129 results on '"Louise Bird"'
Search Results
2. The molecular structure of Schistosoma mansoni PNP isoform 2 provides insights into the nucleoside selectivity of PNPs.
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Juliana Roberta Torini, Larissa Romanello, Fernanda Aparecida Heleno Batista, Vitor Hugo Balasco Serrão, Muhammad Faheem, Ana Eliza Zeraik, Louise Bird, Joanne Nettleship, Yamini Reddivari, Ray Owens, Ricardo DeMarco, Júlio César Borges, José Brandão-Neto, and Humberto D'Muniz Pereira
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Medicine ,Science - Abstract
Purine nucleoside phosphorylases (PNPs) play an important role in the blood fluke parasite Schistosoma mansoni as a key enzyme of the purine salvage pathway. Here we present the structural and kinetic characterization of a new PNP isoform from S. mansoni, SmPNP2. Thermofluorescence screening of different ligands suggested cytidine and cytosine are potential ligands. The binding of cytosine and cytidine were confirmed by isothermal titration calorimetry, with a KD of 27 μM for cytosine, and a KM of 76.3 μM for cytidine. SmPNP2 also displays catalytic activity against inosine and adenosine, making it the first described PNP with robust catalytic activity towards both pyrimidines and purines. Crystal structures of SmPNP2 with different ligands were obtained and comparison of these structures with the previously described S. mansoni PNP (SmPNP1) provided clues for the unique capacity of SmPNP2 to bind pyrimidines. When compared with the structure of SmPNP1, substitutions in the vicinity of SmPNP2 active site alter the architecture of the nucleoside base binding site thus permitting an alternative binding mode for nucleosides, with a 180° rotation from the canonical binding mode. The remarkable plasticity of this binding site enhances our understanding of the correlation between structure and nucleotide selectivity, thus suggesting new ways to analyse PNP activity.
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- 2018
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3. Structure and assembly of a trans-periplasmic channel for type IV pili in Neisseria meningitidis.
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Jamie-Lee Berry, Marie M Phelan, Richard F Collins, Tomas Adomavicius, Tone Tønjum, Stefan A Frye, Louise Bird, Ray Owens, Robert C Ford, Lu-Yun Lian, and Jeremy P Derrick
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Immunologic diseases. Allergy ,RC581-607 ,Biology (General) ,QH301-705.5 - Abstract
Type IV pili are polymeric fibers which protrude from the cell surface and play a critical role in adhesion and invasion by pathogenic bacteria. The secretion of pili across the periplasm and outer membrane is mediated by a specialized secretin protein, PilQ, but the way in which this large channel is formed is unknown. Using NMR, we derived the structures of the periplasmic domains from N. meningitidis PilQ: the N-terminus is shown to consist of two β-domains, which are unique to the type IV pilus-dependent secretins. The structure of the second β-domain revealed an eight-stranded β-sandwich structure which is a novel variant of the HSP20-like fold. The central part of PilQ consists of two α/β fold domains: the structure of the first of these is similar to domains from other secretins, but with an additional α-helix which links it to the second α/β domain. We also determined the structure of the entire PilQ dodecamer by cryoelectron microscopy: it forms a cage-like structure, enclosing a cavity which is approximately 55 Å in internal diameter at its largest extent. Specific regions were identified in the density map which corresponded to the individual PilQ domains: this allowed us to dock them into the cryoelectron microscopy density map, and hence reconstruct the entire PilQ assembly which spans the periplasm. We also show that the C-terminal domain from the lipoprotein PilP, which is essential for pilus assembly, binds specifically to the first α/β domain in PilQ and use NMR chemical shift mapping to generate a model for the PilP:PilQ complex. We conclude that passage of the pilus fiber requires disassembly of both the membrane-spanning and the β-domain regions in PilQ, and that PilP plays an important role in stabilising the PilQ assembly during secretion, through its anchorage in the inner membrane.
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- 2012
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4. The knowledge, barriers and opportunities to improve nutrition and physical activity amongst young people attending an Australian youth mental health service: a mixed-methods study
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Tamieka Mawer, Katherine Kent, Andrew D. Williams, Courtney J. McGowan, Sandra Murray, Marie-Louise Bird, Sibella Hardcastle, and Heather Bridgman
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Mental health ,Service delivery ,Youth ,Adolescents ,Regional programs ,Community nutrition programs ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background Mental illnesses are the leading cause of disability in young people, and lifestyle interventions in young people at risk of mental illness remain a priority. Opportunities to improve nutrition and physical activity among young people through youth mental health services remain unclear. This study aimed to determine the knowledge and behaviors towards nutrition and physical activity, the barriers and enablers to improving behaviors, and the preferred providers and sources of information for nutrition and physical activity among a sample of young people attending a youth mental health service. Methods A mixed-method study was conducted in regional Tasmania, Australia in a sample of young people (15–25 years) attending a youth mental health service (headspace). A quantitative survey (n = 48) determined young people’s nutrition and physical activity knowledge, behaviors, barriers and enablers to achieving recommendations, and their preferred providers and sources of information. Structured interviews and a focus group further explored these concepts (n = 8), including the role of the mental health service as a provider of this support. Results The majority of participants did not meet national recommendations for nutrition and physical activity, despite possessing a high level of knowledge regarding their importance for mental health. Improving mental health was a common enabling factor for participants choosing to alter diet and physical activity habits, but also the leading barrier for participating in physical activity. Young people wanted to receive information from reputable health providers, ideally through social media sources. headspace was seen as an important potential provider of this information. Conclusions Our results indicate that there is a clear need to improve diet and physical activity habits to enhance mental and physical health outcomes in this at-risk group, and youth mental health services could provide further interventions to support their clients. Specialized staff (e.g. dietitians and exercise physiologists) may provide additional benefits alongside existing mental health care support.
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- 2022
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5. Effect of combined exercise training and behaviour change counselling versus usual care on physical activity in patients awaiting hip and knee arthroplasty: A randomised controlled trial
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Andrew D. Williams, Jane O'Brien, Jonathan Mulford, Ronnie Mathew, Deependra Kaji Thapa, Kyra Hamilton, Michael Cheney, Matthew Schmidt, Sam Wu, and Marie-Louise Bird
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Osteoarthritis ,Health action process approach ,Exercise ,Behaviour change ,Hip ,Knee ,Diseases of the musculoskeletal system ,RC925-935 - Abstract
Objective: This study aimed to determine if a novel intervention that combined individualised exercise training with behaviour change counselling based on Health Action Process Approach (HAPA) constructs could elicit long-term increase in physical activity (PA) and reduce comorbidity development among people requiring hip or knee arthroplasty. Method: A pre-registered two arm, parallel group, randomised controlled trial comparing the effect of a 12-week individualised exercise program combined with behavioural counselling delivered by accredited exercise physiologists, versus usual care to Osteoarthritis (OA) patients on public surgery waitlists. Participants were followed up at 6 months after baseline (pre-surgery) and again at 6 months post-surgery. Within and between group differences in post-surgery PA (as measured by ActivPal accelerometer), pain, function, quality of life, HAPA-based behavioural and psychological constructs, and health risk factors were analysed. Results: 63 participants (34 Female; Mean age = 66.4 ± 7.2 yrs) consented to participate in this study. At 6 months post baseline and 6 months post-surgery there were significant improvements in PA, pain, function, and quality of life, however there were no significant differences in the between group responses. Significant between group changes were observed in several psychological constructs related to volition at 6 months post baseline; however, these had disappeared by 6 months post-surgery. Conclusions: An exercise program and HAPA guided counselling intervention can improve psychological constructs related to exercise behaviour; however, these did not result in significant between group changes in PA at the timepoints measured. Further research with larger sample size is required.Trial Registration: Australian New Zealand Clinical Trials Registry (ACTRN 12617000357358) Date of registration: 08/03/2017.
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- 2022
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6. Application of particle swarm optimization to understand the mechanism of action of allosteric inhibitors of the enzyme HSD17β13.
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Amy Ford, Frauke Breitgoff, Miriam Pasquini, Amanda MacKenzie, Stuart McElroy, Steve Baker, Patrizia Abrusci, Simon Varzandeh, Louise Bird, Angeline Gavard, David Damerell, and Martin Redhead
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- 2023
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7. Perspectives on the prospective development of stroke-specific lower extremity wearable monitoring technology: a qualitative focus group study with physical therapists and individuals with stroke
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Dennis R. Louie, Marie-Louise Bird, Carlo Menon, and Janice J. Eng
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Stroke ,Fitness tracker ,Wearable electronic devices ,Walking ,Remote sensing technology ,Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 - Abstract
Abstract Background Wearable activity monitors that track step count can increase the wearer’s physical activity and motivation but are infrequently designed for the slower gait speed and compensatory patterns after stroke. New and available technology may allow for the design of stroke-specific wearable monitoring devices, capable of detecting more than just step counts, which may enhance how rehabilitation is delivered. The objective of this study was to identify important considerations in the development of stroke-specific lower extremity wearable monitoring technology for rehabilitation, from the perspective of physical therapists and individuals with stroke. Methods A qualitative research design with focus groups was used to collect data. Five focus groups were conducted, audio recorded, and transcribed verbatim. Data were analyzed using content analysis to generate overarching categories representing the stakeholder considerations for the development of stroke-specific wearable monitor technology for the lower extremity. Results A total of 17 physical therapists took part in four focus group discussions and three individuals with stroke participated in the fifth focus group. Our analysis identified four main categories for consideration: 1) ‘Variability’ described the heterogeneity of patient presentation, therapy approaches, and therapeutic goals that are taken into account for stroke rehabilitation; 2) ‘Context of use’ described the different settings and purposes for which stakeholders could foresee employing stroke-specific wearable technology; 3) ‘Crucial design features’ identified the measures, functions, and device characteristics that should be considered for incorporation into prospective technology to enhance uptake; and 4) ‘Barriers to adopting technology’ highlighted challenges, including personal attitudes and design flaws, that may limit the integration of current and future wearable monitoring technology into clinical practice. Conclusions The findings from this qualitative study suggest that the development of stroke-specific lower extremity wearable monitoring technology is viewed positively by physical therapists and individuals with stroke. While a single, specific device or function may not accommodate all the variable needs of therapists and their clients, it was agreed that wearable monitoring technology could enhance how physical therapists assess and treat their clients. Future wearable devices should be developed in consideration of the highlighted design features and potential barriers for uptake.
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- 2020
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8. Predicting interest to use mobile-device telerehabilitation (mRehab) by baby-boomers with stroke
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Marie-Louise Bird, Janice J Eng, and Brodie M. Sakakibara
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rehabilitation ,internet ,Medicine (General) ,R5-920 - Abstract
Context and purpose: Demand for stroke rehabilitation services are reaching unprecedented levels due to an overall population aging, driven by the aging of the baby-boomer generation. Delivery of rehabilitation via mobile-device technologies may provide advantages towards meeting the increasing demands on the rehabilitation system by providing individuals with rehabilitation services in their homes and communities. The aim of this paper is to gain an understanding of the interest of current baby-boomers with stroke to use mobile-device technology to receive rehabilitation services such as education, assessments and exercise programs (mRehab). Methods: People living in the community with stroke born between 1946 and 1964 (i.e., baby-boomer generation) who participated in a larger telerehabilitation survey were included in this study. Regression modeling was used to evaluate personal, health/disability and technological predictors of interest to use mobile-devices for telerehabilitation. Results and significance: Fifty people with stroke, mean age 62.7 (4.4) years, 58% male, 54.2% with moderate or moderately severe disability were included; 86% had access to a mobile phone or tablet. Regression analysis resulted in statistically significant personal (education, β = 0.29 [95% CI = 0.05 to 1.11], population of residence, β = 0.30 [95% CI = 0.07 to 0.69]), health (comorbid conditions, β = 0.30 [95% CI = 0.02 to 0.20]) technology (ownership, β = 0.26 [95% CI = 0.01 to 0.86] and attitude towards telerehabilitation, β = 0.25 [95% CI = 0.01 to 0.79]) predictors of interest to use mobile-devices for telerehabilitation (R2 = 33.1%).This study identifies personal, health and technological factors which predict interest of baby-boomers with stroke with ongoing and complex health needs to use mRehab. Health professionals can use this information as they integrate mRehab into their practice and inform future development of mRehab solutions.
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- 2018
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9. Improving physical activity, pain and function in patients waiting for hip and knee arthroplasty by combining targeted exercise training with behaviour change counselling: study protocol for a randomised controlled trial
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Jane O’Brien, Kyra Hamilton, Andrew Williams, James Fell, Jonathan Mulford, Michael Cheney, Sam Wu, and Marie-Louise Bird
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Osteoarthritis ,Physical activity and Health Action Process Approach ,Medicine (General) ,R5-920 - Abstract
Abstract Background Osteoarthritis often results in prolonged periods of reduced physical activity and is associated with adverse health outcomes, including increased risk of cardiovascular and metabolic diseases. Exercise interventions for patients on the waiting list for arthroplasty can reduce the risk of long-term adverse outcomes by increasing activity levels. However, uptake and ongoing positive rates of physical activity in this population are low and the impact of pre-operative behaviour counselling on exercise is not known. Method/design The exercise and behaviour change counselling (ENHANCE) trial is a two-arm assessor-blind randomised controlled trial to assess the effectiveness of a 12-week exercise intervention designed to improve long-term physical activity and functional abilities for people awaiting arthroplasty. Participants on the waiting list for hip and knee arthroplasty are recruited from one clinical site in Australia. After collection of baseline data, participants are randomised to either an intervention or control group. The control group receive usual care, as recommended by evidence-based guidelines. The intervention group receive an individualised programme of exercises and counselling sessions. The 12-week exercise programme integrates multiple elements, including up to five in-person counselling sessions, supported by written materials. Participants are encouraged to seek social support among their friends and self-monitor their physical activity. The primary outcome is physical activity (daily step count and percentage of day spent in sedentary activities). Secondary outcomes include pain ratings, physical function, psychosocial factors and changes in clinical markers linked with potential common chronic diseases (diabetes and cardiovascular disease). All outcomes are assessed at baseline and 26 weeks later and again at 26 weeks post-surgery. Discussion This study seeks to address a significant gap in current osteoarthritis management practice by providing evidence for the effectiveness of an exercise programme combined with behaviour counselling for adults waiting for hip and knee arthroplasty. Theory-driven evidence-based strategies that can improve an individual’s exercise self-efficacy and self-management capacity could have a significant impact on the development of secondary chronic disease in this population. Information gained from this study will contribute to the evidence base on the management of adults waiting for hip and knee arthroplasty. Trial registration Australian New Zealand Clinical Trials Registry, ACTRN12617000357358. Registered on 8 March 2017.
