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  • 1
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    Physical and cognitive impairments in people suffering from long COVID: protocol for a longitudinal population-based cohort study
    BMJ ; 2023
    In:  BMJ Open Vol. 13, No. 3 ( 2023-03), p. e064054-
    Details
    In: BMJ Open, BMJ, Vol. 13, No. 3 ( 2023-03), p. e064054-
    Abstract: Approximately 33% of people who contracted COVID-19 still experience symptoms 12 weeks after infection onset. This persistence of symptoms is now considered a syndrome itself called ‘long COVID’. Evidence regarding long COVID and its cognitive and physical impacts is growing, but the literature is currently lacking objectively measured data to guide towards adapted healthcare trajectories. The objectives are to describe the physical and cognitive impairments experienced by individuals living with long COVID using self-reported and clinical objective measures, and to compare the evolution over time of the physical and cognitive state between adults living with long COVID (at least one physical or cognitive COVID-19 symptom for more than 12 weeks following infection; long COVID group), people who developed COVID-19 but did not experience persistent symptoms (short COVID group) and people who did not develop COVID-19 (control group). Methods and analysis In this longitudinal cohort study, 120 participants will be recruited in each group. Variables will be collected through three evaluation sessions over 6 months (baseline, 3 months, 6 months). Variables include self-administered questionnaires on health-related quality of life, comorbidity, sleep, pain, anxiety, depressive symptoms, fatigue and cognitive function, as well as objective measures of cognitive (attention, memory, executive functioning) and physical (grip strength, balance, gait speed, gait endurance, VO2, frailty) functions. Activity, heart rate and sleep will be monitored with a fitness tracker watch for 7 days following evaluation sessions. Maximum-likelihood analyses of variance (ANOVAs) will be used to compare data at baseline between groups. Repeated measures ANOVAs will be used to compare the longitudinal performance variations across groups of the self-reported and clinical variables. Ethics and dissemination Ethics committees of the CIUSSS de la Capitale-Nationale and CIUSSS de l’Est-de-l’Île-de-Montréal approved the project. Results will be disseminated through clinical and community platforms as well as through peer-reviewed manuscripts and international conferences. Trial registration number NCT05216536 .
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    DOI: 10.1136/bmjopen-2022-064054
    Language: English
    Publisher: BMJ
    Publication Date: 2023
    detail.hit.zdb_id: 2599832-8
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  • 2
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    Knowledge and appropriateness of care of family physicians and physiotherapists in the management of shoulder pain: a survey study in the province of Quebec, Canada
    Springer Science and Business Media LLC ; 2023
    In:  BMC Primary Care Vol. 24, No. 1 ( 2023-02-16)
    Details
    In: BMC Primary Care, Springer Science and Business Media LLC, Vol. 24, No. 1 ( 2023-02-16)
    Abstract: Shoulder pain is difficult to diagnose and treat with half of those affected still symptomatic six months after initial consultation. This may be explained by primary care management not conforming to evidence-based practice. This survey evaluated physiotherapists (PTs) and family physicians' (FPs) knowledge and appropriateness of care in shoulder pain management. Methods A survey sent to PTs and FPs in the province of Quebec, Canada presented four clinical vignettes with cases of rotator cuff (RC) tendinopathy, acute full-thickness RC tear, adhesive capsulitis and traumatic anterior glenohumeral instability. Respondents indicated diagnosis, indications for imaging, specialists’ referrals, and choice of treatments. Answers were compared to recommendations from clinical practice guidelines (CPGs). Participants’ responses were compared between types of providers with Fisher’s exact test. Results Respondents (PTs = 175, FPs = 76) were mostly women with less than ten years of experience. More than 80% of PTs and 84% of FPs correctly diagnosed cases presented. Despite this practice not being recommended, more FPs than PTs recommended an imaging test in the initial management of RC tendinopathy (30% compared to 13%, p  = 0.001) and adhesive capsulitis (51% compared to 22%, p  = 0.02). For full-thickness RC tear and shoulder instability, up to 72% of FPs and 67% of PTs did not refer to a specialist for a surgical opinion, although recommended by CPGs. For RC tendinopathy, 26% of FPs and 2% of PTs ( p   〈  0.001) would have prescribed a corticosteroid infiltration, which is not recommended in the initial management of this disorder. For adhesive capsulitis, significantly more FPs (76%) than PTs (62%) ( p   〈  0.001) suggested an intra-articular corticosteroid infiltration, as recommended by CPGs. For all presented vignettes, up to 95% of family physicians adequately indicated they would refer patients for physiotherapy. In prioritizing rehabilitation interventions, up to 42% of PTs did not consider active exercises as a priority and up to 65% selected passive modalities that are not recommended for all shoulder pain vignettes. Conclusions Most FPs and PTs were able to make adequate diagnoses and select appropriate treatments for shoulder pain, but practices opposed to evidence-based recommendations were chosen by several respondents. Further training of FPs and PTs may be needed to optimize primary care management of different shoulder disorders.
