Norma Macintyre - Academia.edu (original) (raw)

Papers by Norma Macintyre

$Research paper thumbnail of {"__content__"=>"Inter-rater reliability of Dartfish movement analysis software for measuring maximum flexion and extension at the hip and knee in older adults with osteoporosis and osteopenia.", "sup"=>{"__content__"=>"TM"}}$

Physiotherapy theory and practice, Jan 28, 2018

Various methods are used to measure hip and knee joint motion angles; however, their use is often... more Various methods are used to measure hip and knee joint motion angles; however, their use is often limited by cost or inability to measure dynamic movements. The assessment of movement patterns is clinically useful in individuals with osteoporosis (OP) and osteopenia (OPe) through its potential to optimize fracture risk assessment. This study evaluates the inter-rater reliability of using Dartfish 2-D Motion Analysis Software to measure maximum flexion and extension angles at the hip and knee in individuals with OP or OPe while performing five tasks of the Safe Functional Motion test. Twelve participants were videotaped performing the pour, footwear, newspaper, sweep, and sit-to-floor tasks. Five raters used Dartfish to analyze maximum flexion and extension angles at the hip and knee, and an intra-class correlation coefficients (ICC) and SEM were calculated for each measurement. In all five tasks, ICC and SEM values ranged from 0.23 to 0.95, and 1.75 to 11.54 degrees, respectively, w...

$Research paper thumbnail of Therapist's practice patterns for subsequent fall/osteoporotic fracture prevention for patients with a distal radius fracture$

Journal of hand therapy : official journal of the American Society of Hand Therapists, Jan 25, 2018

Cross-sectional survey. Multifactorial risk factor screening and treatment is needed for subseque... more Cross-sectional survey. Multifactorial risk factor screening and treatment is needed for subsequent falls/osteoporotic fractures prevention (SFOFP), given the elevated risk among patients with distal radius fracture (DRF). The primary objective was to describe hand therapists' knowledge and clinical practice patterns for assessment, treatment, referral, and education with respect to SFOFP for patients with DRF older than 45 years. Secondary objective was to explore therapist's preferences in content and delivery of knowledge translation tools that would support implementation of SFOFP. A cross-sectional multinational (Canada, the United States, and India) survey was conducted among 272 therapists from August to October 2014. Completed surveys were analyzed descriptively. Surveys were completed by 157 therapists. Most respondents were from the United States (59%), certified hand therapists (54%), and females (87%). Although 65%-90% believed that they had knowledge about SFOFP...

BMC Health Services Research

Background: Most conventional treatment for musculoskeletal conditions continue to show moderate ... more Background: Most conventional treatment for musculoskeletal conditions continue to show moderate effects, prompting calls for ways to increase effectiveness, including drawing from strategies used across other health conditions. Therapeutic alliance refers to the relational processes at play in treatment which can act in combination or independently of specific interventions. Current evidence guiding the use of therapeutic alliance in health care arises largely from psychotherapy and medicine literature. The objective of this review was to map out the available literature on therapeutic alliance conceptual frameworks, themes, measures and determinants in musculoskeletal rehabilitation across physiotherapy and occupational therapy disciplines. Methods: A scoping review of the literature published in English since inception to July 2015 was conducted using Medline, EMBASE, PsychINFO, PEDro, SportDISCUS, AMED, OTSeeker, AMED and the grey literature. A key search term strategy was employed using "physiotherapy", "occupational therapy", "therapeutic alliance", and "musculoskeletal" to identify relevant studies. All searches were performed between December 2014 and July 2015 with an updated search on January 2017. Two investigators screened article title, abstract and full text review for articles meeting the inclusion criteria and extracted therapeutic alliance data and details of each study. Results: One hundred and thirty articles met the inclusion criteria including quantitative (33%), qualitative (39%), mixed methods (7%) and reviews and discussions (23%) and most data came from the USA (23%). Randomized trials and systematic reviews were 4.6 and 2.3% respectively. Low back pain condition (22%) and primary care (30.7%) were the most reported condition and setting respectively. One theory, 9 frameworks, 26 models, 8 themes and 42 subthemes of therapeutic alliance were identified. Twenty-six measures were identified; the Working Alliance Inventory (WAI) was the most utilized measure (13%). Most of the therapeutic alliance themes extracted were from patient perspectives. The relationship between adherence and therapeutic alliance was examined by 26 articles of which 57% showed some correlation between therapeutic alliance and adherence. Age moderated the relationship between therapeutic alliance and adherence with younger individuals and an autonomy support environment reporting improved adherence. Prioritized goals, autonomy support and motivation were facilitators of therapeutic alliance. Conclusion: Therapeutic Alliance has been studied in a limited extent in the rehabilitation literature with conflicting frameworks and findings. Potential benefits described for enhancing therapeutic alliance might include better exercise adherence. Several knowledge gaps have been identified with a potential for generating future research priorities for therapeutic alliance in musculoskeletal rehabilitation.

