Lucie Pelland - Academia.edu (original) (raw)
Papers by Lucie Pelland
Archives of Physical Medicine and Rehabilitation, Dec 1, 2003
To characterize the responsiveness of the Montréal Rehabilitation Performance Profile (MRPP); to ... more To characterize the responsiveness of the Montréal Rehabilitation Performance Profile (MRPP); to measure the differential effectiveness of a task-specific (TS) and a task-nonspecific (TNS) motor learning format to promote alternating stair descent in children with cognitive impairments; and to evaluate the relevance of the MRPP to evidence-based practice. Randomized comparison of 2 age-matched groups; psychometric testing of measurement tool. School for children with developmental and cognitive impairments. Ambulatory sample of convenience: 18 children, age 5 to 9 years, with moderate to severe cognitive impairment. Not applicable. The MRPP variables measured at baseline; end of 10-week intervention; and 5 and 10 weeks postintervention. Analysis of variance for repeated measures and part-whole correlation. Global stair descent performance improved for both TS and TNS groups over time (P=.001). However, a specific acquisition and retention of the alternating pattern of descent was associated with the TS format. The MRPP was responsive to small differences in stair descent performance that are specific to the format of the motor learning intervention. The MRPP allows clinicians to determine the timing of the intervention needed to maintain or improve stair descent ability.
International Journal of Sports Physiology and Performance
Purpose: To evaluate the contribution of splenius capitis, sternocleidomastoid, and upper fibers ... more Purpose: To evaluate the contribution of splenius capitis, sternocleidomastoid, and upper fibers of trapezius activation to the gains in rate of force development (RFD) of the head and neck during maximum voluntary ballistic contractions. Methods: RFD gain was facilitated by a single-session intervention for maximum voluntary ballistic contractions in the anterior direction, oriented at 45° to the midsagittal plane, which require active restraint of axial rotation. Muscle activation for the agonist (sternocleidomastoid) and 2 antagonists (splenius capitis and upper fibers of trapezius) was evaluated. The study sample included 12 physically active men (mean age, 22.6 y). RFD (N·m·s−1; 0–100 ms) and integrated muscle activity (50 ms before and 100 ms after force onset) were measured at 10 minutes, 20 minutes, and 2 days postintervention, relative to baseline. Muscle activation predictive of RFD gains was evaluated by linear regression analysis. RFD reproducibility was evaluated using ...
Health Education Journal
Objective: To describe the creation of an educational podcast with ‘living cases’ of older adults... more Objective: To describe the creation of an educational podcast with ‘living cases’ of older adults to support students’ learning on a gerontology course and report on students’ evaluation of the project. Setting: Gerontology course in a graduate programme. Method: We developed a podcast series based on interviews with older adults in the community following recent guidelines for creating educational podcasts. The podcast episodes were used in a case-based group assignment to work on during the course and to present findings at the end. Evaluation: Student experiences were evaluated using a mixed-methods survey. Results: From November 2019 to January 2021, case-based podcasts, averaging 17 minutes in length, were created and evaluated. Most students found the content of the podcasts relevant to working with older adults and increased their understanding of the issues facing members of that population. Qualitative analysis of the survey findings found that the overall strengths of the ...
Journal of Physical Therapy Education
International Journal of Gynecology & Obstetrics
Journal of Obstetrics and Gynaecology Canada
Physical Therapy, 2001
Introduction. A structured and rigorous methodology was developed for the formulation of evidence... more Introduction. A structured and rigorous methodology was developed for the formulation of evidence-based clinical practice guidelines (EBCPGs), then was used to develop EBCPGs for selected rehabilitation interventions for the management of shoulder pain. Methods. Evidence from randomized controlled trials (RCTs) and observational studies was identified and synthesized using methods defined by the Cochrane Collaboration that minimize bias by using a systematic approach to literature search, study selection, data extraction, and data synthesis. Meta-analysis was conducted where possible. The strength of evidence was graded as level I for RCTs or level II for nonrandomized studies. Developing Recommendations. An expert panel was formed by inviting stakeholder professional organizations to nominate a representative. This panel developed a set of criteria for grading the strength of both the evidence and the recommendation. The panel decided that evidence of clinically important benefit (defined as 15% greater relative to a control based on panel expertise and empiric results) in patient-important outcomes was required for a recommendation. Statistical significance was also required but was insufficient alone. Patient-important outcomes were decided by consensus as being pain, function, patient global assessment, quality of life, and return to work, providing that these outcomes were assessed with a scale for which measurement reliability and validity have been established. Validating the Recommendations. A feedback survey questionnaire was sent to 324 practitioners from 6 professional organizations. The response rate was 51%. Results. Only 1 positive recommendation of clinical benefit was developed. Ultrasound provided clinically important pain relief relative to a control for patients with calcific tendinitis in the short term (less than 2 months). There was good agreement with this recommendation from practitioners (75%). For several interventions and indications (eg, thermotherapy, therapeutic exercise, massage, electrical stimulation, mechanical traction), there was a lack of evidence regarding efficacy. Conclusions. This methodology of developing EBCPGs provides a structured approach to assessing the literature and developing EBCPGs that incorporates clinicians' feedback and is widely acceptable to practicing clinicians. Further well-designed RCTs are warranted regarding the use of several interventions for patients with shoulder pain where evidence was insufficient to make recommendations.
