Hands-on Research
JUNE 19, 2024, 13h-18h15
Lethbridge-Layton-Mackay Rehabilitation Center
Abstracts of poster communications
Titles of poster presented in French (1 to 7)
1. Evaluation of hearing perception in adolescents and adults with behaviorally and objectively adjusted cochlear implants
Sandra Fortin, François Bergeron, Christine Turgeon
Université Laval, CIRRIS
Introduction: The cochlear implant (CI) is an effective solution for improving hearing in people with severe to profound hearing loss. However, the hearing ability of people with CIs remains variable. Hearing ability depends, among other things, on how the CI is fitted. The standard method of CI fitting is based on people’s perception of the sounds in their CI. This can be a complex process, as people often haven’t heard certain sounds for many years. Objective measurement of ear reflexes is another method of CI adjustment. Although this method is simpler, quicker to perform and can optimize hearing ability, it remains little used in clinical practice.
Objective: To compare the hearing ability of people wearing a CI adjusted using the behavioral method and the objective method.
Methodology: Fifty people aged 14 and over who have received a CI will participate in the project. These people will wear their CI adjusted according to each method for six weeks. The two methods will be compared on measures of : 1) sentence recognition; 2) syllable discrimination; 3) sound quality; and 4) lowest sounds heard.
Results: Hearing ability is expected to be equal or better when CI is adjusted using the objective method compared with the behavioral method.
Conclusion: If the objective method offers equal or superior hearing ability to the behavioral method, the objective method could be used more widely in clinical practice.
2. Deaf culture and the delivery of rehabilitation services to deaf adults; the perspective of healthcare professionals in Quebec
Sandy Poulin Mathieu Hotton, Norman Boucher
Université Laval
Introduction: Deaf adults are people who identify with deaf culture and express themselves mainly in sign language. Unfortunately, they have difficulty accessing health services. Even in the presence of a sign language interpreter, Deaf people express dissatisfaction with the rehabilitation services available to them in Quebec, which they feel are not culturally adapted. The American literature also points out that Deaf people experience acculturation stress when using health services. For example, they restrict their questions for fear of sounding foolish or being judged. On the other hand, workers in Quebec’s CRDPs (centers de réadaptation en déficience physique) report not knowing how to adapt their interventions to the needs of deaf adults. Knowledge of a culture and the ability to modulate one’s attitudes and behaviours in line with it refers to cultural competence. The deaf cultural competence of the interveners in the teams responsible for supporting the social participation of deaf adults in Quebec’s CRDPs is unknown.
Objective: To describe the cultural competence of workers in specialized rehabilitation programs for deaf adults in the province of Quebec. Specifically: 1) to describe stakeholders’ perceptions of their deaf cultural competence, 2) to describe stakeholders’ perspectives on facilitators and barriers to optimal rehabilitation service delivery to deaf adults, and 3) to characterize stakeholders’ deaf cultural competence.
Methodology: A simultaneous mixed design will be used to plan the descriptive-interpretive study and the survey. Qualitative data will be collected from stakeholders (from 4 CRDPs in the province) by means of semi-structured individual interviews. Quantitative data will be collected by electronic questionnaire.
Results: The results available at the symposium will be presented.
Conclusion: Potential spin-offs of the project will be presented. The results could help document the provision of rehabilitation services to deaf adults by Quebec’s CRDPs, determine cultural appropriateness, identify barriers and facilitators to the development of cultural competence, and ultimately improve the accessibility of rehabilitation and health services to the Deaf.
3. Interventions aimed at improving taste and smell: A scoping review
Sarah Hadjeres, Arnaud Saj, Marc Tewfik, Aurélie Houle, Lyne Boissonneault, Nathalie Farley, Perrine Ferre, Fanny Lecuyer, Myrian Grondin, Johannes A Frasnelli and Frédérique Poncet
Université de Montréal, McGill University, CIUSSS West-Central Montréal, CRIR
Loss of taste and smell are cardinal symptoms of COVID-19, and this symptomatology facilitates screening and diagnosis of this disease. These symptoms are also observed in other conditions such as Parkinson’s disease, traumatic brain injury and stroke. Anosmia and agueusia have significant repercussions on activities of daily living, and on the health of affected individuals (e.g. malnutrition, hygiene, safety risks). The aim of this review is to synthesize and analyze the various intervention methods offered to individuals with anosmia and agueusia in the literature. Using the 6-step methodology of Levac et al. the electronic search strategy was based on 6 databases. 138 studies were selected and analyzed. The results indicate a wide range of interventions, including olfactory training, acupuncture, zinc treatment and corticosteroid treatment. This information will serve as the basis for the design and development of a new, more effective rehabilitation approach to improve the quality of care for people affected by COVID-19.
4. Optimizing Transitions in Care and Outcomes for Individuals with Acquired Brain Injuries: How can digital health support care transitions?
Dorra Rakia Allegue, Catherine Marise Giroux , Despoina Petsani, Sara Ahmed
Université Laval, McGill University, Aristotle University
Navigating the healthcare system during the transition period (e.g. from hospital to home) is crucial to ensuring continuity of care and positive health outcomes for people with acquired brain injury (stroke and traumatic brain injury). Despite advances in care practices, there remains a need for systematic improvement in transition management. This study aims to explore the experiences of people with stroke during care transitions, focusing on how digital health can support decisions and tailor healthcare to their needs and preferences.
