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Farley C, Newman ANL, Hoogenes J, Brooks D, Duffett M, Kho ME. Treatment Fidelity in 94 Randomized Controlled Trials of Physical Rehabilitation in the ICU: A Scoping Review. Crit Care Med 2024; 52:717-728. [PMID: 38265271 DOI: 10.1097/ccm.0000000000006192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
OBJECTIVES Recent reviews demonstrated discordant effects of ICU-based physical rehabilitation on physical function. These inconsistencies may be related to differences in treatment fidelity-the extent to which a protocol is delivered as planned. Before evaluating the association of fidelity with outcomes, we must first understand the extent of treatment fidelity reporting in ICU-based physical rehabilitation randomized controlled trials (RCTs). DATA SOURCES Six electronic databases from inception to December 2022. STUDY SELECTION We included RCTs enrolling adults or children admitted to the ICU, if greater than or equal to 50% were invasively mechanically ventilated greater than 24 hours, and underwent an ICU-based physical rehabilitation intervention, with no limitation to comparators or outcomes. DATA EXTRACTION We screened and extracted data independently and in duplicate, with a third reviewer as needed. Extracted data included study characteristics, treatment descriptions, and the presence of National Institutes of Health Behaviour Change Consortium (NIH-BCC) treatment fidelity tool components. Treatment fidelity scores were calculated as the proportion of reported (numerator) out of total NIH-BCC components (denominator). We calculated scores across studies and by treatment group (intervention vs. comparator). We used linear regression to assess for a time trend in study treatment fidelity scores. DATA SYNTHESIS Of 20,433 citations, 94 studies met inclusion criteria. Authors reported a median (first-third quartiles) of 19% (14-26%) of treatment fidelity components across studies. Intervention group scores were higher than comparator groups (24% [19-33%] vs. 14% [5-24%], p < 0.01). We found a mean increase in study treatment fidelity scores by 0.7% (0.3 points) per year. CONCLUSIONS Only 19% of treatment fidelity components were reported across studies, with comparator groups more poorly reported. Future research could investigate ways to optimize treatment fidelity reporting and determine characteristics associated with treatment fidelity conduct in ICU-based physical rehabilitation RCTs.
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Affiliation(s)
- Christopher Farley
- School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Anastasia N L Newman
- School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Jen Hoogenes
- School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Dina Brooks
- School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Mark Duffett
- Departments of Pediatrics and Health Research, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Michelle E Kho
- School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
- Physiotherapy Department, St. Joseph's Healthcare, Hamilton, ON, Canada
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2
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Nikolovski A, Gamgoum L, Deol A, Quilichini S, Kazemir E, Rhodenizer J, Oliveira A, Brooks D, Alsubheen S. Psychometric properties of the Hospital Anxiety and Depression Scale (HADS) in individuals with stable chronic obstructive pulmonary disease (COPD): a systematic review. Disabil Rehabil 2024; 46:1230-1238. [PMID: 36861817 DOI: 10.1080/09638288.2023.2182918] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 02/15/2023] [Accepted: 02/16/2023] [Indexed: 03/03/2023]
Abstract
PURPOSE The Hospital Anxiety and Depression Scale (HADS) is used to assess anxiety and depression in individuals with chronic obstructive pulmonary disease (COPD); however, its measurement properties lack critical appraisal. We aimed to summarize and critically appraise the validity, reliability, and responsiveness of the HADS in COPD. MATERIALS AND METHODS Five electronic databases were searched. The Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines were used to assess the methodological and evidence quality in the selected studies. RESULTS Twelve studies assessed the psychometric properties of the HADS-Total and its subscales HADS-Anxiety and HADS-Depression in COPD. High-quality evidence supported the structural and criterion validity of the HADS-A, the internal consistency of the HADS-T, HADS-A, and HADS-D with Cronbach's alpha values of 0.73-0.87, and before-after treatment responsiveness of HADS-T and its subscales (minimal clinically important difference = 1.4-2; effect size = 0.45-1.40). Moderate-quality evidence supported the test-retest reliability of the HADS-A and HADS-D with excellent coefficient values of 0.86-0.90. CONCLUSIONS The HADS-A is recommended for use in individuals with stable COPD. The lack of high-quality evidence on the validity of the HADS-D and HADS-T prevented drawing robust conclusions about their clinical utility in COPD.
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Affiliation(s)
| | - Lara Gamgoum
- School of Rehabilitation Sciences, McMaster University, Hamilton, Canada
| | - Arshpreet Deol
- School of Rehabilitation Sciences, McMaster University, Hamilton, Canada
| | - Shea Quilichini
- School of Rehabilitation Sciences, McMaster University, Hamilton, Canada
| | - Ethan Kazemir
- School of Rehabilitation Sciences, McMaster University, Hamilton, Canada
| | | | - Ana Oliveira
- School of Rehabilitation Sciences, McMaster University, Hamilton, Canada
- West Park Healthcare Centre, Toronto, Canada
- School of Health Sciences, Lab 3R Respiratory Research and Rehabilitation Laboratory, University of Aveiro (ESSUA), IBMED, Aveiro, Portugal
| | - Dina Brooks
- School of Rehabilitation Sciences, McMaster University, Hamilton, Canada
- West Park Healthcare Centre, Toronto, Canada
- Department of Physical Therapy and Rehabilitation Science, University of Toronto, Toronto, Canada
| | - Sanaa Alsubheen
- School of Rehabilitation Sciences, McMaster University, Hamilton, Canada
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Verweel L, Packham T, Goldstein R, Brooks D, MacKay C. Implementation of virtual pulmonary rehabilitation during the COVID-19 pandemic: Experiences and perceptions of patients and healthcare providers. Respir Med 2024; 225:107588. [PMID: 38460709 DOI: 10.1016/j.rmed.2024.107588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 02/29/2024] [Accepted: 03/06/2024] [Indexed: 03/11/2024]
Abstract
BACKGROUND Pulmonary rehabilitation (PR) plays an important role in the management of symptomatic patients with chronic respiratory diseases (CRD). While studies have investigated the feasibility and efficacy of virtual PR (VPR), it is important to understand the experiences of patients and healthcare providers (HCPs) during the rapid digital health transformation that occurred in the COVID-19 pandemic. OBJECTIVES To explore the experiences and perspectives of patients and HCPs who participated in VPR during the pandemic. METHODS Semi-structured interviews were conducted with CRD patients and HCPs. This study used a qualitative descriptive approach and a team-based inductive thematic analysis. RESULTS Participants included 11 HCPs (7 female; 29-55 years) and 19 CRD patients (11 male; 62-83 years; 15 COPD, 4 COPD/ILD). Three major themes and 10 subthemes were identified: i) the pandemic response: a 'trial by fire' (navigating uncertainty, emotional impact of change, shifting practice amid complexity); ii) beyond the emergency: navigating a 'new normal' (eligibility and assessment for VPR, virtual exercise, virtual education and resources, clinical supervision and patient safety); and iii) care beyond boundaries: the implications of using technology for PR (benefits and limitations of technology, psychosocial implications, VPR in the future). CONCLUSION The pivot to VPR was acknowledged as positive by both patients and HCPs although both groups were mindful of the implementation challenges. These findings provide insight into the experience of HCPs and patients in introducing VPR in response to the pandemic and will inform future implementation of VPR for individuals with CRD.
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Affiliation(s)
- L Verweel
- School of Rehabilitation Sciences, McMaster University, Hamilton, Canada; West Park Healthcare Centre, Toronto, Canada.
| | - T Packham
- School of Rehabilitation Sciences, McMaster University, Hamilton, Canada
| | - R Goldstein
- School of Rehabilitation Sciences, McMaster University, Hamilton, Canada; West Park Healthcare Centre, Toronto, Canada; Departments of Medicine and Physical Therapy, University of Toronto, Toronto, Canada
| | - D Brooks
- School of Rehabilitation Sciences, McMaster University, Hamilton, Canada; West Park Healthcare Centre, Toronto, Canada
| | - C MacKay
- West Park Healthcare Centre, Toronto, Canada; Departments of Medicine and Physical Therapy, University of Toronto, Toronto, Canada
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Farley C, Brooks D, Newman ANL. The effects of inspiratory muscle training on physical function in critically ill adults: Protocol for a systematic review and meta-analysis. PLoS One 2024; 19:e0300605. [PMID: 38517914 PMCID: PMC10959358 DOI: 10.1371/journal.pone.0300605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 02/29/2024] [Indexed: 03/24/2024] Open
Abstract
INTRODUCTION Inspiratory muscle training (IMT) is one possible strategy to ameliorate respiratory muscle weakness due to invasive mechanical ventilation. Recent systematic reviews have focused on respiratory outcomes with minimal attention to physical function. The newest systematic review searched the literature until September 2017 and a recent preliminary search identified 5 new randomized controlled trials focusing on IMT in critical care. As such, a new systematic review is warranted to summarize the current body of evidence and to investigate the effect of IMT on physical function in critical care. MATERIALS AND METHODS We will search for three main concepts ("critical illness", "inspiratory muscle training", "RCT") across six databases from their inception (MEDLINE, EMBASE, Emcare, AMED, CINAHL, CENTRAL) and ClinicalTrials.gov. Two reviewers will independently screen titles, abstracts, and full texts for eligibility using the Covidence web-based software. Eligible studies must include: (1) adult (≥18 years) patients admitted to the intensive care unit (ICU) who required invasive mechanical ventilation for ≥24 hours, (2) an IMT intervention using a threshold device with the goal of improving inspiratory muscle strength, with or without usual care, and (3) randomized controlled trial design. The primary outcome of interest will be physical function. We will use the Cochrane Risk of Bias Tools (ROB2) and will assess the quality of the evidence using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) tool. This protocol has been reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA- P) guidelines and is registered with the International Prospective Register of Systematic Reviews (PROSPERO). CONCLUSION Results will summarize the body of evidence of the effect of IMT on physical function in critically ill patients. We will submit our findings to a peer-reviewed journal and share our results at conferences.
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Affiliation(s)
- Christopher Farley
- Faculty of Health Science, School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Dina Brooks
- Faculty of Health Science, School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
- Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, Canada
- Faculty of Medicine, Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
- Rehabilitation Sciences Institute, School of Graduate Studies, University of Toronto, Toronto, ON, Canada
- Faculty of Medicine, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Anastasia N. L. Newman
- Faculty of Health Science, School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
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5
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Du X, Brooks D, Oh P, Marzolini S. Sex Differences in Depressive Symptoms in 1308 Patients Post-Stroke at Entry to Cardiac Rehabilitation. J Cardiopulm Rehabil Prev 2024:01273116-990000000-00131. [PMID: 38300273 DOI: 10.1097/hcr.0000000000000848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2024]
Abstract
PURPOSE The objective of this study was to determine whether a sex difference exists in the prevalence of post-stroke depressive symptoms (PSDS) at entry to cardiac rehabilitation (CR) and to determine the correlates of PSDS in all patients, and in women and men separately. METHODS People post-stroke at entry to CR from database records (2006-2017) were included. Bivariate analyses identified PSDS correlates (≥16 on the Center for Epidemiologic Studies Depression Scale) in all patients and women and men separately. RESULTS Patients (n = 1308, 28.9% women), mean age of 63.9 ± 12.9 yr, were 24.2 ± 49.9 mo post-stroke at CR entry. Among all patients, 30.0% had PSDS. A greater proportion of women than men had PSDS (38.6 vs 26.6%; P < .001). Correlates of PSDS in all patients were sex (women) (OR = 1.6: 95% CI, 1.14-2.12), being unemployed, ≤60 yr old, prescribed antidepressant medication, having lower cardiorespiratory fitness (peak oxygen uptake [V˙ O2peak ]), chronic obstructive pulmonary disease (COPD), higher body mass index (BMI), no transient ischemic attack, and longer time from stroke to CR entry (>12 mo). Correlates in women were being obese (BMI ≥ 30), 51-70 yr old, prescribed antidepressant medication, and not married. Correlates in men were being ≤60 yr old, unemployed, prescribed antidepressant medication, having lower V˙ O2peak , sleep apnea, COPD, and no hypertension. CONCLUSION Women were disproportionately affected by PSDS at entry to CR in bivariate and multivariable analyses. Women and men had mostly unique correlates of PSDS, indicating tailored strategies to address PSDS are required. Post-stroke depressive symptoms disproportionately affected patients with longer delay to CR entry, suggesting efforts should target timely referral to facilitate earlier and repeated assessments and management.
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Affiliation(s)
- XiaoWei Du
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada (Ms Du and Drs Brooks, Oh, and Marzolini); KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada (Ms Du and Drs Oh and Marzolini); School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada (Dr Brooks); and Faculty of Kinesiology & Physical Education, University of Toronto, Toronto, Ontario, Canada (Drs Oh and Marzolini)
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Paixão C, Rocha V, Brooks D, Marques A. Unsupervised physical activity interventions for people with COPD: A systematic review and meta-analysis. Pulmonology 2024; 30:53-67. [PMID: 35151622 DOI: 10.1016/j.pulmoe.2022.01.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 01/09/2022] [Accepted: 01/10/2022] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION AND OBJECTIVES Unsupervised PA interventions might have a role in the management of chronic obstructive pulmonary disease (COPD) but their effectiveness is largely unknown. Thus, we aimed to identify and synthesise data on the effects of unsupervised PA interventions in people with COPD. MATERIAL AND METHODS Databases were systematically searched in April 2020, with weekly updates until September 2021. Randomised controlled trials and quasi-experimental studies comparing unsupervised PA with usual care, were included. Primary outcomes were dyspnoea, exercise capacity and physical activity. The effect direction plot was performed to synthesise results. Meta-analysis with forest plots were conducted for the Chronic Respiratory Disease questionnaire - dyspnoea domain (CRQ-D), 6-minute walk distance (6MWD) and incremental shuttle walk distance (ISWD). RESULTS Eleven studies with 900 participants with COPD (68±10 years; 58.8% male, FEV1 63.7±15.8% predicted) were included. All interventions were conducted at home, most with daily sessions, for 8-12 weeks. Walking was the most common component. The effect direction plot showed that unsupervised PA interventions improved emotional function, fatigue, health-related quality of life, muscle strength and symptoms of anxiety and depression. Meta-analysis showed statistical, but not clinical, significant improvements in dyspnoea (CRQ-D, MD=0.12, 95% CI 0.09-0.15) and exercise capacity, measured with 6MWD (MD=13.70, 95% CI 3.58-23.83). Statistical and clinical significant improvements were observed in exercise capacity, measured with ISWD (MD=58.59, 95% CI 5.79-111.39). None to minor adverse events and a high adherence rate were found. CONCLUSIONS Unsupervised PA interventions benefits dyspnoea and exercise capacity of people with COPD, are safe and present a high adherence rate. Unsupervised PA interventions should be considered for people with COPD who cannot or do not want to engage in supervised PA interventions or as a maintenance strategy of PA levels.
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Affiliation(s)
- C Paixão
- Lab3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences (ESSUA), University of Aveiro, Aveiro, Portugal; iBiMED - Institute of Biomedicine, University of Aveiro, Aveiro, Portugal; Department of Medical Sciences, University of Aveiro, Aveiro, Portugal
| | - V Rocha
- Lab3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences (ESSUA), University of Aveiro, Aveiro, Portugal; iBiMED - Institute of Biomedicine, University of Aveiro, Aveiro, Portugal
| | - D Brooks
- School of Rehabilitation Sciences, McMaster University, Hamilton, Canada; West Park Healthcare Centre, Toronto, Canada
| | - A Marques
- Lab3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences (ESSUA), University of Aveiro, Aveiro, Portugal; iBiMED - Institute of Biomedicine, University of Aveiro, Aveiro, Portugal.
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Selzler AM, Ellerton C, Ellerton L, Habash R, Nekolaichuk E, Goldstein R, Brooks D. The Relationship between Physical Activity, Depression and Anxiety in People with COPD: A Systematic Review and Meta-analyses. COPD 2023; 20:167-174. [PMID: 37184039 DOI: 10.1080/15412555.2023.2200826] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Depression and anxiety are related to physical activity among people with chronic obstructive pulmonary disease (COPD), although the strength and direction of the reported relationships are inconsistent. This study systematically synthesized the relationships between physical activity and i) depression and ii) anxiety in people with COPD. Physical activity measurement type (objective, self-report) was examined as a moderator of these relationships. A systematic search of physical activity and COPD was conducted from inception to February 2022 across 8 databases. Studies were included if they provided correlation coefficients for the relationship between measures of physical activity and depression or anxiety in people with COPD and were published in English. Two reviewers independently screened, reviewed and extracted data, with discrepancies resolved by a third reviewer. Across 13 studies, a small relationship was found between physical activity and depression, weighted r = -0.15, 95%CI [-0.21, -0.10], which was not moderated by physical activity measurement type. Across 8 studies, a negligible relationship was found between physical activity and anxiety, weighted r = -0.03, 95%CI [-0.11, 0.04], although this was moderated by physical activity measurement type, such that self-reported physical activity had a small negative relationship with anxiety (weighted r = -0.09, 95% CI [-0.15, -0.03]) and objectively measured physical activity had a small positive relationship (weighted r = 0.07, 95% CI [-0.13, 0.26]). In COPD, the bivariate association between physical activity and anxiety and depression are small.