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- 2018
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10. Surface Plasmon Resonance Screening to Identify Active and Selective Adenosine Receptor Binding Fragments
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Claire Shepherd, Sean Robinson, Alice Berizzi, Laura E. J. Thompson, Louise Bird, Simone Culurgioni, Simon Varzandeh, Philip B. Rawlins, Reid H. J. Olsen, and Iva Hopkins Navratilova
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Organic Chemistry ,Drug Discovery ,Biochemistry - Abstract
Surface plasmon resonance (SPR) is a widely used method to study ligand-protein interactions. The throughput and sensitivity of SPR has made it an important technology for measuring low-affinity, ultralow weight fragments (200 Da) in the early stages of drug discovery. However, the biochemistry of membrane proteins, such as G-protein-coupled receptors (GPCRs), makes their SPR fragment screening particularly challenging, especially for native/wild-type, nonthermostabilized mutant receptors. In this study, we demonstrate the use of SPR-based biosensors to study the entire human family of adenosine receptors and present biologically active novel binders with a range of selectivity to human adenosine 2a receptor (hA
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- 2022
11. Stroke survivors’ perceptions of the factors that influence engagement in activity outside dedicated therapy sessions in a rehabilitation unit: A qualitative study
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Heidi Janssen, Marie-Louise Bird, Julie Luker, Annie McCluskey, Jannette Blennerhassett, Louise Ada, Julie Bernhardt, Neil J Spratt, Janssen, Heidi, Bird, Marie-Louise, Luker, Julie, McCluskey, Annie, Blennerhassett, Jannette, Ada, Louise, Bernhardt, Julie, and Spratt, Neil J
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Male ,barriers ,activity ,Rehabilitation ,Stroke Rehabilitation ,Physical Therapy, Sports Therapy and Rehabilitation ,stroke ,rehabilitation ,Stroke ,Activities of Daily Living ,qualitative ,Humans ,Female ,Survivors ,Qualitative Research ,Aged - Abstract
Objective To investigate stroke survivors’ perceptions of factors influencing their engagement in activity outside of dedicated therapy sessions during inpatient rehabilitation. Design Qualitative study. Setting Four metropolitan rehabilitation units in Australia. Participants People undertaking inpatient rehabilitation after stroke. Methods Semi-structured interviews conducted in person by a speech pathologist A stepped iterative process of inductive analysis was employed until data saturation was achieved with themes then applied against the three domains of the Theory of Planned Behaviour (perceived behavioural control, social norms and attitude). Results Interviews of 33 stroke survivors (60% female, median age of 73 years) revealed five themes (i) uncertainty about how to navigate and what was available for use in the rehabilitation unit restricts activity and (ii) post-stroke mobility, fatigue and pre- and post-stroke communication impairments restrict activity (perceived behavioural control); (iii) unit set up, rules (perceived and actual) and staff expectations influence activity and (iv) visiting family and friends are strong facilitators of activity (social norms), and (v) personal preferences and mood influence level of activity (attitude). Conclusion At the individual level, stroke survivors perceived that their ability to be active outside of dedicated therapy sessions was influenced by their impairments, including mood, and their attitude towards and preference for activity. At the ward level, stroke survivors perceived that their ability to be active was influenced by ward set-up, rules and staff expectations. Visitors were perceived to be important facilitators of activity outside of therapy sessions.
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- 2022
12. Is self-reporting workplace activity worthwhile? Validity and reliability of occupational sitting and physical activity questionnaire in desk-based workers
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Scott J. Pedersen, Cecilia M. Kitic, Marie-Louise Bird, Casey P. Mainsbridge, and P. Dean Cooley
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Physical activity ,Sitting behaviour ,Workplace ,Exercise ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background With the advent of workplace health and wellbeing programs designed to address prolonged occupational sitting, tools to measure behaviour change within this environment should derive from empirical evidence. In this study we measured aspects of validity and reliability for the Occupational Sitting and Physical Activity Questionnaire that asks employees to recount the percentage of work time they spend in the seated, standing, and walking postures during a typical workday. Methods Three separate cohort samples (N = 236) were drawn from a population of government desk-based employees across several departmental agencies. These volunteers were part of a larger state-wide intervention study. Workplace sitting and physical activity behaviour was measured both subjectively against the International Physical Activity Questionnaire, and objectively against ActivPal accelerometers before the intervention began. Criterion validity and concurrent validity for each of the three posture categories were assessed using Spearman’s rank correlation coefficients, and a bias comparison with 95 % limits of agreement. Test-retest reliability of the survey was reported with intraclass correlation coefficients. Results Criterion validity for this survey was strong for sitting and standing estimates, but weak for walking. Participants significantly overestimated the amount of walking they did at work. Concurrent validity was moderate for sitting and standing, but low for walking. Test-retest reliability of this survey proved to be questionable for our sample. Conclusions Based on our findings we must caution occupational health and safety professionals about the use of employee self-report data to estimate workplace physical activity. While the survey produced accurate measurements for time spent sitting at work it was more difficult for employees to estimate their workplace physical activity.
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- 2016
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13. Feasibility of a remotely supervised home-based group eHealth Fitness and Mobility Exercise program for stroke: French-Canadian version preliminary study
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Marie-Andrée, Gagnon, Charles Sèbiyo, Batcho, Marie-Louise, Bird, Benoit, Labbé, and Krista L, Best
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Community and Home Care ,Rehabilitation ,Neurology (clinical) - Abstract
The numerous barriers to community-based physical activity programs have been exacerbated by the COVID-19 pandemic, especially among individuals with disabilities. eHealth programs may provide an alternative approach to address the physical activity needs of stroke survivors, but little is known about their feasibility or acceptance.The aims of this study were to 1) evaluate the feasibility of a remotely supervised home-based group eHealth program called Fitness and Mobility Exercise (FAME@home); 2) explore the influence of FAME@home on physical condition, mobility, self-efficacy, depression and anxiety; and 3) describe participants' satisfaction and experiences.A pre-post pilot study was used to recruit stroke survivors (1 y post stroke) to complete a 12-week (2 days/week) eHealth program in small groups (n = 3). Feasibility indicators were assessed for process (e.g. inclusion criteria), resources (e.g. ability to use technology), management (e.g. major challenges), and treatment (e.g. influence on clinical outcomes and adverse events).Nine participants were recruited with a mean (SD) of 60 (13) years of age and 7 (4) years post-stroke; eight completed the program. FAME@home was feasible for indicators of process, management, and treatment. Minor considerations to improve resources were suggested (i.e. support for technology use). There were statistically significant improvements in mobility after completion of FAME@home and 100% of the participants reported satisfaction. No adverse events occurred.FAME@home was feasible to deliver as a remotely supervised group exercise program to community-dwelling stroke survivors, with high levels of retention and adherence. FAME@home improved accessibility to exercise and facilitated engagement by having a class schedule and social interaction.
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- 2022
14. Evaluating the impact of a training program to support transitioning from the hospital to the community for people after stroke: a community case study
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Michelle Lui, Katherine McKellar, Shari Cooper, Janice J. Eng, and Marie-Louise Bird
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Stroke rehabilitation ,Research ,Health Policy ,Transitions ,Hospitals ,Exercise Therapy ,Stroke ,Community navigation ,Humans ,Implementation science ,Public aspects of medicine ,RA1-1270 ,Physiotherapy ,Exercise ,Physical Therapy Modalities - Abstract
Background The transitions in care along the stroke recovery path are challenging, particularly in finding mechanisms to continue one’s recovery once at home. We aim to evaluate the impact of training physiotherapists and fitness instructors from one regional community together to deliver an evidence-based group exercise program starting in the hospital and transitioning to the community using an implementation approach. Methods The evidenced based exercise program Fitness and Mobility Exercise (FAME) for stroke was chosen as the intervention. Data from interviews with stakeholders (community centre and health authority hospital staff including a physiotherapy navigator) was transcribed and themes evaluated using the RE-AIM (Reach, Efficacy, Adoption, Implementation, Maintenance) framework. These data were supplemented by information collected as a quality assurance project within the health authority. Results Two programs were established; one in the community centre (run over 15 months by fitness instructors) and one in the regional hospital (run over 12 months by a rehabilitation assistant under the direction from a physiotherapist). Transitions in care were facilitated by implementing the same evidence-based group exercise class in both the hospital and community setting, so people living with stroke could seamlessly move from one to another. An existing physiotherapist navigator service also was valued as a support for the transitions between the two centres for people with stroke. The hospital group accessed group-based physiotherapy service on average 31 days earlier than they were able to in a one-to-one format. Conclusions This case study described the implementation of the Fitness and Mobility Exercise (FAME) program in one community and the use of a physiotherapist navigator to assist transition between them. After a community training workshop, FAME programs were established within the health authority and the community centre. FAME program participants within the health authority benefited from reduced wait times to access hospital outpatient physiotherapy service. Improvements in function were measured in and reported by the people after stroke attending either the health authority or community centre FAME groups.
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- 2022
15. Patient Engagement: an Assessment of Canadian Radiotherapy Programs’ Current Practices, Perceived Barriers, and Facilitators
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Jennifer Croke, Meredith Giuliani, Caro, Ross Halperin, Cody Harper, Amanda Caissie, Gabrielle Robin, Michael Brundage, Erika Brown, Carol-Anne Davis, Lianne Wilson, and Louise Bird
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medicine.medical_specialty ,business.industry ,Best practice ,medicine.medical_treatment ,Public Health, Environmental and Occupational Health ,Charter ,Patient engagement ,Radiation therapy ,Oncology ,General partnership ,Family medicine ,Radiation oncology ,Medicine ,business ,Accreditation ,Patient education - Abstract
Patient engagement and education have been mandated across Canadian radiation oncology programs (ROP). Guidance documents include the 2014 Canadian Association of Radiation Oncology (CARO) Radiation Therapy Patient Charter, the 2016 Canadian Partnership for Quality Radiotherapy (CPQR) Patient Engagement Guidelines (PEG) for Canadian Radiation Treatment Programs, and Accreditation Canada’s 2017 refresh of Cancer Care Standards. Since little is known regarding uptake of these guidance statements, Canadian ROP were surveyed to assess current patient engagement and education practices. An e-survey was sent to Canadian ROP (n = 44). The survey focused on awareness and uptake of the CARO Patient Charter, CPQR PEG, and patient education practices. Survey development was guided by these documents and expert consensus, including CARO’s Quality and Standards Patient Education/Engagement working group. Many (71%) responding ROP were familiar with the CARO Patient Charter, while 24% reported use. More than half (53%) of ROP were aware of the CPQR PEG, but approximately third (37%) had previously completed a self-audit. Most (88%) ROP view a pan-Canadian, evidence-based approach to educational materials beneficial and feasible (80%), with the majority (89%) willing to share their best practices across the radiotherapy community. Patient engagement and education are nationally mandated and supported by guidance documents. However, gaps have been identified across ROP for awareness and use of available tools, as well as uptake of their processes critical to quality of care. Understanding current practices will inform CPQR/CARO-supported pan-Canadian initiatives to optimize uptake, including development of CPQR Patient Education Guidance for Canadian Radiation Treatment Programs.
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- 2021
16. The Health Literacy of First Year Physiotherapy and Speech Pathology Students and Their Perceived Future Roles in Supporting Their Clients’ Health Literacy
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Romany Martin, Jade Cartwright, and Marie-Louise Bird
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Health, Toxicology and Mutagenesis ,Public Health, Environmental and Occupational Health ,health literacy ,allied health ,health promotion ,physiotherapy ,speech pathology ,Australia - Abstract
Background: Allied health professionals are well positioned to assess and support their clients’ health literacy (HL); however, they report being deficient in HL knowledge and skills. Objective: To explore allied health students’ HL and their perceptions of their roles in supporting clients’ HL. Design: A mixed-methods cross-sectional study was undertaken in August 2022 amongst allied health students enrolled in graduate-entry masters programs at the University of Tasmania. Data collected included the Health Literacy Questionnaire (HLQ) (n = 30) and qualitative telephone interviews (n = 6). Results: Allied health students’ confidence in the knowledge domain of the HLQ was rated as 28.57 from a maximum possible score of 50. Similarly, the students’ confidence in the skills domain of the HLQ was rated as 14.87 from a maximum possible score of 25. Four themes were generated from the qualitative interviews: (1) valuing HL, (2) an innate part of their future roles, (3) contributors to their own HL, and (4) advocacy and their decision to study allied health. Conclusion: This study provides a preliminary insight into the HL of allied health students and highlights the strong perception held by allied health students that supporting clients’ HL is a large component of their future roles.
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- 2023
17. World Café- a community conversation: a Canadian perspective on stroke survivors needs for community integration
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Marie-Louise Bird, Delphine Labbé, Brodie M. Sakakibara, Chieh-Ling Yang, and Janneke Vissers
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Gerontology ,Canada ,030506 rehabilitation ,media_common.quotation_subject ,Community integration ,03 medical and health sciences ,0302 clinical medicine ,Quality of life (healthcare) ,Health care ,medicine ,Humans ,Conversation ,Survivors ,Stroke survivor ,Stroke ,media_common ,Community and Home Care ,Chronic care ,business.industry ,Communication ,Rehabilitation ,Perspective (graphical) ,Stroke Rehabilitation ,medicine.disease ,Neurology (clinical) ,0305 other medical science ,Psychology ,business ,Community Integration ,030217 neurology & neurosurgery - Abstract
Stroke is an acute condition that requires immediate care and long-term community-based chronic care supports. Communities vary in their ability to support the complex needs of this population.To bring stroke recovery stakeholders together to discuss the needs of community-based stroke recovery and develop possible solutions across one province in Canada.The participatory research approach of the World Café was used to explore topics related to community-based stroke recovery. Three World Cafés were held in three communities, including rural, urban-multicultural, and indigenous communities. Sixty-one stakeholders participated in this study. The data was analyzed following an inductive approach for all three Word Cafés.Four main themes were revealed from the data. First,While some similarities in needs and solutions were identified for stroke survivors across three diverse communities, differences between them were also reported. Approaches to enhance better communication among all stakeholders and facilitate a continuous transition from hospital to community are needed. Co-creating solutions with each local community should be considered as individual needs, and challenges are specific to each community.