$Research paper thumbnail of Epidemiology of distal radius fractures and factors predicting risk and prognosis$

Journal of Hand Therapy, 2016

Literature Review. For optimal Distal Radius Fracture (DRF) rehabilitation and fracture preventio... more Literature Review. For optimal Distal Radius Fracture (DRF) rehabilitation and fracture prevention, it is important to understand the epidemiology and factors predictive of injury, chronic pain, chronic disability, and subsequent fracture. To summarize the literature reporting on DRF epidemiology, risk factors, and prognostic factors. Literature synthesis. Although incidence varies globally, DRFs are common across the lifespan and appear to be on the rise. Risk of DRF is determined by personal factors (age, sex/gender, lifestyle, health condition) and environmental factors (population density, climate). For example, age and sex influence risk such that DRF is most common in boys/young men and older women. The most common causes of DRF in the pediatric and young adult age groups include playing/sporting activities and motor vehicle accidents. In contrast, the most common mechanism of injury in older adults is a low-energy trauma because of a fall from a standing height. Poorer health outcomes are associated with older age, being female, poor bone healing (or having an associated fracture of the ulnar styloid), having a compensated injury, and a lower socioeconomic status. Risk stratification according to predictors of chronic pain and disability enable therapists to identify those patients who will benefit from advocacy for more comprehensive assessment, targeted interventions, and tailored educational strategies. The unique opportunity for secondary prevention of osteoporotic fracture after DRF has yet to be realized by treating therapists in the orthopedic community. V.

$Research paper thumbnail of In vivo assessment of the relation between trabecular bone structure in the radius and gender, aging, mechanical loading and fracture$

Bone structure is compromised in individuals with osteoporosis. Indices of trabecular bone struct... more Bone structure is compromised in individuals with osteoporosis. Indices of trabecular bone structure which reflect the connectivity (CI), the average dimensions of the marrow holes (HA) and the area of the largest hole (HM) at the distal radius can determined in vivo. This work evaluates whether these structural indices (1) are influenced by gender, aging and mechanical loading and (2)

Lecture Notes in Computer Science, 2003

Accuracy of a novel fluoroscopy-based method of assessing patellar tracking was determined by com... more Accuracy of a novel fluoroscopy-based method of assessing patellar tracking was determined by comparing the pattern of patellar motion with respect to orientation (flexion, internal rotation, and lateral tilt) and translation (lateral, proximal, and anterior) with the pattern of patellar motion measured using Roentgen Stereophotogrammetric Analysis (RSA) in one cadaver knee specimen. Each pose in the patellar motion could be obtained from a single as well as multiple calibrated fluoroscopic images. The mean error (SD) varies from 0.73 (0.44) to 1.60 (0.48) degrees for patellar orientation and from 0.48 (0.37) to 1.20 (0.57) mm for patellar translation. These errors appear to be sufficiently low to identify clinically significant differences in patellar kinematics.