Methods: Three co-creation sessions were conducted with 18 stakeholders, including researchers, rehabilitation administrators and patient representatives. The sessions were recorded and transcribed for analysis. A conventional content analysis approach was used, using MAXQDA software, to identify common themes and potential areas for improvement in healthcare transitions. Results: Seven central themes emerged from the data analysis: “Data collection” (e.g., Outcome measures reported by e-patients), “Predictive analytics” (Use of artificial intelligence to anticipate patient needs and outcomes), “Resources” (technological, human and organizational), “Barriers to care” (gaps in service delivery, access to necessary technology), “Facilitators of effective transitions” (establishing case manager roles to guide patients through transitions of care), “Long-term goals and outcomes” (setting goals to reduce readmission rates), and “Use of tools and initiatives” (decision support systems to foster patient engagement and optimize care). In conclusion, this study argues for a data-driven, technologically integrated and patient-centric approach to advancing care transitions. Understanding how technology can improve care transitions can help direct patients to the right services and increase the value of care relative to costs.
5. Adaptation of the COOK configuration interface: the TRIAGE method
Mélanie Amaral Dos Santos, Maude Rondeau, Mireille Gagnon-Roy, Carolina Bottari
Université de Montréal, Université de Sherbrooke, Research Centre on Aging (CdRV), CIUSSS West-Central Montréal, CRIR, IURDPM
Introduction: Cognitive deficits after traumatic brain injury (TBI) have several functional impacts and hamper the performance of complex activities, such as meal preparation. Cognitive assistive technologies (CAT), such as the Cognitive Orthosis for coOOking (COOK), can compensate for these deficits. The configuration of COOK is carried out by occupational therapists, which requires gathering their opinions on the configuration process in order to adapt the technology to their needs.
Objectives: The aim of this study was to document occupational therapists’ perceptions of the priority modifications to be made to version 8 (V8) of the COOK configuration system, as well as the opinions of the IT team working on this technology as to the feasibility of these modifications.
Methodology: The TRIAGE method will be carried out with around 10 occupational therapists and 2 members of the DOMUS laboratory IT team, to reach a consensus on the priority and feasible modifications to be made to the COOK configuration platform. This method involves three stages: preparation, individual production and group production.
Benefits: The study will support the technology team in the process of adapting COOK technology while considering the needs of users of the configuration interface (occupational therapists). At the same time, occupational therapists will have the opportunity to familiarize themselves with COOK technology.
Next steps : Based on the results obtained, modifications will be made to the COOK configuration interface with a view to carrying out usability tests in a laboratory setting with occupational therapists and occupational therapy students.
6. Advocacy for Quality Rehabilitation Care and Services in Times of Pandemic: A Policy Brief
Perrine Ferré, Dahlia Kairy, Johanne Higgins, Diana Zidarov, Louis-David Beaulieu, Claude Vincent, Marie-Hélène Milot, Marie-Hélène Boudrias
McGill University, Université de Montréal, Université de Sherbrooke, BRAINlab, Jewish Rehabilitation Hospital, Research Centre on Aging, CIUSSS-de-l’Estrie CHUS, CRIR, IURDPM, CIRRIS, BioNR
During the first waves of the COVID-19 pandemic, the usual rehabilitation care trajectories were disrupted by the new prevention guidelines issued. A pan-provincial team of researchers worked together to analyze the impact of these guidelines on the quality of care and services in rehabilitation facilities designated to receive patients who had contracted COVID-19.
A mixed methodology was used to collect clinical data from over 900 medical records, and to consult some one hundred people who had experienced the first waves of the pandemic in rehabilitation: patients, therapists and managers. A deliberative workshop was held to identify priority solutions in the event of another crisis like the one experienced during the COVID-19 pandemic.
The results demonstrate the agility of healthcare facilities during this crisis. The trajectory of the designated centers enabled functional progress for all users, including those who contracted COVID-19. However, particularly for the latter, good clinical practices in rehabilitation were affected. Crucially, all patients were affected by social and physical isolation.
Stakeholders’ experiential knowledge was used to extract possible solutions, with a view to raising awareness and informing health and social services decision-makers in future crisis situations. The resulting policy brief is a useful knowledge mobilization tool, as well as an example of the potential for stakeholder influence on the rehabilitation system.
7. Conducting a realist review in rehabilitation: challenges and solutions
Nay El Hajj, Cindy Louis-Delsoin
Université de Montréal, IURDPM, CRIR
Introduction: Rehabilitation research often examines the effectiveness of interventions, without necessarily studying the mechanisms explaining the results obtained. The realist review helps to understand how and why an intervention works in a specific context. Nevertheless, gaps persist in the application of this method, restricting its use in health research.
Objectives: To identify the challenges encountered during the conduct of a realist review in rehabilitation, and potential solutions.
Methodology: A multiple-case study was conducted with rehabilitation researchers (n=4) who had conducted at least one realist review. In order to explore qualitatively the challenges and solutions evoked by the researchers, semi-structured interviews were conducted. These were based on the five stages of a realistic review proposed by Pawson et al. (2005), the theoretical framework of the study. Structuring the coding according to the theoretical framework, two independent coders inductively coded the transcripts with QDA Miner software (percentage of agreement=84.1%). Thematic analysis identified themes relating to obstacles and strategies for each stage of a realistic review.
Preliminary results: Two out of four interviews (P01, P04) revealed the following five challenges: Navigating abundant and diverse literature; Adapting methodology to varied contexts; Managing available resources; Mastering the complexity of unconventional analysis methods; Ensuring the rigor of conclusions despite process heterogeneity. Solutions have been developed for each challenge.