BMJ, 2016
ObjeCtive To assess the efficacy of a programme of supervised physiotherapy on the recovery of si... more ObjeCtive To assess the efficacy of a programme of supervised physiotherapy on the recovery of simple grade 1 and 2 ankle sprains. Design A randomised controlled trial of 503 participants followed for six months. setting Participants were recruited from two tertiary acute care settings in Kingston, ON, Canada. PartiCiPants The broad inclusion criteria were patients aged ≥16 presenting for acute medical assessment and treatment of a simple grade 1 or 2 ankle sprain. Exclusions were patients with multiple injuries, other conditions limiting mobility, and ankle injuries that required immobilisation and those unable to accommodate the time intensive study protocol. interventiOn Participants received either usual care, consisting of written instructions regarding protection, rest, cryotherapy, compression, elevation, and graduated weight bearing activities, or usual care enhanced with a supervised programme of physiotherapy. Main OutCOMe Measures The primary outcome of efficacy was the proportion of participants reporting excellent recovery assessed with the foot and ankle outcome score (FAOS). Excellent recovery was defined as a score ≥450/500 at three months. A difference of at least 15% increase in the absolute proportion of participants with excellent recovery was deemed clinically important. Secondary analyses included the assessment of excellent recovery at one and six months; change from baseline using continuous scores at one, three, and six months; and clinical and biomechanical measures of ankle function, assessed at one, three, and six months. results The absolute proportion of patients achieving excellent recovery at three months was not significantly different between the physiotherapy (98/229, 43%) and usual care (79/214, 37%) arms (absolute difference 6%, 95% confidence interval −3% to 15%). The observed trend towards benefit with physiotherapy did not increase in the per protocol analysis and was in the opposite direction by six months. These trends remained similar and were never statistically or clinically important when the FAOS was analysed as a continuous change score. COnClusiOns In a general population of patients seeking hospital based acute care for simple ankle sprains, there is no evidence to support a clinically important improvement in outcome with the addition of supervised physiotherapy to usual care, as provided in this protocol. trial registratiOn ISRCTN 74033088 (www.isrctn.com/ISRCTN74033088) WhAT ThIS STudy AddS In the acute management of patients with grade 1 and 2 ankle sprains presenting to an emergency department within 72 hours of injury, a standard intervention of early supervised physiotherapy plus usual care does not lead to clinically important improvements in functional recovery up to six months after injury compared with usual care alone As 43% of participants in the physiotherapy arm and 38% in the control arm did not reach excellent recovery by six months, there is potential for the investigation of alternative interventions that would reduce morbidity associated with these injuries
The Journal of rheumatology, 2004
The objective of this metaanalysis is to examine the effectiveness of continuous passive motion (... more The objective of this metaanalysis is to examine the effectiveness of continuous passive motion (CPM) following total knee arthroplasty (TKA). This metaanalysis used the methodology proposed by the Cochrane Collaboration. This review of 14 studies (952 patients) found significant improvements in active knee flexion and analgesic use 2 weeks postoperatively with the use of CPM and physiotherapy (PT) compared to PT alone. In addition, length of hospital stay and need for knee manipulations were significantly decreased in the CPM group. Not enough data were available to compare the degree of knee flexion applied or number of hours of application of CPM. However, significant results were not found for other comparisons such as short term CPM application versus longterm CPM application and wide treatment range versus small treatment range for the outcomes of active knee flexion, passive knee flexion and extension, presence of a fixed flexion deformity, use of analgesic, or total knee ran...