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Affiliation(s)
- Anne-Marie Selzler
- Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, Canada
| | - Cindy Ellerton
- Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, Canada
| | - Lauren Ellerton
- Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, Canada
| | - Razanne Habash
- Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, Canada
| | - Erica Nekolaichuk
- Gerstein Science and Information Centre, University of Toronto Libraries, Toronto, ON, Canada
| | - Roger Goldstein
- Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, Canada
- Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Rehabilitation Sciences Institute, School of Graduate Studies, University of Toronto, Toronto, ON, Canada
- Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Dina Brooks
- Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, Canada
- Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Rehabilitation Sciences Institute, School of Graduate Studies, University of Toronto, Toronto, ON, Canada
- Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- School of Rehabilitation Science, Faculty of Health Science, McMaster University, Hamilton, ON, Canada
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Butler SJ, Louie AV, Sutradhar R, Paszat L, Brooks D, Gershon AS. Palliative Care Among Lung Cancer Patients With and Without COPD: A Population-Based Cohort Study. J Pain Symptom Manage 2023; 66:611-620.e4. [PMID: 37619760 DOI: 10.1016/j.jpainsymman.2023.08.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 08/16/2023] [Accepted: 08/16/2023] [Indexed: 08/26/2023]
Abstract
CONTEXT Lung cancer patients with chronic obstructive pulmonary disease (COPD) may have greater palliative care needs due to poor prognosis and symptom burden. OBJECTIVES We sought to compare the provision of timely palliative care and symptom burden by COPD status. METHODS We performed a retrospective, population-based cohort study of individuals diagnosed with lung cancer in Ontario, Canada (2009-2019) using health administrative databases and cancer registries. The impact of COPD on the probability of receiving palliative care was determined accounting for dying as a competing event, overall and stratified by stage. The provision of palliative care for patients with severe symptoms (Edmonton Symptom Assessment Scale score ≥ 7), location of the first palliative care visit and symptom severity were compared by COPD status. RESULTS A total of 74,993 patients were included in the study (48% of patients had available symptom data). At the time of lung cancer diagnosis, 50% of patients had COPD. Stage I-III patients with COPD were more likely to receive palliative care (adjusted Hazard Ratio (HR)s: 1.05-1.31) with no difference for stage IV (1.02, 95% CI: 1.00-1.04). Despite having severe symptoms, very few patients with early-stage disease received palliative care (Stage I: COPD-23% vs. no COPD-18%, SMD = 0.12). Most patients (84%) reported severe symptoms and COPD worsened symptom burden, especially among early-stage patients. CONCLUSION COPD impacts the receipt of palliative care and symptom burden for patients with early-stage lung cancer. Many patients with severe symptoms did not receive palliative care, suggesting unmet needs among this vulnerable population.
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Affiliation(s)
- Stacey J Butler
- Institute of Medical Sciences (S.J.B., A.S.G.), University of Toronto, Toronto, ON, Canada; ICES (S.J.B., R.K., L.P., A.S.G.), Toronto, ON, Canada; Sunnybrook Research Institute (S.J.B., A.V.L., R.S., L.P., A.S.G.), Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Alexander V Louie
- Sunnybrook Research Institute (S.J.B., A.V.L., R.S., L.P., A.S.G.), Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Rinku Sutradhar
- ICES (S.J.B., R.K., L.P., A.S.G.), Toronto, ON, Canada; Sunnybrook Research Institute (S.J.B., A.V.L., R.S., L.P., A.S.G.), Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Dalla Lana School of Public Health (R.S.), University of Toronto, Toronto, ON, Canada
| | - Lawrence Paszat
- ICES (S.J.B., R.K., L.P., A.S.G.), Toronto, ON, Canada; Sunnybrook Research Institute (S.J.B., A.V.L., R.S., L.P., A.S.G.), Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Institute of Health Policy (L.P., ASG), Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Dina Brooks
- School of Rehabilitation Sciences (D.B.), McMaster University, Hamilton, ON, Canada
| | - Andrea S Gershon
- Institute of Medical Sciences (S.J.B., A.S.G.), University of Toronto, Toronto, ON, Canada; ICES (S.J.B., R.K., L.P., A.S.G.), Toronto, ON, Canada; Sunnybrook Research Institute (S.J.B., A.V.L., R.S., L.P., A.S.G.), Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Institute of Health Policy (L.P., ASG), Management and Evaluation, University of Toronto, Toronto, ON, Canada.
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9
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Ilicic AM, Brooks D, Kho M, Goldstein R, Oliveira A. Cough Assessment and Management in Pulmonary Rehabilitation- A Canadian Survey. COPD 2023; 20:71-79. [PMID: 36656707 DOI: 10.1080/15412555.2022.2141622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Pulmonary rehabilitation is a cornerstone intervention for controlling respiratory symptoms in people with chronic respiratory diseases. Chronic cough affects up to 90% of people with chronic respiratory diseases, however, it is currently unknown whether chronic cough is assessed and/or managed in pulmonary rehabilitation. This study aimed to determine if and how chronic cough is assessed and managed in pulmonary rehabilitation. This was a cross-sectional study. Pulmonary rehabilitation programs in Canada were identified via online websites. A representative from each program was invited to complete an online survey including the following topics: program demographics, assessment and management practices, and barriers and facilitators. Of 133 programs contacted, 31 returned a completed survey (23% response rate). Approximately half (52%) of respondents reported enrolling patients with chronic cough. Of those, 45% reported assessing and 62% reported intervening in chronic cough. Inadequate knowledge of assessment and management techniques was commonly identified to be a barrier and increased education was suggested as a possible facilitator. Based on pulmonary rehabilitation programs that responded to our survey, chronic cough is a prevalent symptom; however, it is scarcely assessed and managed. A need for structured education and the use of standardised strategies were reported as facilitators to the assessment and management of chronic cough in pulmonary rehabilitation.
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Affiliation(s)
- Ana Maria Ilicic
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Dina Brooks
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada.,West Park Healthcare Centre, Respiratory Medicine, Toronto, Ontario, Canada.,Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Michelle Kho
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada.,St Joseph's Healthcare, Physiotherapy Department, Hamilton, Ontario, Canada.,St. Joseph's Healthcare, The Research Institute of St. Joe's, Hamilton, Ontario, Canada
| | - Roger Goldstein
- West Park Healthcare Centre, Respiratory Medicine, Toronto, Ontario, Canada.,Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Ana Oliveira
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada.,West Park Healthcare Centre, Respiratory Medicine, Toronto, Ontario, Canada.,Lab 3R Respiratory Research and Rehabilitation Laboratory, University of Aveiro (ESSUA), Aveiro, Portugal.,iBiMED - Institute of Biomedicine, Department of Medical Sciences, University of Aveiro, Aveiro, Portugal
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Rebelo P, Teixeira A, Pinto R, Santos C, Brooks D, Marques A. Intensity of exercise in people with COPD enrolled in community-based physical activities. Pulmonology 2023:S2531-0437(23)00199-X. [PMID: 38008703 DOI: 10.1016/j.pulmoe.2023.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 09/25/2023] [Accepted: 11/02/2023] [Indexed: 11/28/2023] Open
Affiliation(s)
- P Rebelo
- Lab3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro, Aveiro, Portugal; iBiMED - Institute of Biomedicine, Department of Medical Sciences, University of Aveiro, Aveiro, Portugal
| | - A Teixeira
- City council of Estarreja, Sports division, Estarreja, Portugal
| | - R Pinto
- City council of Estarreja, Sports division, Estarreja, Portugal
| | - C Santos
- City council of Estarreja, Sports division, Estarreja, Portugal
| | - D Brooks
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada; West Park Healthcare Centre, Toronto, ON, Canada
| | - A Marques
- Lab3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro, Aveiro, Portugal; iBiMED - Institute of Biomedicine, Department of Medical Sciences, University of Aveiro, Aveiro, Portugal.
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Marzolini S, Robertson AD, MacIntosh BJ, Corbett D, Anderson ND, Brooks D, Koblinsky N, Oh P. Effect of High-Intensity Interval Training and Moderate-Intensity Continuous Training in People With Poststroke Gait Dysfunction: A Randomized Clinical Trial. J Am Heart Assoc 2023; 12:e031532. [PMID: 37947080 PMCID: PMC10727274 DOI: 10.1161/jaha.123.031532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 10/03/2023] [Indexed: 11/12/2023]
Abstract
Background The exercise strategy that yields the greatest improvement in both cardiorespiratory fitness (V ̇ O 2 peak $$ \dot{\mathrm{V}}{\mathrm{O}}_{2\mathrm{peak}} $$ ) and walking capacity poststroke has not been determined. This study aimed to determine whether conventional moderate-intensity continuous training (MICT) or high-intensity interval training (HIIT) have different effects on V ̇ O 2 peak $$ \dot{\mathrm{V}}{\mathrm{O}}_{2\mathrm{peak}} $$ and 6-minute walk distance (6MWD). Methods and Results In this 24-week superiority trial, people with poststroke gait dysfunction were randomized to MICT (5 days/week) or HIIT (3 days/week with 2 days/week of MICT). MICT trained to target intensity at the ventilatory anaerobic threshold. HIIT trained at the maximal tolerable treadmill speed/grade using a novel program of 2 work-to-recovery protocols: 30:60 and 120:180 seconds. V̇O2 and heart rate was measured during performance of the exercise that was prescribed at 8 and 24 weeks for treatment fidelity. Main outcomes were change in V ̇ O 2 peak $$ \dot{\mathrm{V}}{\mathrm{O}}_{2\mathrm{peak}} $$ and 6MWD. Assessors were blinded to the treatment group for V ̇ O 2 peak $$ \dot{\mathrm{V}}{\mathrm{O}}_{2\mathrm{peak}} $$ but not 6MWD. Secondary outcomes were change in ventilatory anaerobic threshold, cognition, gait-economy, 10-meter gait-velocity, balance, stair-climb performance, strength, and quality-of-life. Among 47 participants randomized to either MICT (n=23) or HIIT (n=24) (mean age, 62±11 years; 81% men), 96% completed training. In intention-to-treat analysis, change in V ̇ O 2 peak $$ \dot{\mathrm{V}}{\mathrm{O}}_{2\mathrm{peak}} $$ for MICT versus HIIT was 2.4±2.7 versus 5.7±3.1 mL·kg-1·min-1 (mean difference, 3.2 [95% CI, 1.5-4.8]; P<0.001), and change in 6MWD was 70.9±44.3 versus 83.4±53.6 m (mean difference, 12.5 [95% CI, -17 to 42]; P=0.401). HIIT had greater improvement in ventilatory anaerobic threshold (mean difference, 2.07 mL·kg-1·min-1 [95% CI, 0.59-3.6]; P=0.008). No other between-group differences were observed. During V̇O2 monitoring at 8 and 24 weeks, MICT reached 84±14% to 87±18% of V ̇ O 2 peak $$ \dot{\mathrm{V}}{\mathrm{O}}_{2\mathrm{peak}} $$ while HIIT reached 101±22% to 112±14% of V ̇ O 2 peak $$ \dot{\mathrm{V}}{\mathrm{O}}_{2\mathrm{peak}} $$ (during peak bouts). Conclusions HIIT resulted in more than a 2-fold greater and clinically important change in V ̇ O 2 peak $$ \dot{\mathrm{V}}{\mathrm{O}}_{2\mathrm{peak}} $$ than MICT. Training to target (ventilatory anaerobic threshold) during MICT resulted in ~3 times the minimal clinically important difference in 6MWD, which was similar to HIIT. These findings show proof of concept that HIIT yields greater improvements in cardiorespiratory fitness than conventional MICT in appropriately screened individuals. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT03006731.
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Affiliation(s)
- Susan Marzolini
- KITE Research Institute, Toronto Rehabilitation Institute, University Health NetworkTorontoONCanada
- Rehabilitation Sciences Institute, University of TorontoONCanada
- Faculty of Kinesiology and Physical Education, University of TorontoONCanada
| | | | - Bradley J. MacIntosh
- Sandra E Black Centre for Brain Resilience and Repair, Hurvitz Brain Sciences, Physical Sciences Platform, Sunnybrook Research InstituteTorontoONCanada
| | - Dale Corbett
- Department of Cellular and Molecular MedicineUniversity of OttawaONCanada
| | - Nicole D. Anderson
- Rotman Research Institute, Baycrest Academy for Research and EducationTorontoONCanada
| | - Dina Brooks
- KITE Research Institute, Toronto Rehabilitation Institute, University Health NetworkTorontoONCanada
- Rehabilitation Sciences Institute, University of TorontoONCanada
- McMaster University, Faculty of Health SciencesHamiltonONCanada
| | - Noah Koblinsky
- Rotman Research Institute, Baycrest Academy for Research and EducationTorontoONCanada
| | - Paul Oh
- KITE Research Institute, Toronto Rehabilitation Institute, University Health NetworkTorontoONCanada
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12
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Dasouki S, Quach S, Mancopes R, Mitchell SC, Goldstein R, Brooks D, Oliveira A. A Non-Pharmacological Cough Therapy for People with Interstitial Lung Diseases: A Case Report. Physiother Can 2023; 75:389-394. [PMID: 38037577 PMCID: PMC10686298 DOI: 10.3138/ptc-2021-0081] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 12/23/2021] [Accepted: 02/04/2022] [Indexed: 12/02/2023]
Abstract
Purpose To explore the feasibility of a non-pharmacological cough control therapy (CCT) customized for a client with interstitial lung disease (ILD). Client Description An 83-year-old female with hypersensitivity pneumonitis, and chronic cough for 18 years treated previously with pharmacological treatment for the underlying lung disease and gastroesophageal reflux disease, as well as lozenges and breathing and relaxation strategies. Intervention Four cough education and self-management sessions (45-60 minutes each) facilitated by a physiotherapist and speech-language pathologist via videoconference were conducted. Session topics included mechanisms of cough in ILD, breathing and larynx role in cough control, trigger identification, cough suppression and control strategies, and psychosocial support towards behaviour change using motivational interviewing. Measures and Outcome The following assessments were conducted prior to and one week after the intervention: semi-structured interviews, Leicester Cough Questionnaire, King's Brief Interstitial Lung Disease questionnaire, Functional Assessment of Chronic Illness Therapy Fatigue Scale, modified Borg Scale for severity and intensity of cough, and the Global Rating of Change Questionnaire. Implications Implementing the CCT was feasible. The client reported increased perceived cough control, a reduction in exhaustion from coughing bouts, and a better understanding of the mechanisms behind cough management and suppression. Improvements were also observed in cough-related quality of life, severity, and intensity.
