Chronic lower back pain in aquaculture clam farmers: adoption and feasibility of self-management strategies introduced using a rapid prototype participatory ergonomic approach

International Journal of Occupational Safety and Ergonomics

Background: Lower back pain (LBP) is extremely prevalent in seafood harvesters who often have lim... more Background: Lower back pain (LBP) is extremely prevalent in seafood harvesters who often have limited or no access to ergonomic consultation, occupational health support and rehabilitation services.Purpose: This pilot study aimed to describe a participatory ergonomic approach and determine feasibility and extent of adoption of self-management strategies in clam farmers with LBP.Methods: A rapid prototype participatory ergonomic approach was used to develop context-specific self-management strategies. Options to adjust lifting and repetitive stress were introduced using video clips, demonstrations and discussions in the workplace. Workers chose and implemented 3 strategies for 8 weeks with weekly reminders. Survey and qualitative data from focus groups were analyzed.Results: Team strategies were the most popular, but individual options were used more often. Strategies were considered feasible, acceptable and relatively easy to use. Strategies were implemented relatively consistently, and most improved productivity with decreased pain. Challenges for uptake included changing habit, culture and team dynamics.Discussion/Conclusions: Participatory rapid prototyping provided a feasible and efficient option to introduce strategies for clam farmers with small teams, variable work processes and workloads, and time restrictions. Strategies were considered acceptable, easy to use and most increased productivity. These methods show potential for future research.

Research paper thumbnail of Assessing professionalism in health profession degree programs: A scoping review

Currents in Pharmacy Teaching and Learning, 2021

BACKGROUND To identify and classify methods for assessing professionalism across health professio... more BACKGROUND To identify and classify methods for assessing professionalism across health profession degree programs and identify gaps in the literature regarding types of assessments. METHODS The authors conducted a scoping review of articles published from database inception through 24 January 2020. Included articles described an assessment approach for professionalism in health profession degree programs available in full-text in the English language. Articles were classified based on profession, timing of assessment, feedback type, assessment type, professionalism dimension, and Barr's modified Kirkpatrick hierarchy. RESULTS Authors classified 277 articles meeting inclusion criteria. Most articles were from medical education (62.5%) conducted during didactic (62.1%) or experiential/clinical curriculum (49.8%). Few articles (15.5%) described longitudinal assessment. Feedback type was formative (32.2%) or summative (35%), with only 8.3% using both. Assessment types frequently reported included self-administered rating scales (30%), reflections (18.8%), observed clinical encounters (17.3%), and knowledge-based tests (13.4%). Ethical practice principles (65%) and effective interactions with patients (48.4%) were the most frequently assessed dimensions of professionalism. Authors observed balanced distribution among Barr's modified Kirkpatrick model at levels of reaction (38.3%), modification of perceptions and attitudes (33.6%), acquisition of knowledge and skills (39%), and behavioral change (36.1%). IMPLICATIONS The classification scheme identified in current literature on professionalism assessment does not align with International Ottawa Conference Working Group on the Assessment of Professionalism recommendations. Gaps identified were limited description of professionalism assessment during admissions, infrequent longitudinal assessment, limited use of methods for both formative and summative assessment, and limited reports of assessments applicable to interprofessional education settings.

Research paper thumbnail of Patellar Clunk Syndrome—A Complication After Total Knee Arthroplasty: A Case Report

JOSPT Cases, May 14, 2021

Research paper thumbnail of Becoming an anti-racist interprofessional healthcare organization: Our journey

Journal of Interprofessional Education & Practice, 2022

The COVID-19 pandemic amplified the egregious disproportionate burden of disease based on race, e... more The COVID-19 pandemic amplified the egregious disproportionate burden of disease based on race, ethnicity, and failure of organizations to address structural racism. This paper describes a journey by members of the National Academies of Practice (NAP) who came together to address diversity, equity, and inclusion (DEI). Through collaborative efforts, a virtual, interactive workshop was designed and delivered at NAP's 2021 Virtual Forum to facilitate discussions about DEI priorities across professions and to initiate a sustainable action plan toward achieving inclusive excellence. Resulting discoveries and reflections led us to the essential question: can we truly become an anti-racist interprofessional healthcare organization?

Research paper thumbnail of Teaching and Learning Concepts for Exercise

Therapeutic Exercise Prescription, 2019

Research paper thumbnail of Comparative effectiveness of Pilates and yoga group exercise interventions for chronic mechanical neck pain: quasi-randomised parallel controlled study