Proceedings of the Annual International Conference of the IEEE Engineering in Medicine and Biology Society Volume 13: 1991
In this paper we discuss the importance of assessment of the variability of organization at vario... more In this paper we discuss the importance of assessment of the variability of organization at various levels of analysis as a tool for describing performance of and adaptive strategies for complex multijoint naturally occurring movements. The example of landing from a jump under various environmental constraints is discussed in this context.
Proceedings of 17th International Conference of the Engineering in Medicine and Biology Society, 1995
Discusses two conflicting views of motor development, one based on the hierarchical theory (Forss... more Discusses two conflicting views of motor development, one based on the hierarchical theory (Forssberg, 1985) and the other on the dynamical system theory (Thelen, 1984). Based on experimental evidence on landing from a jump in normal and clumsy children, it is proposed that both points of view can be incorporated into a unified model that addresses concerns of both theories
Cochrane Database of Systematic Reviews, 2002
Electrical stimulation is one of several rehabilitation interventions suggested for the managemen... more Electrical stimulation is one of several rehabilitation interventions suggested for the management of rheumatoid arthritis (RA) to enhance muscle performance. To assess the effectiveness of electrical stimulation for improving muscle strength and function in clients with RA. We searched MEDLINE, Embase, Healthstar, Sports Discus, CINAHL, the Cochrane Controlled Trials Register, the PEDro database, the specialized registry of the Cochrane musculoskeletal group and the Cochrane field of physical and related therapies up to January 2002 according to the sensitive search strategy for RCTs designed for the Cochrane Collaboration. The search was complemented with handsearching of the reference lists. Key experts in the area were contacted for further articles. All randomized controlled trials (RCTs) and controlled clinical trials (CCTs), case-control and cohort studies comparing ES against placebo or another active intervention in patients with RA were selected, according to an a priori protocol. No language restrictions were applied. Two independent reviewers determined the studies to be included based on a priori inclusion criteria. Data were independently abstracted by the same two reviewers, and checked by a third reviewer using a pre-developed form. The same two reviewers, using a validated scale, independently assessed the methodological quality of the RCTs and CCTs. The data analysis was performed using Peto Odds ratios. Of the two relevant studies that were identified in the literature, only one RCT met the inclusion criteria. This RCT compared the effects of two electrostimulation (ES) protocols on hand function in general and on the performance of the first dorsal interosseous muscle in particular, in 15 patients with RA and secondary disuse atrophy of the first dorsal interosseous of the dominant hand. The results showed that ES had significant benefit when compared to a control no treatment group in terms of muscle strength and fatigue resistance of the first dorsal interosseous. Most favourable results were obtained by using a patterned stimulation derived from a fatigued motor unit of the first dorsal interosseous in a normal hand rather than a fixed 10 Hz stimulation frequency. Side effects of the ES application were not reported. ES was shown to have a clinically beneficial effect on grip strength and fatigue resistance for RA patients with muscle atrophy of the hand. However, these conclusions are limited by the low methodological quality of the trial included. More well-designed studies are therefore needed to provide further evidence of the benefits of ES in the management of RA.
Physical Therapy Reviews, 2002
Balneotherapy is an accepted therapeutic approach in Europe. However, its eYcacy for treating rhe... more Balneotherapy is an accepted therapeutic approach in Europe. However, its eYcacy for treating rheumatoid arthritis (RA) remains controversial in North America. This is a meta-analysis of randomized (RCT) and controlled clinical trials (CCT), case-control and cohort studies of balneotherapy compared to control (no treatment) or active therapy (head to head studies). All the included studies (n=7) in this review were identi ed as RCTs. This meta-analysis examines diVerent balneotherapy modalities: Radon-carbon dioxide baths, mud packs, hot sulphur baths, Dead Sea baths, Red Sea baths, and grey sand. Several types of balneotherapy, including radon-carbon dioxide baths, mud packs, hot sulphur baths, combination of hot sulphur baths and mud packs, Dead Sea baths, combination of Dead Sea baths and sulphur baths, and Grey sand and Red Sea baths compared to control were found to be bene cial for RA. These modalities were found to be especially bene cial for pain, grip strength, tender/ swollen joints, patient and physician, and global function. These improvements ranged from 5-93% greater improvement relative to the control group. However, methodological considerations including the poor quality of trials impact the conclusions of this review.