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- 2021
18. Evaluation of a Health Literacy Program for Chronic Conditions
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Shandell Elmer, Heather Bridgman, Andrew Williams, Marie-Louise Bird, Sandra Murray, Rachael Jones, and Michael Cheney
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health literacy ,chronic illness ,Public aspects of medicine ,RA1-1270 - Abstract
Background: Although much is known about health literacy in concept and practice, more research is needed to understand the mechanisms that improve health literacy and result in healthy behavior change. This is particularly so for those at risk of or living with chronic conditions who reside in communities experiencing socioeconomic disadvantage. Objective: The program aimed to improve the prevention and management of chronic conditions by responding to health literacy needs. Methods: A health literacy program, underpinned by Ophelia principles, was developed in consultation with three Neighbourhood Houses located in areas of socioeconomic disadvantage. Four 7-week group programs were delivered by a multidisciplinary team of academic health professionals. The evaluation aimed to explain how the design, content, and approach to delivery resulted in healthy behavior change and increased health literacy for the participants. Four focus groups were conducted to elicit feedback about the participants' experience of the program and recommendations for future programs. Data were thematically analyzed. The focus groups were attended by 22 (43%) of the total 51 program participants. Most of the participants were women with one or more chronic condition and residing in an area of socioeconomic disadvantage. Key Results: Four major themes were identified including the components of self-determination theory (SDT) (autonomy and competence and relatedness) and a separate, but related theme of empowerment. Recommendations for improving future programs were categorized separately. Conclusions: The SDT framework is a useful and novel approach to explaining the evaluation outcomes, the application of the Ophelia principles' underpinning design of the program, and the contribution of a multidisciplinary team of academic health professionals. Future programs will benefit from the SDT as a planning and evaluation framework, as well as understanding the long-term effects of the program within the broader community.
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- 2017
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19. eHealth Literacy and Health Information Seeking Behaviours Among People with Stroke: A Cross-Sectional Study
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Sarah Park, Dinah Amoah, W. Ben Mortenson, Brodie Sakakibara, and Marie-Louise Bird
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Rehabilitation ,Physical Therapy, Sports Therapy and Rehabilitation - Published
- 2022
20. Training physiotherapists to be responsive to their clients’ health literacy needs
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Jane O'Brien, Anna Flittner, Shandell Elmer, Richard H. Osborne, and Marie-Louise Bird
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musculoskeletal diseases ,030506 rehabilitation ,Medical education ,Attitude of Health Personnel ,Professional development ,Physical Therapy, Sports Therapy and Rehabilitation ,Health literacy ,Training (civil) ,Health Literacy ,Physical Therapists ,03 medical and health sciences ,0302 clinical medicine ,Private practice ,Surveys and Questionnaires ,health services administration ,Humans ,Health education ,0305 other medical science ,Psychology ,human activities ,Physical Therapy Modalities ,health care economics and organizations ,030217 neurology & neurosurgery - Abstract
To evaluate health literacy learning modules designed specifically for physiotherapists in private practice.Mixed-method design was used, evaluating pre-post physiotherapist health literacy knowledge and competencies using questionnaires and semi-structured interviews. One rural and one metropolitan private physiotherapy practice were recruited.Clients, physiotherapists, and other clinic staff. The OPHELIA (Optimizing Health Literacy and Access) process was applied to identify the health literacy needs of clients; co-design interventions; and implement and evaluate the interventions. The health literacy learning modules were co-designed with the physiotherapists and included one 3-h face-to-face workshop, followed by two 1-h videoconference workshops. Health literacy knowledge (rated 1-5 for 10 items, max score 50) and skills (rated 1-5 for 5 items, max score 25) were assessed before and after the workshops. Data were analyzed by paired t-test. Interviews were recorded, transcribed, and thematically analyzed.Health literacy knowledge of 19 health professionals improved after the workshop by 63% (pre 26.0 (7.5), post 41.0 (2.7),Improvements in health literacy knowledge and skills are possible through post-graduate professional development.Workshops changed physiotherapists' understanding of their role in promoting health literacy.
- Published
- 2020
21. Piloting an interprofessional chronic pain management program: Perspectives of health students and community clients
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Annette Marlow, Sibella Hardcastle, T Dean, Greer Maine, Sandra Murray, Andrew Williams, Kimberley Norris, Jan Radford, Heather Bridgman, A Todd, Marie-Louise Bird, and Shandell Elmer
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Medical education ,030504 nursing ,Interprofessional Relations ,education ,Chronic pain ,General Medicine ,Peer support ,medicine.disease ,Session (web analytics) ,Constructivist teaching methods ,03 medical and health sciences ,0302 clinical medicine ,Health Occupations ,Multidisciplinary approach ,Content analysis ,medicine ,Humans ,Pain Management ,Health education ,Curriculum ,030212 general & internal medicine ,Students ,0305 other medical science ,Psychology - Abstract
Interprofessional learning (IPL) is vital for developing work-ready graduates of tertiary health professions and enhancing outcomes of patients with chronic pain. Twenty-two students from six health professions participated in or co-facilitated components of a 6-week group chronic pain management program. Twelve community clients with chronic pain and one family member participated. The program was piloted through the University of Tasmania Exercise Physiology Clinic and consisted of an initial assessment, weekly 1-hour group education sessions, and a 1-hour individualized, supervised exercise session. The program was evaluated using a constructivist approach via an investigator developed survey. Seven students and nine clients responded. A conventional content analysis was undertaken. Three categories were identified from students: Importance of IPL, Understanding Chronic Pain, and Improvement Suggestions. Three categories were identified from clients including Beneficial Aspects, Positive Peer Support, and Positive Pain Outcomes. Results indicate the program was beneficial for student learning and improved pain outcomes for participants. The model demonstrates value to student IPL and the potential to flexibly offer a real-world learning experience across many health professions, whilst addressing some of the common challenges associated with implementing IPL within curricula. The outcomes offer ways to explore sustainable implementation of the program long term.
- Published
- 2020
22. Mobility focussed physical outcome measures over telehealth using Zoom platform: intra and inter-rater reliability trial (Preprint)
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Marie-Louise Bird, Felix Peel, Matt Schmidt, Natalie A Fini, Emily Ramage, Brodie M Sakakibara, Dawn B Simpson, Carey Mather, Dominique A Cadilhac, Kiran DK Ahuja, Heather Bridgman, and Coralie English
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education - Abstract
BACKGROUND Rehabilitation provided via telehealth offers an alternative to in-person health care consultations. Effective rehabilitation depends on accurate and relevant assessments that reliably measure changes in function over time. The reliability of a suite of relevant assessments to measure the impact of rehabilitation on physical function during a telehealth consultation is unknown. OBJECTIVE We aimed to measure the intra-rater reliability of mobility-focused physical outcome measures delivered via telehealth using Zoom (a commonly used telecommunication platform), and inter-rater reliability comparing telehealth with in-person assessments. METHODS Healthy volunteers were recruited to complete seven mobility-focussed outcome measures in view of a laptop computer under instruction from a remotely-based researcher. Another in-person researcher (providing the benchmark scores) concurrently recorded their scores. The same researchers collected all of the data. Inter- and intra-rater reliability was assessed for Grip Strength, Functional reach test, Five-time Sit to Stand, 3 and 4 meter walks and Timed up-and-go, using intra-class correlation coefficients (ICC) and Bland-Altman plots. These tests were chosen as they cover a wide array of physical mobility, strength and balance constructs that relate to functional daily activities, require little to no assistance from a clinician, can be performed in the limits of a home environment and were likely to be feasible over a telehealth delivery mode. RESULTS Thirty participants (age 36.2±12.5 years, 63% male) completed all assessments. Inter-rater reliability was excellent for Grip Strength (ICC: 0.99) and Functional reach (ICC: 0.99), good for Five-time Sit to Stand (ICC: 0.842) and 4 Meter Walk (ICC: 0.76), moderate for timed up and go (ICC: 0.64), and poor for 3 Meter Walk (ICC: -0.46). Intra-rater reliability for the remote researcher was excellent for Grip Strength (ICC: 0.91), good for Timed up-and-go, 3 Meter Walk, 4 Meter Walk, Functional reach (ICC: 0.84-0.89) and moderate for Five-time Sit to Stand (ICC: 0.67). Although recorded simultaneously, the timing-based assessments were recorded as significantly longer via telehealth for Five-time Sit to Stand (1.2s), Timed up-and-go (1.0s) and 3 Meter Walk (1.3s). CONCLUSIONS High intra-rater reliability of mobility-focused physical outcome assessments measured over telehealth (Zoom) have been demonstrated. Untimed mobility-focussed physical outcome measures have excellent inter-rater reliability between in-person and telehealth measurement. Timed outcome measures recorded approximately one second longer via telehealth, reducing the reliability of shorter duration tests. Small time differences favouring in-person attendance are of a similar magnitude to clinically importance differences, indicating assessments undertaken using telehealth (Zoom) cannot be compared directly with face-to-face delivery. This has implications for clinicians using blended (some face-to-face and some telehealth) assessments.
- Published
- 2022
23. Mobility-Focused Physical Outcome Measures Over Telecommunication Technology (Zoom): Intra and Interrater Reliability Trial
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Marie-Louise Bird, Felix Peel, Matt Schmidt, Natalie A Fini, Emily Ramage, Brodie M Sakakibara, Dawn B Simpson, Carey Mather, Dominique A Cadilhac, Kiran D K Ahuja, Heather Bridgman, and Coralie English
- Subjects
Rehabilitation ,Physical Therapy, Sports Therapy and Rehabilitation - Abstract
Background Rehabilitation provided via telehealth offers an alternative to currently limited in-person health care. Effective rehabilitation depends on accurate and relevant assessments that reliably measure changes in function over time. The reliability of a suite of relevant assessments to measure the impact of rehabilitation on physical function is unknown. Objective We aimed to measure the intrarater reliability of mobility-focused physical outcome measures delivered via Zoom (a commonly used telecommunication platform) and interrater reliability, comparing Zoom with in-person measures. Methods In this reliability trial, healthy volunteers were recruited to complete 7 mobility-focused outcome measures in view of a laptop, under instructions from a remotely based researcher who undertook the remote evaluations. An in-person researcher (providing the benchmark scores) concurrently recorded their scores. Interrater and intrarater reliability were assessed for Grip Strength, Functional Reach Test, 5-Time Sit to Stand, 3- and 4-Meter Walks and Timed Up and Go, using intraclass correlation coefficients (ICC) and Bland-Altman plots. These tests were chosen because they cover a wide array of physical mobility, strength, and balance constructs; require little to no assistance from a clinician; can be performed in the limits of a home environment; and are likely to be feasible over a telehealth delivery mode. Results A total of 30 participants (mean age 36.2, SD 12.5 years; n=19, 63% male) completed all assessments. Interrater reliability was excellent for Grip Strength (ICC=0.99) and Functional Reach Test (ICC=0.99), good for 5-Time Sit to Stand (ICC=0.842) and 4-Meter Walk (ICC=0.76), moderate for Timed Up and Go (ICC=0.64), and poor for 3-Meter Walk (ICC=–0.46). Intrarater reliability, accessed by the remote researcher, was excellent for Grip Strength (ICC=0.91); good for Timed Up and Go, 3-Meter Walk, 4-Meter Walk, and Functional Reach (ICC=0.84-0.89); and moderate for 5-Time Sit to Stand (ICC=0.67). Although recorded simultaneously, the following time-based assessments were recorded as significantly longer via Zoom: 5-Time Sit to Stand (1.2 seconds), Timed Up and Go (1.0 seconds), and 3-Meter Walk (1.3 seconds). Conclusions Untimed mobility-focused physical outcome measures have excellent interrater reliability between in-person and telehealth measurements. Timed outcome measures took approximately 1 second longer via Zoom, reducing the reliability of tests with a shorter duration. Small time differences favoring in-person attendance are of a similar magnitude to clinically important differences, indicating assessments undertaken using telecommunications technology (Zoom) cannot be compared directly with face-to-face delivery. This has implications for clinicians using blended (ie, some face-to-face and some via the internet) assessments. High intrarater reliability of mobility-focused physical outcome measures has been demonstrated in this study.
