McMaster University: A Global Leader in Rehabilitation Education and Research

Welcome to McMaster University’s prestigious School of Rehabilitation Science, renowned as a pioneering hub for occupational therapy, physiotherapy, speech-language pathology and other exceptional healthcare programs. Celebrated for spearheading a problem-based learning methodology and its international reputation built on evidence-based practice research, the school stands at the forefront of rehabilitation education.

Admission Statistics Showcase Competitive Nature of Programs

McMaster sets high academic standards for its occupational therapy and physiotherapy programs, reflected in the admission statistics. For example, the MSc occupational therapy program requires a minimum GPA and sub-GPA calculated from the most recent 60 units of undergraduate study. This ensures candidates have the analytical abilities to handle complex patient-rated evaluations and patient-related assessments.

Innovations in Education and Clinical Practice

McMaster integrates guidelines for critical review of published research into its curriculum, instilling analytical rigor from the outset. Students employ tools like the Rosalind Franklin Qualitative Research Appraisal Instrument for comprehensive evaluations. Educational elements like anecdotal records, report forms and models like the Canadian Practice Process Framework (CPPF) further enrich learning. Practicum opportunities facilitate application of clinical reasoning learnings in occupational therapy environments.

At the Mc masters university, the SRS School offers rigorous occupational therapy post grad programs, including a Masters degree occupational therapy. Meeting the McMaster OT waitlist requirements, OT students complete foundational occupational therapist education and advanced occupational therapy courses that fulfill the McMaster university standards.

The McMaster PT school, known as ‘Mac PT,’ has stringent doctor of physical therapy admission requirements and high McMaster physiotherapy admission statistics. Students who apply for physiotherapy and meet the eligibility criteria for physiotherapy can pursue a Master of physiotherapy or Master degree of physiotherapy. Those seeking guidance on how to get a masters in physiotherapy can choose graduate physiotherapy options like a Physio masters degree or extensive physiotherapy masters programs. The renowned Masters in physical therapy program provides premier education among McMaster programs.

SLP students at McMaster complete MSC speech and language therapy courses that surpass grad school requirements for speech pathology and prepare them for the McMaster university language requirement. The advanced Speech therapy MSC empowers students to become masters of speech. As one of the premier speech pathology schools near me, McMaster offers access to sought-after speech language pathology programs Ontario has available. From graduate physiotherapy to intricacies of PT physiotherapy, the comprehensive Master of speech program fosters understanding across disciplines.

Speech-Language Pathology, Audiology and Other Offerings

Beyond occupational therapy and physiotherapy, McMaster houses exceptional speech-language pathology and audiology programs, emphasizing evidence-based principles. The school also features unique graduate streams – the MSc and PhD in Rehabilitation Sciences cater to degree-holders pursuing advanced rehabilitation specializations and research.

With its esteemed faculty, problem-based pedagogy and pioneering research, McMaster University’s School of Rehabilitation Science continues advancing the frontiers of clinical education and practice.

Faculty Highlights

Advanced Degrees: Master of Science in Rehabilitation Science (MSC RS)

The Master of Science in Rehabilitation Science (MSC RS) program at McMaster University is a testament to the university’s dedication to advanced research and specialized study. This program offers students the opportunity to delve deeply into various aspects of rehabilitation science, ranging from clinical practices to innovative research methodologies. The MSC RS program is tailored for those seeking to expand their expertise in areas such as occupational therapy, physiotherapy, and speech-language pathology, providing them with the tools and knowledge necessary for groundbreaking work in these fields.

Nestled within the prestigious McMaster University in Hamilton, Ontario, the School of Rehabilitation Science (SRS School) stands out as a leading institution. Here, students are immersed in rehabilitation studies, exploring the depth of occupational therapy, physiotherapy, and speech-language pathology.