Journal of Hand Therapy, 2015

Recently, a shorter version of Western Ontario Rotator Cuff Index (Short-WORC) was proposed as a ... more Recently, a shorter version of Western Ontario Rotator Cuff Index (Short-WORC) was proposed as a subset of 7 items from the original 21-item WORC. However, the reproducibility of the Short-WORC has not been established. To determine reproducibility (reliability and agreement) of the Short-WORC among patients with rotator cuff disorders (RCDs). Patients (n = 153) diagnosed with RCD completed the WORC at baseline and at 3 months post-operatively (n = 146). The Short-WORC was extracted from the full version of WORC. From this retrospective cohort, 43 patients were retested within 5 weeks, if they remained stable. Cronbach&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s alpha (α) and intra class correlation coefficients (ICC2,1) were used to assess internal consistency and test-retest reliability respectively. Standard error measurement (SEM), minimal detectable change (MDC90) and Bland Altman (BA) plots were used to assess agreement. No floor and ceiling effects were reported for either the Short-WORC or WORC. Cronbach&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s α were 0.84 and 0.90 at baseline and 0.89 and 0.95 at 3 month of follow up for Short-WORC and WORC respectively. The ICC2,1 were 0.89 and 0.91 for the Short-WORC and WORC respectively. The agreement parameters for the Short-WORC were: SEMagreement = 8.8, MDC90individual = 20.3, MDC90group = 5.1. We found substantial agreement between the two versions of WORC on BA plots with minimal (mean difference (d) &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;1) systematic differences between them. The limits of agreement (LOA) between two versions of WORC were similar across sessions and fell within range of -11.7 to 13.2 points at test and -14.7 to 14.7 points at retest. Short-WORC and WORC demonstrates strong reproducibility and can be used for group and individual comparison of health-related quality of life (HRQoL) among patients with RCD. Wider LOA may be expected when using the Short-WORC for individual patient assessment. Reproducibility data is essential, but should be supplemented by validation of actual Short-WORC with samples representing the spectrum of RCD. N/A.

Physiotherapy Canada, 2015

Purpose: To identify the characteristics of people with hip or knee osteoarthritis (OA) attending... more Purpose: To identify the characteristics of people with hip or knee osteoarthritis (OA) attending a regional triage centre for an initial consult who are deemed not yet ready for total joint arthroplasty (TJA). Methods: Initial consultation notes (n ¼ 482) were reviewed retrospectively. Predictive variables were derived from the literature a priori, and 14 of these variables were suitable for inclusion in stepwise multiple logistic regression analyses. Results: Of the 222 eligible people, 131 (59%) were deemed not yet ready for TJA. Five variables entered into the model (2 5 ¼ 133.19, p < 0.001) for an overall success rate of 81.1%. Those deemed not yet ready for TJA were more likely to have knee OA (vs. hip OA; odds ratio [OR] ¼ 0.352, p ¼ 0.018), to have less severe OA (OR ¼ 0.246 for each category increase in severity, p < 0.001), to use no gait aid (vs. cane; OR ¼ 0.390, p ¼ 0.033), and to have a higher Lower Extremity Functional Scale score (OR ¼ 1.050 for each 1-point increase, p ¼ 0.003) and better joint status as measured by the Knee Society Scale or Hip Harris Scale (OR ¼ 3.946 for each category increase, p ¼ 0.007). Conclusion: Considering these characteristics will help clinicians to identify individuals likely to require interventions other than TJA.

Physiotherapy Canada

ABSTRACT

ISRN Rehabilitation, 2014

Introduction. This study determined the agreement between measures of standing posture in individ... more Introduction. This study determined the agreement between measures of standing posture in individuals at risk of osteoporotic fracture obtained using the IONmed mobile phone application and a digital inclinometer.Methods. One experienced rater assessed 20 adults, aged 55–88 years, attending an outpatient osteoporosis clinic. A standardized protocol was duplicated to acquire a single measure of spine curvature (lumbosacral angle, lordosis, kyphosis) using the IONmed mobile phone application and a digital inclinometer. Interdevice agreement was determined using the intraclass correlation coefficient (ICC) with 95% confidence intervals (CI) and standard error of the measurement (SEM) with 95% CI and Bland-Altman plots.Results. ICC (95% CI) for lumbosacral angle, lordosis, and kyphosis is 0.97 (0.92, 0.99), 0.97 (0.92, 0.99), and 0.99 (0.98, 1.0), respectively. SEM (95% CI) for lumbosacral angle, lordosis, and kyphosis is 0.99° (0.75, 1.44), 1.33° (1.01, 1.94), and 1.23° (0.94, 1.80), r...

Critical Reviews in Physical and Rehabilitation Medicine, 2010

Clinical diagnosis and treatment of low back pain may be enhanced through the use of imaging moda... more Clinical diagnosis and treatment of low back pain may be enhanced through the use of imaging modalities. This study investigates the use of rehabilitative ultrasound imaging in the physiotherapy management of low back pain associated with dysfunction of the transversus abdominis and multifidus muscles. Although encouraging, current evidence for integrating rehabilitative ultrasound imaging into clinical practice is weak and several knowledge gaps have been identified. In particular, the impact on clinical outcomes needs to be determined and well-designed randomized controlled trials investigating effectiveness for improving physical therapy assessment and treatment are required before endorsing translation of rehabilitative ultrasound imaging into clinical practice.

