Background/objectives: Despite the growing recognition of housing as a significant concern for individuals with a spinal cord injury/dysfunction (SCI/D), there is limited research available on this topic. This scoping review aimed to identify and describe the literature on housing across the continuum for people with an SCI/D.
Methods: This review utilized Arksey and O'Malley's scoping review framework.
Objective: Mild traumatic brain injury (mTBI) is frequently overlooked in polytrauma patients due to the overshadowing of more severe injuries, a fact that makes its identification in post-acute settings challenging since symptoms overlap with other conditions and no validated diagnostic tools exist. To address this gap, this scoping review explored the literature on mTBI diagnosis in post-acute civilian polytrauma settings.
Methods: By utilizing the Arksey and O'Malley framework and PRISMA-ScR guidelines, the review focused on studies from 2010 to 2024 related to delayed mTBI diagnosis in adults.
Objectives: Individuals with lower-limb amputations (LLA) often have deficits in balance and community walking ability. As a result, people with LLA are often sedentary. The aim of this study was to explore perceptions of physical activity from the perspective of people with LLA.
View Article and Find Full Text PDFTo improve transitions in care, a new patient navigation (PN) program was introduced to support older adults with complex care needs transition from hospital to home. The patient navigator is a community social worker embedded in the hospital's care teams. A cohort observational design was used to conduct the study by analysing the patient navigator's clinical notes and hospital's administrative data to describe the characteristics of patients, scope of the patient navigator's activities, and patient outcomes.
View Article and Find Full Text PDFProsthet Orthot Int
November 2024
Background: The clinical landscape of limb loss rehabilitation across Canada is poorly delineated, lacks standard rehabilitation guidelines, and is without a shared clinical database.
Objective: To address these gaps, the objective of the present study was to undertake an environmental scan of the rehabilitation centers across Canada that provide inpatient and/or outpatient services to the limb loss community.
Study Design: An environmental scan was conducted to describe the rehabilitation service structure, program services, and outcome measures of sites across Canada.
Background: Adults with spinal cord injury/dysfunction (SCI/D) face challenges with medications they take to manage their secondary conditions (e.g., pain, urinary tract infections, autonomic dysreflexia).
View Article and Find Full Text PDFIntroduction: Individuals with limb loss frequently report post-amputation phenomena, including nonpainful phantom sensations, phantom limb pain (PLP), and residual limb pain (RLP). Although post-amputation pain is common, not all patients benefit from widely accepted treatments. A greater understanding of phantom limb "telescoping", the experience of one's phantom hand or foot gradually approaching the residual limb, may assist in developing more effective interventions for reducing post-amputation pain.
View Article and Find Full Text PDFA Patient Navigation (PN) model of care was introduced in a large metropolitan hospital in Ontario (Canada) to support transitions in care for older adults in 2019. The patient navigator is a community social worker or "community transitional lead" embedded in the hospital's in care teams to assist with discharge planning and provide follow-up care to older adults, their families, and/or care partners for up to 90 days. Initially, the PN program supported acute care patients and has since expanded in the Emergency Department and Reactivation Care Centre.
View Article and Find Full Text PDFNovel surgical treatments for painful neuromas are increasingly used, but determining which provides the greatest benefit has been difficult due to the inconsistent use of outcome measures. We mapped the current literature of outcome measures used to evaluate peripheral nerve surgery for the management of symptomatic neuromas in patients who underwent an adult-acquired upper extremity amputation (UEA). Medline, Embase, Cochrane, and CINAHL were searched for primary research written in the English language from inception to February 2023.
View Article and Find Full Text PDFBackground: Telemedicine in the realm of rehabilitation includes the remote delivery of rehabilitation services using communication technologies (eg, telephone, emails, and video). The widespread application of virtual care grants a suitable time to explore the intersection of compassion and telemedicine, especially due to the impact of COVID-19 and how it greatly influenced the delivery of health care universally.
Objective: The purpose of this study was to explore how compassionate care is understood and experienced by physiatrists and patients engaged in telemedicine.
Introduction: Lower extremity amputation (LEA) is a life altering procedure, with significant negative impacts to patients, care partners, and the overall health system. There are gaps in knowledge with respect to patterns of healthcare utilization following LEA due to dysvascular etiology.
Objective: To examine inpatient acute and emergency department (ED) healthcare utilization among an incident cohort of individuals with major dysvascular LEA 1 year post-initial amputation; and to identify factors associated with acute care readmissions and ED visits.
Objectives: This research work was performed: (1) To assess the accessibility of in-laboratory polysomnography for individuals with spinal cord injury (SCI); (2) to evaluate the validity of four screening questionnaires for sleep-related breathing disorders (SRBDs); and (3) to assess the association between anthropometric features and apnea-hypopnea index (AHI).
Methods: An Environmental scan (E-scan) was performed in the province of Ontario, where all sleep clinics were invited to complete the E-scan survey. Furthermore, a cross-sectional study was performed at a rehabilitation hospital (Canada), where consecutive adults with subacute/chronic (>1 month) SCI were recruited.
