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Background: People with post COVID-19 syndrome (PCS) commonly complain of tachycardia and worsening of symptoms even after mild activity. However, the relationship between heart rate (HR) and physical activity (PA) in this population is still poorly understood. Objectives: To describe the relationship between HR and PA in people experiencing PCS. Methods: This observational study used data from participants with PCS (≥3 months post infection) collected using wearable devices (accelerometer and Garmin smart watch) over 4 days while performing daily activities. Main variables analyzed included time in different PA intensity levels (sedentary, light, moderate to vigorous (MVPA)), step count, average daily HR, and percentage of time in tachycardia (>100 beats per minute). Results: Sixteen participants had complete data and were included. The mean age of participants was 51±12 years (13 females). Average daily step count was 3462±1831. Average HR and percentage of time in tachycardia were 85±7 bpm and 13.7±10 % respectively. Daily step count was inversely correlated with average daily HR (r = -0.544, p = 0.030). Average daily HR gradually increased across PA levels from sedentary to MVPA (p = <0.001). Percentage of time in tachycardia was significantly lower at the MVPA level compared to the sedentary level after adjusting for age and sex (p = 0.027). Conclusion: PCS patients experience greater percentage of time in tachycardia while doing little to no activity compared to when they are engaged in higher intensities of PA. PCS patients experience greater periods of tachycardia while doing little to no activity compared to higher intensities of PA. Healthcare professionals should consider these findings, as traditional rehabilitation approaches may not be optimal for this group due to tachycardia experienced at rest or at low intensities of activity. It is crucial to design rehabilitation protocols that are both safe and suitable for the specific needs of post COVID-19 pa

Introduction: The delivery of care via videoconferencing (VC) allows physiotherapists (PTs) to connect with patients at a distance. VC requires an entirely hands-off approach, which does not align with physiotherapy’s ‘hands-on’ identity. A hands-off approach requires a change in practice and a change in clinician behaviour. Previous studies have utilised behaviour change theory to explore PTs’ delivery of care via VC, but there is no account of the unique Manitoban contextual or jurisdictional factors. Purpose: The purpose of this study was to explore PTs’ experiences and perceptions about the factors influencing the delivery of care via VC to the Manitoban population. Method: A qualitative description design allowed for an exploration of the lived experiences of Manitoban PTs delivering care via VC. Purposive and snowball sampling resulted in a diverse sample of 20 participants. Semi-structured virtual interviews were conducted between June and August, 2023. Directed content analysis (DCA) was used to analyse the interview data, using the COM-B (Capability, Opportunity, Motivation, and Behaviour) change model. Results: The majority of factors influencing PTs’ delivery of care via VC were categorised in the opportunity components of COM-B and included the internet and technology; patient conditions; and patient expectations. Many PTs gained VC experience during COVID-19, which facilitated clinicians’ psychological capability. Participants described a need for ‘adaptive expertise’. PTs’ motivation to deliver care via VC was limited, predominantly due to the elimination of hands-on care. Conversely, the lack of physical contact was described as a facilitator for PTs who experienced their own physical disabilities or ill health, which limited or prohibited the delivery of care in person. Conclusion: A multitude of factors impeded PTs’ ability to deliver equitable care via VC. Although the knowledge-to-practice gap has narrowed, it has not closed. A lack of motivation

Introduction: With an ever-growing prevalence, diabetes is a significant burden on the health care system and primary care which is where most diabetes care takes place. Physical activity is an effective and underutilized intervention in diabetes prevention and management. However, exercise specialists like physiotherapists and kinesiologists are not commonly members of diabetes care teams. Effective interprofessional collaboration with exercise specialists for diabetes care requires role clarity. Purpose: To promote effective interprofessional collaboration in primary care settings for diabetes care and physical activity by, (a) establishing the competencies of entry-level physiotherapists and kinesiologists for physical activity as an intervention for diabetes in primary care settings and (b) developing a referral pathway for physical activity interventions based on the distinct discipline-specific competencies for use by interprofessional primary care teams. Methods: Eleven physiotherapy and three kinesiology subject matter experts participated in two rounds of Delphi surveys to develop discipline and context specific competencies. These competencies were used to draft clinical tools (competency profiles and referral pathway), that were member-checked and modified based on focus group findings. Descriptive statistics and content analysis were used to analyze quantitative and qualitative data respectively. Results: There was consensus on 38 physiotherapy and 27 kinesiology competencies that highlighted the complexity of physical activity interventions for diabetes and the distinct roles of physiotherapists and kinesiologists in this practice area. Physiotherapy competencies highlight their unique role in supporting people with all types of diabetes to engage in physical activity despite complex medical or physical barriers. Focus group feedback resulted in modifications to the layout of the referral pathway to reflect that both professions can provide physical act