Physiotherapy, 2016

Objectives To determine the effectiveness of Pilates and yoga group exercise interventions for in... more Objectives To determine the effectiveness of Pilates and yoga group exercise interventions for individuals with chronic neck pain (CNP). Design Quasi-randomised parallel controlled study. Setting Community, university and private practice settings in four locations. Participants Fifty-six individuals with CNP scoring ≥3/10 on the numeric pain rating scale for >3 months (controls n=19, Pilates n=20, yoga n=19). Interventions Exercise participants completed 12 small-group sessions with modifications and progressions supervised by a physiotherapist. Main outcome measures The primary outcome measure was the Neck Disability Index (NDI). Secondary outcomes were pain ratings, range of movement and postural measurements collected at baseline, 6 weeks and 12 weeks. Follow-up was performed 6 weeks after completion of the exercise classes (Week 18). Results NDI decreased significantly in the Pilates {baseline: 11.1 [standard deviation (SD) 4.3] vs Week 12: 6.8 (SD 4.3); mean difference-4.3 (95% confidence interval-1.64 to-6.7); P<0.001} and yoga groups [baseline: 12.8 (SD 7.4) vs Week 12: 8.1 (SD 5.6); mean difference-4.7 (95% confidence interval-2.1 to-7.4); P<0.00], with no change in the control group. Pain ratings also improved significantly. Moderate-to-large effect sizes (0.7 to 1.8) and low numbers needed to treat were found. There were no differences in outcomes between the exercise groups or associated adverse effects. No improvements in range of movement or posture were found.

Research paper thumbnail of Outcomes of hip resurfacing in a professional dancer: A case report

Physiotherapy Theory and Practice, 2011

A new surgical option (hip resurfacing arthroplasty) is now available for younger patients with h... more A new surgical option (hip resurfacing arthroplasty) is now available for younger patients with hip osteoarthritis. A more aggressive rehabilitation program than the typical total hip arthroplasty protocol is needed for active individuals. This case report describes interventions used to maximize function in a 46-year-old professional dancer after hip resurfacing with a progressive therapeutic exercise program. Exercise choices were selected to address dance-specific requirements while respecting healing of the posterior capsular incision. Strengthening focused on hip abduction, extension, and external rotation. Precautions included avoiding gluteal stretching until 6 months. Pelvic alignment and weight-bearing distribution were emphasized. The patient was able to return to rehearsal by 7 months, at which time strength was equivalent to the unaffected leg. Range of motion reached unaffected side values at week 8 for internal rotation, week 11 for extension, week 13 for adduction, and week 28 for flexion. External rotation and abduction were still limited at 1 year, which influenced pelvic alignment with resultant pain on the unaffected side. Functional and impairment outcomes are presented with timelines to provide a basis for postoperative benchmarks for active clients after hip resurfacing. Although this case report presents a dance-specific program, exercise progressions for other active individuals may benefit from similar exercise intensity and sports-specific focus. Future rehabilitation programs should take into account possible flexion and external rotation range limitations and the need for gluteal muscle strengthening along with symmetry and pelvic alignment correction. Long-term studies investigating intensity of rehabilitation are warranted for patients intending to participate in higher level athletic activity.

Research paper thumbnail of Physical therapy education and provision in Cambodia: A framework for choice of systems for development projects

Disability and Rehabilitation, 2007

Rehabilitation agencies, policy makers and donors are faced with the choice of the level of rehab... more Rehabilitation agencies, policy makers and donors are faced with the choice of the level of rehabilitation provider to promote in developing countries. This is particularly the case after conflict when new systems are considered and the need for rehabilitation becomes a priority. The complete decimation of medical services in Cambodia highlights the effects of both social change and development agency impact on the establishment of rehabilitation services. This paper discusses the factors that led to the development of four types of physical therapy provider levels in Cambodia with the goal of providing a framework for these decisions. Case study analysis utilizing interviews, site analysis and literature review. There are four levels of physical therapy provider systems that were initiated at different stages of the rebuilding of the country. Rehabilitation workers were trained during the war in refugee camps and afterwards in rehabilitation centers, professional physical therapists were trained in a university programme after the conflict ceased and community follow-up workers and community-based rehabilitation workers were trained to address some of the geographic accessibility issues. Factors that affected the different systems include the post-conflict development agency philosophy, instructor availability and training, financial support, high school education standards, geographic and rural/urban distribution and cost and time for training. The community-based rehabilitation and community follow-up models also address referral systems and social and vocational support. The comparison of the different types of provider and the initiating or driving forces that led to development of these systems are discussed in order to provide agencies which are planning to implement training of rehabilitation providers in developing countries with a decision-making framework. A combined system is the optimal approach; however, the choice of which type of provider level to promote will differ according to political stability, stage of development, presence of trained educators, rural vs. urban need, funding agency philosophy and educational standards in the country.

Research paper thumbnail of Proximal Tibial Fracture Following Total Knee Arthoplasty

Journal of Orthopaedic & Sports Physical Therapy, 2011

The patient was a 74-year-old man, with a history of total knee arthoplasty 14 years earlier, aft... more The patient was a 74-year-old man, with a history of total knee arthoplasty 14 years earlier, after having sustained a pathological fracture of the proximal diaphysis of the left tibia following a fall. Given the unstable nature of the fracture and the severe osteolysis noted below the total knee arthroplasty, surgical management 1 day after the fall entailed packing cancellous bone graft into the defect and realigning the fracture.