- Published
- 2022
24. Three discipline collaborative radiation therapy (3DCRT) special debate: A physicist's time is better spent in direct patient/provider interaction than in the patient's chart
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Todd F, Atwood, Narottam, Lamichhane, Krisha, Howell, Stephanie E, Weiss, Louise, Bird, Charles, Pearson, Michael C, Joiner, Michael M, Dominello, and Jay, Burmeister
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Radiation ,Radiotherapy Planning, Computer-Assisted ,Humans ,Radiology, Nuclear Medicine and imaging ,Radiotherapy, Conformal ,Instrumentation - Published
- 2022
25. The Stroke Recovery in Motion Implementation Planner: Mixed Methods User Evaluation
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Jessica Reszel, Joan van den Hoek, Tram Nguyen, Gayatri Aravind, Mark T Bayley, Marie-Louise Bird, Kate Edwards, Janice J Eng, Jennifer L Moore, Michelle L A Nelson, Michelle Ploughman, Julie Richardson, Nancy M Salbach, Ada Tang, and Ian D Graham
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Medicine (miscellaneous) ,Health Informatics - Abstract
Background As more people are surviving stroke, there is a growing need for services and programs that support the long-term needs of people living with the effects of stroke. Exercise has many benefits; however, most people with stroke do not have access to specialized exercise programs that meet their needs in their communities. To catalyze the implementation of these programs, our team developed the Stroke Recovery in Motion Implementation Planner, an evidence-informed implementation guide for teams planning a community-based exercise program for people with stroke. Objective This study aimed to conduct a user evaluation to elicit user perceptions of the usefulness and acceptability of the Planner to inform revisions. Methods This mixed methods study used a concurrent triangulation design. We used purposive sampling to enroll a diverse sample of end users (program managers and coordinators, rehabilitation health partners, and fitness professionals) from three main groups: those who are currently planning a program, those who intend to plan a program in the future, and those who had previously planned a program. Participants reviewed the Planner and completed a questionnaire and interviews to identify positive features, areas of improvement, value, and feasibility. We used descriptive statistics for quantitative data and content analysis for qualitative data. We triangulated the data sources to identify Planner modifications. Results A total of 39 people participated in this study. Overall, the feedback was positive, highlighting the value of the Planner’s comprehensiveness, tools and templates, and real-world examples. The identified areas for improvement included clarifying the need for specific steps, refining navigation, and creating more action-oriented content. Most participants reported an increase in knowledge and confidence after reading the Planner and reported that using the resource would improve their planning approach. Conclusions We used a rigorous and user-centered process to develop and evaluate the Planner. End users indicated that it is a valuable resource and identified specific changes for improvement. The Planner was subsequently updated and is now publicly available for community planning teams to use in the planning and delivery of evidence-informed, sustainable, community-based exercise programs for people with stroke.
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- 2022
26. How Community-Based Teams Use the Stroke Recovery in Motion Implementation Planner: Longitudinal Qualitative Field Test Study
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Jessica Reszel, Joan van den Hoek, Tram Nguyen, Gayatri Aravind, Mark T Bayley, Marie-Louise Bird, Kate Edwards, Janice J Eng, Jennifer L Moore, Michelle L A Nelson, Michelle Ploughman, Julie Richardson, Nancy M Salbach, Ada Tang, and Ian D Graham
- Subjects
Medicine (miscellaneous) ,Health Informatics - Abstract
Background The Stroke Recovery in Motion Implementation Planner guides teams through the process of planning for the implementation of community-based exercise programs for people with stroke, in alignment with implementation science frameworks. Objective The purpose of this study was to conduct a field test with end users to describe how teams used the Planner in real-world conditions; describe the effects of Planner use on participants’ implementation-planning knowledge, attitudes, and activities; and identify factors influencing the use of the Planner. Methods This field test study used a longitudinal qualitative design. We recruited teams across Canada who intended to implement a community-based exercise program for people with stroke in the next 6 to 12 months and were willing to use the Planner to guide their work. We completed semistructured interviews at the time of enrollment, monitoring calls every 1 to 2 months, and at the end of the study to learn about implementation-planning work completed and Planner use. The interviews were analyzed using conventional content analysis. Completed Planner steps were plotted onto a timeline for comparison across teams. Results We enrolled 12 participants (program managers and coordinators, rehabilitation professionals, and fitness professionals) from 5 planning teams. The teams were enrolled in the study between 4 and 14 months, and we conducted 25 interviews. We observed that the teams worked through the planning process in diverse and nonlinear ways, adapted to their context. All teams provided examples of how using the Planner changed their implementation-planning knowledge (eg, knowing the steps), attitudes (eg, valuing community engagement), and activities (eg, hosting stakeholder meetings). We identified team, organizational, and broader contextual factors that hindered and facilitated uptake of the Planner. Participants shared valuable tips from the field to help future teams optimize use of the Planner. Conclusions The Stroke Recovery in Motion Implementation Planner is an adaptable resource that may be used in diverse settings to plan community-based exercise programs for people with stroke. These findings may be informative to others who are developing resources to build the capacity of those working in community-based settings to implement new programs and practices. Future work is needed to monitor the use and understand the effect of using the Planner on exercise program implementation and sustainability.
- Published
- 2022
27. Impairments, and physical design and culture of a rehabilitation unit influence stroke survivor activity: qualitative analysis of rehabilitation staff perceptions
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Heidi Janssen, Marie-Louise Bird, Julie Luker, Ben Sellar, Angela Berndt, Samantha Ashby, Annie McCluskey, Louise Ada, Jannette Blennerhassett, Julie Bernhardt, Neil J. Spratt, Janssen, Heidi, Bird, Marie-Louise, Luker, Julie, Sellar, Ben, Berndt, Angela, Ashby, Samantha, McCluskey, Annie, Ada, Louise, Blennerhassett, Jannette, Bernhardt, Julie, and Spratt, Neil J
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Male ,Stroke ,barriers ,activity ,Rehabilitation ,Stroke Rehabilitation ,Humans ,Female ,Survivors ,Social Environment ,environment ,stroke ,Qualitative Research - Abstract
This study aimed to investigate rehabilitation staff perceptions of factors influencing stroke survivor activity outside of dedicated therapy time for the purpose of supporting successful translation of activity promoting interventions in a rehabilitation unit. Purposive sampling of multi-disciplinary teams from four rehabilitation units was performed, and semi-structured interviews were conducted by telephone, digitally audio-recorded and then transcribed verbatim. A stepped iterative process of thematic analysis was employed until data saturation was reached. All but one of the 22 participants were female, the majority were either physiotherapists or occupational therapists, with a median of 4 years (interquartile range, 2–10) working at their respective rehabilitation units. Analysis of the data revealed three themes: (i) stroke survivor characteristics influence their activity outside therapy, (ii) the rehabilitation environment influences physical, cognitive, and social activity, and (iii) institutional priorities, staff culture, and attitude can be barriers to activity. Rehabilitation units were perceived to be unstimulating, and visitors considered enablers of activity when resources were perceived to be scarce. Our results suggest careful consideration of the involvement of visitors, an individual’s needs and preferences, and the institution’s priorities and staff attitude may result in greater stroke survivor activity during rehabilitation.Implications for rehabilitationStaff should consider stroke survivor impairments and a rehabilitation unit’s institutional priorities and staff attitudes when aiming to enhance stroke survivor engagement in activity.The physical and social environment of a rehabilitation unit can be optimised by rehabilitation staff to promote activity.Utilisation of visitors of stroke survivors on a rehabilitation unit may be one way to enhance engagement in activity.Discussion within the rehabilitation team concerning “ownership” of the role of supporting stroke survivor activity outside of structured therapy time may support better engagement in same. Staff should consider stroke survivor impairments and a rehabilitation unit’s institutional priorities and staff attitudes when aiming to enhance stroke survivor engagement in activity. The physical and social environment of a rehabilitation unit can be optimised by rehabilitation staff to promote activity. Utilisation of visitors of stroke survivors on a rehabilitation unit may be one way to enhance engagement in activity. Discussion within the rehabilitation team concerning “ownership” of the role of supporting stroke survivor activity outside of structured therapy time may support better engagement in same.
- Published
- 2022
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28. 'Connecting patients and therapists remotely using technology is feasible and facilitates exercise adherence after stroke'
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Coralie English, Dawn B. Simpson, Michele L. Callisaya, Matthew W. Schmidt, Marie-Louise Bird, Seana L. Gall, Monique Breslin, and Stuart T. Smith
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Male ,030506 rehabilitation ,medicine.medical_specialty ,Patients ,Functional exercise ,medicine.medical_treatment ,03 medical and health sciences ,0302 clinical medicine ,Humans ,Medicine ,Adverse effect ,Stroke ,Aged ,Monitoring, Physiologic ,Telerehabilitation ,Aged, 80 and over ,Community and Home Care ,Rehabilitation ,business.industry ,Stroke Rehabilitation ,Repetitive task ,Mean age ,Usability ,Recovery of Function ,Exercise adherence ,Middle Aged ,medicine.disease ,Exercise Therapy ,Treatment Outcome ,Patient Satisfaction ,Physical therapy ,Feasibility Studies ,Patient Compliance ,Female ,Patient Safety ,Neurology (clinical) ,0305 other medical science ,business ,Goals ,030217 neurology & neurosurgery - Abstract
Purpose: Repetitive task practice after stroke is important to improve function, yet adherence to exercise is low. The aim of this study was to determine whether using the internet, a tablet application, and a chair sensor that connected to a therapist was feasible in monitoring adherence and progressing a functional exercise at home.Methods: Ten participants with stroke completed a 4-week sit-to-stand exercise using the technology at home (ACTRN12616000051448). A therapist remotely monitored exercise adherence, progressed goals, and provided feedback via the app. Measures of feasibility (design, recruitment/withdrawals, adherence, safety, participant satisfaction and estimates of effect on function) were collected.Results: Participants' mean age was 73.6 years [SD 9.9 years]. The system was feasible to deliver and monitor exercise remotely. All participants completed the study performing a mean 125% of prescribed sessions and 104% of prescribed repetitions. Participants rated the system usability (78%), enjoyment (70%) and system benefit (80%) as high. No adverse events were reported. The mean pre- and post-intervention difference in the total short performance physical battery score was 1.4 (95% CI 0.79, 2.00).Conclusions: It was feasible and safe to prescribe and monitor exercises using an app and sensor-based system. A definitive trial will determine whether such technology could facilitate greater exercise participation after stroke.
- Published
- 2019
29. A systematic review of systematic reviews of needs of family caregivers of older adults with dementia
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Oladele Atoyebi, Janice J. Eng, François Routhier, Marie-Louise Bird, and W. Ben Mortenson
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Health (social science) ,Geriatrics and Gerontology - Abstract
Family caregivers provide vital assistance to older adults living with dementia. An accurate assessment of the needs of caregivers supports the development and provision of appropriate solutions to address these needs. This review of systematic reviews analyzes and synthesizes the needs identified by family caregivers. We conducted a systematic review of systematic reviews using the AMSTAR guideline. Electronic databases were searched for systematic reviews on the needs of caregivers in the context of dementia using a combination of keywords and medical subject headings. Records resulting from the search were screened by two reviewers. Data on the needs of caregivers were extracted from the articles and analyzed using a narrative synthesis approach. Out of the 17 potentially eligible systematic reviews obtained initially, 6 met the inclusion criteria. In total, 20 main needs were identified in the reviews included in this study. The need for information and social support were prominent in this review. Factors such as gender, resources available to the caregiver and the care recipient's health status may influence caregivers' needs. Interventions can be tailored toward addressing the most prominent needs of caregivers such as adequate information and resources and available programs may further accommodate and offer need-tailored support to them.
- Published
- 2021
30. Online advice for the symptomatic management of post-stroke fatigue: A scoping review
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Tiev Miller, Rachel Stockley, Avril Drummond, Caroline Watkins, Rachel Georgiou, Kiran Deep Kaur Ahuja, and Marie-Louise Bird
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Search Engine ,Internet ,Psychiatry and Mental health ,Clinical Psychology ,Consumer Health Information ,Humans ,Comprehension ,Fatigue - Abstract
Limited medical evidence for managing post-stroke fatigue leads stroke survivors to seek information through other sources. This scoping review aimed to identify and assess the range and quality of web-based recommendations for managing post-stroke fatigue.Publicly accessible websites providing advice for post-stroke fatigue management were considered for review using the Joanna Briggs Institute's methodology. Using the search term "fatigue stroke", the first two pages of results from each search engine (Google, Yahoo, and Bing) were assessed against predetermined criteria. Findings were reported in accordance with PRISMA-ScR checklist. Quality and readability were also assessed.Fifty-seven websites were identified; 16 primary and 11 linked websites met the inclusion criteria and demonstrated moderate to high quality and high readability. Primary websites were curated by non-government organizations (n = 10/16), companies (n = 4/16) or were media and blog websites (n = 2/16). Additional resources were provided on linked websites. All websites provided non-pharmacological advice, with four also describing pharmacological management. Many websites included advice related to physical activity modification (n = 18/27) and energy conservation strategies (e.g. activity prioritization, planning, pacing) (n = 26/27). Direction to seek health professional advice appeared frequently (n = 16/27).The quality of publicly available web-based advice for people with post-stroke fatigue was moderate to high in most websites, with high readability. Energy conservation strategies and physical activity modification appear frequently. The general nature of the advice provided on most websites is supported by direction to healthcare professionals (i.e., clinical referral) who may assist in the practical individualization of strategies for managing post-stroke fatigue.
- Published
- 2022
31. Setting the scene for the Second Stroke Recovery and Rehabilitation Roundtable
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Janice J. Eng, Michael O'Sullivan, Marie-Louise Bird, Andrew N. Clarkson, Gert Kwakkel, Marion F Walker, Jane Burridge, Karen Borschmann, Julie Bernhardt, Kathryn S Hayward, Steven C. Cramer, Dale Corbett, Rehabilitation medicine, Amsterdam Movement Sciences - Restoration and Development, and Amsterdam Neuroscience - Neurovascular Disorders
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Rehabilitation ,business.industry ,medicine.medical_treatment ,Stroke Rehabilitation ,Congresses as Topic ,medicine.disease ,Priority areas ,Stroke ,Neurology ,Nursing ,Rehabilitation Research ,Intervention (counseling) ,medicine ,Humans ,Cognitive Dysfunction ,Motor recovery ,Stroke recovery ,Cognitive impairment ,Working group ,business - Abstract
The Stroke Recovery and Rehabilitation Roundtable (SRRR) meetings bring together an international group of preclinical and clinical researchers along with statisticians, methodologists, funders and consumers, working to accelerate the development of effective treatments for stroke recovery and to support best-evidence uptake in rehabilitation practice. The first meeting (2016) focused on four recommendation areas: translation of preclinical evidence into human discovery trials; recovery biomarkers to provide knowledge of therapeutic targets and prognosis in human stroke; intervention development, monitoring, and reporting standards; and standardized measurement in motor recovery trials. The impact of SRRR is growing, with uptake of recommendations emerging, and funders exploring ways to incorporate research targets and recommendations. At our second meeting (SRRR2, 2018), we worked on new priority areas: (1) cognitive impairment, (2) standardizing metrics for measuring quality of movement, (3) improving development of recovery trials, and (4) moving evidence-based treatments into practice. To accelerate progress towards breakthrough treatments, formation of an International Stroke Recovery and Rehabilitation Alliance is our next step, where working groups will take recommendations and build partnerships needed to achieve our goals.