Problem: The importance of being physically active in older adults has been well documented. Physical activity has been associated with improved physical capacity (muscle strength, balance, endurance), slowing of age-associated cognitive decline and neurodegeneration, and decreasing the likelihood of developing chronic disease. There is a tendency to become less active with age. Clinicians need to find ways to help older adults maintain physical activity levels. The objective of this study was to estimate the association of balance and walking self-efficacy with physical activity and describe the types and duration of self-reported moderate to vigorous physical activity (MVPA) and self-reported physical activity (of all intensities) in community-dwelling older adults with difficulty walking outside. Methods: Baseline data from the Getting Older Adults Outdoors (GO-OUT) randomized controlled trial were used in this cross-sectional study. Simple and multiple linear regression models were used to estimate the associations of balance and walking self-efficacy with objective and self-reported measures of physical activity. Participants were asked to wear accelerometers to obtain moderate to vigorous physical activity (MVPA) information. The Community Health Activities Model Program for Seniors questionnaire (CHAMPS) was used to analyze the type and duration of self-reported physical activity. Results: Data from 190 participants (139 females and 51 males) with an average age of 74.5 years was available for analysis. Balance and walking self-efficacy were positively associated with objectively measured MVPA while walking self-efficacy alone was positively associated with self-reported physical activity. Participants reported spending most of their time in light-intensity physical activities such as walking for errands or leisure. Conclusion: This research provides evidence of a relationship between balance and walking self-efficacy with physical activity. It also confirms

Context: The amplitude, time of peak excitation, and spatial distribution of excitation of the scapular muscles have been hypothesized to contribute to the increased risk of shoulder pain in older females. Objectives: To determine whether there are differences in the amplitude, % task time to peak, or spatial distribution of excitation in the four scapular muscles [upper (UT), middle (MT), lower (LT) trapezius and serratus anterior (SA)] during the raising phases of loaded shoulder flexion in the sagittal plane in four groups [older female (OF), older male (OM), younger female (YF), younger male (YM)]. Methods: 52 individuals were recruited to participate in the study. Participants completed five repetitions of loaded shoulder flexion holding a load equivalent to 30% maximum force while EMG of the SA, UT, MT, and LT. A two-way (age*sex) analysis of variance (ANOVA) was conducted for each muscle to determine the effect of age and sex on the dependent variables (average amplitude and percentage of task time to peak excitation). Statistical parametric mapping (SPM) t-tests were used to determine differences in the spatial distribution of the UT, MT, and LT between the ages and sexes. Results: No significant differences were found in the average amplitude of excitation between the groups for the UT, MT, LT, or SA. The % task time to peak was significantly later for the SA in the OM (p<0.01, d=1.44) and OF (p<0.01, d=1.33) groups compared to the YF group. Significant differences in the spatial distribution of the UT, MT, and LT were found between older and younger adults at 70-75% task time (p<0.05) and in the LT at 95-100% task time (p<0.05). Significant differences in the spatial distribution of the LT were found between the sexes at 70-75% (p<0.05) and 95-100% (p<0.05) task time. Conclusions: Differences in the % task time to peak excitation of the SA exist between OMs and OFs compared to YFs. Significant differences in the spatial distribution of the trapezius were f

There is substantial evidence to support the idea that physical activity leads to health benefits for older adults. These benefits include a decreased rate of falls and fall-related injuries, osteoporosis, and dementia. Despite the numerous benefits of physical activity, many older adults do not meet the recommended physical activity guidelines. Motivational interviewing (MI) is a client-centred counselling style for strengthening motivation for change. MI has shown to be promising in the general adult population for improving physical activity levels. However, evidence is lacking to support MI's effectiveness in physical activity among older adults. This thesis has four objectives: 1) to synthesize evidence on the effect of MI on physical activity among older adults 2) to determine the feasibility of using virtual MI to improve physical activity among community-dwelling older adults 3) to explore the experiences of older adults and counsellors involved in virtual MI and 4) to examine the influence of counsellors’ behaviours and skills on participants’ change and sustain talk during MI sessions. For objective 1, a systematic review and meta-analysis was conducted. Objective 2 was achieved using a feasibility study with a single-group pre- and post-design. A qualitative descriptive design guided the data collection and analysis for objective 3. Lastly, objective 4 utilized a sequential observational method to examine the transition between the counsellors’ behaviours and participants’ utterances. The meta-analysis of three trials showed that the effect of MI on physical activity among older adults was not different between treatment and control groups. The findings from the feasibility study show that virtual MI should be a feasible and acceptable approach for improving physical activity among older adults. From the experiences of older adults and counsellors using virtual MI, we identified the interconnections between technology, relationships between older adults a