Next steps. Full analysis of the interviews will enrich these preliminary avenues, helping to guide a better application of realist review in rehabilitation.
Titles of poster presented in French (8 to 26)
8. Adapting to Change: Coping Experiences With The Vision Rehabilitation Process
Joshua Simmonds, Walter Wittich, PhD
Université de Montréal
Please note: you are visually impaired. The poster includes a QR code making it accessible in English and French.
Background: Being visually impaired is one of the most feared forms of disability. It is associated with social stigmatization, functional difficulties and psychological problems that seriously affect quality of life. When a visual impairment is diagnosed, referral to vision rehabilitation is (ideally) introduced early in the process. This process includes, among other things, orientation and mobility training, the teaching of adaptive technologies and the provision of psychosocial support with the overall aim of fostering independence and social integration. Objective: Although our understanding of coping with vision loss is well documented and some psychological interventions have been proposed, little is known about the coping process of individuals receiving vision rehabilitation, as no research has been conducted over time. Methods: A mixed-methods approach using qualitative triangulation will synthesize information from three studies. The first study is a literature review to determine what is currently known about the coping process when receiving vision rehabilitation. The second study is retrospective, using focus groups to examine how individuals had previously coped when receiving vision rehabilitation for the first time. The third study is prospective, implementing a qualitative longitudinal method to explore the coping process of newly referred individuals and their low vision therapist in response to receiving vision rehabilitation over 12 months. Anticipated results: Understanding the coping process and its role for those receiving vision rehabilitation will advance vision rehabilitation programs and service delivery. In addition, triangulated data from three studies will demonstrate the need to consider psychological factors in vision rehabilitation.
9. Cross-cultural adaptation and validation of the Brain Injury Visual Symptom Survey Questionnaire into French, a questionnaire for screening visual impairments after a brain injury
Nathalie Naman, Gaudreault Malepart, G; Ting C.T; Poncet, F.
Université de Montréal, McGill Université, CIUSSS West-Central Montréal
The BIVSS, a visual screening test for TBI is validated and freely available to clinicians.
Visual symptoms secondary to mild/moderate traumatic brain injury (TBI) are common but often overlooked. The Brain Injury Visual Symptom Survey (BIVSS) is a self-administered tool used to screen for visual symptoms associated with TBI. However, it is not available in French.
Objective: To translate and adapt the BIVSS into French (BIVSS-F) and assess its reliability in adult participants with CBT.
Two-stage methods: 1) Translate and culturally adapt the BIVSS into French (translation, synthesis, back-translation, review, pre-test, validation). 2) Test the BIVSS-F, online, with adults who have undergone mild-to-moderate CBT and with control participants up to twice to assess test-retest reliability.
Results: 1) Creation of the BIVSS-F; 2) 75 participants with CBT (x¯=38.50 years, SD=13.43) and 51 controls (x¯= 37.47 years, SD: 13.25) participated in the study. The internal consistency of the BIVSS-F was high for each condition, including the overall score (Cronbach’s α = 0.958). The BIVSS-F discriminates control subjects from CBTs (Chen’s d=1.33). The clinical threshold is 25/112; a score above 25 predicts a visual symptom and CBT. Test-retest (n=33), performed 15 days apart, showed good test-retest reliability of the BIVSS-F (ICC=0.97).
Conclusion: Clinicians now have at their disposal a new, reliable measurement tool, validated in French: the BIVSS-F. It is capable of detecting visual symptoms attributable to CCT, and points the way towards optometric assessment.
10. Step & Speak: Unlocking functional potential through the Interdisciplinary Treadmill Program (ITP)
Arlene Rosenberg, , Ourania Papanas, Alexie Gendron, Samantha Quinn
Lethbridge-Layton-Mackay Rehabilitation Centre
Introduction: The Interdisciplinary Treadmill Program (ITP) is an experimental program for children aged 4 to 13 with primary diagnoses of speech, language and/or motor disorders. ITP involves progressing through a variety of complex sequences (directional walking) on a specialized treadmill.
Objectives: ITP targets speech, language, gross motor coordination and visuo-motor integration; essential skills for daily functioning.
Methodology: Each client participates in two thirty-minute sessions per week for ten weeks, applying individualized objectives derived from physiotherapy and speech therapy disciplines. Pre- and post-intervention tests are carried out to assess the effectiveness of the intervention.
Results: Initial results suggest socio-emotional, communication and physical benefits. Participants showed measurable gains in walking patterns, ball skills, stair navigation, sitting and standing posture, speech sound production and language skills. Observations also included improvements in focused participation and attention, autonomy and organization, as well as self-reported increases in self-confidence in communication and motor skills. In addition, an unexpected positive outcome of the program was the detection of a possible motor diagnosis (e.g. cerebral palsy) that might otherwise have remained undetected in some children with primary language disorders not previously followed up in physiotherapy.
Conclusion: ITP represents an innovative, unique and time-efficient opportunity for our customers to target interdisciplinary outcomes involving the whole body. For therapists, it enhances a comprehensive and in-depth understanding of our complex clientele. Next steps include a joint CRIR project with JRH to evaluate the effectiveness of this program, and a scoping review by MSPOT to assess what other interdisciplinary interventions are available to target these areas.