Physical Therapy Reviews, 2004
Physical Therapy Reviews, 2002
Thermotherapy is a commonly used modality in treating rheumatoid arthritis (RA). Superfi cial moi... more Thermotherapy is a commonly used modality in treating rheumatoid arthritis (RA). Superfi cial moist-heat fomentations (hot packs) at diVerent temperatures, cryotherapy (ice packs), paraffin wax baths and faradic baths have been used as diVerent thermotherapy modalities. This ...
Physical Therapy Reviews, 2004
Osteoarthritis (OA) is a chronic degenerative joint dis-ease affecting nearly three million Canad... more Osteoarthritis (OA) is a chronic degenerative joint dis-ease affecting nearly three million Canadians1 and 30 million Americans,2 with the knee being the most com-mon affected joint.3,4 Its prevalence increases with advanced age and is substantially higher in females than males after the ...
Physical Therapy Reviews, 2002
To assess the efficacy of balneotherapy in patients with osteoarthritis (OA) of the knee. Searchi... more To assess the efficacy of balneotherapy in patients with osteoarthritis (OA) of the knee. Searching MEDLINE, EMBASE, HeathSTAR, SPORTDiscus, CINAHL, the Cochrane Controlled Trials Register, PEDro, the specialised register of the Cochrane Musculoskeletal Group, and the Cochrane Field of Physical and Related Therapies until September 2002. In addition, reference lists of the included studies were screened and experts (including the coordinating offices of the aforementioned Cochrane Groups) were contacted. The search strategy was reported. Studies were included if they were reported in either French or English. Peer-reviewed abstracts were eligible. Study selection Study designs of evaluations included in the review Comparative controlled trials (including randomised controlled trials (RCTs), non-randomised studies, case-control and cohort studies) were eligible for inclusion if they included at least 5 patients in each treatment group. Studies in which the participants acted as their own control were excluded. Where reported, the duration of follow-up in the included studies was 12 weeks.
Pediatric Physical Therapy, 2010
The aims of this review were to (1) identify and evaluate research evidence regarding the develop... more The aims of this review were to (1) identify and evaluate research evidence regarding the developmental outcomes of infants with congenital muscular torticollis (CMT) and (2) critically appraise and compare the outcomes of interventions targeting neck muscle extensibility and strength with those considering neck muscle function within the broader context of global infant development. Summary: An association between CMT and early developmental delay is supported by levels 3B, 4, and 5 evidence; no evidence was found of longer-term influences of CMT on the development of perceptual, cognitive, and motor skills. The effectiveness of passive manual stretching is supported by levels 2A, 3B, 4, and 5 evidence; no clear evidence was found of the effectiveness of developmentally supportive interventions. Conclusion: Controlled studies are needed to clarify the developmental consequences of CMT.
Journal of Orthopaedic & Sports Physical Therapy, 2008
Journal of Electromyography and Kinesiology, 2004
The purpose of this research was to develop and test an analytical tool that would recognize and ... more The purpose of this research was to develop and test an analytical tool that would recognize and classify the surface electromyographic (EMG) signal of co-activating muscles of the leg into pre-defined patterns of muscle activity: burst, tonic, and tonicburst. Developed to study the task of landing from a jump in children, the pattern recognition technique (PRT) quantifies the full-wave rectified surface EMG signal over a short-duration sampling window by a single linear regression value. Shifting the sampling window across the data string ultimately defines the signal by a set of regression values that produce the recognizable burst, tonic and tonic-burst patterns on a least-squares surface plot. Statistical comparison of the PRT to the classical combination of threshold detection (+2 S.D. of mean baseline activity) and visual inspection proves the PRT to be more reliable on repeated measures for event detection and classification, with a Kappa statistic of 0.83 compared to 0.54 for threshold detection. Application of the PRT to motor control studies is presented for the regulation of the mechanical response of the leg during impact. Responsiveness of the PRT is tested, issues of accuracy and validity are addressed, and limitations in spatial-temporal resolution are identified.