- Published
- 2019
32. Implementation in rehabilitation: a roadmap for practitioners and researchers
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Kim Miller, Jacqui Morris, Elizabeth A Lynch, Louise Connell, Marie-Louise Bird, Nicola M. Kayes, Suzie Mudge, Kathryn Jarvis, Susanne Bernhardsson, and Rebecca J Fisher
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implementation science ,030506 rehabilitation ,Rehabilitation ,Process management ,Computer science ,medicine.medical_treatment ,implementation context ,Analogy ,Context (language use) ,A300 ,Research findings ,Knowledge translation ,03 medical and health sciences ,0302 clinical medicine ,Research Design ,Sustainability ,medicine ,Humans ,Road map ,Implementation research ,0305 other medical science ,Delivery of Health Care ,030217 neurology & neurosurgery - Abstract
PURPOSE:\ud Despite growth in rehabilitation research, implementing research findings into rehabilitation practice has been slow. This creates inequities for patients and is an ethical issue. However, methods to investigate and facilitate evidence implementation are being developed. This paper aims to make these methods relevant and accessible for rehabilitation researchers and practitioners.\ud \ud METHODS:\ud Rehabilitation practice is varied and complex and occurs within multilevel healthcare systems. Using a "road map" analogy, we describe how implementation concepts and theories can inform implementation strategies in rehabilitation. The roadmap involves a staged journey that considers: the nature of evidence; context for implementation; navigation tools for implementation; strategies to facilitate implementation; evaluation of implementation outcomes; and sustainability of implementation. We have developed a model to illustrate the journey, and four case studies exemplify implementation stages in rehabilitation settings.\ud \ud RESULTS AND CONCLUSIONS:\ud Effective implementation strategies for the complex world of rehabilitation are urgently required. The journey we describe unpacks that complexity to provide a template for effective implementation, to facilitate translation of the growing evidence base in rehabilitation into improved patient outcomes. It emphasizes the importance of understanding context and application of relevant theory, and highlights areas which should be targeted in new implementation research in rehabilitation. Implications for rehabilitation Effective implementation of research evidence into rehabilitation practice has many interconnected steps and a roadmap analogy is helpful in defining them. Understanding context for implementation is critically important and using theory can facilitate development of understanding. Research methods for implementation in rehabilitation should be carefully selected and outcomes should evaluate implementation success as well as clinical change. Sustainability requires regular revisiting of the interconnected steps.
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- 2019
33. Deep muscles, deeper understanding: An investigation into abdominal muscle activation during vocalization and the impact of active training for the stage actor
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Robert Lewis and Marie-Louise Bird
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Linguistics and Language ,medicine.medical_specialty ,Literature and Literary Theory ,Visual Arts and Performing Arts ,business.industry ,education ,Muscle activation ,Language and Linguistics ,Physical medicine and rehabilitation ,Abdominal muscles ,Motor unit recruitment ,medicine ,Voice ,business ,Voice projection - Abstract
Stage actors need breath control for voice projection and resonance. However, little is known about the abdominal muscle activation during vocalizations of different sounds and different lung volumes. The impact of training on muscle activation is likewise under-reported in the literature. This Voicing describes the content of an intervention used in an intensive six-week series of training workshops and forms the basis for a research project where muscle recruitment before and after was measured in both trained and untrained performers. Through participation in this intensive workshop, an untrained performer demonstrates changes in muscle recruitment with reduced activation of the global muscles and improved muscle efficiency.
- Published
- 2019
34. Perceived benefits and barriers to yoga participation after stroke: A focus group approach
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T.M. Blake, A. Harris, M. Austin, and Marie-Louise Bird
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Male ,Gerontology ,Health Knowledge, Attitudes, Practice ,media_common.quotation_subject ,medicine.medical_treatment ,education ,MEDLINE ,Psychological intervention ,03 medical and health sciences ,0302 clinical medicine ,Perception ,medicine ,Humans ,030212 general & internal medicine ,Stroke ,media_common ,business.industry ,Yoga ,Stroke Rehabilitation ,Cognition ,Focus Groups ,medicine.disease ,Focus group ,humanities ,Complementary and alternative medicine ,Feeling ,Female ,Stroke recovery ,business ,human activities ,030217 neurology & neurosurgery - Abstract
Background and Purpose: There is increasing evidence to suggest yoga can be beneficial to health and wellbeing after stroke. The purpose of this study was to identify perceived benefits and barriers to yoga participation among adults with chronic stroke. Materials and methods Twenty-six community dwelling adults (14 female, 12 male) who were at least 6-months post-stroke participated in four focus groups held at local stroke recovery meetings. Data was recorded and transcripts were analysed thematically. Results Participants identified whole body benefits, the return of connection and feeling health in mind as the primary benefits of yoga. Perceived barriers included physical barriers to participation, cognitive challenges, environmental access, and financial limitations. Conclusion Stroke survivors perceive yoga practice provides benefits in ‘connectedness’. Future interventions should recognize the importance of yoga instructor training, focus on the mind-body connection aspects of yoga, and modifying activities to safely accommodate the physical abilities of the participants.
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- 2019
35. Building a Bridge to the Community: An Integrated Knowledge Translation Approach to Improving Participation in Community-Based Exercise for People After Stroke
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Janice J. Eng, E Bagnall, A Wright, BW Mortenson, K Hayley, J Yao, F Chu, Marie-Louise Bird, and N Acerra
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Male ,Evidence-based practice ,Health Personnel ,Community organization ,Physical Therapy, Sports Therapy and Rehabilitation ,Translational Research, Biomedical ,03 medical and health sciences ,0302 clinical medicine ,Stakeholder Participation ,Knowledge translation ,Health care ,Humans ,030212 general & internal medicine ,Qualitative Research ,Original Research ,Medical education ,business.industry ,Stroke Rehabilitation ,Focus Groups ,Middle Aged ,Focus group ,Exercise Therapy ,3. Good health ,Cross-Sectional Studies ,Female ,Observational study ,Independent Living ,business ,Psychology ,030217 neurology & neurosurgery ,Independent living ,Qualitative research - Abstract
Background People who have had a stroke and are living in the community have low levels of physical activity, which reduces their functional capacity and increases risks of developing secondary comorbid conditions. Exercise delivered in community centers can address these low levels of physical activity; however, implementing evidence-based programs to meet the needs of all community stakeholders is challenging. Objectives The objective of this study was to determine implementation factors to facilitate participation in relevant exercise and physical activity for people with chronic health conditions, like stroke. Design The design consisted of a qualitative observational study using an integrated knowledge translation approach. Methods Supported by an integrated knowledge translation approach, a series of focus groups—with stakeholder group representation that included people who had had a stroke and care partners, community organizations (ie, support groups, community center staff), health care providers, and exercise deliverers—was conducted. During the focus groups, participants provided perspectives on factors that could influence implementation effectiveness. Focus groups were recorded, transcribed, and thematically analyzed. Results Forty-eight stakeholders participated. Based on the themes, a new implementation model that describes the importance of relationships between community centers, clinicians, and people who have had a stroke is proposed. The development of partnerships facilitates the implementation and delivery of exercise programs for people with ongoing health needs. These partnerships address unmet needs articulated in the focus groups and could fill a gap in the continuity of care. Conclusions Data from this study support the need for the community sector to offer a continuing service in partnership with the health system and people with chronic health needs. It indicates the potential of clinicians to partner with people with chronic health conditions and empower them to improve participation in relevant health behaviors, like community-based exercise.
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- 2019
36. Do clinical guidelines guide clinical practice in stroke rehabilitation? An international survey of health professionals
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Elizabeth A Lynch, Louise Connell, Marie-Louise Bird, and Lilian Braighi Carvalho
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medicine.medical_specialty ,Evidence-based practice ,Health Personnel ,medicine.medical_treatment ,education ,C630 ,03 medical and health sciences ,0302 clinical medicine ,Surveys and Questionnaires ,Humans ,Medicine ,030212 general & internal medicine ,Stroke ,health care economics and organizations ,Rehabilitation ,Health professionals ,business.industry ,Stroke Rehabilitation ,International survey ,Survey research ,Guideline ,medicine.disease ,3. Good health ,Clinical Practice ,Evidence-Based Practice ,Family medicine ,business ,030217 neurology & neurosurgery - Abstract
To identify health professionals awareness of stroke rehabilitation guidelines, and factors perceived to influence guideline use internationally.Online survey study. Open-ended responses were thematically analysed, guided by the Consolidated Framework for Implementation Research.Data from 833 respondents from 30 countries were included. Locally developed guidelines were available in 22 countries represented in the sample. Respondents from high-income countries were more aware of local guidelines compared with respondents from low- and middle-income countries.Local contextual factors such as management support and a culture of valuing evidence-based practice were reported to positively influence guideline use, whereas inadequate time and shortages of skilled staff inhibited the delivery of guideline-recommended care. Processes reported to improve guideline use included education, training, formation of workgroups, and audit-feedback cycles. Broader contextual factors included accountability (or lack thereof) of health professionals to deliver rehabilitation consistent with guideline recommendations.While many health professionals were aware of clinical guidelines, they identified multiple barriers to their implementation. Efforts should be made to raise awareness of local guidelines in low- and middle-income countries. More attention should be paid to addressing local contextual factors to improve guideline use internationally, going beyond traditional strategies focused on individual health professionals.IMPLICATIONS FOR REHABILITATIONSystems are required so people and organisations are held accountable to deliver evidence-based care in stroke rehabilitation.Locally developed stroke rehabilitation guidelines should be promoted to boost awareness of these guidelines in low- and middle-income countries.In all regions, strategies to influence or adapt to the local setting, are required to optimise guideline use.
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- 2021
37. Evidence-based stroke rehabilitation : Do priorities for practice change and feasibility of implementation vary across high income, upper and lower-middle income countries?
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John M. Solomon, Caroline L Watkins, Karen Borschmann, Sanjana Gururaj, Marie-Louise Bird, Marion F Walker, and Janice J. Eng
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Gerontology ,030506 rehabilitation ,knowledge translation ,Evidence-based practice ,medicine.medical_treatment ,Psychological intervention ,C630 ,Distribution (economics) ,Context (language use) ,rehabilitation ,03 medical and health sciences ,0302 clinical medicine ,Knowledge translation ,lower-middle income countries ,medicine ,Humans ,L340 ,upper-middle income countries ,implementation ,Developing Countries ,Stroke ,Socioeconomic status ,Rehabilitation ,business.industry ,Stroke Rehabilitation ,1. No poverty ,medicine.disease ,high-income countries ,stroke ,3. Good health ,Income ,Quality of Life ,Feasibility Studies ,Business ,0305 other medical science ,030217 neurology & neurosurgery - Abstract
Purpose The context of implementation plays an important role in the delivery of optimal treatments in stroke recovery and rehabilitation. Considering that stroke systems of care vary widely across the globe, the goal of the present paper is to compare healthcare providers’ priority of key areas in translating stroke research to clinical practice among High Income Countries, Upper Middle- and Lower Middle-Income Countries (HICs, UMICs, LMICs). We also aimed to compare perceptions regarding the key areas’ feasibility of implementation, and formulate recommendations specific to each socioeconomic region. Methods Data related to recommendations for knowledge translation in stroke, from a primary survey from the second Stroke Recovery and Rehabilitation Roundtable were segregated based on socioeconomic region. Frequency distribution was used to compare the key areas for practice change and examine the perceived feasibility of implementation of the same across HIC, UMIC and LMICs. Results A total of 632 responses from healthcare providers across 28 countries were received. Interdisciplinary care and access to services were high priorities across the three groups. Transitions in Care and Intensity of Practice were high priority areas in HICs, whereas Clinical Practice Guidelines were a high priority in LMICs. Interventions specific to clinical discipline, screening and assessment were among the most feasible areas in HICs, whereas Intensity of practice and Clinical Practice Guidelines were perceived as most feasible to implement in LMICs. Conclusion We have identified healthcare providers’ priorities for addressing international practice change across socioeconomic regions. By focusing on the most feasible key areas, we can aid the channeling of appropriate resources to bridge the disparities in stroke outcomes across HICs, UMICs and LMICs. IMPLICATIONS FOR REHABILITATION • It is pertinent to examine the differences in priorities of stroke rehabilitation professionals and the feasibility of implementing evidence-based practice across socioeconomic regions. • There is an urgent necessity for the development of clinical practice guidelines for stroke rehabilitation in Low-Middle Income Countries, taking into consideration the cultural, economic and geographical constraints. • In upper-middle income countries, encouraging family support and timely screening and assessment for aphasia, cognition and depression appear to be the low hanging fruits to enhance quality of life after stroke. • Innovative ways to increase intensity of practice and channelling of resources to improve transitions in care may prove to be the most beneficial in advancing stroke rehabilitation in high income countries.