11. Identifying Food literacy assessment dimensions for people with low vision
Mahboubeh Esmati, Hanah Boxerman, Martin Bergevin, Walter Wittich, Frederique Poncet, Marie Nadin Lamontagne
Université de Montréal, McGill University, Lethbridge-Layton-Mackay Rehabilitation Centre, CIUSSS West-Central Montréal, CRIR
Introduction: The functional skills domain of food literacy focuses on practical abilities, including dimensions such as nutritional knowledge, food preparation skills, food safety and hygiene. Visual impairments significantly affect a person’s ability to carry out daily activities essential to their overall satisfaction and well-being. Visually impaired people face many challenges when cooking and preparing meals. To meet these challenges, rehabilitation professionals can set up specialized training programs, integrate assistive technologies and provide personalized support. To our knowledge, there are currently no standardized, validated tools for assessing functional food literacy skills in people with low vision.
Objectives: (1) To identify individual and group consensus preferences of team members regarding functional food literacy skills of people with low vision. (2) To validate the dimensions of functional food literacy skills with people with low vision.
Methodology: This study will be conducted in two stages. 1) We will use the Technique pour la Recherche d’Information par Animation d’un Groupe d’Experts (TRIAGE) method to identify different dimensions of the functional food literacy skills assessment tool for people with low vision. The research will involve 24 participants divided into two groups: clinicians and users with low vision. 2) We will test these dimensions with 10 people with low vision in a natural environment (home kitchen or rehabilitation center kitchen).
Expected results: This study aims to develop the dimensions of a comprehensive assessment to promote the safety, competence, independence and quality of life of people with low vision, bridging the existing knowledge gap and improving their well-being.
12. Psychometric Properties of the Mini-Balance Evaluation Systems Test and Physical Function Measures in Patients with Ehlers-Danlos Syndrome/Hypermobility Spectrum Disorders
Soomin Lee, Jonathan Bourque, Laurence Noël, Elizabeth Hazel, Emma Ramsay, Raphaël Bélice, Shawn Robbins
McGill Université, Lethbridge-Layton-Mackay Rehabilitation Center, Montréal General Hospital, McGill University Health Centre
Introduction: Ehlers-Danlos syndrome (EDS) and hypermobility spectrum disorders (HDS) are associated with alterations in balance and physical function. However, the psychometric properties of relevant outcome measures remain largely unexplored.
Objectives: The aims of this study were to assess the construct validity of the Mini-Balance Evaluation Systems Test (Mini-BESTest) as well as the test-retest reliability of the Mini-BESTest, the Six Minute Walk Test (6MWT) and the Lower Extremity Functional Scale (LEFS) in patients with EDS/TSH.
Methodology: Participants with SED/TSH (n = 20) participated in two visits scheduled one or two weeks apart. Construct validity of the Mini-BESTest was determined by Pearson correlations between strength platform balance measures, the 6MWT and the LEFS. The test-retest reliability of the measures was assessed by intraclass correlation coefficients (ICC). Minimum detectable change values with 95% confidence (MDC95) were also calculated.
Results: The Mini-BESTest demonstrated strong construct validity through significant correlations with strength platform balance measures, the 6MWT and the LEFS (r = -0.409 to 0.663). Test-retest reliability was excellent for the Mini-BESTest, 6MWT and LEFS (ICC = 0.908 to 0.955). The MDC95 was 4 for the Mini-BESTest, 76.54 m for the 6MWT and 11 for the LEFS.
Conclusion: The Mini-BESTest is valid and reliable for assessing balance and mobility in patients with SED/TSH. The 6MWT and LEFS were also deemed reliable for this population.
13. Accessibility and communication support training modules for long-term care providers to improve care for older residents living with deafblindness
Walter Wittich, , Ballard, S.A.,Jaiswal, A., Pichora-Fuller, M.K., Savundranayagam, M., Reed, M., Mick, P., Wilchesky, M.
Université de Montréal, University of Toronto in Mississauga, Western University, Baycrest Center, University of Saskatchewan, McGill University, CIUSSS West-Central Montréal
This is a phased approach using mixed methodologies. In collaboration with a co-creation group of knowledge-users, we developed content for three bilingual online video training modules of 10 minutes each, tailored to LTC providers, using an online survey, focus groups and member verification.
Results: Survey participants included 12 unregulated care providers (e.g., volunteers, caregivers, paid companions) and 17 regulated staff (e.g., nurses, social workers, occupational therapists or physiotherapists). Most respondents were women (90%) with an average of 8.5 years’ experience in LTC. Only 14% had received formal training in communication strategies with people living with combined vision and hearing difficulties.
Overall, all participants agreed that training on sensory disabilities and communication strategies is a high priority and is currently a gap in their training. They confirmed that mechanisms for reporting such observations to regulated staff were very important. Additional common care and education priorities for both groups of participants included adapting communication behaviors, as well as knowledge of the use and maintenance of assistive technologies that may be owned by the facility or the resident.
Conclusion: Ultimately, we anticipate that our training modules under development will improve communication, enrich the care experience of LTC residents, facilitate the development of relationships between residents with deafblindness and their caregivers, reduce caregiver workload and improve the overall quality of care in this environment.
14. A systemic crisis response model for persons with ID and or ASD
Daniela Mireles, Shari Joseph, Sean Stirrup
Miriam Centre, CIUSSS West-Central Montréal
To present the results, impact and future considerations of a new multidisciplinary crisis response team, inspired by the START model, aimed at the stabilization of individuals with autism and/or intellectual disabilities with severe behavioral disorders and their systems.