Patients from equity-deserving populations, such as those who are from racialized communities, the 2SLGBTQI+ community, who are refugees or immigrants, and/or who have a disability, may experience a unique set of challenges accessing virtual models of care. The objective of this qualitative study was to describe the experiences of patients from equity-deserving communities and their family members who received care from a Virtual Emergency Department (ED) in Toronto, Canada. Forty-three participants (36 patients and 7 family caregivers) with different and intersecting identities who used the Virtual ED participated in the study.
View Article and Find Full Text PDFBackground: Functional use of the upper extremities (UEs) is a top recovery priority for individuals with cervical spinal cord injury (cSCI), but the inability to monitor recovery at home and limitations in hand function outcome measures impede optimal recovery.
Objectives: We developed a framework using wearable cameras to monitor hand use at home and aimed to identify the best way to report information to clinicians.
Methods: A dashboard was iteratively developed with clinician ( = 7) input through focus groups and interviews, creating low-fidelity prototypes based on recurring feedback until no new information emerged.
Purpose: To understand how persons with non-dysvascular lower limb amputation (LLA) use occupations to contextualize their quality of life (QoL).
Methods: A qualitative study using an interpretative description approach was conducted. Analysis of the interviews was guided by an occupational perspective, which considers the day-to-day activities that are important to an individual.
Objective: To synthesize the outcomes reported in the rehabilitation and community literature for adults with traumatic lower limb amputation (LLA).
Data Sources: The search strategy was conducted in 3 databases (Medline, EMBASE, and CINAHL) from inception to April 2022.
Study Selection: To be eligible, articles could be of any design but were required to have at least 50% adult individuals with traumatic LLA and had to report on interventions and outcomes in either a rehabilitation or community setting.
Purpose: Hand function plays a major role in the successful performance of activities of daily living (ADLs), such as eating. There is a lack of data exploring how persons with hand impairment manage food packaging and its impact on eating.
Methods: A convenience sample of 12 inpatients with hand impairments undergoing rehabilitation participated in a qualitative interview where they were asked questions about their experiences with food packaging and independent eating, and asked to open a set of commonly available hospital food packages, first without any tools/aids, and then with tools/aids if they desired to use them.
Objective: The purpose of this scoping review was to summarize the literature on barriers and facilitators that influence the provision and uptake of inpatient cardiac rehabilitation (ICR).
Methods: A literature search was conducted using PsycINFO, MEDLINE, EMBASE, CINAHL and AgeLine. Studies were included if they were published in English after the year 2000 and focused on adults who were receiving some form of ICR (eg, exercise counselling and training, education for heart-healthy living).
Hospitalization is often viewed as a burdensome and stressful period for older adults and their family caregivers; however, little attention has been given to the positive aspects of the care continuum journey. The purpose of this article is to highlight the positive aspects of healthcare from the perspective of Canadian older adults with complex needs and their family caregivers. This study utilized a strengths-based theoretical perspective to conduct a secondary qualitative analysis of interviews with 12 older adults and seven family caregivers.
View Article and Find Full Text PDFObjective: Widespread visitor restrictions were implemented during the COVID-19 pandemic at acute and inpatient rehabilitation hospitals. Family caregivers were physically isolated from their loved ones, which challenged engagement in patient care and readiness for their role. Thus, we aimed to explore the involvement of family caregivers in COVID-19 patients as they journeyed across the care continuum during the early phase of the COVID-19 pandemic.
View Article and Find Full Text PDFThis article describes the Quality Improvement (QI) initiative of a culture change model, CareTO. CareTO is a made-in-Toronto, resident-driven, person-centred approach to care that was implemented across all units of a City of Toronto-operated Long-Term Care (LTC) home during the COVID-19 pandemic. The City of Toronto's Seniors Services and Long-Term Care (SSLTC) Division partnered with an external QI team to support the implementation of CareTO at the pilot site.
View Article and Find Full Text PDFPurpose: To critically explore experiences following thumb amputation and delineate elements of an ideal thumb prosthesis from the end user perspective.
Methods: A qualitative study was undertaken with end user stakeholder groups, which included persons with a thumb amputation, rehabilitation professionals, and prosthetists. Analysis proceeded in line with conventional content analysis.
Background: Multiple sclerosis (MS) is an autoimmune disease that is often treated with multiple medications. Managing multiple medications, also known as polypharmacy, can be challenging for persons with MS. Toolkits are instructional resources designed to promote behaviour change.
View Article and Find Full Text PDFDespite the high prevalence of stroke among South Asian communities in high-income countries, a comprehensive understanding of their unique experiences and needs after stroke is lacking. This study aimed to synthesize the literature examining the experiences and needs of South Asian community members impacted by stroke and their family caregivers residing in high-income countries. A scoping review methodology was utilized.
View Article and Find Full Text PDFThe objective of this study is to describe the healthcare utilization, and clinical and sociodemographic features of a cohort of 74 coronavirus disease 2019 (COVID-19) patients admitted to a tertiary rehabilitation hospital in Toronto, Canada. A retrospective chart review was performed using 74 charts from patients admitted to a COVID-19 rehabilitation unit between 11 April 2020 and 30 April 2021. Measures of central tendency, SDs, interquartile ranges, frequencies, and proportions were calculated to analyze clinical and sociodemographic data.
View Article and Find Full Text PDF