    Type of Medium: Online Resource
    ISSN: 2731-4553
    URL: Article
    DOI: 10.1186/s12875-023-01999-6
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 3107315-3
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  • 3
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    The burden of waiting to access pain clinic services: perceptions and experiences of patients with rheumatic conditions
    Springer Science and Business Media LLC ; 2021
    In:  BMC Health Services Research Vol. 21, No. 1 ( 2021-12)
    Details
    In: BMC Health Services Research, Springer Science and Business Media LLC, Vol. 21, No. 1 ( 2021-12)
    Abstract: Extensive waiting times before receiving services is a major barrier to adequate pain management. Waiting times may have a detrimental impact on patients’ conditions and quality of life. However, there remains a lack of knowledge on the actual experiences of patients waiting to receive services, especially for those with rheumatic conditions. The present study aimed to gain an in-depth understanding of perceptions and experiences of patients with rheumatic conditions regarding access to pain clinic services. The secondary objective was to identify possible solutions to improve this access according to patients’ perspectives. Methods This qualitative study based on semi-structured interviews was conducted with adults with rheumatic conditions waiting to access pain clinics in the province of Quebec, Canada. Interviews were transcribed verbatim and analyzed using thematic content analysis. Results Twenty-six participants were interviewed (22 women and 4 men; mean age 54 ± 10 years). Four main themes were identified: 1) the perception that waiting time is unacceptably long; 2) how the lack of information affects patients’ experiences of waiting; 3) patients’ various expectations towards the pain clinic, from high hopes to disillusionment and 4) carrying an emotional, physical and financial burden resulting from the wait. Participants reported several solutions to improve the experience of waiting, including providing information to patients, increasing resources, improving prioritization processes and care coordination, and providing alternative interventions to patients during the wait. Conclusions For patients with rheumatic conditions, access to pain clinic services is challenging due to extensive waiting times. The burden it imposes on them adds to the existing challenge of living with a chronic rheumatic condition. The solutions identified by participants could serve as building blocks to develop and implement measures to improve patients’ experience of accessing pain-related services.
    Type of Medium: Online Resource
    ISSN: 1472-6963
    URL: Article
    DOI: 10.1186/s12913-021-06114-y
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2050434-2
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  • 4
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    “It feels like an endless fight”: a qualitative study exploring healthcare utilization of persons with rheumatic conditions waiting for pain clinic admission
    Springer Science and Business Media LLC ; 2022
    In:  BMC Musculoskeletal Disorders Vol. 23, No. 1 ( 2022-09-22)
    Details
    In: BMC Musculoskeletal Disorders, Springer Science and Business Media LLC, Vol. 23, No. 1 ( 2022-09-22)
    Abstract: Individuals living with a rheumatic pain condition can face delays in accessing pain clinics, which prevents them from receiving timely treatment. Little is known regarding their specific healthcare utilization in order to alleviate pain while waiting to obtain services in pain clinics. Hence, the aim of this study was to explore the perceptions and experiences of persons living with rheumatic conditions regarding healthcare utilization while waiting to access a pain clinic. Methods In this qualitative descriptive study, semi-structured interviews were conducted with adults living with a painful rheumatic condition that reported either being waiting for admission in a pain clinic, having been referred but then denied pain clinic services, or having received services during the previous six months, in the province of Quebec, Canada. The interviews were transcribed verbatim, and an inductive thematic analysis was performed. Results Twenty-six individuals were interviewed (22 women and 4 men; mean age 54 ± 10 years). Three themes were identified: 1) lacking guidance in identifying solutions to their complex and multidimensional needs, 2) struggling to obtain and maintain services due to systemic access barriers, and 3) displaying resilience through a search for accessible and sustainable self-management strategies. Conclusions The current approaches and structures of health services fail to adequately answer the service needs of individuals experiencing painful rheumatic conditions. Important shifts are required in pain education, in increasing access to multidisciplinary approaches at the primary care level and in breaking down barriers individuals with chronic pain face to receive appropriate and timely care.