Introduction: The Crisis Prevention, Response and Treatment Service (CPRTS) involves a multidisciplinary team contacted to rapidly manage a crisis and equip the user and their system with essential prevention and management tools. One of the main objectives of this service is to improve the user’s support network to prevent relapse.
Objectives:Assess users in crisis and offer 24/7 services. Implement cross-system crisis prevention and intervention services. Assist in the development of clinical and community supports around the individual to strengthen care connections to better support the user and/or system in crisis.
Methodology: Emergency assessment. Service registration. Crisis review and planning. Discharge.
Results:
User 1 in crisis: The need for medical assessment and placement was identified. A thorough medical assessment was completed within two weeks. A safety plan and behavioral support plan were developed and implemented during this period. A suitable resource for adults with severe behavioral problems was then selected. Psychosocial support was provided to the family and network. The user successfully transitioned to a permanent resource within a month of the crisis.
User 2 in crisis: A three-month clinical respite placement was provided, including behavioral interventions and psychosocial support. After gradual reintegration at home, the user remained stable for several weeks. The family then reassessed the need for a permanent placement, but due to unavailable resources, the user remained at home and his behavior and family situation deteriorated.
Conclusion:SPRTC interventions showed positive results in stabilizing the individual and their surrounding systems. For User 1, the availability of a specialized resource equipped for severe behavioral disorders provided a long-term solution, reducing the risk of future crisis. User 2 stressed the need for the development of a specialized residential unit, adapted to the needs of this population.
15.Strength in community: Exploring equity-oriented strategies for care beyond the clinic
Nicole George, Madison Leggatt, Xavier Laplante, Maxana Weiss, Sara Ahmed
McGill University
Introduction: Community resources can complement clinical rehabilitation services to provide comprehensive, equity-oriented care. However, there is a division between the health and community sectors, with a lack of clear direction on how best to connect them. Strategic efforts are needed to understand how to collaboratively integrate community resources into clinical care. This work provides an opportunity for clinical teams to learn from the experience and expertise of individuals in the community.
Objective: To examine how community resources can support quality of life and potential strategies for creating links with health services, from the perspective of individuals working in local community organizations.
Methodology: This study adopts a qualitative research design with a purposive sample of representatives of community organizations that promote equity, diversity and inclusion (n=10). Semi-structured face-to-face interviews (each lasting 1 hour) were conducted online, and transcripts were analyzed using inductive and deductive coding strategies for thematic analysis following the Conceptual Framework method.
Anticipated results: Themes initially identified included the role of the community in addressing unmet needs (e.g., social belonging, mental health) and associated resources (e.g., workshops, programs). Clinical-community links could offer recognition and validation to community organizations, with suggested linkage strategies including opportunities for information exchange (e.g. awareness-raising, forums) and inclusion in decision-making (e.g. committees). Potential barriers (e.g. time, language, mistrust) and facilitators (e.g. opinion leaders, openness, existing networks) were highlighted. The final themes will be presented.
Conclusions: These findings will be used in a knowledge mobilization meeting between rehabilitation teams, community organizations and people with lived experience to co-create solutions for integrated collaborative community care.
16.Differences in individual VF-14 scores between age-related macular degeneration and other vision impairments
Severina Ferreira-Lopes, Aaron Johnson
Concordia Vision Lab University, Lethbridge-Layton-Mackay Rehabilitation Center, Vision health vision network, CRIR
The Visual Function Index (VF-14) is a questionnaire designed to measure impairments in visual function (Steinberg et al., 1994). Although it was created for cataract patients, it has also been validated for other conditions (e.g., age-related macular degeneration (AMD); Mackenzie et al., 2002). Typically, researchers report only the total VF-14 score. In this study, we explored whether there are differences between AMD and other sources of visual impairment in total and individual VF-14 scores. Using data from the Montreal Barriers Study and Concordia’s Retinal Image Database, we analyzed a sample of 371 individuals with AMD and 452 others with different conditions. The VF-14 was administered in hospitals and rehabilitation centers in the Greater Montreal area. Results showed no statistically significant difference in the VF-14 total score between the two groups (p = .568, d = .07) and across most conditions. However, people with AMD performed worse on question 1 – reading small print (p = .008, d = .19) and question 10 – playing sports (p = .009, d = .261). We also find that those with other vision loss conditions score significantly lower on question 11 – cooking (p=.04, d=-.16). These results show that examining the overall total score of the VF-14 may not be as informative as examining individual question scores, suggesting that individual scores should also be considered when analyzing the VF-14 in research.
17.The Effectiveness of Medial Pivot Knee Arthroplasty Implants at Improving Gait in Patients with Knee Osteoarthritis: An Interim Analysis of an RCT
Nicolas Herrera, Shawn Robbins, John Antoniou,
McGill University, CRIR, Jewish General Hopital
Objective: Over 47,000 total knee arthroplasty (TKA) procedures are performed in Canada every year, most of them for osteoarthritis of the knee. These procedures are performed using a variety of designs to maximize results and restore normal knee motion. The MC design is an innovative approach purporting to reproduce normal knee motion, resulting in better knee movement after TKA compared with other implant designs. However, the evidence is unclear, and further research is needed. Thus, our aim is to compare knee kinematics between patients following TKA with an MC or PS implant during walking and stair-climbing tasks one year after surgery.