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Affiliation(s)
- Sabrina Dasouki
- From the:
Respiratory Medicine, West Park Healthcare Centre, Toronto, Ontario, Canada
| | - Shirley Quach
- From the:
Respiratory Medicine, West Park Healthcare Centre, Toronto, Ontario, Canada
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Renata Mancopes
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
- Toronto Rehabilitation Institute, University Health Network, Swallowing Rehabilitation Research Laboratory, Toronto, Ontario, Canada
| | - Sarah Chamberlain Mitchell
- Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, United Kingdom
| | - Roger Goldstein
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Departments of Medicine and Physical Therapy and Rehabilitation Institute, University of Toronto, Toronto, Ontario, Canada
| | - Dina Brooks
- From the:
Respiratory Medicine, West Park Healthcare Centre, Toronto, Ontario, Canada
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Departments of Medicine and Physical Therapy and Rehabilitation Institute, University of Toronto, Toronto, Ontario, Canada
| | - Ana Oliveira
- From the:
Respiratory Medicine, West Park Healthcare Centre, Toronto, Ontario, Canada
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Lab3R – Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro, Aveiro, Portugal
- Institute for Biomedicine, University of Aveiro, Aveiro, Portugal
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13
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Selzler AM, Lee L, Brooks D, Kohli R, Rose L, Goldstein R. Exploring factors affecting the timely transition of ventilator assisted individuals in Ontario from acute to long-term care: Perspectives of healthcare professionals. Can J Respir Ther 2023; 59:223-231. [PMID: 37927454 PMCID: PMC10622171 DOI: 10.29390/001c.89103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 10/11/2023] [Indexed: 11/07/2023]
Abstract
Rationale Ventilator Assisted Individuals (VAIs) frequently remain in intensive care units (ICUs) for a prolonged period once clinically stable due to a lack of transition options. These VAIs occupy ICU beds and resources that patients with more acute needs could better utilize. Moreover, VAIs experience improved outcomes and quality of life in long-term and community-based environments. Objective To better understand the perspectives of healthcare providers (HCPs) working in an Ontario ICU regarding barriers and facilitators to referral and transition of VAIs from the ICU to a long-term setting. Methods We conducted semi-structured interviews with ten healthcare providers involved in VAI transitions. Main Results Perceived barriers included long wait times for long-term care settings, insufficient bed availability at discharge locations, medical complexity of patients, long waitlists, and a lack of transparency of waitlists. Facilitators included strong partnerships and trusting relationships between referring and discharge locations, a centralized referral system, and utilization of community partnerships across care sectors. Conclusions Insufficient resourcing of long-term care is a key barrier to transitioning VAIs from ICU to long-term settings; strong partnerships across care sectors are a facilitator. System-level approaches, such as a single-streamlined referral system, are needed to address key barriers to timely transition.
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Affiliation(s)
| | | | - Dina Brooks
- West Park Healthcare Centre
- McMaster University
- Departments of Medicine & Physical Therapy University of Toronto
| | | | - Louise Rose
- Florence Nightingale Faculty of Nursing King's College London
| | - Roger Goldstein
- West Park Healthcare Centre
- Departments of Medicine & Physical Therapy University of Toronto
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14
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Paixão C, Alves A, Grave AS, Ferreira PG, Brooks D, Marques A. Chester step test to identify functional impairment in interstitial lung disease. Pulmonology 2023:S2531-0437(23)00158-7. [PMID: 37743173 DOI: 10.1016/j.pulmoe.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 07/23/2023] [Accepted: 08/28/2023] [Indexed: 09/26/2023] Open
Affiliation(s)
- C Paixão
- Respiratory Research and Rehabilitation Laboratory (Lab3R), School of Health Sciences (ESSUA), University of Aveiro, Aveiro, Portugal; iBiMED - Institute of Biomedicine, Department of Medical Sciences, University Aveiro, Aveiro, Portugal
| | - A Alves
- REMEO Home Department, Linde Healthcare, Porto, Portugal
| | - A S Grave
- Respiratory Research and Rehabilitation Laboratory (Lab3R), School of Health Sciences (ESSUA), University of Aveiro, Aveiro, Portugal; iBiMED - Institute of Biomedicine, Department of Medical Sciences, University Aveiro, Aveiro, Portugal
| | - P G Ferreira
- ILD Outpatient Clinic, Pulmonology Department - Centro Hospitalar Universitário de Coimbra (CHUC), Coimbra, Portugal; Faculty of Medicine of University of Coimbra (FMUC), Coimbra, Portugal
| | - D Brooks
- School of Rehabilitation Science, McMaster University, Hamilton, Canada; West Park Healthcare Centre, Toronto, Canada
| | - A Marques
- Respiratory Research and Rehabilitation Laboratory (Lab3R), School of Health Sciences (ESSUA), University of Aveiro, Aveiro, Portugal; iBiMED - Institute of Biomedicine, Department of Medical Sciences, University Aveiro, Aveiro, Portugal.
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15
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Verweel L, Newman A, Michaelchuk W, Packham T, Goldstein R, Brooks D. The effect of digital interventions on related health literacy and skills for individuals living with chronic diseases: A systematic review and meta-analysis. Int J Med Inform 2023; 177:105114. [PMID: 37329765 DOI: 10.1016/j.ijmedinf.2023.105114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/28/2023] [Accepted: 05/29/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Chronic diseases are a leading cause of death and disease burden globally. Digital interventions could be an approach to improve patients' ability to find, evaluate, and use health information. OBJECTIVES The main objective was to conduct a systematic review to determine the effect of digital interventions on digital health literacy for patients living with chronic disease. Secondary objectives were to provide an overviewof the design and delivery characteristics of interventions that impact digital health literacy in people with chronic disease. METHODS Randomized controlled trials examining digital health literacy (and related components) for individuals with cardiovascular disease, chronic lung disease, osteoarthritis, diabetes, chronic kidney disease, and HIV were identified. This review was conducted following the PRIMSA guidelines. Certainty was assessed using GRADE and the Cochrane risk of bias tool. Meta-analyses were conducted using Review Manager 5.1. The protocol was registered on PROSPERO (CRD42022375967). RESULTS 9386 articles were identified and 17 articles representing 16 unique trials were included. Studies evaluated 5138 individuals with one or more chronic conditions (50% women, ages 42 ± 7-71 ± 12 years). The most targeted conditions were cancer, diabetes, cardiovascular disease, and HIV. Interventions included: skills training, websites, electronic personal health records, remote patient monitoring, and education. The effects of the interventions were related to: (i) digital health literacy, (ii) health literacy, (iii) health information skills, (iv) technology skills and access, and (v) self-management and participation in care. A meta-analysis of three studies identified the effect of digital interventions was better than usual care for eHealth literacy (1.22 [CI 0.55, 1.89], p < 0.001). CONCLUSIONS The evidence of the effects of digital interventions on related health literacy is limited. Existing studies reflect the heterogeneity in study design, population, and outcome measures. There is a need for further studies on the effects of digital interventions on related health literacy for individuals with chronic conditions.
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Affiliation(s)
- L Verweel
- School of Rehabilitation Sciences, McMaster University, Hamilton, Canada; West Park Healthcare Centre, Toronto, Canada.
| | - A Newman
- School of Rehabilitation Sciences, McMaster University, Hamilton, Canada; West Park Healthcare Centre, Toronto, Canada
| | - W Michaelchuk
- West Park Healthcare Centre, Toronto, Canada; Department of Physical Therapy, University of Toronto, Toronto, Canada
| | - T Packham
- School of Rehabilitation Sciences, McMaster University, Hamilton, Canada
| | - R Goldstein
- West Park Healthcare Centre, Toronto, Canada; Department of Physical Therapy, University of Toronto, Toronto, Canada
| | - D Brooks
- School of Rehabilitation Sciences, McMaster University, Hamilton, Canada; West Park Healthcare Centre, Toronto, Canada
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16
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Rebelo P, Antão J, Brooks D, Marques A. Effect of Data Reduction Techniques on Daily Moderate to Vigorous Physical Activity Collected with ActiGraph ® in People with COPD. J Clin Med 2023; 12:5340. [PMID: 37629381 PMCID: PMC10455487 DOI: 10.3390/jcm12165340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 07/06/2023] [Accepted: 08/15/2023] [Indexed: 08/27/2023] Open
Abstract
ActiGraph® is a valid, frequently used, accelerometer to quantify moderate to vigorous physical activities (MVPA) in people with COPD. The impact of ActiGraph processing techniques on this population is unknown. This study aimed to explore the effect of data reduction techniques on MVPA in people with COPD. MVPA/day, through ActiGraph GT3X+, was estimated using: Troiano, Freedson 98 and FreedsonVM3 cutoffs, 15-s and 60-s epochs, and normal and low-frequency extension (LFE) filters. Cutoff, epoch, and filter effects were explored with Aligned Rank Transform-ANOVA. Lin's concordance correlation coefficients and Bland-Altman plots were used to evaluate agreement and bias between different techniques. The analysis included 136 people with COPD (79% male; 68 ± 8 years; FEV1 51 ± 17% predicted). MVPA/day differed according to cutoff, filter, and epoch selection (p-value < 0.001). FreedsonVM3 cutoff, 15-s epochs, and LFE yielded the highest MVPA (45 min/day, 68% of physically active participants). Troiano cutoff, 60-s epochs, and normal filter yielded the lowest MVPA (8 min/day, 20% of physically active participants). Only comparisons between Troiano and Freedson98 cutoffs presented an almost perfect agreement. ActiGraph data reduction techniques affected MVPA/day estimates and their interpretation at the individual and group level. Studies using different processing criteria should not be compared in people with COPD. Future studies with a gold standard are required to ascertain which processing technique produces the most accurate MVPA estimates in COPD. Meanwhile, future trials employing the ActiGraph GT3X+ may consider estimating MVPA based on Freedson VM3 cutofffs, 60-s epochs, and normal filter.
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Affiliation(s)
- Patrícia Rebelo
- Lab3R—Respiratory Research and Rehabilitation Laboratory, School of Health Sciences (ESSUA), University of Aveiro, 3810-193 Aveiro, Portugal; (P.R.); (J.A.)
- iBiMED—Institute of Biomedicine, University of Aveiro, 3810-193 Aveiro, Portugal
- Department of Medical Sciences, University of Aveiro, 3810-193 Aveiro, Portugal
| | - Joana Antão
- Lab3R—Respiratory Research and Rehabilitation Laboratory, School of Health Sciences (ESSUA), University of Aveiro, 3810-193 Aveiro, Portugal; (P.R.); (J.A.)
- iBiMED—Institute of Biomedicine, University of Aveiro, 3810-193 Aveiro, Portugal
- Department of Medical Sciences, University of Aveiro, 3810-193 Aveiro, Portugal
- Department of Research and Development, Ciro, 6085 NM Horn, The Netherlands
- Department of Respiratory Medicine, Maastricht University Medical Centre, NUTRIM School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht University, 6200 MD Maastricht, The Netherlands
| | - Dina Brooks
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, ON L8S 1C7, Canada;
- West Park Healthcare Centre, Toronto, ON M6M 2J5, Canada
| | - Alda Marques
- Lab3R—Respiratory Research and Rehabilitation Laboratory, School of Health Sciences (ESSUA), University of Aveiro, 3810-193 Aveiro, Portugal; (P.R.); (J.A.)
- iBiMED—Institute of Biomedicine, University of Aveiro, 3810-193 Aveiro, Portugal
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17
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Selzler AM, Brooks D, Marques A, Souto-Miranda S, Goldstein R, Cruz J. Assessing caregiving experience in COPD: content validity of the Zarit Burden Interview in Canadian and Portuguese caregivers. Disabil Rehabil 2023; 45:2826-2836. [PMID: 35976167 DOI: 10.1080/09638288.2022.2107089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 07/20/2022] [Accepted: 07/23/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE Informal caregivers play an important role in chronic disease management but their experience is often neglected. The objective of this study was to explore the content validity of the Zarit Burden Interview (ZBI) in caregivers of individuals with COPD in Canada and Portugal. MATERIALS AND METHODS Cognitive debriefing interviews were conducted with informal caregivers of individuals with moderate to very severe COPD. Participants completed the ZBI and verbalised their thinking process to assess the adequacy of the questionnaire's content and instructions. Content validity was assessed using deductive content analysis of interviews and descriptive statistics of questionnaire responses. RESULTS Nine caregivers from Canada (age = 67 ± 8 years) and 13 from Portugal (age = 69 ± 7 years) participated. For Canadian caregivers, 3/22 items were not understood, and 8/22 items were not relevant to at least 1/3 of them. For Portuguese caregivers, 1/22 items were not understood, and 20/22 items were not relevant to at least 1/3 of them. The distribution of response choices was approximately symmetrical for 17/22 items in the Canadian sample. The response option "no/never" was selected by at least 75% of Portuguese participants for 18/22 items. CONCLUSIONS The instrument was well understood by caregivers of people with COPD, but its relevance is uncertain.IMPLICATIONS FOR REHABILITATIONInformal caregivers provide essential care for people living with disability and chronic disease, but their experience is often neglected.The Zarit Burden Interview assesses caregiver burden but has not been validated in caregivers of people with chronic obstructive pulmonary disease.In its current form, the Zarit Burden Interview does not adequately represent the experience of COPD caregivers.We recommend selecting tools that assess caregiver burden that have been validated in the caregiver population of interest.
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Affiliation(s)
| | - Dina Brooks
- Respiratory Medicine, West Park Healthcare Centre, Toronto, Canada
- Rehabilitation Science Institute, Department of Physical Therapy, University of Toronto, Toronto, Canada
- Department of Medicine, University of Toronto, Toronto, Canada
- School of Rehabilitation Science, McMaster University, Hamilton, Canada
| | - Alda Marques
- Lab3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal
- Institute of Biomedicine (iBiMED), University of Aveiro, Aveiro, Portugal
| | - Sara Souto-Miranda
- Lab3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal
- Institute of Biomedicine (iBiMED), University of Aveiro, Aveiro, Portugal
| | - Roger Goldstein
- Respiratory Medicine, West Park Healthcare Centre, Toronto, Canada
- Department of Medicine, University of Toronto, Toronto, Canada
| | - Joana Cruz
- Lab3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal
- Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Leiria, Portugal
- School of Health Sciences (ESSLei), Polytechnic of Leiria, Leiria, Portugal
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18
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Ryzer D, Bhatti B, Streicher A, Weinberg P, Hanna F, Moretto J, Brooks D, Quach S, Oliveira A. Cognitive Interventions in Individuals With Chronic Respiratory Diseases: Protocol for a Systematic Review. JMIR Res Protoc 2023; 12:e48235. [PMID: 37505801 PMCID: PMC10422171 DOI: 10.2196/48235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 06/23/2023] [Accepted: 06/27/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND Chronic respiratory diseases (CRDs) may cause reduced oxygen availability to organs and body tissues, leading to an increased risk for ischemic damage, which can result in brain tissue injury. This damage can lead to a myriad of neurological symptoms contributing to cognitive decline. Cognitive interventions may attenuate cognitive deficits in people with CRDs; however, the effects have not yet been systematically summarized in the literature. OBJECTIVE The purpose of this systematic review is to assess the effects of cognitive interventions (including cognitive behavioral therapy and transcranial brain stimulation) on cognitive function (primary outcome), HRQL, self-management, symptoms, physical activity, physical function, ability to complete activities of daily living (ADLs), hospital admissions, functional capacity, functional performance, psychological and social outcomes, exacerbations, healthcare utilization, and survival in individuals with CRDs. METHODS This review will be conducted in accordance with the Cochrane handbook for systematic reviews of interventions and reported following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Searches will be performed in MEDLINE, Embase, Emcare, PsycINFO, Scopus, and CINAHL. Articles will be included if they focus on the effects of cognitive interventions on adults with CRDs, are published in peer-reviewed journals, and are written in English, French, or Portuguese. Risk of bias will be evaluated with the Cochrane Risk of Bias 2 tool for randomized controlled trials, and the Risk of Bias in Non-randomized Studies of Interventions tool for nonrandomized studies. Meta-analyses will be performed if at least 2 studies provided sufficient data for a specific outcome. The GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) assessment will be used to evaluate the overall quality of the evidence. RESULTS This systematic review was initiated in November 2022 and registered with PROSPERO in February 2023, prior to title and abstract screening. Full-text screening of articles will be completed in June 2023. Data extraction and drafting of the manuscript will occur from July 2023 to August 2023, with expected publication in February 2024. CONCLUSIONS This systematic review will summarize the effects of cognitive interventions on cognitive function in people with CRDs. It will guide health care professionals in selecting evidence-based strategies to enhance cognitive well-being and overall health outcomes for individuals with CRDs. Additionally, it will identify research gaps and highlight areas for future exploration, supporting researchers in advancing knowledge in this field. TRIAL REGISTRATION PROSPERO CRD42023396234; https://tinyurl.com/mwjrfbxv. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/48235.
