Musculoskeletal disorders (MSDs) are a leading cause of disability, and they place a substantial burden on the publicly funded health care system. Every year, almost one-quarter of the Canadian population consults a primary care physician for MSDs.(Mackay, 2010) Yet most people with MSDs can be managed by a physiotherapist and do not need to see a physician.(Ludvigsson, 2012) Physiotherapists deliver cost-effective interventions for people with MSDs, (Dionne, 2013) and they have a comprehensive knowledge of this field.(Childs 2005) Furthermore, physiotherapists can contribute to the promotion of healthy lifestyles and the prevention of chronic diseases. (Dufour, 2014; Black, 2016) There is limited access to community-based (i.e. outpatient) physiotherapy services due to a range of factors including costs, wait times, and geographical location. (Bath, 2016 & 2018) Canadians with lower incomes are less likely to report seeking care with a physiotherapist than a family physician (Bath 2018) and an estimated one third of Canadians do not have additional health insurance to help cover costs of private physiotherapy care. (Sanofi, 2017) Policies and programs that support subsidized funded access to private physiotherapy care for MSDs are known to be variable across Canada, yet there is no known formal and recent collation of this national variability. A structured environmental scan of current provincial and territorial policies and programs that support subsidized funded access to private physiotherapy care for would help to address this knowledge gap.
The student would work with the supervisor and a national network of physiotherapists, other health care providers, and decision/ policy makers to perform an environmental scan of current provincial and territorial policies and programs that support subsidized funded access to private physiotherapy care for MSDs in Canada. The student will collect data to inform the environmental scan through a combination of literature review (research and grey literature), key informant interviews, and surveys. The findings will be summarized in a written report in addition to a manuscript to be submitted to a peer-reviewed journal. This environmental scan will serve to inform further research projects and funding applications, advocacy efforts, and policy decisions regarding this issue.
The student will gain knowledge and skills pertaining to: literature review and synthesis (both research and grey literature); communication with national physiotherapy collaborators and other stakeholders; survey and interview development; analysis of practice, policy, evaluation and research findings; report writing; and oral presentation. Most importantly the student will gain an in-depth awareness of the practice and policy landscape in Canada regarding funding policies and programs that support community-based access to physiotherapy care for MSDs.
Background and Research Topic:
Safe and effective resistance training relies on a thorough understanding of exercise technique, precautions, and specific stresses applied to potentially vulnerable body structures. Recent literature has documented the athletic, strength, and health benefits of performing deep squats as part of a comprehensive resistance training program; however, there is considerable debate amongst therapists and coaches as to the safety and efficacy of squatting to a depth that necessitates some degree of spinal flexion. The so-called "butt wink" is proposed to occur when the depth of squatting results in maximal hip flexion, and subsequently, posterior pelvic tilt (ie. "wink") and lumbar spinal flexion to achieve that depth. It has been suggested that this amount of spinal flexion would be dangerous under heavy loads and cause abnormal stresses on the lumbar spine. Contrary to this suggestion, however, is anecdotal evidence from athletes in the sport of Weightlifting, where catching a load in a Clean or a Snatch lift necessitates this depth of squatting as part of their sport. In addition, our lab has preliminary data on squatting styles that suggests that there is no difference in the lumbar stresses (shear and compression forces) that occur with different squatting styles that result in different levels of lumbar flexion (Edington, C. MSc Thesis, 2017, co-supervised by Dr. Joel Lanovaz and Dr. Scotty Butcher). It is unknown, however, how the change in depth of squatting results in changes in lumbar spine forces, and in particular, in the changes that occur at the point that the "wink" occurs and beyond. The purpose of this study, therefore, is to examine the kinematics and kinetics of squatting to varying depths, with a particular emphasis on the changes that occur to the lumbar spine forces prior to and during the posterior pelvic tilt, or "wink", that occurs with very deep squats.
Description of Duties:
The successful student will work with the research team of Dr. Scotty Butcher and Dr. Joel Lanovaz to assist in recruiting participants, completing the testing, data reduction, and data analysis. As part of these duties, the student will learn and practice the data collection techniques established by our previous work, as well as learn to use and interpret the biomechanical outcomes. If time allows, the student will assist with the writing of the manuscript for this study. The successful student will be offered authorship on any manuscripts produced as part of this research, in addition to the required MPT Research presentation.
Background: Individuals are often provided with walking aids such as crutches and walkers to offload an injured lower extremity. These devices may further impair function in older individuals as they are difficult to use, require increased energy expenditure and contribute to increase forces through the stance limb, which facilitates sedentary behavior and co-morbid consequences such as decreased conditioning and poor quality of life. Further, individuals who are not able to walk with a walking aid may choose to push themselves with one foot while in the wheelchair, which may subject the foot to abnormal force and subsequent injury.
Objective: The objective of this study is to determine the influence of arm strength on self-selected walking speed (SSWS), rate of perceived exertion (RPE) vertical ground reaction force (VGRF) under the stance limb and participant assistive device preference in a healthy older population under 5 walking conditions: bipedal walking, unilateral walking with a walker, unilateral walking with crutches, unilateral walking with a wheeled knee walker (WKW), and unilateral progression of a wheelchair with one foot.
Design: A prospective, randomized crossover study
Ethics approval has already been obtained. The student will be responsible for recruitment and testing of 30 healthy adults over the age of 50, data management and analysis, and assisting with presentation and manuscript development.