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- 2021
38. The Association between Seasonal Variation in Vitamin D, Postural Sway, and Falls Risk: An Observational Cohort Study
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Marie-Louise Bird, Keith D. Hill, Iain Robertson, Madeleine J. Ball, Jane K. Pittaway, and Andrew D. Williams
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Geriatrics ,RC952-954.6 - Abstract
Introduction. Low serum vitamin D levels are associated with increased postural sway. Vitamin D varies seasonally. This study investigates whether postural sway varies seasonally and is associated with serum vitamin D and falls. Methods. In a longitudinal observational study, eighty-eight independently mobile community-dwelling older adults (69.7 ± 7.6 years) were evaluated on five occasions over one year, measuring postural sway (force platform), vitamin D levels, fall incidence, and causes and adverse outcomes. Mixed-methods Poisson regression was used to determine associations between measures. Results. Postural sway did not vary over the year. Vitamin D levels varied seasonally (P
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- 2013
- Full Text
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39. Somatic mosaicism and common genetic variation contribute to the risk of very-early-onset inflammatory bowel disease
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Serra, Eva Gonçalves, Schwerd, Tobias, Moutsianas, Loukas, Cavounidis, Athena, Fachal, Laura, Pandey, Sumeet, Kammermeier, Jochen, Croft, Nicholas M, Posovszky, Carsten, Rodrigues, Astor, Russell, Richard K, Barakat, Farah, Auth, Marcus K H, Heuschkel, Robert, Zilbauer, Matthias, Fyderek, Krzysztof, Braegger, Christian, Travis, Simon P, Satsangi, Jack, Parkes, Miles, Thapar, Nikhil, Ferry, Helen, Matte, Julie C, Gilmour, Kimberly C, Wedrychowicz, Andrzej, Sullivan, Peter, Moore, Carmel, Sambrook, Jennifer, Ouwehand, Willem, Roberts, David, Danesh, John, Baeumler, Toni A, Fulga, Tudor A, Karaminejadranjbar, Mohammad, Ahmed, Ahmed, Wilson, Rachel, Barrett, Jeffrey C, Elkadri, Abdul, Griffiths, Anne M, Snapper, Scott B, Shah, Neil, Muise, Aleixo M, Wilson, David C, Uhlig, Holm H, Anderson, Carl A, Marlen, Zurek, Caterina, Strisciuglio, Mamoun, Elawad, Bernice, Lo, Carolina, Arancibia-Carcamo, Adam, Bailey, Ellie, Barnes, Elizabeth Louise, Bird-Lieberman, Oliver, Brain, Barbara, Braden, Jane, Collier, James, East, Lucy, Howarth, Satish, Keshav, Paul, Klenerman, Simon, Leedham, Rebecca, Palmer, Fiona, Powrie, Alison, Simmons, Matthew, Walker, Zoe, Tolkien, Stephen, Kaptoge, David, Allen, Susan, Mehenny, Jonathan, Mant, Emanuele, Di Angelantonio, Simon G, Thompson, Bahtiyar, Yilmaz, Pascal, Juillerat, Markus, Geuking, Reiner, Wiest, Andrew J, Macpherson, Francisco Damian, Bravo, Lukas, Brügger, Ove, Carstens, Ulrike Graf, Bigler, Benjamin, Heimgartner, Monica, Rusticeanu, Sybille, Schmid-Uebelhart, Bruno, Strebel, Aurora, Tatu, Radu, Tutuian, Ove, Øyås, Charlotte, Ramon, Jörg, Stelling, Yannick, Franc, Nicolas, Fournier, Valerie E H, Pittet, Bernard, Burnand, Mara, Egger, Delphine, Golay, Astrid, Marot, Leilla, Musso, Valérie, Pittet, Jean-Benoît, Rossel, Vivianne, Seematter, Joachim, Sommer, Rachel, Vulliamy, Pierre, Michetti, Michel H, Maillard, Céline, Keller, Andreas, Nydegger, Alain, Schoepfe, Eva, Archanioti, Jessica, Ezri, Montserrat, Fraga, Alain, Schoepfer, Christoph, Müller, Gerhard, Rogler, Luc, Biedermann, Mirjam, Blattmann, Sabine, Burk, Barbara, Dora, Michael, Fried, Benjamin, Misselwitz, Beat, Müllhaupt, Nicole, Obialo, Daniel, Pohl, Nadia, Raschle, Michael, Scharl, Stephan, Vavricka, Roland, Von Känel, Jonas, Zeitz, Karim, Abdelrahman, Gentiana, Ademi, Jan, Borovicka, Stephan, Brand, Remus, Frei, Johannes, Haarer, Christina, Knellwolf-Grieger, Claudia, Krieger-Grübel, Patrizia, Künzler, Christa, Meyenberger, Pamela, Meyer, Nina, Röhrich, Mikael, Sawatzki, Martin, Schelling, Gian-Marco, Semadeni, Michael, Sulz, Dorothee, Zimmermann, Patrick, Aepli, Dominique H, Criblez, Cyrill, Hess, Jean-Pierre, Richterich, Johannes, Spalinger, Dominic, Staudenmann, Andreas, Stulz, Stefanie, Wöhrle, Amman, Thomas, Claudia, Anderegg, Henrik, Köhler, Rachel, Kusche, Anca-Teodora, Antonino, Eviano, Arrigoni, José M, Bengoa, Sophie, Cunningham, Philippe, de Saussure, Laurent, Girard, Diana Bakker, de Jong, Polat, Bastürk, Simon, Brunner, Lukas, Degen, Petr, Hruz, Carolina, Khalid-de Bakker, Jan, Niess, Bruno, Balsiger, Janine, Haldemann, Gaby, Saner, Frank, Seibold, Peter, Bauerfeind, Andrea, Becocci, Dominique, Belli, Janek, Binek, Peter, Hengstler, Stephan, Boehm, Tujana, Boldanov, Patrick, Bühr, Rebekka, Koller, Vanessa, Rueger, Arne, Senning, Emanuel, Burri, Sophie, Buyse, Dahlia-Thao, Cao, Fabrizia, D'Angelo, Joakim, Delarive, Christopher, Doerig, Roxane, Hessler, Claudia, Preissler, Ronald, Rentsch, Branislav, Risti, Marc Alain, Ritz, Michael, Steuerwald, Jürg, Vögtlin, Markus, Sagmeister, Bernhard, Sauter, Susanne, Schibli, Christiane, Sokollik, Hugo, Schlauri, Jean-François, Schnegg, Mariam, Seirafi, Holger, Spangenberger, Philippe, Stadler, Peter, Staub, Volker, Stenz, Michela, Tempia-Caliera, Joël, Thorens, Kaspar, Truninger, Patrick, Urfer, Francesco, Viani, Dominique, Vouillamoz, Silvan, Zander, Tina, Wyli, L, Jostins, N A, Kennedy, T, Ahmad, C A, Lamb, C, Edwards, A, Hart, C, Hawkey, J C, Mansfield, C, Mowat, W G, Newman, A, Simmons, M, Tremelling, J C, Lee, N J, Prescott, C G, Mathew, C W, Lees, D P B, McGovern, S R, Targan, G, Botwin, E, Mengesha, P, Fleshner, C, Landers, D, Li, J D, Rioux, A, Bitton, J, Côté-Daigneault, M J, Daly, R, Xavier, K, Morris, G, Boucher, J H, Cho, C, Abraham, M, Merad, B, Sands, I, Peter, K, Hao, Y, Itan, R H, Duerr, L, Konnikova, M B, Schwartz, S, Proksell, E, Johnston, V, Miladinova, W, Chen, S R, Brant, L, Datta, M S, Silverberg, L P, Schumm, S, Birch, M, Giri, K, Gettler, Y, Sharma, C, Stevens, M, Lazarev, T, Haritunians, Fachal, Laura [0000-0002-7256-9752], Croft, Nicholas M [0000-0002-1519-6435], Posovszky, Carsten [0000-0002-9487-8812], Russell, Richard K [0000-0001-7398-4926], Zilbauer, Matthias [0000-0002-7272-0547], Travis, Simon P [0000-0002-2690-4361], Matte, Julie C [0000-0001-5642-648X], Wedrychowicz, Andrzej [0000-0003-1448-167X], Fulga, Tudor A [0000-0002-1056-0082], Karaminejadranjbar, Mohammad [0000-0002-7770-2065], Ahmed, Ahmed [0000-0001-6509-2581], Muise, Aleixo M [0000-0001-9624-3346], Wilson, David C [0000-0003-0879-1129], Apollo - University of Cambridge Repository, UCL - SSS/IREC/MONT - Pôle Mont Godinne, UCL - (MGD) Service de gastro-entérologie, Croft, Nicholas M. [0000-0002-1519-6435], Russell, Richard K. [0000-0001-7398-4926], Travis, Simon P. [0000-0002-2690-4361], Matte, Julie C. [0000-0001-5642-648X], Fulga, Tudor A. [0000-0002-1056-0082], Muise, Aleixo M. [0000-0001-9624-3346], Wilson, David C. [0000-0003-0879-1129], Eva Gonçalves, Serra, Tobias, Schwerd, Loukas, Moutsiana, Athena, Cavounidi, Laura, Fachal, Sumeet, Pandey, Jochen, Kammermeier, Nicholas M, Croft, Carsten, Posovszky, Astor, Rodrigue, Richard K, Russell, Farah, Barakat, Marcus K H, Auth, Robert, Heuschkel, Matthias, Zilbauer, Krzysztof, Fyderek, Christian, Braegger, Simon P, Travi, Jack, Satsangi, Miles, Parke, Nikhil, Thapar, Helen, Ferry, Julie C, Matte, Kimberly C, Gilmour, Andrzej, Wedrychowicz, Peter, Sullivan, Carmel, Moore, Jennifer, Sambrook, Willem, Ouwehand, David, Robert, John, Danesh, Toni A, Baeumler, Tudor A, Fulga, Mohammad, Karaminejadranjbar, Ahmed, Ahmed, Rachel, Wilson, Jeffrey C, Barrett, Abdul, Elkadri, Anne M, Griffith, Scott B, Snapper, Neil, Shah, Aleixo M, Muise, David C, Wilson, Holm H, Uhlig, Carl A, Anderson, Zurek, Marlen, Strisciuglio, Caterina, Elawad, Mamoun, Lo, Bernice, Arancibia-Carcamo, Carolina, Bailey, Adam, Barnes, Ellie, Bird-Lieberman, Elizabeth Louise, Brain, Oliver, Braden, Barbara, Collier, Jane, East, Jame, Howarth, Lucy, Keshav, Satish, Klenerman, Paul, Leedham, Simon, Palmer, Rebecca, Powrie, Fiona, Simmons, Alison, Walker, Matthew, Tolkien, Zoe, Kaptoge, Stephen, Allen, David, Mehenny, Susan, Mant, Jonathan, Di Angelantonio, Emanuele, Thompson, Simon G, Yilmaz, Bahtiyar, Juillerat, Pascal, Geuking, Marku, Wiest, Reiner, Macpherson, Andrew J, Bravo, Francisco Damian, Brügger, Luka, Carstens, Ove, Bigler, Ulrike Graf, Heimgartner, Benjamin, Rusticeanu, Monica, Schmid-Uebelhart, Sybille, Strebel, Bruno, Tatu, Aurora, Tutuian, Radu, Øyås, Ove, Ramon, Charlotte, Stelling, Jörg, Franc, Yannick, Fournier, Nicola, Pittet, Valerie E H, Burnand, Bernard, Egger, Mara, Golay, Delphine, Marot, Astrid, Musso, Leilla, Pittet, Valérie, Rossel, Jean-Benoît, Seematter, Vivianne, Sommer, Joachim, Vulliamy, Rachel, Michetti, Pierre, Maillard, Michel H, Keller, Céline, Nydegger, Andrea, Schoepfe, Alain, Archanioti, Eva, Ezri, Jessica, Fraga, Montserrat, Schoepfer, Alain, Müller, Christoph, Rogler, Gerhard, Biedermann, Luc, Blattmann, Mirjam, Burk, Sabine, Dora, Barbara, Fried, Michael, Misselwitz, Benjamin, Müllhaupt, Beat, Obialo, Nicole, Pohl, Daniel, Raschle, Nadia, Scharl, Michael, Vavricka, Stephan, Von Känel, Roland, Zeitz, Jona, Abdelrahman, Karim, Ademi, Gentiana, Borovicka, Jan, Brand, Stephan, Frei, Remu, Haarer, Johanne, Knellwolf-Grieger, Christina, Krieger-Grübel, Claudia, Künzler, Patrizia, Meyenberger, Christa, Meyer, Pamela, Röhrich, Nina, Sawatzki, Mikael, Schelling, Martin, Semadeni, Gian-Marco, Sulz, Michael, Zimmermann, Dorothee, Aepli, Patrick, Criblez, Dominique H, Hess, Cyrill, Richterich, Jean-Pierre, Spalinger, Johanne, Staudenmann, Dominic, Stulz, Andrea, Wöhrle, Stefanie, Thomas, Amman, Anderegg, Claudia, Köhler, Henrik, Kusche, Rachel, Antonino, Anca-Teodora, Arrigoni, Eviano, Bengoa, José M, Cunningham, Sophie, de Saussure, Philippe, Girard, Laurent, de Jong, Diana Bakker, Bastürk, Polat, Brunner, Simon, Degen, Luka, Hruz, Petr, Khalid-de Bakker, Carolina, Niess, Jan, Balsiger, Bruno, Haldemann, Janine, Saner, Gaby, Seibold, Frank, Bauerfeind, Peter, Becocci, Andrea, Belli, Dominique, Binek, Janek, Hengstler, Peter, Boehm, Stephan, Boldanov, Tujana, Bühr, Patrick, Koller, Rebekka, Rueger, Vanessa, Senning, Arne, Burri, Emanuel, Buyse, Sophie, Cao, Dahlia-Thao, D'Angelo, Fabrizia, Delarive, Joakim, Doerig, Christopher, Hessler, Roxane, Preissler, Claudia, Rentsch, Ronald, Risti, Branislav, Ritz, Marc Alain, Steuerwald, Michael, Vögtlin, Jürg, Sagmeister, Marku, Sauter, Bernhard, Schibli, Susanne, Sokollik, Christiane, Schlauri, Hugo, Schnegg, Jean-Françoi, Seirafi, Mariam, Spangenberger, Holger, Stadler, Philippe, Staub, Peter, Stenz, Volker, Tempia-Caliera, Michela, Thorens, Joël, Truninger, Kaspar, Urfer, Patrick, Viani, Francesco, Vouillamoz, Dominique, Zander, Silvan, Wyli, Tina, Jostins, L, Kennedy, N A, Ahmad, T, Lamb, C A, Edwards, C, Hart, A, Hawkey, C, Mansfield, J C, Mowat, C, Newman, W G, Simmons, A, Tremelling, M, Lee, J C, Prescott, N J, Mathew, C G, Lees, C W, Mcgovern, D P B, Targan, S R, Botwin, G, Mengesha, E, Fleshner, P, Landers, C, Li, D, Rioux, J D, Bitton, A, Côté-Daigneault, J, Daly, M J, Xavier, R, Morris, K, Boucher, G, Cho, J H, Abraham, C, Merad, M, Sands, B, Peter, I, Hao, K, Itan, Y, Duerr, R H, Konnikova, L, Schwartz, M B, Proksell, S, Johnston, E, Miladinova, V, Chen, W, Brant, S R, Datta, L, Silverberg, M S, Schumm, L P, Birch, S, Giri, M, Gettler, K, Sharma, Y, Stevens, C, Lazarev, M, Haritunians, T, Carrami, Eli M [0000-0002-7770-2065], COLORS in IBD group investigators, Oxford IBD cohort study investigators, INTERVAL Study, Swiss IBD cohort investigators, UK IBD Genetics Consortium, NIDDK IBD Genetics Consortium, Zurek, M., Strisciuglio, C., Elawad, M., Lo, B., Arancibia-Carcamo, C., Bailey, A., Barnes, E., Bird-Lieberman, E.L., Brain, O., Braden, B., Collier, J., East, J., Howarth, L., Keshav, S., Klenerman, P., Leedham, S., Palmer, R., Powrie, F., Simmons, A., Walker, M., Tolkien, Z., Kaptoge, S., Allen, D., Mehenny, S., Mant, J., Di Angelantonio, E., Thompson, S.G., Yilmaz, B., Juillerat, P., Geuking, M., Wiest, R., Macpherson, A.J., Bravo, F.D., Brügger, L., Carstens, O., Bigler, U.G., Heimgartner, B., Rusticeanu, M., Schmid-Uebelhart, S., Strebel, B., Tatu, A., Tutuian, R., Øyås, O., Ramon, C., Stelling, J., Franc, Y., Fournier, N., Pittet, VEH, Burnand, B., Egger, M., Golay, D., Marot, A., Musso, L., Pittet, V., Rossel, J.B., Seematter, V., Sommer, J., Vulliamy, R., Michetti, P., Maillard, M.H., Keller, C., Nydegger, A., Schoepfe, A., Archanioti, E., Ezri, J., Fraga, M., Schoepfer, A., Müller, C., Rogler, G., Biedermann, L., Blattmann, M., Burk, S., Dora, B., Fried, M., Misselwitz, B., Müllhaupt, B., Obialo, N., Pohl, D., Raschle, N., Scharl, M., Vavricka, S., Von