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Affiliation(s)
- Danielle Ryzer
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Bushra Bhatti
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Alana Streicher
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Paula Weinberg
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Fady Hanna
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Jessica Moretto
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Dina Brooks
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
- Respiratory Research, West Park Healthcare Center, Toronto, ON, Canada
- Department of Medicine, Rehabilitation Science Institute and Physical Therapy, University of Toronto, Toronto, ON, Canada
| | - Shirley Quach
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
- Respiratory Research, West Park Healthcare Center, Toronto, ON, Canada
| | - Ana Oliveira
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
- Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro, Aveiro, Portugal
- Institute of Biomedicine, Department of Medical Sciences, University of Aveiro, Aveiro, Portugal
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Butler SJ, Louie AV, Sutradhar R, Paszat L, Brooks D, Gershon AS. Association between COPD and Stage of Lung Cancer Diagnosis: A Population-Based Study. Curr Oncol 2023; 30:6397-6410. [PMID: 37504331 PMCID: PMC10377848 DOI: 10.3390/curroncol30070471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 06/26/2023] [Accepted: 07/01/2023] [Indexed: 07/29/2023] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is associated with an increased risk of lung cancer; however, the association between COPD and stage of lung cancer diagnosis is unclear. We conducted a population-based cross-sectional analysis of lung cancer patients (2008-2020) in Ontario, Canada. Using estimated propensity scores and inverse probability weighting, logistic regression models were developed to assess the association between COPD and lung cancer stage at diagnosis (early: I/II, advanced: III/IV), accounting for prior chest imaging. We further examined associations in subgroups with previously diagnosed and undiagnosed COPD. Over half (55%) of all lung cancer patients in Ontario had coexisting COPD (previously diagnosed: 45%, undiagnosed at time of cancer diagnosis: 10%). Compared to people without COPD, people with COPD had 30% lower odds of being diagnosed with lung cancer in the advanced stages (OR = 0.70, 95% CI: 0.68 to 0.72). Prior chest imaging only slightly attenuated this association (OR = 0.77, 95% CI: 0.75 to 0.80). The association with lower odds of advanced-stage diagnosis remained, regardless of whether COPD was previously diagnosed (OR = 0.68, 95% CI: 0.66 to 0.70) or undiagnosed (OR = 0.77, 95% CI: 0.73 to 0.82). Although most lung cancers are detected in the advanced stages, underlying COPD was associated with early-stage detection. Lung cancer diagnostics may benefit from enhanced partnership with COPD healthcare providers.
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Affiliation(s)
- Stacey J Butler
- Institute of Medical Sciences, University of Toronto, Toronto, ON M5S 1A8, Canada
- ICES, Toronto, ON M4N 3M5, Canada
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada
| | - Alexander V Louie
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada
| | - Rinku Sutradhar
- ICES, Toronto, ON M4N 3M5, Canada
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada
| | - Lawrence Paszat
- ICES, Toronto, ON M4N 3M5, Canada
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON M5T 3M6, Canada
| | - Dina Brooks
- School of Rehabilitation Sciences, McMaster University, Hamilton, ON L8S 1C7, Canada
| | - Andrea S Gershon
- Institute of Medical Sciences, University of Toronto, Toronto, ON M5S 1A8, Canada
- ICES, Toronto, ON M4N 3M5, Canada
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON M5T 3M6, Canada
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Newman ANL, Oliveira A, Goldstein R, Farley C, Nair P, Brooks D. The effects of pulmonary rehabilitation on inflammatory biomarkers in patients with chronic obstructive pulmonary disease: Protocol for a systematic review and meta-analysis. PLoS One 2023; 18:e0287549. [PMID: 37368891 DOI: 10.1371/journal.pone.0287549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 06/07/2023] [Indexed: 06/29/2023] Open
Abstract
INTRODUCTION Chronic obstructive pulmonary disease (COPD) is a common, preventable lung disease which affects more than 300 million people worldwide. People with COPD have elevated levels of inflammatory biomarkers, which are linked to physiological alterations in the respiratory system and extrapulmonary manifestations. Pulmonary rehabilitation (PR) is one of the strategies used in the management of individuals with COPD irrespective of severity, however its effect on systemic inflammation is poorly understood. We report the protocol of a systematic review on the effects of PR on systemic inflammation in patients with COPD. MATERIALS AND METHODS Using the search terms "chronic obstructive pulmonary disease", "pulmonary rehabilitation", and "inflammatory biomarkers" and their synonyms, five databases (AMED, CINAHL, Ovid MEDLINE, MEDLINE (Pubmed), EMBASE) will be searched from their inception to identify primary literature evaluating the effects of PR on systemic inflammation. Two reviewers will independently screen titles, abstracts, and full texts for eligibility using the Covidence web-based software. Eligible studies must be published in a peer-reviewed journal and include: (1) participants with COPD undergoing PR with an exercise component of at least 4 weeks in length and (2) a measure of systemic inflammation (e.g., bloodwork or sputum sample) as an outcome of interest. We will use the Cochrane Risk of Bias Tools (ROB2 and ROBINS-I) and will rate the quality of the evidence using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) tool. This protocol has followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) guidelines and is registered with the International Prospective Register of Systematic Reviews (PROSPERO). CONCLUSION The results of this systematic review will summarize the status of the evidence highlighting the effect of PR on systemic inflammation. A manuscript will be drafted and submitted to a peer-reviewed journal and shared at conferences.
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Affiliation(s)
- Anastasia N L Newman
- Faculty of Health Science, School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Ana Oliveira
- Faculty of Health Science, School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
- Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, Canada
- Lab 3R -Respiratory Research and Rehabilitation Laboratory, School of Health Sciences (ESSUA) and Institute of Biomedicine, Aveiro, Portugal
| | - Roger Goldstein
- Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, Canada
- Faculty of Medicine, Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
- Rehabilitation Sciences Institute, School of Graduate Studies, University of Toronto, Toronto, ON, Canada
- Faculty of Medicine, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Christopher Farley
- Faculty of Health Science, School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | | | - Dina Brooks
- Faculty of Health Science, School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
- Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, Canada
- Faculty of Medicine, Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
- Rehabilitation Sciences Institute, School of Graduate Studies, University of Toronto, Toronto, ON, Canada
- Faculty of Medicine, Department of Medicine, University of Toronto, Toronto, ON, Canada
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21
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Quach S, Michaelchuk W, Benoit A, Oliveira A, Packham TL, Goldstein R, Brooks D. Mobile heath applications for self-management in chronic lung disease: a systematic review. Netw Model Anal Health Inform Bioinform 2023; 12:25. [PMID: 37305790 PMCID: PMC10242585 DOI: 10.1007/s13721-023-00419-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 04/05/2023] [Accepted: 05/07/2023] [Indexed: 06/13/2023]
Abstract
Integration of mobile health (mHealth) applications (apps) into chronic lung disease management is becoming increasingly popular. MHealth apps may support adoption of self-management behaviors to assist people in symptoms control and quality of life enhancement. However, mHealth apps' designs, features, and content are inconsistently reported, making it difficult to determine which were the effective components. Therefore, this review aims to summarize the characteristics and features of published mHealth apps for chronic lung diseases. A structured search strategy across five databases (CINAHL, Medline, Embase, Scopus and Cochrane) was performed. Randomized controlled trials investigating interactive mHealth apps in adults with chronic lung disease were included. Screening and full-text reviews were completed by three reviewers using Research Screener and Covidence. Data extraction followed the mHealth Index and Navigation Database (MIND) Evaluation Framework (https://mindapps.org/), a tool designed to help clinicians determine the best mHealth apps to address patients' needs. Over 90,000 articles were screened, with 16 papers included. Fifteen distinct apps were identified, 8 for chronic obstructive pulmonary disease (53%) and 7 for asthma (46%) self-management. Different resources informed app design approaches, accompanied with varying qualities and features across studies. Common reported features included symptom tracking, medication reminders, education, and clinical support. There was insufficient information to answer MIND questions regarding security and privacy, and only five apps had additional publications to support their clinical foundation. Current studies reported designs and features of self-management apps differently. These app design variations create challenges in determining their effectiveness and suitability for chronic lung disease self-management. Registration: PROSPERO (CRD42021260205). Supplementary Information The online version contains supplementary material available at 10.1007/s13721-023-00419-0.
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Affiliation(s)
- Shirley Quach
- School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster University, Hamilton, ON Canada
- Respiratory Research, West Park Healthcare Center, Toronto, ON Canada
| | - Wade Michaelchuk
- Respiratory Research, West Park Healthcare Center, Toronto, ON Canada
- Rehabilitation Science Institute, Faculty of Medicine, University of Toronto, Toronto, ON Canada
| | - Adam Benoit
- Respiratory Research, West Park Healthcare Center, Toronto, ON Canada
| | - Ana Oliveira
- Respiratory Research, West Park Healthcare Center, Toronto, ON Canada
- Lab3R–Respiratory Research and Rehabilitation Laboratory, University of Aveiro (ESSUA), Aveiro, Portugal
| | - Tara L. Packham
- School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster University, Hamilton, ON Canada
| | - Roger Goldstein
- Respiratory Research, West Park Healthcare Center, Toronto, ON Canada
- Rehabilitation Science Institute, Faculty of Medicine, University of Toronto, Toronto, ON Canada
| | - Dina Brooks
- School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster University, Hamilton, ON Canada
- Respiratory Research, West Park Healthcare Center, Toronto, ON Canada
- Rehabilitation Science Institute, Faculty of Medicine, University of Toronto, Toronto, ON Canada
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Alsubheen SA, Ellerton C, Goldstein R, Brooks D. Validity and reliability of the University of California and Los Angeles Loneliness Scale in individuals with chronic obstructive pulmonary disease. Canadian Journal of Respiratory, Critical Care, and Sleep Medicine 2023. [DOI: 10.1080/24745332.2023.2176798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
Affiliation(s)
- Sanaa A. Alsubheen
- School of Rehabilitation Science, Faculty of Health Science, McMaster University, Hamilton, ON, Canada
| | - Cindy Ellerton
- Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, Canada
| | - Roger Goldstein
- School of Rehabilitation Science, Faculty of Health Science, McMaster University, Hamilton, ON, Canada
- Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, Canada
- Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Dina Brooks
- School of Rehabilitation Science, Faculty of Health Science, McMaster University, Hamilton, ON, Canada
- Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, Canada
- Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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23
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Michaelchuk W, Colella TJF, Goldstein RS, Brooks D. Wearable device for sedentary behavior change in chronic obstructive pulmonary disease is feasible and acceptable. Canadian Journal of Respiratory, Critical Care, and Sleep Medicine 2023. [DOI: 10.1080/24745332.2023.2177213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/10/2023]
Affiliation(s)
- Wade Michaelchuk
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
- West Park Healthcare Centre, Respiratory Medicine, Toronto, Ontario, Canada
| | - Tracey JF Colella
- Kite-Toronto Rehabilitation, University Health Network, Toronto, Ontario, Canada
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Roger S. Goldstein
- West Park Healthcare Centre, Respiratory Medicine, Toronto, Ontario, Canada
- Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Dina Brooks
- West Park Healthcare Centre, Respiratory Medicine, Toronto, Ontario, Canada
- Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
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Paixão C, Almeida S, Ferreira PG, Mendes MA, Brooks D, Marques A. Lifestyle integrated functional exercise for people with interstitial lung disease (iLiFE): A mixed-methods feasibility study. Heart Lung 2023; 60:20-27. [PMID: 36878103 DOI: 10.1016/j.hrtlng.2023.02.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 02/15/2023] [Accepted: 02/19/2023] [Indexed: 03/07/2023]
Abstract
BACKGROUND People with interstitial lung disease (ILD) present low levels of physical activity (PA) and spend most of their time at home, especially in advanced stages of the disease. The Lifestyle Integrated Functional Exercise for people with ILD (iLiFE) embedding PA in patients' daily routines was developed and implemented. OBJECTIVES This study aimed to explore the feasibility of iLiFE. METHODS A pre/post mixed-methods feasibility study was conducted. Feasibility of iLiFE was determined by participant recruitment/retention, adherence, feasibility of outcome measures and adverse events. Measures of PA, sedentary behaviour, balance, muscle strength, functional performance/capacity, exercise capacity, impact of the disease, symptoms (i.e., dyspnoea, anxiety, depression, fatigue and cough) and health-related quality of life were collected at baseline and post-intervention (12-weeks). Semi-structured interviews with participants were conducted in-person immediately after iLiFE. Interviews were audio-recorded, transcribed and analysed by deductive thematic analysis. RESULTS Ten participants (5♀, 77±3y; FVCpp 77.1 ± 4.4, DLCOpp 42.4 ± 6.6) were included, but only nine completed the study. Recruitment was challenging (30%) and retention high (90%). iLiFE was feasible, with excellent adherence (84.4%) and no adverse events. Missing data were associated with one dropout and non-compliance with the accelerometer (n = 1). Participants reported that iLiFE contributed to (re)gain control in their daily life, namely through improving their well-being, functional status and motivation. Weather, symptoms, physical impairments and lack of motivation were identified as threats to keep an active lifestyle. CONCLUSIONS iLiFE seems to be feasible, safe and meaningful for people with ILD. A randomised controlled trial is needed to strengthen these promising findings.
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Affiliation(s)
- Cátia Paixão
- Lab3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal; iBiMED - Institute of Biomedicine, University of Aveiro, Aveiro, Portugal; Department of Medical Sciences, University of Aveiro, Aveiro, Portugal
| | - Sara Almeida
- Lab3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal
| | - Pedro G Ferreira
- ILD Outpatient Clinic, Pulmonology Department - Centro Hospitalar Universitario de Coimbra (CHUC), Coimbra, Portugal; Faculty of Medicine of University of Coimbra (FMUC), Coimbra, Portugal- Coimbra, Portugal
| | - M Aurora Mendes
- Lab3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal; Pulmonology Department, Centro Hospitalar do Baixo Vouga, Aveiro, Portugal
| | - Dina Brooks
- School of Rehabilitation Science, McMaster University, Hamilton, Canada; West Park Healthcare Centre, Toronto, Canada - Hamilton, Canada
| | - Alda Marques
- Lab3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal; iBiMED - Institute of Biomedicine, University of Aveiro, Aveiro, Portugal.
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Oliveira A, Habash R, Ellerton L, Maybank A, Alsubheen S, Marques A, Goldstein R, Brooks D. Interstitial lung diseases specific measures in exercise interventions: A systematic review of measurement properties. Ann Phys Rehabil Med 2023; 66:101682. [PMID: 35659584 DOI: 10.1016/j.rehab.2022.101682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 05/01/2022] [Accepted: 05/04/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND Effects of exercise-based interventions (EBIs) on people with interstitial lung disease (ILD) are not yet fully understood. Reasons may include the limited use of ILD-specific measures and/or the lack of adequate information regarding their measurement properties. The purpose of this review was to summarize the ILD-specific outcome measures used in EBI studies and their measurement properties. METHODS This was a two-phase systematic review: phase 1 identified ILD-specific measures used in EBI studies; phase 2 reviewed their measurement properties. PubMed, Web of Science, Scopus, EBSCO and EMBASE were searched up to March 2021. One reviewer extracted data, and 2 reviewers independently assessed studies risk of bias as well as the quality of measurement properties using the Consensus-Based Standards for the Selection of Health Status Measurement Instruments (COSMIN) recommendations. RESULTS Phase 1 identified 18 records. The St George's Respiratory Questionnaire for Interstitial Pulmonary Fibrosis (SGRQ-IPF) was the only ILD-specific outcome measure used (n = 2 trials). Phase 2 resulted in 31 eligible records; measurement properties were reported for 12 measures. Measures presented sufficient content validity, internal consistency (Cronbach's alpha 0.61-0.96), test-retest reliability (intraclass correlation coefficient 0.39; 0.96), hypothesis testing and responsiveness but were insufficient for measurement error and indeterminate for cross-cultural and structural validity. The outcome measures King's Brief Interstitial Lung Disease and SGRQ-IPF had higher evidence of adequate measurement properties than other measures. Quality of the evidence was mostly very low to moderate. CONCLUSIONS ILD-specific outcome measures are used infrequently in EBI trials, and there is scarce information regarding their measurement properties. DATABASE REGISTRATION CRD42018112466.