Methods: Following a pre-analysis randomized clinical trial, participants undergoing TKA for knee osteoarthritis received either MC (n=8) or PS (n=8) implants. Data were collected before surgery and one year after surgery. Joint angles were measured during walking and stair ascent/descent using three-dimensional motion capture and force platforms. A one-factor mixed ANCOVA compared groups one year after surgery, adjusting for baseline. The partial effect coefficient eta2 measured effect size.
Results: MC, n=5 and PS, n=3 passed the stair climbing/descending task. During stair climbing, MC had a greater amplitude of internal knee rotation (p=0.02). The MC group showed greater knee flexion amplitude and a taller effect during walking one year after surgery compared with the traditional group (p=0.031). No significant difference in knee flexion or internal rotation amplitude during stair ascent/descent. There was also no significant difference in the range of internal rotation of the knee during walking, despite the average size of the MC group.
Conclusion: The TKA MC implant resulted in greater knee flexion and internal rotation amplitude during functional activities. The results should be interpreted with caution, as the analysis is preliminary.
18. Empowering stroke care: harnessing Digital Health Interventions among clinicians for better individuals’ outcomes
Alice Misana, Dr. Sara Ahmed, Dr. Aliki Thomas, Dr. Zachary Boychuck, Dr. Catherine Marise Giroux, Dennis Radman, Fernanda Menescal
McGill University, Division of Clinical Epidemiology, Department of Medicine, CRIR, Constance Lethbridge Rehabilitation Center
Stroke is a major cause of long-term disability worldwide, necessitating effective interventions for care. Digital health interventions (DHI) present themselves as promising solutions, but misinformation persists, hindering their optimal use. To address this challenge, a knowledge transfer (KT) intervention was developed to improve clinicians’ knowledge and skills in using IHDs in stroke care.
This multifaceted project involved the synthesis of evidence on the effectiveness of IHDs in stroke care and the development of a toolkit to improve clinicians’ skills and knowledge. The toolkit, informed by an umbrella review assessing IHD effectiveness and barriers, offers evidence-based educational resources for shared decision-making between clinicians and clients. By presenting comprehensive information about each IHD in the toolkit, including level of evidence, target population, financial considerations, appropriate parameters, equipment details, procedure modalities, potential risks and precautions, we aim to overcome barriers and promote adoption.
By highlighting the importance of integrating IHD into stroke rehabilitation, the project offers valuable insights. For example, virtual reality interventions show significant improvements in various aspects of stroke recovery such as upper limb function, ADLs and cognitive function, while telehealth interventions improve systolic blood pressure and medication compliance. Telemedicine interventions reduce treatment times and hospital stays, benefiting functional outcomes, while self-directed interventions such as CIMT and interactive games also show promise on ADLs.
Future research will assess the impact of the toolkit on clinicians’ knowledge, skills and adoption of IHD in clinical care. Ultimately, the development of educational resources like the Toolkit offers the promise of improving clinician skills and patient care in stroke management, fostering positive transformations in healthcare delivery.
19. Agency and D/deaf Individuals: A Cultural, Service-Delivery Model for Informed Intervention and Mental Health Services
Emmanuela Tedone
McGill University, Lethbridge-Constance-Mackay Rehabilitation Center
Most D/deaf children are born to hearing parents, receive a cochlear implant (CI) and are exposed to a speech-only approach. A CI may provide D/deaf children with early access to sound and the eventual development of spoken language, but they are not exposed to natural, accessible language at a time when language acquisition is crucial and brain development is at its most rapid. While learning a sign language is another consideration for parents of D/deaf children, it often raises a dilemma still debated today about how best to improve developmental outcomes. Without accessible communication, however, D/deaf children can develop what has been termed language deprivation syndrome, and present cognitive, emotional, psychosocial and behavioral challenges while taking into account cultural and social factors. Overall, the needs of D/deaf children are neglected by the lack of culturally informed clinicians involved in diagnosis and treatment.
Deaf awareness training (DAT) is one way of promoting cultural competence. There is no known DAT for psychologists in training. The objectives are to develop and evaluate the impact of a DAT, and to measure outcomes on attitudes towards deaf people, knowledge about deafness, and practical applications of early intervention and affirmative mental health services. The DAT will be facilitated by two deaf people and two American Sign Language (ASL) interpreters. It will include information, discussion, role-playing and clinical vignettes on barriers and improvements for mental health services. Using block randomization, consenting participants from McGill and Concordia universities will be randomly assigned to either the intervention/training (3 groups) or the wait-and-see control group (2 groups). All will complete questionnaires on Attitudes towards Deafness (Cooper et al., 2004) and Cultural Competence Knowledge of Deaf People (Hoang et al., 2011) at Times 1, 2 and 3. At Time 3 (3-month follow-up), participants in the intervention and wait-and-see control groups will be asked to complete questionnaires and respond to vignettes on the transfer of knowledge and attitudes to hypothetical clinical situations. Group comparisons will be used to determine the impact of DAT at all time points. A thematic analysis will be carried out. Control group participants will have access to the program after data collection. Intervention participants are expected to demonstrate improved attitudes and knowledge from Time 1 to Time 3. The research has policy implications for early intervention services, and the development of teaching strategies that include deaf culture and agency.
20. From Theory to Practice: Mapping the Landscape of Artificial Intelligence in Stroke– A Scoping Review
Lee Hill, Narimane Ait Hamou Dorra Rakia Allégue, Audrey Durand, Rola El Halabieh, Sara Ahmed
McGill University, Université Laval, PCHI Lab
AI has great potential to improve stroke rehabilitation and care. This review explores applications of AI to improve diagnosis, treatment and clinical decision support, thus benefiting stroke survivors.