Archives of Physical Medicine and Rehabilitation, Dec 1, 2003
To characterize the responsiveness of the Montréal Rehabilitation Performance Profile (MRPP); to ... more To characterize the responsiveness of the Montréal Rehabilitation Performance Profile (MRPP); to measure the differential effectiveness of a task-specific (TS) and a task-nonspecific (TNS) motor learning format to promote alternating stair descent in children with cognitive impairments; and to evaluate the relevance of the MRPP to evidence-based practice. Randomized comparison of 2 age-matched groups; psychometric testing of measurement tool. School for children with developmental and cognitive impairments. Ambulatory sample of convenience: 18 children, age 5 to 9 years, with moderate to severe cognitive impairment. Not applicable. The MRPP variables measured at baseline; end of 10-week intervention; and 5 and 10 weeks postintervention. Analysis of variance for repeated measures and part-whole correlation. Global stair descent performance improved for both TS and TNS groups over time (P=.001). However, a specific acquisition and retention of the alternating pattern of descent was associated with the TS format. The MRPP was responsive to small differences in stair descent performance that are specific to the format of the motor learning intervention. The MRPP allows clinicians to determine the timing of the intervention needed to maintain or improve stair descent ability.
International Journal of Sports Physiology and Performance
Purpose: To evaluate the contribution of splenius capitis, sternocleidomastoid, and upper fibers ... more Purpose: To evaluate the contribution of splenius capitis, sternocleidomastoid, and upper fibers of trapezius activation to the gains in rate of force development (RFD) of the head and neck during maximum voluntary ballistic contractions. Methods: RFD gain was facilitated by a single-session intervention for maximum voluntary ballistic contractions in the anterior direction, oriented at 45° to the midsagittal plane, which require active restraint of axial rotation. Muscle activation for the agonist (sternocleidomastoid) and 2 antagonists (splenius capitis and upper fibers of trapezius) was evaluated. The study sample included 12 physically active men (mean age, 22.6 y). RFD (N·m·s−1; 0–100 ms) and integrated muscle activity (50 ms before and 100 ms after force onset) were measured at 10 minutes, 20 minutes, and 2 days postintervention, relative to baseline. Muscle activation predictive of RFD gains was evaluated by linear regression analysis. RFD reproducibility was evaluated using ...
Health Education Journal
Objective: To describe the creation of an educational podcast with ‘living cases’ of older adults... more Objective: To describe the creation of an educational podcast with ‘living cases’ of older adults to support students’ learning on a gerontology course and report on students’ evaluation of the project. Setting: Gerontology course in a graduate programme. Method: We developed a podcast series based on interviews with older adults in the community following recent guidelines for creating educational podcasts. The podcast episodes were used in a case-based group assignment to work on during the course and to present findings at the end. Evaluation: Student experiences were evaluated using a mixed-methods survey. Results: From November 2019 to January 2021, case-based podcasts, averaging 17 minutes in length, were created and evaluated. Most students found the content of the podcasts relevant to working with older adults and increased their understanding of the issues facing members of that population. Qualitative analysis of the survey findings found that the overall strengths of the ...
Journal of Physical Therapy Education
International Journal of Gynecology & Obstetrics
Journal of Obstetrics and Gynaecology Canada
Physical Therapy, 2001
Introduction. A structured and rigorous methodology was developed for the formulation of evidence... more Introduction. A structured and rigorous methodology was developed for the formulation of evidence-based clinical practice guidelines (EBCPGs), then was used to develop EBCPGs for selected rehabilitation interventions for the management of shoulder pain. Methods. Evidence from randomized controlled trials (RCTs) and observational studies was identified and synthesized using methods defined by the Cochrane Collaboration that minimize bias by using a systematic approach to literature search, study selection, data extraction, and data synthesis. Meta-analysis was conducted where possible. The strength of evidence was graded as level I for RCTs or level II for nonrandomized studies. Developing Recommendations. An expert panel was formed by inviting stakeholder professional organizations to nominate a representative. This panel developed a set of criteria for grading the strength of both the evidence and the recommendation. The panel decided that evidence of clinically important benefit (defined as 15% greater relative to a control based on panel expertise and empiric results) in patient-important outcomes was required for a recommendation. Statistical significance was also required but was insufficient alone. Patient-important outcomes were decided by consensus as being pain, function, patient global assessment, quality of life, and return to work, providing that these outcomes were assessed with a scale for which measurement reliability and validity have been established. Validating the Recommendations. A feedback survey questionnaire was sent to 324 practitioners from 6 professional organizations. The response rate was 51%. Results. Only 1 positive recommendation of clinical benefit was developed. Ultrasound provided clinically important pain relief relative to a control for patients with calcific tendinitis in the short term (less than 2 months). There was good agreement with this recommendation from practitioners (75%). For several interventions and indications (eg, thermotherapy, therapeutic exercise, massage, electrical stimulation, mechanical traction), there was a lack of evidence regarding efficacy. Conclusions. This methodology of developing EBCPGs provides a structured approach to assessing the literature and developing EBCPGs that incorporates clinicians' feedback and is widely acceptable to practicing clinicians. Further well-designed RCTs are warranted regarding the use of several interventions for patients with shoulder pain where evidence was insufficient to make recommendations.