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Affiliation(s)
- Ana Oliveira
- School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada; West Park Healthcare Centre, Toronto, Ontario, Canada; Lab3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal; iBiMED - Institute of Biomedicine, Department of Medical Sciences, University of Aveiro, Aveiro, Portugal.
| | | | | | - Aline Maybank
- West Park Healthcare Centre, Toronto, Ontario, Canada
| | - Sanaa Alsubheen
- School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Alda Marques
- Lab3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal; iBiMED - Institute of Biomedicine, Department of Medical Sciences, University of Aveiro, Aveiro, Portugal
| | - Roger Goldstein
- West Park Healthcare Centre, Toronto, Ontario, Canada; Department of Medicine, Physical Therapy and Rehabilitation Science Institute, University of Toronto, Ontario, Canada
| | - Dina Brooks
- School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada; West Park Healthcare Centre, Toronto, Ontario, Canada; Department of Medicine, Physical Therapy and Rehabilitation Science Institute, University of Toronto, Ontario, Canada
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Wiley E, Brooks D, MacDermid JC, Sakakibara B, Stratford PW, Tang A. Does peak expiratory flow moderate trajectories of cognitive function among individuals with lung diseases? A longitudinal analysis of the National Health and Aging Trends Study. Respir Med 2023; 207:107120. [PMID: 36646395 DOI: 10.1016/j.rmed.2023.107120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 01/11/2023] [Accepted: 01/13/2023] [Indexed: 01/15/2023]
Abstract
INTRODUCTION Impaired cognitive function can co-exist in chronic respiratory diseases. However, it is not clear if peak expiratory flow (PEF) impacts changes in cognitive function. Our objective was to explore whether peak expiratory flow moderates trajectories of memory, visuospatial abilities, and executive function in individuals with chronic respiratory diseases. METHODS This was an analysis of individuals with lung diseases from the National Health and Aging Trends Study. Multivariable-adjusted generalized linear mixed models were used to estimate trajectories of immediate and delayed recall, and clock drawing over a 10-year follow-up. The interaction between PEF and time were plotted using sex-specific values for peak expiratory flow at 10th, 50th and 90th percentiles. RESULTS In females, interactions of time-by-PEF were found for both immediate (n = 489, t = 2.73, p<0.01) and delayed recall (n = 489, t = 3.38, p<0.01). Females in the 10th vs. 90th percentile of PEF declined in immediate recall at 0.14 vs. 0.065 words/year, and 0.17 vs. 0.032 words/year for delayed recall. Among males, recall declined linearly over 10 years (immediate recall: n = 296, t = -3.08, p < 0.01; delayed recall: n = 292, t = -2.46, p = 0.02), with no interaction with PEF. There were no time-by-PEF interactions nor declines over time in clock drawing scores in both sexes (females: n = 484, t = 0.25, p = 0.81; males: n = 291, t = -0.61, p = 0.55). CONCLUSION Females with the lowest PEF values experienced the greatest rates of decline in immediate and delayed recall over 10 years of follow-up, whereas males experienced similar declines in memory outcomes across all levels of PEF. Clock drawing scores remained stable over 10 years in both sexes.
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Affiliation(s)
- Elise Wiley
- School of Rehabilitation Science, McMaster University, Hamilton, ON, L8S 1C7, Canada.
| | - Dina Brooks
- School of Rehabilitation Science, McMaster University, Hamilton, ON, L8S 1C7, Canada; Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, M6M 2J5, Canada; Department of Physical Therapy, University of Toronto, Toronto, ON, M5G 1V7, Canada.
| | - Joy C MacDermid
- School of Rehabilitation Science, McMaster University, Hamilton, ON, L8S 1C7, Canada; School of Physical Therapy, Western University, London, ON, N6A 1H1, Canada.
| | - Brodie Sakakibara
- Department of Occupational Science & Occupational Therapy, Centre for Chronic Disease Prevention and Management, Southern Medical Program, University of British Columbia, Kelowna, BC, V1V 1V7, Canada.
| | - Paul W Stratford
- School of Rehabilitation Science, McMaster University, Hamilton, ON, L8S 1C7, Canada.
| | - Ada Tang
- School of Rehabilitation Science, McMaster University, Hamilton, ON, L8S 1C7, Canada.
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Quach S, Benoit A, Oliveira A, Packham TL, Goldstein R, Brooks D. Features and characteristics of publicly available mHealth apps for self-management in chronic obstructive pulmonary disease. Digit Health 2023; 9:20552076231167007. [PMID: 37065541 PMCID: PMC10102951 DOI: 10.1177/20552076231167007] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 03/15/2023] [Indexed: 04/18/2023] Open
Abstract
Mobile health applications (mHealth apps) may be able to support people living with chronic obstructive pulmonary disease (COPD) to develop the appropriate skills and routines for adequate self-management. Given the wide variety of publicly available mHealth apps, it is important to be aware of their characteristics to optimize their use and mitigate potential harms. Objective To report the characteristics and features of publicly available apps for COPD self-management. Methods MHealth apps designed for patients' COPD self-management were searched in the Google Play and Apple app stores. Two reviewers trialed and assessed the eligible apps using the MHealth Index and Navigation Database framework to describe the characteristics, qualities, and features of mHealth apps across five domains. Results From the Google Play and Apple stores, thirteen apps were identified and eligible for further evaluation. All thirteen apps were available for Android devices, but only seven were available for Apple devices. Most apps were developed by for-profit organizations (8/13), non-profit organizations (2/13), and unknown developers (3/13). Many apps had privacy policies (9/13), but only three apps described their security systems and two mentioned compliance with local health information and data usage laws. Education was the common app feature; additional features were medication reminders, symptom tracking, journaling, and action planning. None provided clinical evidence to support their use. Conclusions Publicly available COPD apps vary in their designs, features, and overall quality. These apps lack evidence to support their clinical use and cannot be recommended at this time.
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Affiliation(s)
- Shirley Quach
- School of Rehabilitation Sciences,
McMaster University, Hamilton, Canada
- Respiratory Research, West Park Healthcare center, Toronto, Canada
- Shirley Quach, School of Rehabilitation
Science, McMaster University, IAHS, 1400 Main Street West Institute for Applied
Health Sciences (IAHS) Building - Room 403, Hamilton, ON L8S 1C7, Canada.
| | - Adam Benoit
- Respiratory Research, West Park Healthcare center, Toronto, Canada
| | - Ana Oliveira
- School of Rehabilitation Sciences,
McMaster University, Hamilton, Canada
- Respiratory Research, West Park Healthcare center, Toronto, Canada
- Lab3R – Respiratory Research and
Rehabilitation Laboratory, University of Aveiro
(ESSUA), Aveiro, Portugal
| | - Tara L. Packham
- School of Rehabilitation Sciences,
McMaster University, Hamilton, Canada
| | - Roger Goldstein
- Respiratory Research, West Park Healthcare center, Toronto, Canada
- Department of Medicine, University of
Toronto, Toronto, Canada
| | - Dina Brooks
- School of Rehabilitation Sciences,
McMaster University, Hamilton, Canada
- Respiratory Research, West Park Healthcare center, Toronto, Canada
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Hipólito N, Martins S, Ruivo A, Flora S, Silva CG, Marques A, Brooks D, Cruz J. Construct validity and reliability of the Informal Caregiver Burden Assessment Questionnaire (QASCI) in caregivers of patients with COPD. Respir Med 2022; 205:107027. [PMID: 36343503 DOI: 10.1016/j.rmed.2022.107027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 10/12/2022] [Accepted: 10/21/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION COPD often leads to loss of independence in daily activities which may increase the dependency on the informal caregiver, resulting in caregiving burden. Several instruments have been used to assess caregiving burden in COPD; however, their measurement properties have been poorly investigated in this population. This study assessed the construct validity and reliability of the Informal Caregiver Burden Assessment Questionnaire (QASCI) in informal caregivers of patients with COPD. METHODS Participants completed the QASCI (higher scores indicate higher burden) and the following questionnaires to assess construct validity: Zarit Burden Interview (ZBI), Hospital Anxiety and Depression Scale (HADS) and World Health Organization Quality of Life Instrument - Short Form (WHOQOL-Bref). QASCI was completed again one week later to assess test-retest reliability. Statistical analyses included: Pearson's (r) or Spearman's (ρ) correlations (construct validity); Cronbach's α (internal consistency); Intraclass Correlation Coefficient (ICC2,1, test-retest reliability) and Standard Error of Measurement (SEM), Minimal Detectable Change (MDC95) and Bland and Altman 95% Limits of Agreement (LoA). RESULTS Fifty caregivers (62.7 ± 9.8 years, 88% female; patients' FEV1 = 45.2 ± 21.3%predicted) participated. QASCI mean score was 28.5 ± 19.8 (moderate burden). QASCI was positively correlated with ZBI (r = 0.908; p < 0.01), HADS anxiety (r = 0.613; p < 0.01) and depression (ρ = 0.634; <0.01) and negatively correlated with WHOQOL-Bref (-0.476 to -0.739) (all p < 0.01). Cronbach's α was 0.793 for the QASCI total score (subscales: 0.747-0.932). The ICC2,1 was 0.924, SEM 2.8 and MDC95 7.8, and the LoA were -18.3 to 11.1. CONCLUSIONS The QASCI seems to be a promising measure to assess burden levels associated with informal caregiving in COPD.
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Affiliation(s)
- Nádia Hipólito
- Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Campus 5, Rua de Santo André, nº 66-68, 2410-541, Leiria, Portugal
| | - Sara Martins
- Clínica Albano da Silva Teixeira, R. Dom Afonso Henriques 27 A39, 3720-244, Oliveira de Azeméis, Portugal
| | - Adriana Ruivo
- Naturidade Porto de Mós, Unidade de Cuidados Continuados Integrados, R. dos Vales nº 5, 2480-109, Porto de Mós, Portugal
| | - Sofia Flora
- Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Campus 5, Rua de Santo André, nº 66-68, 2410-541, Leiria, Portugal
| | - Cândida G Silva
- Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Campus 5, Rua de Santo André, nº 66-68, 2410-541, Leiria, Portugal; School of Health Sciences, Polytechnic of Leiria, Campus 2, Morro do Lena, Alto do Vieiro - Apartado 4137, 2411-901, Leiria, Portugal; Coimbra Chemistry Centre, Department of Chemistry, University of Coimbra, 3004-535, Coimbra, Portugal
| | - Alda Marques
- Lab 3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences (ESSUA), University of Aveiro, Campus Universitário de Santiago, 3810-193, Aveiro, Portugal; Institute of Biomedicine (iBiMED), University of Aveiro, Campus Universitário de Santiago, 3810-193, Aveiro, Portugal
| | - Dina Brooks
- School of Rehabilitation Science, McMaster University, 1400 Main Street West Institute for Applied Health Sciences (IAHS) Building - Room 403, Hamilton, ON L8S 1C7, Canada; West Park Healthcare Centre, 82 Buttonwood Avenue, Toronto, ON M6M 2J5, Canada; University of Toronto, 27 King's College Cir, Toronto, ON M5S 1A1, Canada
| | - Joana Cruz
- Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Campus 5, Rua de Santo André, nº 66-68, 2410-541, Leiria, Portugal; School of Health Sciences, Polytechnic of Leiria, Campus 2, Morro do Lena, Alto do Vieiro - Apartado 4137, 2411-901, Leiria, Portugal; Lab 3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences (ESSUA), University of Aveiro, Campus Universitário de Santiago, 3810-193, Aveiro, Portugal.
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De B, Andres G, Bates C, Staren E, Kutscher E, Brooks D, Buscema J, Gin R, Thaker N. Total Cost of Cancer Care: Evaluating Health System Expenditures through Eight Performance Periods of the Oncology Care Model. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Pandey S, Krause E, DeRose J, MacCrann N, Jain B, Crocce M, Blazek J, Choi A, Huang H, To C, Fang X, Elvin-Poole J, Prat J, Porredon A, Secco L, Rodriguez-Monroy M, Weaverdyck N, Park Y, Raveri M, Rozo E, Rykoff E, Bernstein G, Sánchez C, Jarvis M, Troxel M, Zacharegkas G, Chang C, Alarcon A, Alves O, Amon A, Andrade-Oliveira F, Baxter E, Bechtol K, Becker M, Camacho H, Campos A, Carnero Rosell A, Carrasco Kind M, Cawthon R, Chen R, Chintalapati P, Davis C, Di Valentino E, Diehl H, Dodelson S, Doux C, Drlica-Wagner A, Eckert K, Eifler T, Elsner F, Everett S, Farahi A, Ferté A, Fosalba P, Friedrich O, Gatti M, Giannini G, Gruen D, Gruendl R, Harrison I, Hartley W, Huff E, Huterer D, Kovacs A, Leget P, McCullough J, Muir J, Myles J, Navarro-Alsina A, Omori Y, Rollins R, Roodman A, Rosenfeld R, Sevilla-Noarbe I, Sheldon E, Shin T, Troja A, Tutusaus I, Varga T, Wechsler R, Yanny B, Yin B, Zhang Y, Zuntz J, Abbott T, Aguena M, Allam S, Annis J, Bacon D, Bertin E, Brooks D, Burke D, Carretero J, Conselice C, Costanzi M, da Costa L, Pereira M, De Vicente J, Dietrich J, Doel P, Evrard A, Ferrero I, Flaugher B, Frieman J, García-Bellido J, Gaztanaga E, Gerdes D, Giannantonio T, Gschwend J, Gutierrez G, Hinton S, Hollowood D, Honscheid K, James D, Jeltema T, Kuehn K, Kuropatkin N, Lahav O, Lima M, Lin H, Maia M, Marshall J, Melchior P, Menanteau F, Miller C, Miquel R, Mohr J, Morgan R, Palmese A, Paz-Chinchón F, Petravick D, Pieres A, Plazas Malagón A, Sanchez E, Scarpine V, Serrano S, Smith M, Soares-Santos M, Suchyta E, Tarle G, Thomas D, Weller J. Dark Energy Survey year 3 results: Constraints on cosmological parameters and galaxy-bias models from galaxy clustering and galaxy-galaxy lensing using the redMaGiC sample. Int J Clin Exp Med 2022. [DOI: 10.1103/physrevd.106.043520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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O’Hoski S, Ellerton L, Selzler AM, Goldstein R, Brooks D. Priorities in Pulmonary Rehabilitation Research: The Patient Perspective. Physiother Can 2022; 74:257-264. [PMID: 37325205 PMCID: PMC10262837 DOI: 10.3138/ptc-2020-0081] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 02/25/2021] [Accepted: 03/01/2021] [Indexed: 08/26/2023]
Abstract
Purpose: We aimed to elicit patients' views of research priorities related to pulmonary rehabilitation (PR). Method:We used a modified nominal group technique in which participants with chronic lung conditions who had completed PR attended one of five meetings during which they generated ideas, discussed them with the group, and prioritized their top three topics. Afterward, they completed member checking and satisfaction questionnaires. Results:Fourteen participants (mean age 71 years) prioritized 25 topics, which included music as a motivator, education about the reason for various assessments and exercises, and ongoing patient assessment and follow-up. Most participants "totally agreed" that the summarized topics matched what they thought was important in PR research (75%) and that the meeting was a positive experience (100%). Participants indicated that the findings of this study accurately reflected their priorities. Conclusions:Individuals who have completed PR may have questions about programme components including assessment, treatment, and strategies for promoting motivation. To inform future research projects and identify knowledge translation needs, we will distribute a questionnaire to a larger sample of former PR patients to further prioritize the 25 topics identified in the meetings.
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Affiliation(s)
- Sachi O’Hoski
- Respiratory Research, West Park Healthcare Centre, Toronto, Ontario, Canada
- School of Rehabilitation Sciences, Institute of Applied Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Lauren Ellerton
- Respiratory Research, West Park Healthcare Centre, Toronto, Ontario, Canada
| | - Anne-Marie Selzler
- Respiratory Research, West Park Healthcare Centre, Toronto, Ontario, Canada
| | - Roger Goldstein
- Respiratory Research, West Park Healthcare Centre, Toronto, Ontario, Canada
- School of Rehabilitation Sciences, Institute of Applied Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Rehabilitation Sciences and Department of Physical Therapy, University of Toronto, Ontario, Toronto, Canada
| | - Dina Brooks
- Respiratory Research, West Park Healthcare Centre, Toronto, Ontario, Canada
- School of Rehabilitation Sciences, Institute of Applied Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Rehabilitation Sciences and Department of Physical Therapy, University of Toronto, Ontario, Toronto, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
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Eftekhar P, Li MH, Semple MJ, Richardson D, Brooks D, Mochizuki G, Dutta T. Investigation of the Kinematic Upper-Limb Movement Assessment (KUMA): A Pilot Study. Physiother Can 2022. [DOI: 10.3138/ptc-2019-0023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Purpose: Upper limb movement disorders are common after stroke and can severely impact activities of daily living. Available clinical measures of these disorders are subjective and may lack the sensitivity needed to track a patient’s progress and to compare different therapies. Kinematic analyses can provide clinicians with more objective measures for evaluating the effects of rehabilitation. We present a novel method to assess the quality of upper limb movement: the Kinematic Upper-limb Movement Assessment (KUMA). This assessment uses motion capture to provide three kinematic measures of upper limb movement: active range of motion, speed, and compensatory trunk movement. The researchers sought to evaluate the ability of the KUMA to distinguish motion in the affected versus unaffected limb. Method: We used the KUMA with three participants with stroke to assess three single-joint movements in: wrist flexion and extension, elbow flexion and extension, and shoulder flexion/extension and abduction/adduction. Participants also completed the Modified Ashworth Scale and the Chedoke-McMaster Stroke Assessment, two clinical measures of functional ability. Results: The KUMA distinguished between affected and unaffected upper limb motion. Conclusions: The KUMA provides clinicians with supplementary objective information for motion characterization that is not available through clinical measures alone. The KUMA can complement existing clinical measures such as the MAS and CMSA and can be helpful for monitoring patient progress.