Introduction: Stroke is the leading cause of adult disability and the third leading cause of death in Canada. It is estimated that 40% of stroke survivors experience moderate to severe disability. These survivors are then faced with navigating the continuum of acute and post-acute rehabilitation care. Artificial intelligence (AI) is increasingly used in various aspects of stroke care, offering promising solutions to improve diagnosis, treatment and clinical decision support. The aim of this review is to provide an overview of the application of AI in rehabilitation to improve the continuum of post-stroke care. A secondary objective is to assess how gender and equity have been addressed in the development and application of AI.
Methods and analyses: A scoping review will be conducted on how AI methods have been used to improve care for adult stroke patients. This review will follow the recommendations of the Preference Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-ScR) checklist for scoping reviews. A literature search will be carried out between 2005 and 2024, using the PUBMED, CINAHL and Google Scholar databases. A combination of the following search terms will be used: “artificial intelligence”, “stroke” and “care”. Data extraction will be performed using a developed data extraction tool. A narrative summary will accompany the indexed results and describe the results aligned with the study objectives.
Next steps: We anticipate that the results of this study will highlight areas of AI application in stroke rehabilitation and inform future research and clinical practice aimed at improving transitional care for patients.
21. The International Classification of Functioning, Disability, and Health: Perspectives from Individuals with Lived Experience of Deafblindness from Across the Six World Health Organization Regions
Shirley Dumassais, Meredith Prain, Keith R. McVilly, Mahadeo Sukhai, Allan Wareham, Daniela, Anze, Ricard Lopez, Renu Minhas, Sonja van de Molengraft, Mirko Baur, Atul Jaiswal, Tosin O. Ogedengbe, Sarah Granberg, Walter Wittich
Université de Montréal, Able Australia, University of Sydney, Canadian Hearing Services, Canadian National Institute for the Blind, European Deafblindness Network, DeafBlind Ontario Services, Royal Kentalis, Deafblind International, Orebro University
Vision and hearing challenges as well as emotional, social, environmental and personal factors are crucial in the management of patients with deafblindness.
Introduction: The World Health Organization’s (WHO) International Classification of Functioning, Disability and Handicap (ICF) provides a comprehensive and universally applicable health terminology framework. ICF-derived core sets simplify the coding system with a more concise set of codes specific to conditions such as sensory loss. These core sets are developed in collaboration with the population concerned, in this case, people living with deafblindness.
Methods: In this phase of establishing a core set for deafblindness, a qualitative study was carried out, comprising individual interviews and group sessions in which participants answered six open-ended questions. The aim of this study was to identify the aspects of body functions and structures, environmental and personal factors most important to people living with deafblindness.
Results: Analysis of responses from 72 people with deafblindness and/or their carers in the six WHO regions revealed recurring themes in body structures, functions and environmental factors. These included eye and ear problems and subsequent vision and hearing problems, emotional and personality functions, and societal attitudes, family and caregivers influencing outcomes. Communication, socialization, walking and interpersonal interactions and relationships were recognized as central to activities and participation. In addition, COVID-19 pandemic, health status and age emerged as personal factors.
Conclusion: This study uncovered crucial information concerning sensory function, emotional well-being and societal barriers. These findings highlight the need to develop a core set of ICF adapted to deafblindness, with potential implications for more effective health, rehabilitation and support services for this unique population.
22. Mapping accessible employment pathways for youth with disabilities
Amelia Hagelstam Renshaw, , Keiko Shikako, Roberta Cardoso, Mehrnoosh Movahed, Linda Nguyen
McGill University
The transition from school to work is particularly difficult for young people with disabilities. This remains a problem because the barriers faced by young people with disabilities in multiple contexts throughout their lives persist in their employment as well. Although the Canadian government is currently developing standards for the employment of people with disabilities, there are no youth-specific guidelines. Accessible Standards Canada is developing a five-year plan to listen to the voices of youth with disabilities and develop standards that take into account the creation of inclusive community spaces leading to employment. As part of this five-year plan, our objectives are to map youth employment accessibility, identify community factors that contribute to youth employment in Canada, and conduct a realist review to identify community factors that influence youth employment. In terms of methodological approach, we would follow the guidelines of the Joanna Briggs Institute Reviewers or JBI to guide this review. Our anticipated outcomes are to identify community factors contributing to the employment of young people with disabilities in Canada. Our findings could then inform practice and drive real change and understanding.
23. Improving Interdisciplinary Communication: A focus on the reinforcement of completion and optimal use of a preexisting standardized tool and the effect of this compliance on patient and interdisciplinary team satisfaction with communication at Catherine Booth Hospital
Hanaa El hajj, , Pearl Whammond
CIUSSS West-Central Montréal
Regular interdisciplinary rounds serve as a platform for communication between our team members and enable collaborative decision-making. To further improve communication, it is proposed to reinforce the optimal use of our standardized communication tool, the Interdisciplinary Intervention Plan document, during rounds. This tool has been created to facilitate communication between team members and ensure that all key and relevant information is documented and shared. Our CSI will encourage optimal completion of the tool during rounds, demonstrating each user’s current status, risks, family concerns and goals, required assessments, medical and psychosocial needs and discharge plan. The ISC will ask questions during rounds to ensure that all sections of the interdisciplinary intervention tool are completed appropriately, record roles and responsibilities assigned during rounds, transcribe relevant information onto the user’s whiteboard and share updates with patients and their families with the aim of fostering users’ participation in their care plan and encouraging transparency, collaboration and accountability among interdisciplinary team members.