BMJ, 2016
ObjeCtive To assess the efficacy of a programme of supervised physiotherapy on the recovery of si... more ObjeCtive To assess the efficacy of a programme of supervised physiotherapy on the recovery of simple grade 1 and 2 ankle sprains. Design A randomised controlled trial of 503 participants followed for six months. setting Participants were recruited from two tertiary acute care settings in Kingston, ON, Canada. PartiCiPants The broad inclusion criteria were patients aged ≥16 presenting for acute medical assessment and treatment of a simple grade 1 or 2 ankle sprain. Exclusions were patients with multiple injuries, other conditions limiting mobility, and ankle injuries that required immobilisation and those unable to accommodate the time intensive study protocol. interventiOn Participants received either usual care, consisting of written instructions regarding protection, rest, cryotherapy, compression, elevation, and graduated weight bearing activities, or usual care enhanced with a supervised programme of physiotherapy. Main OutCOMe Measures The primary outcome of efficacy was the proportion of participants reporting excellent recovery assessed with the foot and ankle outcome score (FAOS). Excellent recovery was defined as a score ≥450/500 at three months. A difference of at least 15% increase in the absolute proportion of participants with excellent recovery was deemed clinically important. Secondary analyses included the assessment of excellent recovery at one and six months; change from baseline using continuous scores at one, three, and six months; and clinical and biomechanical measures of ankle function, assessed at one, three, and six months. results The absolute proportion of patients achieving excellent recovery at three months was not significantly different between the physiotherapy (98/229, 43%) and usual care (79/214, 37%) arms (absolute difference 6%, 95% confidence interval −3% to 15%). The observed trend towards benefit with physiotherapy did not increase in the per protocol analysis and was in the opposite direction by six months. These trends remained similar and were never statistically or clinically important when the FAOS was analysed as a continuous change score. COnClusiOns In a general population of patients seeking hospital based acute care for simple ankle sprains, there is no evidence to support a clinically important improvement in outcome with the addition of supervised physiotherapy to usual care, as provided in this protocol. trial registratiOn ISRCTN 74033088 (www.isrctn.com/ISRCTN74033088) WhAT ThIS STudy AddS In the acute management of patients with grade 1 and 2 ankle sprains presenting to an emergency department within 72 hours of injury, a standard intervention of early supervised physiotherapy plus usual care does not lead to clinically important improvements in functional recovery up to six months after injury compared with usual care alone As 43% of participants in the physiotherapy arm and 38% in the control arm did not reach excellent recovery by six months, there is potential for the investigation of alternative interventions that would reduce morbidity associated with these injuries
The Journal of rheumatology, 2004
The objective of this metaanalysis is to examine the effectiveness of continuous passive motion (... more The objective of this metaanalysis is to examine the effectiveness of continuous passive motion (CPM) following total knee arthroplasty (TKA). This metaanalysis used the methodology proposed by the Cochrane Collaboration. This review of 14 studies (952 patients) found significant improvements in active knee flexion and analgesic use 2 weeks postoperatively with the use of CPM and physiotherapy (PT) compared to PT alone. In addition, length of hospital stay and need for knee manipulations were significantly decreased in the CPM group. Not enough data were available to compare the degree of knee flexion applied or number of hours of application of CPM. However, significant results were not found for other comparisons such as short term CPM application versus longterm CPM application and wide treatment range versus small treatment range for the outcomes of active knee flexion, passive knee flexion and extension, presence of a fixed flexion deformity, use of analgesic, or total knee ran...