    Type of Medium: Online Resource
    ISSN: 1471-2474
    URL: Article
    DOI: 10.1186/s12891-022-05808-6
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2041355-5
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  • 5
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    The Association Between Running Injuries and Training Parameters: A Systematic Review
    Journal of Athletic Training/NATA ; 2022
    In:  Journal of Athletic Training Vol. 57, No. 7 ( 2022-07-01), p. 650-671
    Details
    In: Journal of Athletic Training, Journal of Athletic Training/NATA, Vol. 57, No. 7 ( 2022-07-01), p. 650-671
    Abstract: To synthesize the current evidence on the incidence of running-related injuries (RRIs) and their association with training parameters (distance, duration, frequency, intensity), as well as recent changes in training parameters. Data Sources Searches were conducted in MEDLINE/Ovid, CINAHL, Embase, and SPORTDiscus from their inception through July 7, 2020. Study Selection Included articles had to report prospective data on RRIs and training parameters or any changes in parameters and be published in English or French. Two reviewers independently screened the titles, abstracts, and full texts. Data Extraction Two independent raters performed data extraction and quality assessment using QualSyst, a quality appraisal tool. Data Synthesis A total of 36 articles that involved 23 047 runners were included. Overall, 6043 runners (26.2%) sustained an RRI (incidence range = 8.8%–91.3%). The incidence of RRI was 14.9% in novice runners (range = 9.4%–94.9%), 26.1% in recreational runners (range = 17.9%–79.3%), and 62.6% in competitive runners (range = 52.6%–91.3%). The 3 most frequently injured body parts were the knee (25.8%), foot/ankle (24.4%), and lower leg (24.4%). Overall, evidence about the association between weekly running distance, duration, frequency, intensity, or specific changes in training parameters and the onset of RRIs was conflicting. Conclusions Despite high rates of RRIs, current evidence does not consistently link RRIs with specific training parameters or recent changes in training parameters. Therefore, caution should be taken when recommending optimal parameters or progressions. Given the multifactorial nature of RRIs, future studies also need to consider the interactions between training parameters as well as psychosocial, hormonal, lifestyle, and recovery outcomes to better understand the onset of RRIs.
    Type of Medium: Online Resource
    ISSN: 1938-162X , 1062-6050
    URL: Article
    URL: Article
    DOI: 10.4085/1062-6050-0195.21
    DOI: 10.4085/1062-6050-0195.21.S1
    Language: English
    Publisher: Journal of Athletic Training/NATA
    Publication Date: 2022
    detail.hit.zdb_id: 2070051-9
    SSG: 31
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  • 6
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    〈p〉Factors associated with waiting times for persons with rheumatic conditions in multidisciplinary pain treatment facilities〈/p〉
    Informa UK Limited ; 2019
    In:  Journal of Pain Research Vol. Volume 12 ( 2019-07), p. 2379-2390
    Details
    In: Journal of Pain Research, Informa UK Limited, Vol. Volume 12 ( 2019-07), p. 2379-2390
    Type of Medium: Online Resource
    ISSN: 1178-7090
    URL: Journal
    URL: Article
    DOI: 10.2147/JPR
    DOI: 10.2147/JPR.S206519
    Language: English
    Publisher: Informa UK Limited
    Publication Date: 2019
    detail.hit.zdb_id: 2495284-9
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  • 7
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    Strategies to reduce waiting times in outpatient rehabilitation services for adults with physical disabilities: A systematic literature review
    SAGE Publications ; 2022
    In:  Journal of Health Services Research & Policy Vol. 27, No. 2 ( 2022-04), p. 157-167
    Details
    In: Journal of Health Services Research & Policy, SAGE Publications, Vol. 27, No. 2 ( 2022-04), p. 157-167
    Abstract: Identifying effective strategies to reduce waiting times is a crucial issue in many areas of health services. Long waiting times for rehabilitation services have been associated with numerous adverse effects in people with disabilities. The main objective of this study was to conduct a systematic literature review to assess the effectiveness of service redesign strategies to reduce waiting times in outpatient rehabilitation services for adults with physical disabilities. Methods We conducted a systematic review, searching three databases (MEDLINE, CINAHL and EMBASE) from their inception until May 2021. We identified studies with comparative data evaluating the effect of rehabilitation services redesign strategies on reducing waiting times. The Mixed Methods Appraisal Tool was used to assess the methodological quality of the studies. A narrative synthesis was conducted. Results Nineteen articles including various settings and populations met the selection criteria. They covered physiotherapy ( n = 11), occupational therapy ( n = 2), prosthetics ( n = 1), exercise physiology ( n = 1) and multidisciplinary ( n = 4) services. The methodological quality varied ( n = 10 high quality, n = 6 medium, n = 3 low); common flaws being missing information on the pre-redesign setting and characteristics of the populations. Seven articles assessed access processes or referral management strategies (e.g. self-referral), four focused on extending/modifying the roles of service providers (e.g. to triage) and eight changed the model of care delivery (e.g. mode of intervention). The different redesign strategies had positive effects on waiting times in outpatient rehabilitation services. Conclusions This review highlights the positive effects of many service redesign strategies. These findings suggest that there are several effective strategies to choose from to reduce waiting times and help better respond to the needs of persons experiencing physical disabilities.