Känel, R., Zeitz, J., Abdelrahman, K., Ademi, G., Borovicka, J., Brand, S., Frei, R., Haarer, J., Knellwolf-Grieger, C., Krieger-Grübel, C., Künzler, P., Meyenberger, C., Meyer, P., Röhrich, N., Sawatzki, M., Schelling, M., Semadeni, G.M., Sulz, M., Zimmermann, D., Aepli, P., Criblez, D.H., Hess, C., Richterich, J.P., Spalinger, J., Staudenmann, D., Stulz, A., Wöhrle, S., Thomas, A., Anderegg, C., Köhler, H., Kusche, R., Antonino, A.T., Arrigoni, E., Bengoa, J.M., Cunningham, S., de Saussure, P., Girard, L., de Jong, D.B., Bastürk, P., Brunner, S., Degen, L., Hruz, P., Bakker, C.K., Niess, J., Balsiger, B., Haldemann, J., Saner, G., Seibold, F., Bauerfeind, P., Becocci, A., Belli, D., Binek, J., Hengstler, P., Boehm, S., Boldanov, T., Bühr, P., Koller, R., Rueger, V., Senning, A., Burri, E., Buyse, S., Cao, D.T., D'Angelo, F., Delarive, J., Doerig, C., Hessler, R., Preissler, C., Rentsch, R., Risti, B., Ritz, M.A., Steuerwald, M., Vögtlin, J., Sagmeister, M., Sauter, B., Schibli, S., Sokollik, C., Schlauri, H., Schnegg, J.F., Seirafi, M., Spangenberger, H., Stadler, P., Staub, P., Stenz, V., Tempia-Caliera, M., Thorens, J., Truninger, K., Urfer, P., Viani, F., Vouillamoz, D., Zander, S., Wyli, T., Jostins, L., Kennedy, N.A., Ahmad, T., Lamb, C.A., Edwards, C., Hart, A., Hawkey, C., Mansfield, J.C., Mowat, C., Newman, W.G., Tremelling, M., Lee, J.C., Prescott, N.J., Mathew, C.G., Lees, C.W., McGovern, DPB, Targan, S.R., Botwin, G., Mengesha, E., Fleshner, P., Landers, C., Li, D., Rioux, J.D., Bitton, A., Côté-Daigneault, J., Daly, M.J., Xavier, R., Morris, K., Boucher, G., Cho, J.H., Abraham, C., Merad, M., Sands, B., Peter, I., Hao, K., Itan, Y., Duerr, R.H., Konnikova, L., Schwartz, M.B., Proksell, S., Johnston, E., Miladinova, V., Chen, W., Brant, S.R., Datta, L., Silverberg, M.S., Schumm, L.P., Birch, S., Giri, M., Gettler, K., Sharma, Y., Stevens, C., Lazarev, M., and Haritunians, T.
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0301 basic medicine ,Male ,Multifactorial Inheritance ,General Physics and Astronomy ,631/208/1516 ,13 ,Inflammatory bowel disease ,Whole Exome Sequencing ,Adult ,Age of Onset ,Case-Control Studies ,Child ,Child, Preschool ,Cohort Studies ,Female ,Genes, Recessive ,Genetic Predisposition to Disease ,Genetic Variation ,Humans ,Infant ,Infant, Newborn ,Inflammatory Bowel Diseases/etiology ,Inflammatory Bowel Diseases/genetics ,Loss of Function Mutation ,Mosaicism ,Mutation ,NADPH Oxidase 2/genetics ,Pedigree ,Primary Immunodeficiency Diseases/complications ,Primary Immunodeficiency Diseases/genetics ,Risk Factors ,0302 clinical medicine ,Primary Immunodeficiency Disease ,Medicine ,lcsh:Science ,Exome sequencing ,49/31 ,education.field_of_study ,Multidisciplinary ,Medical genetics ,article ,692/699/249/1570 ,631/250/249/2510/257 ,631/208/248 ,3. Good health ,NADPH Oxidase 2 ,030211 gastroenterology & hepatology ,Case-Control Studie ,Human ,medicine.medical_specialty ,Science ,Primary Immunodeficiency Diseases ,Population ,45/22 ,45/23 ,digestive system ,General Biochemistry, Genetics and Molecular Biology ,03 medical and health sciences ,Immunological deficiency syndromes ,Exome Sequencing ,Immunogenetics ,Allele ,education ,45 ,business.industry ,Risk Factor ,Inflammatory Bowel Disease ,Case-control study ,General Chemistry ,medicine.disease ,Inflammatory Bowel Diseases ,digestive system diseases ,49 ,030104 developmental biology ,Immunology ,Primary immunodeficiency ,lcsh:Q ,Age of onset ,Cohort Studie ,business - Abstract
Very-early-onset inflammatory bowel disease (VEO-IBD) is a heterogeneous phenotype associated with a spectrum of rare Mendelian disorders. Here, we perform whole-exome-sequencing and genome-wide genotyping in 145 patients (median age-at-diagnosis of 3.5 years), in whom no Mendelian disorders were clinically suspected. In five patients we detect a primary immunodeficiency or enteropathy, with clinical consequences (XIAP, CYBA, SH2D1A, PCSK1). We also present a case study of a VEO-IBD patient with a mosaic de novo, pathogenic allele in CYBB. The mutation is present in ~70% of phagocytes and sufficient to result in defective bacterial handling but not life-threatening infections. Finally, we show that VEO-IBD patients have, on average, higher IBD polygenic risk scores than population controls (99 patients and 18,780 controls; P, Adult forms of inflammatory bowel disease (IBD) are of a polygenic nature, but paediatric and very early onset (VEO) IBD also occur as monogenic forms. Here, using whole exome sequencing, the authors explore both the monogenic and polygenic contribution to VEO-IBD and characterize a rare somatic mosaic VEO-IBD patient.
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- 2020
40. Evaluating an interprofessional workshop on persistent pain: The role of Adult Learning and Social Identity theories
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Andrew Williams, Sandra Murray, Annette Marlow, Sibella Hardcastle, Kimberley Norris, Greer Maine, Karina Jane Heyworth, Shandell Elmer, T Dean, Jan Radford, Heather Bridgman, Marie-Louise Bird, and A Todd
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Gerontology ,education.field_of_study ,Population ageing ,Learning environment ,Population ,Chronic pain ,Context (language use) ,medicine.disease ,Workforce ,Learning theory ,medicine ,Psychology ,education ,Human services - Abstract
Interprofessional learning (IPL) is vital for developing work-ready health graduates and enhancing outcomes of people living with persistent pain. Our aim was to pilot an authentic IPL workshop on persistent pain in an Exercise Physiology Clinic. We also sought to explore the application of Adult Learning and Social Identity theories in understanding learning outcomes. Thirty students from five health disciplines participated in a half-day workshop on IPL and persistent pain, facilitated by multidisciplinary staff. Workshop activities included authentic, simulated case studies and problem-based learning. A mixed-methods, pre-post survey showed significant increases in students’ confidence in understanding their own and others’ discipline roles in managing persistent pain (p < 0.001), readiness for IPL (p = 0.046) and self-efficacy (p < 0.001). These increases were supported by qualitative outcomes, which were mapped onto Adult Learning and Social Identity theory. A preliminary conceptual framework was developed incorporating proposed learning mechanisms This innovative workshop, delivered through an Exercise Physiology clinic, formed an effective learning environment, increasing understanding of discipline roles generally and in the pain context. It led to a preliminary conceptual framework to understand learning processes underpinned by theory. There is potential for application of this IPL approach for other chronic conditions. Persistent (or chronic) pain, is defined as pain experienced every day for three months or more in the previous six-month period and affects at least one in five Australians (Access Economics, 2007). Persistent pain is associated with ageing, lower socio-economic status, less employment participation and poorer health status (Blyth et al., 2001). In 2018 in Australia, the overall cost of persistent pain was estimated to be $139.3 billion and the nation’s third most costly health problem (Pain Australia, 2020). In Tasmania, an island state of Australia with a population of just over half a million people, the persistent pain problem is compounded by an ageing population, increased prevalence of chronic disease, higher lifestyle risk factors, lower educational attainment and workforce participation and higher poverty rates relative to the rest of Australia (Department of Health and Human Services [DHHS], 2018). Although recommendations that persistent pain be assessed and managed with a multimodal, multidisciplinary approach are widely accepted (Gatchel et al., 2007), less than 10% of the Australian pain population accesses multidisciplinary care due to geographical challenges and service availability and access (Pain Australia, 2020). Tasmania, characterised by higher geographical dispersion across rural and remote areas is no exception, with access worsening with remoteness (DHHS, 2018). As the Tasmanian (and Australian) population ages, the need for a skilled health workforce to manage the growing and increasingly complex demands for persistent pain presentations will increase. This need has prompted calls for the development and enhancement of multidisciplinary undergraduate education programs (National Drug and Alcohol Research Centre, 2012; Pain Australia, 2011).
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- 2020
41. Implementation and Evaluation of the Graded Repetitive Arm Supplementary Program (GRASP) for People With Stroke in a Real World Community Setting: Case Report
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Chieh-Ling Yang, Janice J. Eng, and Marie-Louise Bird
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Adult ,Male ,media_common.quotation_subject ,medicine.medical_treatment ,Fidelity ,Physical Therapy, Sports Therapy and Rehabilitation ,Case Report ,Audit ,Coaching ,Translational Research, Biomedical ,Upper Extremity ,03 medical and health sciences ,0302 clinical medicine ,Quality of life (healthcare) ,Nursing ,medicine ,Humans ,030212 general & internal medicine ,Action research ,media_common ,Aged ,Aged, 80 and over ,Rehabilitation ,business.industry ,Attendance ,Stroke Rehabilitation ,Recovery of Function ,Middle Aged ,Local community ,Exercise Therapy ,Quality of Life ,Female ,business ,Psychology ,030217 neurology & neurosurgery ,Program Evaluation - Abstract
Objective Exercise programs to improve upper extremity function following stroke in the community setting are needed as the length of hospital stay continues to decrease. However, little has been done to increase understanding of how to translate an evidence-based rehabilitation intervention to real-world programs. The purpose of this case report was to describe a process evaluation of the implementation of an evidence-based upper extremity rehabilitation intervention for stroke, the Graded Repetitive Arm Supplementary Program, in a community setting. Methods (Case Description) A partnership between a nonprofit support organization and a local community center was established to deliver the program in the community. The Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework with mixed methods was used to evaluate the implementation. Results Reach: Twenty people were screened, 14 people met eligibility requirements, and 13 consented to participate. The program reached approximately 1.25% of the potential target population. Effectiveness: Participants with stroke demonstrated significant improvement in upper extremity function and quality of life as measured by the Fugl-Meyer Assessment for upper extremity, Action Research Arm Test, Rating of Everyday Arm-use in the Community and Home Scale, and Stroke Impact Scale. Adoption: Factors that facilitated program uptake were the well-planned implementation and the workplace coaching based on the audit results. Factors contributing to ongoing participation were the social support within the group environment and the instructor’s capability of engaging the group. Implementation: A partnership between a nonprofit organization and a local community center was successfully established. The program was implemented as intended as verified by a fidelity checklist. Participant adherence was high as confirmed by the average attendance and practice time. Maintenance: Both the partner organization and community center continued to offer the program. Conclusion The Graded Repetitive Arm Supplementary Program had good fidelity of the critical principles and core components and was effective in improving upper extremity function and quality of life. Impact This partnership model may serve as the first step for future larger-scale implementation and could be used to move other stroke rehabilitation interventions into community settings.