World Journal of Meta-Analysis, 2014

Calcified Tissue International, 2015

The objective of this study was to estimate the associations between muscular fat infiltration, t... more The objective of this study was to estimate the associations between muscular fat infiltration, tibia bone mineral quantity and distribution, and physical function in healthy older women. Thirty-five women (aged 60-75 years, mean 70 years) were recruited from the community. Percent intramuscular fat (%IntraMF) within the right leg tibialis anterior, soleus, and gastrocnemius muscles and total intermuscular fat (IMF) were segmented from magnetic resonance imaging scans at the mid-calf. Intramyocellular lipid (IMCL) content in the right tibialis anterior was measured with proton magnetic resonance spectroscopy. Right tibia bone content, area, and strength were measured at the 4, 14, and 66 % sites using peripheral quantitative computed tomography. Physical function was assessed by gait speed on the 20 m walking test. After adjusting for age, body size, and activity level, %IntraMF had a negative association with bone content and area at all tibia sites (r = -0.31 to -0.03). Conversely, greater IMF was associated with increased bone content and area (r = 0.04-0.32). Correlation coefficients for the association between IMCL and bone were negative (r = -0.44 to -0.03). All measures of fat infiltration had a negative association with observed physical function (r = -0.42 to -0.04). Our findings suggest that muscular fat infiltration in the leg of healthy postmenopausal women has a compartment-specific relationship with bone status and physical function. Minimizing fat accumulation within and between muscle compartments may prevent bone fragility and functional decline in women.

Critical Reviews in Physical and Rehabilitation Medicine, 2011

ABSTRACT Evidence-based exercise recommendations for postmenopausal women with osteoporotic verte... more ABSTRACT Evidence-based exercise recommendations for postmenopausal women with osteoporotic vertebral fractures are lacking. Exercising in water can strengthen muscles while reducing spinal compression loading. Despite the fact that the water exercise sessions occur during a brief period of time compared to the time spent in weight-bearing activities each week, the water environment has been considered a limitation for slowing the rate of bone loss. The overall objective of this literature review is to determine the effect of aquatic exercise on bone in postmenopausal women with osteoporosis of the spine and at high risk for future osteoporotic fracture. Few randomized controlled trials have evaluated the effectiveness of aquatic exercise in postmenopausal women with established osteoporosis, and fewer still have included primary outcome measures related to fracture incidence and bone strength (density and/or geometry). The medical imaging methods available for assessing bone adaptations to exercise targeting the spine are also limited. Further research is required to determine the effect of aquatic exercise on bone and to develop exercise guidelines for this particular group at high risk for osteoporotic fracture.

Critical Reviews in Physical and Rehabilitation Medicine, 2012

ABSTRACT Osteoarthritis is one of the four leading causes of pain. To date, clinicians providing ... more ABSTRACT Osteoarthritis is one of the four leading causes of pain. To date, clinicians providing health care to people with knee osteoarthritis pain focus on evaluating pain intensity and its effect on physical function and provide management with foundations in theories of pain including gate control and specificity. Pain theories such as these have been driving pain management and pain research since the seventeenth century, when Rene Descartes proposed his reflex theory of pain. The purpose of this paper is to describe the evolution of pain theories leading up to the gate control theory and the neuromatrix theory, provide a critical review of these two theories specifically, and discuss the strengths and challenges of integrating these two theories in the guidance of knee osteoarthritis pain management. Integration of the gate control theory, which focuses on the spinal processing of pain, and the neuromatrix theory, which focuses on central processing of pain, gives a broader model for understanding and addressing the multiple dimensions of pain phenomena. The integrated gate control−neuromatrix model presented in this paper provides a theoretical basis for considering the cognitive and affective aspects in addition to the sensory aspects of osteoarthritis pain. Discussion of the multidimensional aspects of pain includes clinical implications and recommendations for evaluation and treatment approaches. Finally, future directions for research are recommended to test the proposed model and improve the management of osteoarthritis pain.

The Journal of orthopaedic and sports physical therapy, 2015

Study Design Systematic review of measurement properties. Objectives To summarize the measurement... more Study Design Systematic review of measurement properties. Objectives To summarize the measurement properties of the Patient-Rated Wrist Evaluation (PRWE) questionnaire. Background The PRWE is a region-specific outcome measure initially developed for assessing pain and function in individuals with distal radius fracture. However, subsequent research has expanded its use to other wrist/hand conditions. A systematic review of the measurement properties of the PRWE can enhance the understanding of its clinical applicability across different wrist/hand pathologies. Methods The MEDLINE, Embase, and CINAHL databases were searched using predefined search terms. A hand search of the bibliography of the primary studies was performed. Studies assessing at least 1 measurement property of the PRWE, either in the English version or versions in other languages, were included in this review. Two raters performed data extraction and critical appraisal of the primary studies using standardized instru...