Proceedings of the Annual International Conference of the IEEE Engineering in Medicine and Biology Society Volume 13: 1991
In this paper we discuss the importance of assessment of the variability of organization at vario... more In this paper we discuss the importance of assessment of the variability of organization at various levels of analysis as a tool for describing performance of and adaptive strategies for complex multijoint naturally occurring movements. The example of landing from a jump under various environmental constraints is discussed in this context.
Proceedings of 17th International Conference of the Engineering in Medicine and Biology Society, 1995
Discusses two conflicting views of motor development, one based on the hierarchical theory (Forss... more Discusses two conflicting views of motor development, one based on the hierarchical theory (Forssberg, 1985) and the other on the dynamical system theory (Thelen, 1984). Based on experimental evidence on landing from a jump in normal and clumsy children, it is proposed that both points of view can be incorporated into a unified model that addresses concerns of both theories
Cochrane Database of Systematic Reviews, 2002
Electrical stimulation is one of several rehabilitation interventions suggested for the managemen... more Electrical stimulation is one of several rehabilitation interventions suggested for the management of rheumatoid arthritis (RA) to enhance muscle performance. To assess the effectiveness of electrical stimulation for improving muscle strength and function in clients with RA. We searched MEDLINE, Embase, Healthstar, Sports Discus, CINAHL, the Cochrane Controlled Trials Register, the PEDro database, the specialized registry of the Cochrane musculoskeletal group and the Cochrane field of physical and related therapies up to January 2002 according to the sensitive search strategy for RCTs designed for the Cochrane Collaboration. The search was complemented with handsearching of the reference lists. Key experts in the area were contacted for further articles. All randomized controlled trials (RCTs) and controlled clinical trials (CCTs), case-control and cohort studies comparing ES against placebo or another active intervention in patients with RA were selected, according to an a priori protocol. No language restrictions were applied. Two independent reviewers determined the studies to be included based on a priori inclusion criteria. Data were independently abstracted by the same two reviewers, and checked by a third reviewer using a pre-developed form. The same two reviewers, using a validated scale, independently assessed the methodological quality of the RCTs and CCTs. The data analysis was performed using Peto Odds ratios. Of the two relevant studies that were identified in the literature, only one RCT met the inclusion criteria. This RCT compared the effects of two electrostimulation (ES) protocols on hand function in general and on the performance of the first dorsal interosseous muscle in particular, in 15 patients with RA and secondary disuse atrophy of the first dorsal interosseous of the dominant hand. The results showed that ES had significant benefit when compared to a control no treatment group in terms of muscle strength and fatigue resistance of the first dorsal interosseous. Most favourable results were obtained by using a patterned stimulation derived from a fatigued motor unit of the first dorsal interosseous in a normal hand rather than a fixed 10 Hz stimulation frequency. Side effects of the ES application were not reported. ES was shown to have a clinically beneficial effect on grip strength and fatigue resistance for RA patients with muscle atrophy of the hand. However, these conclusions are limited by the low methodological quality of the trial included. More well-designed studies are therefore needed to provide further evidence of the benefits of ES in the management of RA.
Physical Therapy Reviews, 2002
Balneotherapy is an accepted therapeutic approach in Europe. However, its eYcacy for treating rhe... more Balneotherapy is an accepted therapeutic approach in Europe. However, its eYcacy for treating rheumatoid arthritis (RA) remains controversial in North America. This is a meta-analysis of randomized (RCT) and controlled clinical trials (CCT), case-control and cohort studies of balneotherapy compared to control (no treatment) or active therapy (head to head studies). All the included studies (n=7) in this review were identi ed as RCTs. This meta-analysis examines diVerent balneotherapy modalities: Radon-carbon dioxide baths, mud packs, hot sulphur baths, Dead Sea baths, Red Sea baths, and grey sand. Several types of balneotherapy, including radon-carbon dioxide baths, mud packs, hot sulphur baths, combination of hot sulphur baths and mud packs, Dead Sea baths, combination of Dead Sea baths and sulphur baths, and Grey sand and Red Sea baths compared to control were found to be bene cial for RA. These modalities were found to be especially bene cial for pain, grip strength, tender/ swollen joints, patient and physician, and global function. These improvements ranged from 5-93% greater improvement relative to the control group. However, methodological considerations including the poor quality of trials impact the conclusions of this review.