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Affiliation(s)
- Parvin Eftekhar
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
- Toronto Rehabilitation Institute, Toronto, Ontario, Canada
- Sunnybrook Research Institute, Toronto, Ontario, Canada
- Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Toronto, Ontario, Canada
| | - Michael H. Li
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada
| | | | - Denyse Richardson
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
- Toronto Rehabilitation Institute, Toronto, Ontario, Canada
- Division of Physiatry, University of Toronto, Toronto, Ontario, Canada
| | - Dina Brooks
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
- Toronto Rehabilitation Institute, Toronto, Ontario, Canada
- Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Toronto, Ontario, Canada
- West Park Healthcare Centre, Toronto, Ontario, Canada
- Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
| | - George Mochizuki
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
- Toronto Rehabilitation Institute, Toronto, Ontario, Canada
- Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Toronto, Ontario, Canada
- Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Tilak Dutta
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
- Toronto Rehabilitation Institute, Toronto, Ontario, Canada
- Institute for Biomaterials and Biomechanical Engineering, University of Toronto, Toronto, Ontario, Canada
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Alsubheen SA, Beauchamp MK, Ellerton C, Goldstein R, Alison JA, Dechman G, Haines KJ, Harrison SL, Holland AE, Lee AL, Marques A, Spencer L, Stickland M, Skinner EH, Brooks D. Validity of the Activities-specific Balance Confidence Scale in individuals with chronic obstructive pulmonary disease. Expert Rev Respir Med 2022; 16:689-696. [DOI: 10.1080/17476348.2022.2099378] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Sanaa A. Alsubheen
- School of Rehabilitation Science, Faculty of Health Science, McMaster University,Hamilton, ON, Canada
| | - Marla K. Beauchamp
- School of Rehabilitation Science, Faculty of Health Science, McMaster University,Hamilton, ON, Canada
- Department of Respiratory Medicine, West Park Healthcare Centre, Toronto ON, Canada
| | - Cindy Ellerton
- Department of Respiratory Medicine, West Park Healthcare Centre, Toronto ON, Canada
- Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto ON, Canada
| | - Roger Goldstein
- Department of Respiratory Medicine, West Park Healthcare Centre, Toronto ON, Canada
- Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto ON, Canada
- Rehabilitation Sciences Institute, School of Graduate Studies, University of Toronto, Toronto ON, Canada
- Department of Medicine, Faculty of Medicine, University of Toronto, Toronto ON, Canada
| | - Jennifer A. Alison
- School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney NSW, Australia
- Allied Health, Sydney Local Health District, Sydney, Australia
| | - Gail Dechman
- School of Physiotherapy, Faculty of Health, Dalhousie University, Halifax NS, Canada
- Department of Medicine, Respirology, Dalhousie University and Nova Scotia Health Authority, Halifax NS, Canada
| | | | - Samantha L. Harrison
- School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom
| | - Anne E. Holland
- Department of Physiotherapy, Alfred Health, Melbourne VIC, Australia
- Respiratory Research, Monash University, Melbourne VIC, Australia
- Institute for Breathing and Sleep, Melbourne VIC, Australia
| | - Annemarie L. Lee
- Institute for Breathing and Sleep, Melbourne VIC, Australia
- Department of Physiotherapy, School of Primary and Allied Health Care, Monash University, Melbourne VIC, Australia
- Department of Allied Health Research, Cabrini Health, Malvern VIC, Australia
| | - Alda Marques
- Lab3R-Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, ESSUA) and Institute of Biomedicine, iBiMED), University of Aveiro, Aveiro, Portugal
| | - Lissa Spencer
- School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney NSW, Australia
- Department of Physiotherapy, Royal Prince Alfred Hospital, Camperdown NSW, Australia
| | - Michael Stickland
- Division of Pulmonary Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton AB, Canada
- G.F. MacDonald Centre for Lung Health, Covenant Health, Edmonton, AB, Canada
| | - Elizabeth H. Skinner
- Physiotherapy Department, Western Health, Melbourne VIC, Australia
- Department of Physiotherapy, School of Primary and Allied Health Care, Monash University, Melbourne VIC, Australia
| | - Dina Brooks
- Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto ON, Canada
- Rehabilitation Sciences Institute, School of Graduate Studies, University of Toronto, Toronto ON, Canada
- Department of Medicine, Faculty of Medicine, University of Toronto, Toronto ON, Canada
- Respiratory Research, Monash University, Melbourne VIC, Australia
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Ilicic AM, Oliveira A, Habash R, Kang Y, Kho M, Goldstein R, Brooks D. Non-pharmacological Management of Non-productive Chronic Cough in Adults: A Systematic Review. Front Rehabil Sci 2022; 3:905257. [PMID: 36188925 PMCID: PMC9397766 DOI: 10.3389/fresc.2022.905257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 05/03/2022] [Indexed: 11/23/2022]
Abstract
Background Chronic cough is a common reason for medical referral and its prevalence is on the rise. With only one pharmaceutical therapy currently under review for the treatment of refractory chronic cough, exploring non-pharmacological chronic cough management therapies is important. This systematic review summarizes the effectiveness of non-pharmacological chronic cough therapies in adults with non-productive refractory chronic cough or cough due to chronic respiratory diseases. Methods We searched Medline, Embase, Cochrane, CINAHL, and Scopus from inception to September 2021. Randomized controlled trials published in English, Portuguese, or French, and examining the effects of non-pharmacological therapies in adults with chronic non-productive cough (>8 weeks; <2 teaspoons sputum) were included. Mean differences, medians, and odds ratios were calculated as appropriate. Results 16,546 articles were identified and six articles representing five unique studies were included. Studies evaluated 228 individuals with refractory chronic cough or chronic cough due to a chronic respiratory disease [162 women (71%); 52 ± 11 to 61 ± 8 years old]. Obstructive sleep apnea was the only chronic respiratory disease studied. Non-pharmacological therapies included education, cough suppression, breathing techniques, mindfulness, and continuous positive airway pressure. When standing alone, non-pharmacological cough therapies improved cough-specific health related quality of life when not associated with interventions (mean diff MD 1.53 to 4.54), cough frequency (MD 0.59 95%CI 0.36 to 0.95), and voice outcomes (MD 0.3 to 1) when compared to control interventions. Conclusion The evidence of non-pharmacological therapies for non-productive chronic cough is limited. Existing studies reflect the heterogeneity in study design, sample size, and outcome measures. Thus, clinical recommendations for using the most effective interventions remain to be confirmed.
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Affiliation(s)
- Ana Maria Ilicic
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Ana Oliveira
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
- West Park Healthcare Centre, Toronto, ON, Canada
- Lab 3R Respiratory Research and Rehabilitation Laboratory, University of Aveiro (ESSUA), Aveiro, Portugal
- Department of Medical Sciences, iBiMED – Institute of Biomedicine, University of Aveiro, Aveiro, Portugal
| | | | - Yejin Kang
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Michelle Kho
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
- St. Joseph's Healthcare, Hamilton, ON, Canada
- The Research Institute of St. Joe's, St. Joseph's Healthcare, Hamilton, ON, Canada
| | - Roger Goldstein
- West Park Healthcare Centre, Toronto, ON, Canada
- Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
| | - Dina Brooks
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
- West Park Healthcare Centre, Toronto, ON, Canada
- Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
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Alsubheen SA, Beauchamp M, Ellerton C, Goldstein R, Alison J, Dechman G, Haines KJ, Harrison S, Holland A, Lee A, Marques A, Spencer L, Stickland M, Skinner EH, Brooks D. Age and Sex Differences in Balance Outcomes among Individuals with Chronic Obstructive Pulmonary Disease (COPD) at Risk of Falls. COPD 2022; 19:166-173. [PMID: 35392741 DOI: 10.1080/15412555.2022.2038120] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
No previous research has examined age and sex differences in balance outcomes in individuals with chronic obstructive pulmonary disease (COPD) at risk of falls. A secondary analysis of baseline data from an ongoing trial of fall prevention in COPD was conducted. Age and sex differences were analyzed for the Berg Balance scale (BBS), Balance Evaluation System Test (BEST test) and Activities-specific Balance Confidence Scale (ABC). Overall, 223 individuals with COPD were included. Females had higher balance impairments than males [BBS: mean (SD) = 47 (8) vs. 49 (6) points; BEST test: 73 (16) vs. 80 (16) points], and a lower confidence to perform functional activities [ABC = 66 (21) vs. 77 (19)]. Compared to a younger age (50-65 years) group, age >65 years was moderately associated with poor balance control [BBS (r = - 0.37), BEST test (r = - 0.33)] and weakly with the ABC scale (r = - 0.13). After controlling for the effect of balance risk factors, age, baseline dyspnea index (BDI), and the 6-min walk test (6-MWT) explained 38% of the variability in the BBS; age, sex, BDI, and 6-MWT explained 40% of the variability in the BEST test; And BDI and the 6-MWT explained 44% of the variability in the ABC scale. This study highlights age and sex differences in balance outcomes among individuals with COPD at risk of falls. Recognition of these differences has implications for pulmonary rehabilitation and fall prevention in COPD, particularly among females and older adults.
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Affiliation(s)
- Sanaa A Alsubheen
- School of Rehabilitation Science, Faculty of Health Science, McMaster University, Hamilton, ON, Canada.,Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, Canada
| | - Marla Beauchamp
- School of Rehabilitation Science, Faculty of Health Science, McMaster University, Hamilton, ON, Canada.,Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, Canada
| | - Cindy Ellerton
- Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, Canada.,Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Roger Goldstein
- Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, Canada.,Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Rehabilitation Sciences Institute, School of Graduate Studies, University of Toronto, Toronto, ON, Canada.,Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Jennifer Alison
- School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Gail Dechman
- School of Physiotherapy, Faculty of Health, Dalhousie University, Halifax, NS, Canada.,Department of Medicine, Respirology, Dalhousie University and Nova Scotia Health Authority, Halifax, NS, Canada
| | | | - Samantha Harrison
- School of Health and Social Care, Teesside University, Middlesbrough, UK
| | - Anne Holland
- Department of Physiotherapy, Alfred Health, Melbourne, VIC, Australia.,Department of Allergy, Immunology and Respiratory Medicine, Monash University, Melbourne, VIC, Australia.,Respiratory Research, Monash University, Melbourne, VIC, Australia.,Institute for Breathing and Sleep, Melbourne, VIC, Australia
| | - Annemarie Lee
- Institute for Breathing and Sleep, Melbourne, VIC, Australia.,Department of Physiotherapy, School of Primary and Allied Health Care, Monash University, Melbourne, VIC, Australia.,Centre for Allied Health Research and Education, Cabrini Health, Malvern, VIC, Australia
| | - Alda Marques
- Lab3R-Respiratory Research and Rehabilitation Laboratory, School of Health Sciences (ESSUA) and Institute of Biomedicine (iBiMED), University of Aveiro, Aveiro, Portugal
| | - Lissa Spencer
- Department of Physiotherapy, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - Michael Stickland
- Division of Pulmonary Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.,G.F. MacDonald Centre for Lung Health, Covenant Health, Edmonton, AB, Canada
| | - Elizabeth H Skinner
- Physiotherapy Department, Western Health, Melbourne, VIC, Australia.,Institute for Breathing and Sleep, Melbourne, VIC, Australia
| | - Dina Brooks
- Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Rehabilitation Sciences Institute, School of Graduate Studies, University of Toronto, Toronto, ON, Canada.,Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Department of Allergy, Immunology and Respiratory Medicine, Monash University, Melbourne, VIC, Australia
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Michaelchuk W, Oliveira A, Marzolini S, Nonoyama M, Maybank A, Goldstein R, Brooks D. Design and delivery of home-based telehealth pulmonary rehabilitation programs in COPD: A systematic review and meta-analysis. Int J Med Inform 2022; 162:104754. [PMID: 35395474 DOI: 10.1016/j.ijmedinf.2022.104754] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 02/24/2022] [Accepted: 03/27/2022] [Indexed: 12/11/2022]
Abstract
RATIONALE Home-based telehealth pulmonary rehabilitation (HTPR) for chronic obstructive pulmonary disease (COPD) is increasingly common partly due to the COVID-19 pandemic. However, optimal HTPR programming has not been described. This review provides a comprehensive overview of the design, delivery, and effects of HTPR for people with COPD. METHODS Relevant databases were searched to July 2021 for studies on adults with COPD utilizing information or communication technology to monitor or deliver HTPR. A meta-analysis was performed on a subset of randomized controlled trials. RESULTS Of 3124 records retrieved, 38 studies evaluating 1993 individuals with stable COPD (age 54-75 and FEV1 31-92% predicted) were included. Program components included exercise and education (n = 17) or exercise alone (n = 15) with in-clinic baseline assessments commonly conducted (n = 26). Few trials (n = 7) featured synchronous virtual exercise supervision. Aerobic exercise commonly involved walking (n = 14) and cycling (n = 11) and most programs included resistance training (n = 25). Exercise progressions and emergency action plans were inconsistently reported. Meta-analysis demonstrated HTPR was comparable to outpatient PR and had a greater effect than usual care for the modified Medical Research Council dyspnea scale (mean difference [95 %CI]: -0.49 [-0.77, -0.22], p < 0.01) and COPD Assessment Test score (-4.90 [-7.13, -2.67], p < 0.01). Neither HTPR nor outpatient PR impacted sedentary time or step count. Only 6% of studies reported race and no studies reported participant ethnicity. CONCLUSION This review revealed the heterogeneity of HTPR program designs in COPD. HTPR programs had similar effects to outpatient PR programs and greater effects than usual care for people with COPD.
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Affiliation(s)
- Wade Michaelchuk
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Canada; Westpark Healthcare Centre, Respiratory Medicine, Toronto, Canada
| | - Ana Oliveira
- Westpark Healthcare Centre, Respiratory Medicine, Toronto, Canada; School of Rehabilitation Science, McMaster University, Hamilton, Canada; Lab3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal; IBiMED - Institute of Biomedicine, University of Aveiro, Aveiro, Portugal
| | - Susan Marzolini
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Canada; KITE Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
| | - Mika Nonoyama
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Canada; Faculty of Health Sciences, Ontario Tech University, Canada
| | - Aline Maybank
- Westpark Healthcare Centre, Respiratory Medicine, Toronto, Canada; Medical Sciences, Dalhousie University, Halifax, Canada
| | - Roger Goldstein
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Canada; Westpark Healthcare Centre, Respiratory Medicine, Toronto, Canada; Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Canada
| | - Dina Brooks
- Westpark Healthcare Centre, Respiratory Medicine, Toronto, Canada; School of Rehabilitation Science, McMaster University, Hamilton, Canada; Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Canada.