The study suggests evaluating the effectiveness of the existing interdisciplinary intervention tool when used optimally with reinforced implementation. Pre- and post-enforcement evaluation will be carried out to measure indicators such as clarity of information exchanged between team members, clarity of communication to users and their families, overall satisfaction of users and team members with the effectiveness of interdisciplinary team rounds and subsequent information sharing, adherence to program-specified length of stay, a smoother discharge process and less confusion over roles and responsibilities. Evaluation of the tool’s reinforcement can be based on feedback received from users and team members. The aim is to highlight the importance of respecting optimal tool completion and the effect this has on interdisciplinary communication between team members and users, and between team members themselves.
Overall, this study highlights the importance of adhering to the completion of the interdisciplinary intervention plan to optimize communication, delineate roles and responsibilities, and improve user outcomes.
24. The effect of Sex-Specific footwear on cutting kinematics in soccer
Karen Chen, Moreno Morelli, Nicolas Herrera, Ethan Wilkie, Shawn Robbins
McGill University, St. Mary’s Hospital
In soccer, female athletes are more susceptible to injury than males during rapid directional changes (i.e., pivoting movements). Women tend to have riskier pivoting patterns often attributed to anatomical differences. However, generic soccer cleats for women are commonly designed using male foot patterns, neglecting the unique anatomical and biomechanical needs of female players. Consequently, the influence of women-specific footwear on pivoting patterns remains understudied.
This study aims to estimate the impact of female-specific cleats on joint kinematics, compared to generic cleats, in young female soccer players performing an unanticipated lateral pivoting movement.
32 healthy female participants, aged 13 to 17, will be recruited from the Concordia Regional Soccer Association sports program. Participants will test both female-specific and generic cleats in a pivoting task, consisting of an unanticipated lateral pivoting movement at 450 (± 10º), and a shoe-pulling task, involving a slalom run with speeds recorded using gantry timers. Visual analog scales will assess shoe comfort after the slalom. Kinematic data will be collected using a markerless motion capture system and processed with Visual 3D. Principal component analysis and repeated covariance analysis will examine joint angle characteristics as a function of shoe condition, while controlling for approach speed and executed pivot angle. A separate analysis of variance will examine shoe conditions on traction and shoe comfort. Expected results include reduced-risk pivoting patterns and faster running speeds with women-specific spikes than with generic spikes.
The findings of this study will contribute to the development of footwear better suited to female athletes, potentially reducing the gender injury gap.
25. Monitoring Childhood Disability Rights to Inform Health and Social Policy
Ananya Chandra, , Keiko Shikako, Raphael Lencucha, Sebastian Jodoin
McGill University
This project supports a rights-based approach to health policy and service delivery systems to promote the well-being of children with disabilities.
Children with disabilities in Canada face persistent challenges to their health and well-being, including mental health, cardiovascular problems and pandemic recovery. Disability has a significant impact on social determinants of health such as education, income and social inclusion. To address these issues, it is necessary to prioritize the human rights of children with disabilities in the design of policies and programs. However, little public health research has examined the integration of human rights into Canadian policies to support the health of children with disabilities. To fill this gap, a project examines legislation at the federal, provincial and territorial levels from the year 2000 onwards, using the UN Conventions on the Rights of Persons with Disabilities (CRPD) and on the Rights of the Child (CRC) as analytical frameworks. Using a categorization dictionary based on the relevant articles of these conventions, text mining methods analyze how Canadian policies reflect these rights, taking into account geographical and temporal variations. The study aims to reveal the prevalence of rights-based language in legislation, provincial priorities for children’s rights, federal government approaches to public health and social policy, and changes in the use of rights language over time. By identifying strengths, gaps and intersectional considerations in the implementation of rights, the project aims to inform future public health policies and programs to ensure equitable health for all children with disabilities in Canada.
26. Elaboration of an interprofessional collaborative model for dysphagia management at the Jewish general hospital
Aisha Khan, Dallas Warren, Clemence Kao, Christina Vinokuroff
CIUSSS West-Central Montréal
Introduction: Dysphagia is an impairment of swallowing function that can result from a wide range of conditions. In hospital, dysphagia is associated with increased length of stay, mortality rates and healthcare costs, as well as an impact on the patient’s quality of life (1). Facilities that adopt an interdisciplinary approach to dysphagia management achieve better outcomes for users (2).
Objectives : To ensure that users with dysphagia are identified and receive appropriate care by competent professionals in a timely manner throughout the hospital; to facilitate interprofessional collaboration and ensure adequate transfer of information between professionals and between care units.
Methodology: A participatory approach, led and facilitated by two professional practice consultants, was used to develop recommendations for optimizing service delivery in line with best practice standards. An interdisciplinary advisory group was formed, comprising two clinical representatives from the clinical nutrition and speech-language pathology departments.
1. A literature review of best practice recommendations for the screening and assessment of dysphagia in hospitalized adults;
2. A comparative analysis of current service models for dysphagia screening and assessment practices in Quebec acute care centers;
3. Mapping of the current dysphagia screening and assessment process at the JGH and identification of barriers to optimal service delivery:
4. Audit current charting practices for clinical assessment of swallowing at the JGH:
5. Validation of results with an interdisciplinary advisory group.
Results: An interprofessional collaboration model for the assessment and management of dysphagia has been developed and piloted. Implementation is underway.