Physical Therapy Reviews, 2004
Physical Therapy Reviews, 2002
Thermotherapy is a commonly used modality in treating rheumatoid arthritis (RA). Superfi cial moi... more Thermotherapy is a commonly used modality in treating rheumatoid arthritis (RA). Superfi cial moist-heat fomentations (hot packs) at diVerent temperatures, cryotherapy (ice packs), paraffin wax baths and faradic baths have been used as diVerent thermotherapy modalities. This ...
Physical Therapy Reviews, 2004
Osteoarthritis (OA) is a chronic degenerative joint dis-ease affecting nearly three million Canad... more Osteoarthritis (OA) is a chronic degenerative joint dis-ease affecting nearly three million Canadians1 and 30 million Americans,2 with the knee being the most com-mon affected joint.3,4 Its prevalence increases with advanced age and is substantially higher in females than males after the ...
Physical Therapy Reviews, 2002
To assess the efficacy of balneotherapy in patients with osteoarthritis (OA) of the knee. Searchi... more To assess the efficacy of balneotherapy in patients with osteoarthritis (OA) of the knee. Searching MEDLINE, EMBASE, HeathSTAR, SPORTDiscus, CINAHL, the Cochrane Controlled Trials Register, PEDro, the specialised register of the Cochrane Musculoskeletal Group, and the Cochrane Field of Physical and Related Therapies until September 2002. In addition, reference lists of the included studies were screened and experts (including the coordinating offices of the aforementioned Cochrane Groups) were contacted. The search strategy was reported. Studies were included if they were reported in either French or English. Peer-reviewed abstracts were eligible. Study selection Study designs of evaluations included in the review Comparative controlled trials (including randomised controlled trials (RCTs), non-randomised studies, case-control and cohort studies) were eligible for inclusion if they included at least 5 patients in each treatment group. Studies in which the participants acted as their own control were excluded. Where reported, the duration of follow-up in the included studies was 12 weeks.
Pediatric Physical Therapy, 2010
The aims of this review were to (1) identify and evaluate research evidence regarding the develop... more The aims of this review were to (1) identify and evaluate research evidence regarding the developmental outcomes of infants with congenital muscular torticollis (CMT) and (2) critically appraise and compare the outcomes of interventions targeting neck muscle extensibility and strength with those considering neck muscle function within the broader context of global infant development. Summary: An association between CMT and early developmental delay is supported by levels 3B, 4, and 5 evidence; no evidence was found of longer-term influences of CMT on the development of perceptual, cognitive, and motor skills. The effectiveness of passive manual stretching is supported by levels 2A, 3B, 4, and 5 evidence; no clear evidence was found of the effectiveness of developmentally supportive interventions. Conclusion: Controlled studies are needed to clarify the developmental consequences of CMT.
Journal of Orthopaedic & Sports Physical Therapy, 2008
Journal of Electromyography and Kinesiology, 2004
The purpose of this research was to develop and test an analytical tool that would recognize and ... more The purpose of this research was to develop and test an analytical tool that would recognize and classify the surface electromyographic (EMG) signal of co-activating muscles of the leg into pre-defined patterns of muscle activity: burst, tonic, and tonicburst. Developed to study the task of landing from a jump in children, the pattern recognition technique (PRT) quantifies the full-wave rectified surface EMG signal over a short-duration sampling window by a single linear regression value. Shifting the sampling window across the data string ultimately defines the signal by a set of regression values that produce the recognizable burst, tonic and tonic-burst patterns on a least-squares surface plot. Statistical comparison of the PRT to the classical combination of threshold detection (+2 S.D. of mean baseline activity) and visual inspection proves the PRT to be more reliable on repeated measures for event detection and classification, with a Kappa statistic of 0.83 compared to 0.54 for threshold detection. Application of the PRT to motor control studies is presented for the regulation of the mechanical response of the leg during impact. Responsiveness of the PRT is tested, issues of accuracy and validity are addressed, and limitations in spatial-temporal resolution are identified.