2011
Dr. Guillaume Desroches
Sitting Pivot Transfers in Individuals with a Spinal Cord Injury: Minimizing Upper Extremity Risk Exposure and Maximizing Performance.
Individuals with a spinal cord injury (SCI) generally experience sensory-motor impairments that can affect, to various degrees, their upper limbs, their trunk or their lower limbs. Despite intensive rehabilitation efforts, the majority of individuals with SCI use a manually-propelled wheelchair as their primary household or community source of mobility in daily life. As a consequence, their upper extremities (U/E) become highly strained during manual wheelchair propulsion and numerous wheelchair-related functional activities (i.e.; sitting transfers) which may increase the risk of developing secondary U/E musculoskeletal impairments (i.e.; shoulder impingement, rotator cuff injuries, carpal tunnel syndrome, etc.) over time. In turn, these secondary impairments may have deleterious consequences on the ability to perform functional mobility tasks, and ultimately interfere with societal participation among individuals with SCI. Using a comprehensive biomechanical method, the current project will determine the best and safest techniques to lessen the risk exposure of secondary impairments at the upper limb and falls during sitting transfer among adult SCI. Key performance indicators, including limiting factors, will be identified to better orient clinical practice. Hence, the new knowledge emerging from this innovative project is expected to enhance the capability of clinicians, especially physiotherapists and occupational therapists, to develop novel, specific, effective and safe evidence-based rehabilitation interventions and technologies to optimize performance during sitting transfers and maximize societal participation in individuals who rely on a wheelchair for mobility.
2008
Cyril Duclos
Brain activity of force production in persons with neurological muscle weakness.
Brain lesions due to stroke result in a reduction of strength on the affected body side. Gait is then slower and more asymmetrical than in control subjects. The authors believe that the brain determines the forces to be produced as a proportion of the maximal strength of the subjects, even though strength is reduced on one leg by the stroke. This would explain the asymmetry observed in hemiparetic gait. The first objective of this study is to quantify brain activity associated with force production. We will therefore measure brain activity with functional magnetic resonance imaging during force production tasks in hemiparetic and control subjects. They would first produce the same force, such as lifting a light weight at the tip of each foot, successively with each ankle. We expect that more cerebral activity will be measured when the force is produced with the affected side than with the non-affected side. This could explain the motor difficulties these persons face during a task such as gait, which normally involves symmetrical forces on the two legs. Conversely, when they will produce the same effort, such as 30 % of their maximal strength in pulling the tip of their foot upward, the same brain activity should be measured for the contraction on each side. However, in this condition, the force produced will be smaller on the affected side because of the reduction of maximal strength due to the stroke. These results would confirm the idea that the brain determines the strength to produce on each side according to the maximal strength of the muscles involved in the task. The second objective of the study is to determine whether strength gain associated with a specific training program would normalise the brain activity symmetry in the same testing protocol. This study has the potential to show the neurobiological basis of gait asymmetry and provide a new rationale to strengthening muscle groups in order to reduce disabilities due to stroke.
2005
Lora Marie Giangregorio
Ottawa Health Research Institute
Areas of study:
- Body weight supported treadmill training after hip fracture;
- Systematic review of exercise interventions after SCI;
- Quality of life and patient utilities after hip fracture.
Nancy Salbach
University of Toronto
Areas of study:
- Factors influencing information access by physiotherapists providing care for persons with stroke.