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- 2020
42. Evaluation and facilitation of intervention fidelity in community exercise programs through an adaptation of the TIDier framework
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Marie-Louise Bird, William B. Mortenson, and Janice J. Eng
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Adult ,Male ,Scale-up ,media_common.quotation_subject ,Framework ,Psychological intervention ,Fidelity ,Audit ,Coaching ,Health informatics ,Health administration ,03 medical and health sciences ,0302 clinical medicine ,Humans ,Medicine ,Community Health Services ,030212 general & internal medicine ,Adaptation ,Evaluation ,media_common ,Medical education ,Program ,business.industry ,lcsh:Public aspects of medicine ,Health Policy ,Nursing research ,Stroke Rehabilitation ,lcsh:RA1-1270 ,Middle Aged ,Checklist ,Exercise Therapy ,Implementation ,Feasibility Studies ,Female ,business ,030217 neurology & neurosurgery ,Program Evaluation ,Research Article - Abstract
Background Despite high quality evidence supporting multiple physical and cognitive benefits of community-based exercise for people after stroke, there is little understanding on how to facilitate uptake of these research findings to real-world programs. A common barrier is a lack of standardised training for community fitness instructors, which hampers the ability to train more instructors to deliver the program as it was designed. Scaling up program delivery, while maintaining program fidelity, is complex. The objective of this research is to explore novel use of the Template for Intervention Description and Replication (TIDier) framework to evaluate and support implementation fidelity of a community exercise program. Methods We embedded intervention fidelity evaluation into an inaugural training program for fitness instructors who were to deliver the Fitness and Mobility Exercise Program for stroke, which has established efficacy. The training program consisted of a face-to-face workshop followed by 3 worksite ‘audit and feedback coaching cycles’ provided over 3 iterations of the 12-week program offered over 1 year. A modified TIDIER checklist (with 2 additional criteria) was used within the training workshop to clarify the key ‘active ingredients’ that were required for program fidelity, and secondly as a basis for the audit and feedback process enabling the quantitative measurement of fidelity. Data were collected from audits of observed classes and from a survey provided by fitness instructors who implemented the program. Results We demonstrated the feasibility of the TIDier checklist to capture 14 essential items for implementation evaluation of a complex exercise intervention for people with chronic health conditions over 3 iterations of the program. Based on the audit tool, program fidelity was high and improved over time. Three content areas for workplace coaching (intensity monitoring, space, and educational tips) were identified from the audit tool and were addressed. Conclusion Training of staff to deliver exercises to high need populations utilising workshops and workplace coaching that used the TIDier framework for training, onsite audit and feedback resulted in a high level of fidelity to the program principles. A novel checklist based on the TIDier framework was useful for embedding implementation fidelity in complex community-based interventions.
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- 2020
43. Additional file 1 of Perspectives on the prospective development of stroke-specific lower extremity wearable monitoring technology: a qualitative focus group study with physical therapists and individuals with stroke
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Louie, Dennis, Marie-Louise Bird, Menon, Carlo, and Eng, Janice
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InformationSystems_GENERAL ,ComputingMilieux_THECOMPUTINGPROFESSION ,Data_FILES - Abstract
Additional file 1. Focus group guide for healthcare professionals.
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- 2020
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44. Additional file 2 of Perspectives on the prospective development of stroke-specific lower extremity wearable monitoring technology: a qualitative focus group study with physical therapists and individuals with stroke
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Louie, Dennis, Marie-Louise Bird, Menon, Carlo, and Eng, Janice
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ComputingMethodologies_IMAGEPROCESSINGANDCOMPUTERVISION ,Data_FILES ,ComputingMethodologies_COMPUTERGRAPHICS - Abstract
Additional file 2. Focus group guide for individuals with stroke.
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- 2020
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45. Perspectives on the prospective development of stroke-specific lower extremity wearable monitoring technology: a qualitative focus group study with physical therapists and individuals with stroke
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Janice J. Eng, Marie-Louise Bird, Carlo Menon, and Dennis R. Louie
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Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Wearable computer ,Health Informatics ,Context (language use) ,Walking ,lcsh:RC321-571 ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Prospective Studies ,030212 general & internal medicine ,Remote sensing technology ,Stroke ,Wearable electronic devices ,lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry ,Qualitative Research ,Wearable technology ,Fitness tracker ,Rehabilitation ,business.industry ,Research ,Stroke Rehabilitation ,Equipment Design ,Focus Groups ,Middle Aged ,medicine.disease ,Focus group ,Physical Therapists ,Lower Extremity ,Content analysis ,Physical therapy ,Female ,Psychology ,business ,030217 neurology & neurosurgery ,Qualitative research - Abstract
Background Wearable activity monitors that track step count can increase the wearer’s physical activity and motivation but are infrequently designed for the slower gait speed and compensatory patterns after stroke. New and available technology may allow for the design of stroke-specific wearable monitoring devices, capable of detecting more than just step counts, which may enhance how rehabilitation is delivered. The objective of this study was to identify important considerations in the development of stroke-specific lower extremity wearable monitoring technology for rehabilitation, from the perspective of physical therapists and individuals with stroke. Methods A qualitative research design with focus groups was used to collect data. Five focus groups were conducted, audio recorded, and transcribed verbatim. Data were analyzed using content analysis to generate overarching categories representing the stakeholder considerations for the development of stroke-specific wearable monitor technology for the lower extremity. Results A total of 17 physical therapists took part in four focus group discussions and three individuals with stroke participated in the fifth focus group. Our analysis identified four main categories for consideration: 1) ‘Variability’ described the heterogeneity of patient presentation, therapy approaches, and therapeutic goals that are taken into account for stroke rehabilitation; 2) ‘Context of use’ described the different settings and purposes for which stakeholders could foresee employing stroke-specific wearable technology; 3) ‘Crucial design features’ identified the measures, functions, and device characteristics that should be considered for incorporation into prospective technology to enhance uptake; and 4) ‘Barriers to adopting technology’ highlighted challenges, including personal attitudes and design flaws, that may limit the integration of current and future wearable monitoring technology into clinical practice. Conclusions The findings from this qualitative study suggest that the development of stroke-specific lower extremity wearable monitoring technology is viewed positively by physical therapists and individuals with stroke. While a single, specific device or function may not accommodate all the variable needs of therapists and their clients, it was agreed that wearable monitoring technology could enhance how physical therapists assess and treat their clients. Future wearable devices should be developed in consideration of the highlighted design features and potential barriers for uptake.
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- 2020
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46. An Innovative STRoke Interactive Virtual thErapy (STRIVE) online platform for community-dwelling stroke survivors : A randomized controlled trial
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Liam Johnson, Marie-Louise Bird, Makii Muthalib, and Wei-Peng Teo
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Male ,030506 rehabilitation ,Internationality ,Time Factors ,Physical Therapy, Sports Therapy and Rehabilitation ,upper limb ,Statistics, Nonparametric ,Upper Extremity ,03 medical and health sciences ,0302 clinical medicine ,Occupational Therapy ,Humans ,Single-Blind Method ,Survivors ,Aged ,Aged, 80 and over ,exercise ,Virtual Reality Exposure Therapy ,Rehabilitation ,Stroke Rehabilitation ,Recovery of Function ,Middle Aged ,stroke ,Exercise Therapy ,Paresis ,Treatment Outcome ,technology ,virtual reality ,Female ,Independent Living ,0305 other medical science ,030217 neurology & neurosurgery ,Follow-Up Studies - Abstract
Objective To investigate the STRoke Interactive Virtual thErapy (STRIVE) intervention on upper-extremity clinical outcomes in community-dwelling stroke survivors. Design Assessor-blinded randomized controlled trial. Setting Study screening and testing was conducted in a university clinic. Participants completed the virtual therapy (VT) intervention in a community-based stroke support group setting. Participants Of 124 stroke survivors initially assessed, 60 participants were recruited (time poststroke, 13.4±8.9 y). Participants were allocated to either VT or control group using a block randomization design and were stratified by sex. Interventions Participants were randomized to receive 8 weeks of VT or usual care. The intervention consisted of approximately 45 minutes of twice weekly VT training on the Jintronix Rehabilitation System. Main Outcome Measures Between-group differences in the Fugl-Meyer Upper Extremity scale and Action Research Arm Test score were joint primary outcomes in this study. Results Significant between-group differences for the Fugl-Meyer Upper Extremity scale were seen at the end of the intervention (F1, 1=5.37, P=.02, d=0.41). No significant differences were observed with the Action Research Arm Test. No adverse events were reported. Conclusions We demonstrated clinically meaningful improvements in gross upper extremity motor function and use of the affected arm after a VT intervention delivered via a community-based stroke support group setting. This data adds to the contexts in which VT can be used to improve upper limb function. Use of VT in community-based rehabilitation in chronic stroke recovery is supported.
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- 2020
47. Additional file 2 of Evaluation and facilitation of intervention fidelity in community exercise programs through an adaptation of the TIDier framework
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Marie-Louise Bird, Mortenson, William, and Eng, Janice
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Additional files 2: Table S1. TIDier adapted checklist with examples.
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- 2020
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48. Additional file 1 of Evaluation and facilitation of intervention fidelity in community exercise programs through an adaptation of the TIDier framework
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Marie-Louise Bird, Mortenson, William, and Eng, Janice
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GeneralLiterature_INTRODUCTORYANDSURVEY ,Data_FILES ,ComputingMilieux_COMPUTERSANDEDUCATION - Abstract
Additional file 1. Survey for Exercise Instructors.
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- 2020
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49. Blood Pressure Response to Interrupting Workplace Sitting Time With Non-Exercise Physical Activity
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Kiran D.K. Ahuja, Scott J. Pedersen, Andrew Williams, C Mainsbridge, Marie-Louise Bird, and Dean Cooley
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Adult ,Male ,Occupational sitting ,Mean arterial pressure ,medicine.medical_specialty ,Time Factors ,hypertension ,Systole ,Movement ,Diastole ,Physical activity ,Health Promotion ,030204 cardiovascular system & hematology ,workplace health ,Prehypertension ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Humans ,Medicine ,Arterial Pressure ,030212 general & internal medicine ,preventative medicine ,Workplace ,Occupational Health ,Sitting Position ,business.industry ,public health ,Public Health, Environmental and Occupational Health ,Original Articles ,Middle Aged ,Sitting time ,Blood pressure ,Cardiology ,e-health ,Female ,business ,Software ,Cohort study - Abstract
Objective: To evaluate the blood pressure (BP) effects of a yearlong e-health solution designed to interrupt prolonged occupational sitting time. Methods: BP data of 228 desk-based employees (45.1 ± 10.5 years) were analyzed at baseline, 3, 6, 9, and 12 months. Results: Systolic BP significantly reduced from baseline for the first 9 months (1.0 to 3.4 mmHg; P
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- 2018
50. Improving physical activity, pain and function in patients waiting for hip and knee arthroplasty by combining targeted exercise training with behaviour change counselling: study protocol for a randomised controlled trial
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Kyra Hamilton, Michael Cheney, Andrew Williams, James W. Fell, Marie-Louise Bird, Sam Shi Xuan Wu, Jane O'Brien, and Jonathan Mulford
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Counseling ,Health Knowledge, Attitudes, Practice ,Time Factors ,Knee Joint ,Arthroplasty, Replacement, Hip ,medicine.medical_treatment ,Health Behavior ,Medicine (miscellaneous) ,Disease ,Osteoarthritis, Hip ,law.invention ,Study Protocol ,0302 clinical medicine ,Randomized controlled trial ,Behavior Therapy ,law ,Pharmacology (medical) ,030212 general & internal medicine ,Arthroplasty, Replacement, Knee ,Pain Measurement ,Randomized Controlled Trials as Topic ,education.field_of_study ,lcsh:R5-920 ,Osteoarthritis, Knee ,Arthralgia ,Biomechanical Phenomena ,Exercise Therapy ,Physical activity and Health Action Process Approach ,Treatment Outcome ,Hip Joint ,lcsh:Medicine (General) ,Psychosocial ,medicine.medical_specialty ,Waiting Lists ,Population ,Tasmania ,03 medical and health sciences ,Social support ,Intervention (counseling) ,Osteoarthritis ,medicine ,Humans ,education ,030203 arthritis & rheumatology ,business.industry ,Recovery of Function ,Arthroplasty ,Clinical trial ,Physical therapy ,business - Abstract
Background: Osteoarthritis often results in prolonged periods of reduced physical activity and is associated with adverse health outcomes, including increased risk of cardiovascular and metabolic diseases. Exercise interventions for patients on the waiting list for arthroplasty can reduce the risk of long-term adverse outcomes by increasing activity levels. However, uptake and ongoing positive rates of physical activity in this population are low and the impact of pre-operative behaviour counselling on exercise is not known. Method/design: The exercise and behaviour change counselling (ENHANCE) trial is a two-arm assessor-blind randomised controlled trial to assess the effectiveness of a 12-week exercise intervention designed to improve long-term physical activity and functional abilities for people awaiting arthroplasty. Participants on the waiting list for hip and knee arthroplasty are recruited from one clinical site in Australia. After collection of baseline data, participants are randomised to either an intervention or control group. The control group receive usual care, as recommended by evidence-based guidelines. The intervention group receive an individualised programme of exercises and counselling sessions. The 12-week exercise programme integrates multiple elements, including up to five in-person counselling sessions, supported by written materials. Participants are encouraged to seek social support among their friends and self-monitor their physical activity. The primary outcome is physical activity (daily step count and percentage of day spent in sedentary activities). Secondary outcomes include pain ratings, physical function, psychosocial factors and changes in clinical markers linked with potential common chronic diseases (diabetes and cardiovascular disease). All outcomes are assessed at baseline and 26 weeks later and again at 26 weeks post-surgery. Discussion: This study seeks to address a significant gap in current osteoarthritis management practice by providing evidence for the effectiveness of an exercise programme combined with behaviour counselling for adults waiting for hip and knee arthroplasty. Theory-driven evidence-based strategies that can improve an individual’s exercise self-efficacy and self-management capacity could have a significant impact on the development of secondary chronic disease in this population. Information gained from this study will contribute to the evidence base on the management of adults waiting for hip and knee arthroplasty. Trial registration: Australian New Zealand Clinical Trials Registry, ACTRN12617000357358 . Registered on 8 March 2017.
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- 2018
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