Introduction: Walking is the most common physical activity reported by Canadian adults. Community-ambulation requires many skills such as muscle strength, balance, endurance along with other factors. Clinicians use capacity tests to measure physical abilities to better understand the relationship between what people can do (capacity) and what people really do in their daily lives (performance). Our objective was to determine individual and collective relationships between mobility capacity and walking performance to better understand how to use and interpret tests of capacity in clinical situations. Methods: This study was a secondary data analysis. Baseline data from 168 participants (≥63 years of age) of the GO-OUT study, conducted in 4 Canadian cities (Edmonton, Winnipeg, Toronto, and Montreal), were analyzed. The multiple linear regression analyses included mobility capacity tests (6-minute Walk Test (6MWT), comfortable 10-metre Walk Test (10mWT), 30-second Sit-to-Stand (30sSTS) and Mini-BESTest); and walking performance measures collected with 7-day accelerometry (peak 30-minute cadence, time walked in bouts and steps/day). Frailty status data were used to test for a moderation effect. Results: Outcomes from multiple linear regression models with single capacity measures demonstrated that tests of capacity were positively related with walking performance measures, however they explained only a small amount of the variance in peak 30-minute cadence (24-28%), time walked in bouts (12-17%), and steps/day (18-22%). Analyses of the combined capacity measures using multiple linear regression demonstrated larger amounts of variance were explained in all walking performance measures (peak 30-minute cadence R2 =37%, with 6MWT and 30sSTS significant; time walked in bouts R2 =19%, with 10mWT significant; steps/day R2=25%, with 30sSTS significant; all p ≤ 0.05). Frailty did not moderate any relationships. Conclusion: The 6MWT and 30sSTS are significantly associated with pe

Introduction: Neighbourhood walkability has been suggested to influence walking behaviors. However, few studies focused on their relationships in Canadian older adults. The aims of this study were (1) to compare outdoor walking and moderate-to-vigorous physical activity time (MVPA) time in older adults with self-reported difficulty in different cities in Canada; (2) to estimate the associations between outdoor walking and subscale scores and the total scores of neighbourhood walkability; and (3) to estimate the associations between MVPA time and subscale scores and the total scores of neighbourhood walkability. Methods: This was a secondary data analysis of the Getting Older adults OUTdoors (GO-OUT) study. We used data from the baseline evaluation from 190 participants who had self-reported difficulty in outdoor walking in Edmonton (n=51), Winnipeg (n=53), Toronto (n=50), and Montreal (n=36). We compared the between-city differences in outdoor walking and MVPA time. We also attempted to use parametric tests to investigate the relationships between neighbourhood walkability, assessed by Neighbourhood Environmental Walkability Scale (NEWS), and outdoor walking and MVPA. Since the assumptions of normality, homogeneity of variances and homoscedasticity were all violated, Kruskal-Wallis test and Spearman’s rho were conducted. Results: We found (1) significant differences in MVPA time but not outdoor walking time between participants who resided in Edmonton, Winnipeg, Toronto, and Montreal, and (2) significant but weak associations between land-use mix diversity and land-use mix access, and outdoor walking (Spearman’s rho = 0.172 to 0.233) and (3) between residential density, land-use mix access and street connectivity and MVPA time (Spearman’s rho = -0.235 to 0.208). Conclusion: Several aspects of neighbourhood walkability play a significant role in outdoor walking and MVPA time among community-dwelling older adults. Understanding the relationships between neighbourhood

There are many discussions about the occurrence of hamstring injury, especially in running dominant sports such as Canadian rules football. Many interventions exist to decrease the risk and/or occurrence of hamstring injury, with the Nordic Curl being among one of the most studied interventions. The Nordic Curl is commonly implemented as part of a preventative injury program, often alongside various other methods of injury prevention exercises. Limited research exists on the implementation of a “more difficult” variation of the conventional Nordic Curl, which involves keeping the concentric portion in the exercise, as opposed to only completing the eccentric portion. This modified Nordic Curl (mNC) exercise was completed in one professional football team over the duration of four competitive seasons, post practice in a progressive manner to an upper limit of 5 reps per practice. Hamstring injury data collected during the four years of implementing the mNC was compared to the prior four years of hamstring injury data in three categories: rate of hamstring injuries per 4 years; average calendar days lost due to injury; and a comparison of total hamstring injuries per timeframe of the season. Independent t-tests were calculated to analyze for differences between rate of hamstring injuries in the two time periods (intervention vs non-intervention), and average time lost due to hamstring injury between the two time periods. Four Mann Whitney U tests were conducted to examine temporal differences in number of injuries between the intervention and non-intervention periods using four separate timeframes within the competitive season. No significant differences were found with any analyses, but large effect sizes were observed for differences between the groups for rate of hamstring injuries and the number of injuries that occurred in the first 6 weeks of the season. The results suggest the mNC does not significantly affect hamstring injury rates, time lost due to injury or