Magma (New York, N.Y.), Jan 15, 2014

The object was to assess whether cross-sectional area (CSA) and water diffusion properties of leg... more The object was to assess whether cross-sectional area (CSA) and water diffusion properties of leg muscles in young and older women change with increased time spent in supine rest. Healthy young (n = 9, aged 20-30 years) and older (n = 9, aged 65-75 years) women underwent MRI scanning of the right leg at baseline, 30 and 60 min of supine rest. Muscle CSA was derived from proton density images. Water diffusion properties [apparent diffusion coefficient (ADC) and fractional anisotropy (FA)] of the tibialis anterior and posterior, soleus, and medial and lateral heads of the gastrocnemius were derived from diffusion tensor imaging (DTI). Repeated measures ANOVAs and Bonferroni post hoc tests determined the effects of time and group on each muscle outcome. In both groups, muscle CSA and FA did not significantly change over time, whereas ADC significantly decreased. A greater decline at 30 min for young women was only observed for ADC in the medial gastrocnemius. Regardless of age, ADC val...

Clinical Rehabilitation, 2014

Objective: To investigate the contributions of physiotherapy and occupational therapy to self-man... more Objective: To investigate the contributions of physiotherapy and occupational therapy to self-management interventions and the theoretical models used to support these interventions in chronic disease. Data sources: We conducted two literature searches to identify studies that evaluated self-management interventions involving physiotherapists and occupational therapists in MEDLINE, the Cochrane Library, CINAHL, EMBASE, AMED (Allied and Complementary Medicine), SPORTdiscus, and REHABDATA databases. Study selection: Four investigator pairs screened article title and abstract, then full text with inclusion criteria. Selected articles ( n = 57) included adults who received a chronic disease self-management intervention, developed or delivered by a physiotherapist and/or an occupational therapist compared with a control group. Data extraction: Four pairs of investigators performed independent reviews of each article and data extraction included: (a) participant characteristics, (b) the s...

Introduction The Bone and Joint Monitor Project was developed to quantify the global burden of mu... more Introduction The Bone and Joint Monitor Project was developed to quantify the global burden of musculoskeletal conditions and develop strategies for their prevention. Experts within the Monitor Project have worked previously with officers at the World Health Organization (WHO) to estimate morbidity and mortality associated with rheumatic conditions. The present collaboration seeks means of providing additional and more current burden data. Objective To develop recommendations for performing epidemiological studies in sample populations with musculoskeletal conditions and problems, accounting for determinants and consequences to the individual and society. Methods Recommendations have been developed identifying the most relevant domains for measuring and monitoring the various musculoskeletal conditions by review of epidemiological data on occurrence, determinants and outcomes, and by expert opinion. Instruments that measure these domains were reviewed. Results The domains recommended follow the principles of the WHO International Classification of Functioning, Disability and Health [1,2], and consider: health condition; body function and structure; activity limitation; participation restriction; personal and environmental contextual factors; and, in addition, the resource utilisation and social consequences. The musculoskeletal conditions and problems considered were osteoarthitis, inflammatory arthritis, osteoporosis, spinal problems, musculoskeletal trauma and injuries, and musculoskeletal pain with restricted activity. The selection of indicators for each domain considered the feasibility of their use in a health interview survey (HIS), a health examination survey (HES), a register or a clinical study. Consensus on case definition was reached depending on the study methodology. For example, osteoporosis defined by bone densitometry cannot be ascertained in an HIS, whereas the outcome of osteoporosis (i.e. fragility fracture) can be. Osteoarthitis can be identified as joint pain in an HIS but the preferred definition is pain with X-ray changes and can only be ascertained in an HES. Previously validated generic and disease-specific instruments have been identified that include indicators for all or most of the recommended domains for the consequences of the different conditions and problems. The indicators of the domains for resource utilisation and social consequences and feasibility for collection will vary in different socioeconomic and geographic areas. Guidance on sampling methods is also being developed. Conclusions The comparability of data collected across the globe will improve by the application of agreed upon indicators that consider key domains for the different musculoskeletal conditions and problems in epidemiological studies conducted in different populations.