    Type of Medium: Online Resource
    ISSN: 1355-8196 , 1758-1060
    URL: Article
    DOI: 10.1177/13558196211065707
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2022
    detail.hit.zdb_id: 2039416-0
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  • 8
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    Stratégies pour éviter l’utilisation à long terme des opioïdes après un traumatisme : enquête sur les pratiques canadiennes
    Springer Science and Business Media LLC ; 2023
    In:  Canadian Journal of Anesthesia/Journal canadien d'anesthésie Vol. 70, No. 1 ( 2023-01), p. 87-99
    Details
    In: Canadian Journal of Anesthesia/Journal canadien d'anesthésie, Springer Science and Business Media LLC, Vol. 70, No. 1 ( 2023-01), p. 87-99
    Type of Medium: Online Resource
    ISSN: 0832-610X , 1496-8975
    URL: Article
    DOI: 10.1007/s12630-022-02328-8
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2050416-0
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  • 9
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    The association between waiting time and multidisciplinary pain treatment outcomes in patients with rheumatic conditions
    Springer Science and Business Media LLC ; 2020
    In:  BMC Rheumatology Vol. 4, No. 1 ( 2020-12)
    Details
    In: BMC Rheumatology, Springer Science and Business Media LLC, Vol. 4, No. 1 ( 2020-12)
    Abstract: Access to multidisciplinary pain treatment facilities (MPTF) is limited by extensive waiting time in many countries. However, there is a lack of knowledge about the impact of waiting time on clinical outcomes, particularly for patients with rheumatic conditions. This study examined the association between waiting time for MPTF and clinical outcomes in patients with rheumatic conditions. Methods Data were extracted from the Quebec Pain Registry, a large database of patients who received services in MPTF. The associations between waiting time (classified as 〈  2 months, 2–6 months and  〉   6 months) and change in pain interference, pain intensity and health-related quality of life, from the initial visit at the MPTF to the 6-month follow-up, were tested using generalized estimating equations. Results A total of 3230 patients with rheumatic conditions (mean age: 55.8 ± 14.0 years; 66% were women) were included in the analysis. Small significant differences in improvement between waiting time groups were revealed, with patients waiting less than 2 months having a larger improvement in all clinical outcomes compared to patients who waited 2–6 months or over 6 months before their initial visit (adjusted time X group effect p  ≤ 0.001). Only patients waiting less than 2 months reached a clinically important improvement in pain interference (1.12/10), pain intensity (1.3/10) and physical and mental quality of life (3.9 and 3.7/100). Conclusions Longer delays experienced by patients before receiving services in MPTF were associated with statistically significant smaller improvements in pain interference, pain intensity and health-related quality of life; these differences were, however, not clinically significant. Based on these results, we advise that strategies are developed not only to reduce waiting times and mitigate their impacts on patients with rheumatic conditions, but also to improve treatment effectiveness in MPTF.
    Type of Medium: Online Resource
    ISSN: 2520-1026
    URL: Article
    DOI: 10.1186/s41927-020-00157-0
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
    detail.hit.zdb_id: 2918121-5
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  • 10
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    Physiotherapists' ability to diagnose and manage shoulder disorders in an outpatient orthopedic clinic: results from a concordance study
    Elsevier BV ; 2020
    In:  Journal of Shoulder and Elbow Surgery Vol. 29, No. 8 ( 2020-08), p. 1564-1572
    Details
    In: Journal of Shoulder and Elbow Surgery, Elsevier BV, Vol. 29, No. 8 ( 2020-08), p. 1564-1572
    Type of Medium: Online Resource
    ISSN: 1058-2746
    URL: Article
    DOI: 10.1016/j.jse.2019.11.030
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2020
    detail.hit.zdb_id: 2046901-9
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