Patient Assessment Techniques: PRWE

The Patient-Rated Wrist Evaluation (PRWE) serves as a prime example of the practical and effective patient assessment tools taught at McMaster’s rehabilitation programs. Widely used in physiotherapy contexts, PRWE helps practitioners evaluate wrist pain and disability, allowing for a more tailored and effective treatment plan. Its integration into the curriculum underscores McMaster’s commitment to providing students with hands-on, applicable skills that directly translate to improved patient care.

Educational Approach: History of Problem-Based Learning at McMaster

McMaster University has been a pioneer in adopting and refining problem-based learning, a pedagogical approach that has transformed educational methods within the School of Rehabilitation Science. This approach, centered on real-world problems and student-led learning, encourages critical thinking, collaboration, and practical application of knowledge. The history of problem-based learning at McMaster reflects the university’s innovative spirit and its continuous effort to enhance the educational experience for its students.

How to Become a Speech-Language Pathologist in Ontario

Educational Requirements

Bachelor’s and Master’s Degrees: Aspiring speech-language pathologists in Ontario are required to complete a comprehensive educational pathway. This includes a 4-year Bachelor’s degree followed by a Master’s degree in Speech-Language Pathology (SLP). These programs are designed to provide the foundational knowledge and specialized skills necessary for a career in SLP.

Prerequisites: Master’s programs in this field often have specific prerequisites. Candidates are usually expected to have completed coursework in child development, linguistics, and human physiology. These prerequisites ensure that students have a well-rounded understanding of the various aspects critical to speech-language pathology.

Institutions Offering Programs: Ontario boasts several prestigious institutions offering SLP programs. Notable universities include McMaster University, Université d’Ottawa, University of Toronto, and Western University, each providing unique perspectives and expertise in the field.

Professional Registration

CASLPO Membership: To legally practice as a speech-language pathologist in Ontario, obtaining registration with the College of Audiologists and Speech-Language Pathologists of Ontario (CASLPO) is mandatory. This registration ensures that practitioners meet the professional standards and ethical guidelines required in the province.

Notable Institutions and Programs in Ontario

CanChild at McMaster University

Focus: CanChild, situated within the School of Rehabilitation Science at McMaster University, plays a significant role in advancing research related to children and youth with disabilities and their families. This institution is a center for excellence in clinical and health services research, contributing immensely to the field.

School of Rehabilitation Science at McMaster University

Programs Offered: The School of Rehabilitation Science offers a diverse range of programs, including Occupational Therapy, Physiotherapy, Speech-Language Pathology, and more.

Educational Approach and Research Focus: The school is renowned for its innovative, problem-based education methodology. It is particularly noted for its intensive research in areas such as childhood disability, musculoskeletal health, healthy aging, and primary care.

McMaster University’s Graduate Programs

Advanced Studies: For those seeking higher education, McMaster University offers MSc and PhD programs in Rehabilitation Sciences. These programs are open to students with degrees in Occupational Therapy, Physiotherapy, Speech-Language Pathology, or other health-relevant fields, providing an opportunity for advanced study and research.

Key Personalities and Organizations

Other Notable Programs and Roles

FHS Schools and Departments at McMaster University

Diverse Fields: The Faculty of Health Sciences at McMaster University includes a range of schools and departments like Anesthesia, Biochemistry and Biomedical Sciences, Clinical Epidemiology & Biostatistics, Family Medicine, Nursing, Obstetrics and Gynecology, Psychiatry, Radiology, and more.

Support and Leadership: The Faculty of Health Sciences Human Resources department provides essential leadership, support, and resources to faculty and staff working within these diverse fields.

Counselling and Therapy University Programs in Ontario

Wide Range of Options: Ontario offers a variety of specialized degrees in counselling and therapy. Institutions like Saint Paul University, University of Western Ontario, University of Guelph, University of Ottawa, University of Toronto, Wilfrid Laurier University, and Canada Christian College provide tailored programs catering to different aspects of counselling and therapy.

Online Counselling Programs in Ontario

Athabasca University: This university offers an online M.C. in Counselling, with specializations in Art Therapy and Counselling Psychology, allowing for flexible and accessible learning options for students.