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Nikolovski A, Gamgoum L, Deol A, Quilichini S, Kazemir E, Rhodenizer J, Oliveira A, Brooks D, Alsubheen S. Psychometric properties of the hospital anxiety and depression scale (HADS) in individuals with chronic obstructive pulmonary disease (COPD): A systematic review protocol (Preprint). JMIR Res Protoc 2022; 11:e37854. [PMID: 36136379 PMCID: PMC9539646 DOI: 10.2196/37854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 07/13/2022] [Accepted: 07/30/2022] [Indexed: 11/13/2022] Open
Abstract
Background In individuals with chronic obstructive pulmonary disease (COPD), anxiety and depression contribute to increased mortality and exacerbations, decreased physical functioning, and deteriorated health-related quality of life. The Hospital Anxiety and Depression Scale (HADS) is a patient-reported tool developed to measure symptoms of anxiety and depression in clinical settings. The HADS has been frequently used with individuals with COPD; however, its measurement properties lack critical appraisal in this population. Objective This review aims to summarize and critically appraise the validity, reliability, and responsiveness of the HADS in individuals with COPD. Methods Five electronic databases (MEDLINE, Embase, Scopus, PsychINFO, and Web of Science) will be systematically searched. Articles will be included if they assessed the measurement properties of the HADS in COPD; were published in a peer-reviewed journal; and were written in English. The COSMIN (Consensus-based Standards for the Selection of Health Measurement Instruments) guidelines will be used to assess the methodological quality and level of evidence in the selected studies. Results To date, 12 articles met the inclusion criteria and will be included in the systematic review. The results of the psychometric properties of HADS will be qualitatively summarized and compared against the criteria for good measurement properties. The overall quality of evidence will be graded using the modified Grading of Recommendations, Assessment, Development and Evaluation approach. We expect to complete the systematic review by December 2022. Conclusions This systematic review will be the first to evaluate the psychometric properties of the HADS in individuals with COPD. Given the negative impact of anxiety and depression on physical functioning and health-related quality of life, this systematic review provides an opportunity to use the HADS as a validated measurement tool for the assessment and treatment of anxiety and depression in individuals with COPD. Trial Registration PROSPERO CRD42022302064; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=302064 International Registered Report Identifier (IRRID) PRR1-10.2196/37854
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Affiliation(s)
| | - Lara Gamgoum
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Arshpreet Deol
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Shea Quilichini
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Ethan Kazemir
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | | | - Ana Oliveira
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
- West Park Healthcare Centre, Toronto, ON, Canada
- Lab 3R Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro, Aveiro, Portugal
| | - Dina Brooks
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
- West Park Healthcare Centre, Toronto, ON, Canada
- Department of Physical Therapy and Rehabilitation Science, University of Toronto, Toronto, ON, Canada
| | - Sanaa Alsubheen
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
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Gruber D, DiCarlo-Meacham A, Welch E, Rogers C, Brooks D, Dengler K. Younger women with more pronounced benefit from combination liposomal bupivacaine pudendal block during posterior colporrhaphy. Am J Obstet Gynecol 2022. [DOI: 10.1016/j.ajog.2021.12.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Miller E, Brooks D, O'Brien KK, Beavers L, Stratford P, Nonoyama M, Mori B. Assessing the inter-rater and intra-rater reliability of the Physical Therapy Competence Assessment for Airway Suctioning (PT-CAAS). Physiother Res Int 2022; 27:e1944. [PMID: 35174940 DOI: 10.1002/pri.1944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 12/01/2021] [Accepted: 01/29/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND AND PURPOSE The Physical Therapy Competence Assessment for Airway Suctioning (PT-CAAS) is a recently developed measure to assess the clinical competence of physiotherapists who perform airway suctioning with adults. The purpose of this study was to assess the inter-rater and intra-rater reliability of the PT-CAAS. METHODS Scoring rules were developed through expert consultation. Reliability was then assessed using nine videos of suctioning performed in a simulated learning environment. A repeated measures design was used, with two replicate sets of measurements made by each participant for all videos. Data were analyzed using a repeated measures model for the concurrent assessment of inter-rater and intra-rater reliability. Participants were physiotherapists with suctioning experience. RESULTS Twenty physiotherapists completed initial scoring and re-scoring for all nine videos; their data were included in the analysis. Intraclass correlation coefficients (ICCs) for inter-rater reliability ranged from 0.569 [lower one-sided 95% confidence interval (CI): 0.395; standard error of measurement (SEM): 0.963] for infection control to 0.759 (lower one-sided 95% CI: 0.612; SEM: 0.722) for post-suctioning assessment and care. The inter-rater ICC for overall performance was 0.752 (lower one-sided 95% CI: 0.602; SEM: 0.660). ICCs for intra-rater reliability ranged from 0.759 (lower one-sided 95% CI: 0.197; SEM 0.721) for infection control to 0.860 (lower one-sided 95% CI: 0.544; SEM: 0.550) for post-suctioning assessment and care. The intra-rater ICC for overall performance was 0.867 (lower one-sided 95% CI: 0.559; SEM: 0.483). DISCUSSION Evidence of moderate to good inter-rater and good intra-rater reliability was found; however, the results should be interpreted with caution given the wide CIs and relatively large SEMs. Improved assessor training and assessments of reliability using a larger sample size are recommended.
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Affiliation(s)
- Erin Miller
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada.,Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Dina Brooks
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada.,Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada.,School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada.,West Park Healthcare Centre, Toronto, Ontario, Canada.,Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Kelly K O'Brien
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada.,Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada.,Institute of Health Policy, Management and Evaluation (IHPME), University of Toronto, Toronto, Ontario, Canada
| | - Lindsay Beavers
- Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada.,Unity Health Toronto, Toronto, Ontario, Canada
| | - Paul Stratford
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Mika Nonoyama
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada.,Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada.,Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada.,Respiratory Therapy & Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Brenda Mori
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada.,Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
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Abbott T, Aguena M, Alarcon A, Allam S, Alves O, Amon A, Andrade-Oliveira F, Annis J, Avila S, Bacon D, Baxter E, Bechtol K, Becker M, Bernstein G, Bhargava S, Birrer S, Blazek J, Brandao-Souza A, Bridle S, Brooks D, Buckley-Geer E, Burke D, Camacho H, Campos A, Carnero Rosell A, Carrasco Kind M, Carretero J, Castander F, Cawthon R, Chang C, Chen A, Chen R, Choi A, Conselice C, Cordero J, Costanzi M, Crocce M, da Costa L, da Silva Pereira M, Davis C, Davis T, De Vicente J, DeRose J, Desai S, Di Valentino E, Diehl H, Dietrich J, Dodelson S, Doel P, Doux C, Drlica-Wagner A, Eckert K, Eifler T, Elsner F, Elvin-Poole J, Everett S, Evrard A, Fang X, Farahi A, Fernandez E, Ferrero I, Ferté A, Fosalba P, Friedrich O, Frieman J, García-Bellido J, Gatti M, Gaztanaga E, Gerdes D, Giannantonio T, Giannini G, Gruen D, Gruendl R, Gschwend J, Gutierrez G, Harrison I, Hartley W, Herner K, Hinton S, Hollowood D, Honscheid K, Hoyle B, Huff E, Huterer D, Jain B, James D, Jarvis M, Jeffrey N, Jeltema T, Kovacs A, Krause E, Kron R, Kuehn K, Kuropatkin N, Lahav O, Leget PF, Lemos P, Liddle A, Lidman C, Lima M, Lin H, MacCrann N, Maia M, Marshall J, Martini P, McCullough J, Melchior P, Mena-Fernández J, Menanteau F, Miquel R, Mohr J, Morgan R, Muir J, Myles J, Nadathur S, Navarro-Alsina A, Nichol R, Ogando R, Omori Y, Palmese A, Pandey S, Park Y, Paz-Chinchón F, Petravick D, Pieres A, Plazas Malagón A, Porredon A, Prat J, Raveri M, Rodriguez-Monroy M, Rollins R, Romer A, Roodman A, Rosenfeld R, Ross A, Rykoff E, Samuroff S, Sánchez C, Sanchez E, Sanchez J, Sanchez Cid D, Scarpine V, Schubnell M, Scolnic D, Secco L, Serrano S, Sevilla-Noarbe I, Sheldon E, Shin T, Smith M, Soares-Santos M, Suchyta E, Swanson M, Tabbutt M, Tarle G, Thomas D, To C, Troja A, Troxel M, Tucker D, Tutusaus I, Varga T, Walker A, Weaverdyck N, Wechsler R, Weller J, Yanny B, Yin B, Zhang Y, Zuntz J. Dark Energy Survey Year 3 results: Cosmological constraints from galaxy clustering and weak lensing. Int J Clin Exp Med 2022. [DOI: 10.1103/physrevd.105.023520] [Citation(s) in RCA: 106] [Impact Index Per Article: 53.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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41
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Amon A, Gruen D, Troxel M, MacCrann N, Dodelson S, Choi A, Doux C, Secco L, Samuroff S, Krause E, Cordero J, Myles J, DeRose J, Wechsler R, Gatti M, Navarro-Alsina A, Bernstein G, Jain B, Blazek J, Alarcon A, Ferté A, Lemos P, Raveri M, Campos A, Prat J, Sánchez C, Jarvis M, Alves O, Andrade-Oliveira F, Baxter E, Bechtol K, Becker M, Bridle S, Camacho H, Carnero Rosell A, Carrasco Kind M, Cawthon R, Chang C, Chen R, Chintalapati P, Crocce M, Davis C, Diehl H, Drlica-Wagner A, Eckert K, Eifler T, Elvin-Poole J, Everett S, Fang X, Fosalba P, Friedrich O, Gaztanaga E, Giannini G, Gruendl R, Harrison I, Hartley W, Herner K, Huang H, Huff E, Huterer D, Kuropatkin N, Leget P, Liddle A, McCullough J, Muir J, Pandey S, Park Y, Porredon A, Refregier A, Rollins R, Roodman A, Rosenfeld R, Ross A, Rykoff E, Sanchez J, Sevilla-Noarbe I, Sheldon E, Shin T, Troja A, Tutusaus I, Tutusaus I, Varga T, Weaverdyck N, Yanny B, Yin B, Zhang Y, Zuntz J, Aguena M, Allam S, Annis J, Bacon D, Bertin E, Bhargava S, Brooks D, Buckley-Geer E, Burke D, Carretero J, Costanzi M, da Costa L, Pereira M, De Vicente J, Desai S, Dietrich J, Doel P, Ferrero I, Flaugher B, Frieman J, García-Bellido J, Gaztanaga E, Gerdes D, Giannantonio T, Gschwend J, Gutierrez G, Hinton S, Hollowood D, Honscheid K, Hoyle B, James D, Kron R, Kuehn K, Lahav O, Lima M, Lin H, Maia M, Marshall J, Martini P, Melchior P, Menanteau F, Miquel R, Mohr J, Morgan R, Ogando R, Palmese A, Paz-Chinchón F, Petravick D, Pieres A, Romer A, Sanchez E, Scarpine V, Schubnell M, Serrano S, Smith M, Soares-Santos M, Tarle G, Thomas D, To C, Weller J. Dark Energy Survey Year 3 results: Cosmology from cosmic shear and robustness to data calibration. Int J Clin Exp Med 2022. [DOI: 10.1103/physrevd.105.023514] [Citation(s) in RCA: 42] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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42
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Beauchamp MK, Janaudis-Ferreira T, Wald J, Aceron R, Bhutani M, Bourbeau J, Brooks D, Dechman G, Goldstein R, Goodridge D, Hernandez P, Marciniuk D, Penz E, J. Ryerson C, Saey D, Stickland MK, Weatherald J. Canadian Thoracic Society position statement on rehabilitation for COVID-19 and implications for pulmonary rehabilitation. Canadian Journal of Respiratory, Critical Care, and Sleep Medicine 2022. [DOI: 10.1080/24745332.2021.1992939] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Marla K. Beauchamp
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | | | - Joshua Wald
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Raymond Aceron
- Faculty of Nursing, University of Alberta, Royal Alexandra Hospital, Edmonton, Alberta, Canada
| | - Mohit Bhutani
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Jean Bourbeau
- Research Institute of the McGill University Health Centre, McGill University, Montreal, Québec, Canada
| | - Dina Brooks
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Gail Dechman
- School of Physiotherapy, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Roger Goldstein
- West Park Healthcare Centre, University of Toronto, Toronto, Ontario, Canada
| | - Donna Goodridge
- West Park Healthcare Centre, University of Toronto, Toronto, Ontario, Canada
- Respiratory Research Centre, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Paul Hernandez
- West Park Healthcare Centre, University of Toronto, Toronto, Ontario, Canada
- Department of Medicine, Dalhousie University, Halifax, Nova Scotia Canada
| | - Darcy Marciniuk
- West Park Healthcare Centre, University of Toronto, Toronto, Ontario, Canada
- Division of Respirology, Critical Care and Sleep Medicine, and the Respiratory Research Centre, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Erika Penz
- West Park Healthcare Centre, University of Toronto, Toronto, Ontario, Canada
- Division of Respirology, Critical Care and Sleep Medicine, and the Respiratory Research Centre, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Christopher J. Ryerson
- West Park Healthcare Centre, University of Toronto, Toronto, Ontario, Canada
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Heart Lung Innovation, St. Paul’s Hospital, Vancouver, British Columbia, Canada
| | - Didier Saey
- West Park Healthcare Centre, University of Toronto, Toronto, Ontario, Canada
- Institut Universitaire de cardiologie et de pneumologie de Québec, Université Laval, Québec, Québec, Canada
| | - Michael K. Stickland
- West Park Healthcare Centre, University of Toronto, Toronto, Ontario, Canada
- G.F. MacDonald Centre for Lung Health & Alberta Health Services Medicine Strategic Clinical Network, Edmonton, Canada
| | - Jason Weatherald
- West Park Healthcare Centre, University of Toronto, Toronto, Ontario, Canada
- Department of Medicine, Division of Respirology, Libin Cardiovascular Institute, University of Calgary, Calgary, Alberta, Canada
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O’Hoski S, Ellerton C, Ellerton L, Brooks D, Goldstein R. Patient Priorities for Pulmonary Rehabilitation Research. J Patient Exp 2022. [DOI: 10.1177/23743735221107244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Patient engagement in setting research priorities may guide a clinical research program to ensure relevance to the target population. In this cross-sectional survey, people who had participated in pulmonary rehabilitation were asked to prioritize research topics relevant to this area. Twenty-four previously identified topics were presented under 7 themes. Respondents were asked to select all themes and topics of importance, and then to rank them in order of importance. Ninety-six responses were included. The top ranked topic in the top ranked theme was creating an after-maintenance program to keep patients on track.
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Affiliation(s)
- Sachi O’Hoski
- Respiratory Research, West Park Healthcare Centre, Toronto, Canada
- School of Rehabilitation Sciences, Institute of Applied Health Sciences, McMaster University, Hamilton, Canada
| | - Cindy Ellerton
- Respiratory Research, West Park Healthcare Centre, Toronto, Canada
| | - Lauren Ellerton
- Respiratory Research, West Park Healthcare Centre, Toronto, Canada
| | - Dina Brooks
- Respiratory Research, West Park Healthcare Centre, Toronto, Canada
- School of Rehabilitation Sciences, Institute of Applied Health Sciences, McMaster University, Hamilton, Canada
- Rehabilitation Sciences and Department of Physical Therapy, University of Toronto, Toronto, Canada
- Department of Medicine, University of Toronto, Toronto, Canada
| | - Roger Goldstein
- Respiratory Research, West Park Healthcare Centre, Toronto, Canada
- Rehabilitation Sciences and Department of Physical Therapy, University of Toronto, Toronto, Canada
- Department of Medicine, University of Toronto, Toronto, Canada
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44
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Rebelo P, Brooks D, Marques A. Measuring intensity during free-living physical activities in people with chronic obstructive pulmonary disease: a systematic literature review. Ann Phys Rehabil Med 2021; 65:101607. [PMID: 34818590 DOI: 10.1016/j.rehab.2021.101607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 09/20/2021] [Accepted: 09/24/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Measuring intensity of physical activity (PA) is important to ensure safety and the effectiveness of PA interventions in chronic obstructive pulmonary disease (COPD). OBJECTIVE This systematic review identified which outcomes, outcome measures and instruments have been used to assess single free-living PA-related intensity in people with COPD and compared the intensity level (light, moderate, vigorous) obtained by different outcome measures. METHODS PubMed, Scopus, Web of Science, Cochrane Library and EBSCO were searched for original studies of COPD and assessing single free-living PA-related intensity were included. Agreement was calculated as the number of agreements between 2 measures [same intensity level]/ number of comparisons using both measures*100. RESULTS We included 43 studies (1282 people with COPD, mean age 66 years, 65% men, 49% FEV1%pred) and identified 13 outcomes, 46 outcome measures and 22 instruments. The most-reported outcomes, outcome measures and instruments were dyspnoea with the Borg scale 0-10; cardiac function, via heart rate (HR) using HR monitors; and pulmonary gas exchange, namely oxygen consumption (VO2), using portable gas analysers, respectively. The most frequently assessed PAs were walking and lifting, changing or moving weights/objects. Agreement between the outcome measures ranged from 0 (%VO2peak vs metabolic equivalent of task [MET]; %HRpeak vs Fatigue Borg; MET vs walking speed) to 100% (%HRreserve vs dyspnoea Borg; fatigue and exertion Borg vs walking speed). %VO2peak/reserve elicited the highest intensity. Hence, Borg scores, %HRreserve and MET may underestimate PA-related intensity. CONCLUSIONS Various methodologies are used to assess single free-living PA-related intensity and yield different intensity levels for the same PA. Future studies, further exploring the agreement between the different outcome measures of PA-related intensity and discussing their advantages, disadvantages and applicability in real-world settings, are urgent. These would guide future worldwide recommendations on how to assess single free-living PA-related intensity in COPD, which is essential to optimise PA interventions and ensure patient safety.
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Affiliation(s)
- Patrícia Rebelo
- Lab3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal; iBiMED - Institute of Biomedicine, Department of Medical Sciences, University of Aveiro, Aveiro, Portugal
| | - Dina Brooks
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada; West Park Healthcare Centre, Toronto, ON, Canada
| | - Alda Marques
- Lab3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal; iBiMED - Institute of Biomedicine, Department of Medical Sciences, University of Aveiro, Aveiro, Portugal.
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45
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Alsubheen SA, Oliveira A, Habash R, Goldstein R, Brooks D. Systematic review of psychometric properties and cross-cultural adaptation of the University of California and Los Angeles loneliness scale in adults. Curr Psychol 2021; 42:1-15. [PMID: 34785877 PMCID: PMC8586628 DOI: 10.1007/s12144-021-02494-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2021] [Indexed: 12/30/2022]
Abstract
This systematic review assessed the psychometric properties and the cross-cultural adaptation of the University of California and Los Angeles Loneliness scale (UCLA-LS) in adults. A systematic search of four electronic databases (PubMed, EMBASE, Scopus, and PsycINFO) was conducted from inception until March 2021. We followed the Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines for data extraction and evidence synthesis. Eighty-one studies assessed the validity and reliability of the UCLA-LS, translated into many languages, and applied across several countries/societies. Three versions of the 20-item and nine short versions of the UCLA-LS with 3 to 20 questions were identified. High-quality evidence supported the internal structure of the UCLAs: 4, 6, 7 and 10, while low-to moderate-quality evidence supported the construct validity of the UCLAs: 3, 4, 6, 8, 16 and 20. Moderate-quality evidence supported the test-retest reliability of version 3 UCLA-20 with excellent interclass coefficients values of 0.76-0.93. The UCLAs: 4, 6, 7 and 10 had the most robust internal structure and may therefore be the most useful for informing clinicians and social psychologists engaged in assisting those with loneliness. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s12144-021-02494-w.
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Affiliation(s)
- Sanaa A. Alsubheen
- School of Rehabilitation Science, McMaster University, 1400 Main Street West, IAHS Building Room 430, Hamilton, ON L8S 1C7 Canada
| | - Ana Oliveira
- School of Rehabilitation Science, McMaster University, 1400 Main Street West, IAHS Building Room 430, Hamilton, ON L8S 1C7 Canada
- Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, ON Canada
- Lab3R – Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal
- Institute for Biomedicine (iBiMED), University of Aveiro, Aveiro, Portugal
| | - Razanne Habash
- Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, ON Canada
| | - Roger Goldstein
- Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, ON Canada
- Faculty of Medicine, University of Toronto, Toronto, ON Canada
| | - Dina Brooks
- School of Rehabilitation Science, McMaster University, 1400 Main Street West, IAHS Building Room 430, Hamilton, ON L8S 1C7 Canada
- Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, ON Canada
- Department of Physical Therapy and Rehabilitation Science, University of Toronto, Toronto, ON Canada
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46
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Flora S, Hipólito N, Brooks D, Marques A, Morais N, Silva CG, Silva F, Ribeiro J, Caceiro R, Carreira BP, Burtin C, Pimenta S, Cruz J, Oliveira A. Phenotyping Adopters of Mobile Applications Among Patients With COPD: A Cross-Sectional Study. Front Rehabilit Sci 2021; 2:729237. [PMID: 36188799 PMCID: PMC9397739 DOI: 10.3389/fresc.2021.729237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 10/13/2021] [Indexed: 11/13/2022]
Abstract
Effectiveness of technology-based interventions to improve physical activity (PA) in people with COPD is controversial. Mixed results may be due to participants' characteristics influencing their use of and engagement with mobile health apps. This study compared demographic, clinical, physical and PA characteristics of patients with COPD using and not using mobile apps in daily life. Patients with COPD who used smartphones were asked about their sociodemographic and clinic characteristics, PA habits and use of mobile apps (general and PA-related). Participants performed a six-minute walk test (6MWT), gait speed test and wore an accelerometer for 7 days. Data were compared between participants using (App Users) and not using (Non-App Users) mobile apps. A sub-analysis was conducted comparing characteristics of PA–App Users and Non-Users. 59 participants were enrolled (73% Male; 66.3 ± 8.3 yrs; FEV1 48.7 ± 18.4% predicted): 59% were App Users and 25% were PA-App Users. Significant differences between App Users and Non-App Users were found for age (64.2 ± 8.9 vs. 69.2 ± 6.3yrs), 6MWT (462.9 ± 91.7 vs. 414.9 ± 82.3 m), Gait Speed (Median 1.5 [Q1–Q3: 1.4–1.8] vs. 2.0 [1.0–1.5]m/s), Time in Vigorous PA (0.6 [0.2–2.8] vs. 0.14 [0.1–0.7]min) and Self-Reported PA (4.0 [1.0–4.0] vs. 1.0 [0.0–4.0] Points). Differences between PA–App Users and Non-Users were found in time in sedentary behavior (764.1 [641.8–819.8] vs. 672.2 [581.2–749.4] min) and self-reported PA (4.0 [2.0–6.0] vs. 2.0 [0.0–4.0] points). People with COPD using mobile apps were younger and had higher physical capacity than their peers not using mobile apps. PA-App Users spent more time in sedentary behaviors than Non-Users although self-reporting more time in PA.
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Affiliation(s)
- Sofia Flora
- Center for Innovative Care and Health Technology, Polytechnic of Leiria, Leiria, Portugal
| | - Nádia Hipólito
- Center for Innovative Care and Health Technology, Polytechnic of Leiria, Leiria, Portugal
| | - Dina Brooks
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
- West Park Healthcare Centre, Toronto, ON, Canada
| | - Alda Marques
- Respiratory Research and Rehabilitation Laboratory, School of Health Sciences (ESSUA), University of Aveiro, Aveiro, Portugal
- Institute of Biomedicine, University of Aveiro, Aveiro, Portugal
| | - Nuno Morais
- Center for Innovative Care and Health Technology, Polytechnic of Leiria, Leiria, Portugal
- School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal
- Centre for Rapid and Sustainable Product Development, Polytechnic Institute of Leiria, Leiria, Portugal
| | - Cândida G. Silva
- Center for Innovative Care and Health Technology, Polytechnic of Leiria, Leiria, Portugal
- School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal
- Department of Chemistry, Coimbra Chemistry Centre, University of Coimbra, Coimbra, Portugal
| | - Fernando Silva
- School of Technology and Management, Computer Science and Communications Research Centre, Polytechnic Institute of Leiria, Leiria, Portugal
| | - José Ribeiro
- School of Technology and Management, Computer Science and Communications Research Centre, Polytechnic Institute of Leiria, Leiria, Portugal
| | - Rúben Caceiro
- Center for Innovative Care and Health Technology, Polytechnic of Leiria, Leiria, Portugal
- School of Technology and Management, Computer Science and Communications Research Centre, Polytechnic Institute of Leiria, Leiria, Portugal
| | - Bruno P. Carreira
- Center for Innovative Care and Health Technology, Polytechnic of Leiria, Leiria, Portugal
- School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal
- Unidade de Saúde Familiar Pedro e Inês, ACeS Oeste Norte, Alcobaça, Portugal
| | - Chris Burtin
- Faculty of Rehabilitation Sciences, REVAL—Rehabilitation Research Center, Hasselt University, Diepenbeek, Belgium
- BIOMED—Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium
| | - Sara Pimenta
- Center for Innovative Care and Health Technology, Polytechnic of Leiria, Leiria, Portugal
| | - Joana Cruz
- Center for Innovative Care and Health Technology, Polytechnic of Leiria, Leiria, Portugal
- Respiratory Research and Rehabilitation Laboratory, School of Health Sciences (ESSUA), University of Aveiro, Aveiro, Portugal
- School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal
- *Correspondence: Joana Cruz
| | - Ana Oliveira
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
- West Park Healthcare Centre, Toronto, ON, Canada
- Respiratory Research and Rehabilitation Laboratory, School of Health Sciences (ESSUA), University of Aveiro, Aveiro, Portugal
- Institute of Biomedicine, University of Aveiro, Aveiro, Portugal
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Li LSK, Butler SJ, Ellerton L, Goldstein RS, Brooks D. Pain among Individuals with Chronic Respiratory Diseases Attending Pulmonary Rehabilitation. Physiother Can 2021; 73:304-312. [PMID: 34880534 DOI: 10.3138/ptc-2020-0015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Purpose: This study reports on the prevalence and impact of pain in individuals with different chronic respiratory diseases attending pulmonary rehabilitation (PR). Method: A retrospective review of medical records data was conducted for 488 participants who had attended a PR programme over a 2-year period. Data on pain and medication history taken from multidisciplinary medical records, together with participant demographics and PR outcomes, were extracted. We compared pain among participants with different types of chronic respiratory disease. Results: The overall prevalence of pain was 77%, with a significantly higher prevalence among individuals with obstructive lung diseases (80%) compared with restrictive lung diseases (69%; p = 0.04). Some participants (17%) who took pain medications did not discuss pain with their clinicians. The presence of pain and different reporting of pain did not have a negative impact on the PR programme completion rate (p = 0.74), improvements in exercise capacity (p = 0.51), or health-related quality of life (all four chronic respiratory disease questionnaire domains, p>0.05). Conclusions: The prevalence of pain is high among individuals with chronic respiratory disease attending PR. The presence or absence of pain was not negatively associated with the programme completion rate or PR outcomes; therefore, pain should not deter clinicians from referring patients to PR.
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Affiliation(s)
- Lok Sze Katrina Li
- Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia.,Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, Ontario, Canada
| | - Stacey J Butler
- Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, Ontario, Canada.,Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Lauren Ellerton
- Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, Ontario, Canada
| | - Roger S Goldstein
- Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, Ontario, Canada.,Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Dina Brooks
- Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, Ontario, Canada.,Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada.,School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
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48
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Wshah A, Selzler AM, Hill K, Brooks D, Goldstein R. Embedding a Behavior Change Program Designed to Reduce Sedentary Time Within a Pulmonary Rehabilitation Program Is Feasible in People With COPD. J Cardiopulm Rehabil Prev 2021; 42:45-51. [PMID: 34520411 DOI: 10.1097/hcr.0000000000000624] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE This study examined the feasibility of embedding a 4-wk intervention, which sought to reduce sedentary time (SED), into a pulmonary rehabilitation program (PRP) in people with chronic obstructive pulmonary disease. METHODS This was an intervention study that comprised one face-to-face session and three follow-up visits. Primary outcomes related to feasibility and included adherence to data completion undertaken before and during the intervention period, participant satisfaction with the intervention (out of 100%), and participant achievement of intervention goals. Secondary outcomes, collected before and after the intervention period, included SED and daily step count. RESULTS Of 28 eligible individuals approached to participate, 21 (75%) were enrolled and 19 (90%) completed the program (13 females; age 69.1 ± 8.7 yr). Sixteen participants (84%) were adherent to wearing a physical activity monitor before and during the intervention period. The satisfaction score was 90 ± 12%. Over the intervention period, a total of 73 intervention goals were set, of which 41 (56%) were achieved. The effect of the intervention on SED was unclear. CONCLUSIONS Embedding this intervention in a PRP appears to be feasible; however, its impact on SED should be further evaluated.
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Affiliation(s)
- Adnan Wshah
- Respiratory Medicine, West Park Healthcare Centre, Toronto, Ontario, Canada (Drs Wshah, Selzler, Brooks, and Goldstein); Rehabilitation Sciences Institute (Drs Wshah, Brooks, and Goldstein) and Department of Medicine (Drs Brooks and Goldstein), University of Toronto, Toronto, Ontario, Canada; Department of Physical and Occupational Therapy, Hashemite University, Zarqa, Jordan (Dr Wshah); School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia (Dr Hill); and School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada (Dr Brooks)
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49
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Abstract
Purpose: Guidelines for pulmonary rehabilitation (PR) include balance training but lack specific parameters. After a knowledge translation project at our site, clinicians modified the physiotherapy programme to facilitate the sustainability of balance training as part of PR. The purpose of this study was to explore whether the modified programme resulted in improved balance and balance confidence. A secondary aim was to provide information on the way in which balance training was operationalized as part of PR for clinicians wanting to incorporate it into an existing PR programme. Method: We conducted a retrospective study of patients with chronic obstructive pulmonary disease, enrolled in a 4- to 6-week inpatient PR programme over a 1-year period. Balance training was provided biweekly with a staff-to-patient ratio of 2:11. Participants completed the brief Balance Evaluation Systems Test (brief-BESTest) and Activities-Specific Balance Confidence (ABC) scale at the beginning and end of PR. Results: The 85 participants had a mean age of 69.5 (SD 9.0) years. After completing an average of 7.6 balance sessions (min-max 2-13), participants showed improvements in brief-BESTest (mean difference 3.2 [95% CI: 2.5, 3.9] points) and ABC (mean difference 7.8 [95% CI: 4.1, 11.5] percent). Conclusions: A staff-to-patient ratio of 2:11 and a training frequency of twice per week for 4-6 weeks improved balance. This result will inform how we incorporate balance training into existing PR programmes.
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Affiliation(s)
- Sachi O'Hoski
- Respiratory Research, West Park Healthcare Centre, Toronto, Ontario, Canada.,School of Rehabilitation Sciences, Institute of Applied Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Samantha L Harrison
- School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom
| | - Stacey Butler
- Respiratory Research, West Park Healthcare Centre, Toronto, Ontario, Canada.,Faculty of Medicine, Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Roger Goldstein
- Respiratory Research, West Park Healthcare Centre, Toronto, Ontario, Canada.,Faculty of Medicine, Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Dina Brooks
- Respiratory Research, West Park Healthcare Centre, Toronto, Ontario, Canada.,School of Rehabilitation Sciences, Institute of Applied Health Sciences, McMaster University, Hamilton, Ontario, Canada
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McDuff K, Benaim A, Wong M, Burley A, Gandhi P, Wallace A, Brooks D, Vaughan-Graham J, Patterson KK. Analyzing the Eye Gaze Behaviour of Students and Experienced Physiotherapists during Observational Movement Analysis. Physiother Can 2021; 73:129-135. [PMID: 34456422 DOI: 10.3138/ptc-2019-0047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Purpose: Physiotherapists use observational movement analysis (OMA) to inform clinical reasoning. This study aimed to (1) determine the feasibility of characterizing eye gaze behaviour during OMA with eye-tracking technology, (2) characterize experienced neurological physiotherapists' and physiotherapy students' eye gaze behaviour during OMA, and (3) investigate differences in eye gaze behaviour during OMA between physiotherapy students and experienced physiotherapists. Method: Eight students and eight physiotherapists wore an eye-tracking device while watching a video of a person with a history of stroke and subsequent concussion perform sit to stand. Feasibility criteria were (1) successful calibration of the eye tracker, and successful collection of data, for 80% of the participants and (2) moderate interrater reliability of the investigators, measured by intra-class correlation coefficients (ICCs). Three investigators independently recorded the participants' foveal fixations. Differences between physiotherapists and students in number of fixations, duration per fixation, and total duration of fixations were evaluated using unpaired t-tests, mean differences, and 95% CIs. Results: Data were collected for all participants. ICCs ranged from 0.64 to 0.78. Fixations by physiotherapists were shorter (mean 368.5 [SD 80.8] ms) and greater in number (mean 18.9 [SD 2.2]) than those by students (mean 459.0 [SD 64.2] ms, p = 0.03, and mean 15.9 [SD 2.7], p = 0.03), respectively. Conclusions: Measuring eye gaze behaviour during OMA using eye tracker technology is feasible. Physiotherapists made more fixations of shorter duration than students. Further investigation of how experienced therapists perform OMA and apply it to clinical reasoning may inform the instruction of OMA.
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Affiliation(s)
| | | | | | | | | | - Aaron Wallace
- KITE Research Institute, University Health Network, Toronto
| | - Dina Brooks
- Department of Physical Therapy.,KITE Research Institute, University Health Network, Toronto.,Rehabilitation Sciences Institute, University of Toronto.,School of Rehabilitation Science, McMaster University, Hamilton, Ont
| | - Julie Vaughan-Graham
- Department of Physical Therapy.,KITE Research Institute, University Health Network, Toronto
| | - Kara K Patterson
- Department of Physical Therapy.,KITE Research Institute, University Health Network, Toronto.,Rehabilitation Sciences Institute, University of Toronto
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