Mission and Vision of the MSc in Physiotherapy Program

The MSc in Physiotherapy Program is dedicated to delivering a top-tier, forward-thinking, and cohesive educational experience, aligned with the principles of the Faculty of Health Sciences. Emphasizing problem-solving, small group dynamics, self-guided learning, and the fusion of academic and clinical training, the program endeavors to offer both professional and interdisciplinary learning opportunities, working in conjunction with the broader community and university.

The program aims to nurture physiotherapists who are compassionate, reflective, and scholarly in their approach. These practitioners will be equipped to provide patient-focused, effective, and efficient healthcare, critically analyze the scientific underpinnings of their practice, adapt and lead in changing environments, engage collaboratively in interprofessional teams, and commit to ongoing personal and professional development.

Core Values

The program is grounded in:

• Excellence: Striving for the highest standards in all our activities.
• Caring: Showing genuine concern for the welfare of every individual.
• Respect: Maintaining honesty and integrity while appreciating each person’s uniqueness.
• Collaboration: Promoting partnerships and teamwork within our communities and among ourselves.
• Innovation: Creating a space that encourages creativity, openness, and willingness to take risks.

Program Goals

The overarching aim is to equip students to function in various roles across diverse practice settings. As clinical scholars, they will embody conscientious and ethical conduct, applying their knowledge and skills in a research-informed manner to benefit individuals, patients, systems, and organizations.

MSc Physiotherapy Program Update and Overview

Website Transition Announcement: The School of Rehabilitation Science is currently updating its website. The information available may not fully represent the current state of the Program. For accurate details, revisit after April 2020 or contact [email protected] for specific inquiries.

Mission, Vision, Values, and Graduate Outcomes

Mission: The program focuses on educating physiotherapy students to:

• Provide empathetic and proficient physiotherapy in diverse health settings, integrating evidence-based practices, professional norms, and collaborative care.
• Exhibit leadership in their field, communities, and in enhancing physiotherapy knowledge.

Vision: To revolutionize physiotherapy education, advocacy, research, and knowledge dissemination.

Values: We prioritize:

• Collaborative and Team Efforts
• Innovative and Creative Approaches
• Responsibility and Accountability
• Transparency and Uprightness
• Commitment to Continuous Learning
• Active Citizenship

Student Outcomes and Expected Graduate Attributes

Graduates from the McMaster Physiotherapy Program will be proficient in:

• Clinical skills across healthcare settings, encompassing physiotherapy diagnosis, prognosis, evaluation, and treatment. (Physiotherapy Expertise)
• Collaborative and ethical healthcare delivery. (Professionalism, Collaboration, Communication, Management)
• Contributing to society and their profession through advocacy and development. (Leadership, Scholarship, Professionalism, Communication, Collaboration)
• Applying research evidence effectively in practice to evaluate intervention outcomes and contribute to physiotherapy knowledge. (Scholarship, Management)
• Excelling in knowledge dissemination using various communication methods, including digital platforms. (Communication, Collaboration, Scholarship)
• Operating independently and responsibly as self-regulated physiotherapy professionals. (Physiotherapy Expertise, Professionalism, Scholarship)

Essential Competencies as per http://www.alliancept.org/wp-content/uploads/2018/02/Competency-Profile-Final2018_EN.pdf.

Program Outcomes

The program commits to:

• Offering innovative learning experiences mirroring current and future physiotherapy and educational practices.
• Providing a solid academic and clinical foundation for safe practice within professional and ethical boundaries.
• Emphasizing the importance of professional growth and lifelong learning.
• Delivering a curriculum tailored to the educational needs of students and the communities served.
• Maintaining program quality through continuous outcome assessments.
• Informing communities about the evolving roles in physiotherapy.

Eligibility Criteria for Master’s Programs in Occupational Therapy and Physiotherapy

The Master’s programs in Occupational Therapy (MSc OT) and Physiotherapy (MSc PT) at our institution invite around 65 candidates each year for enrollment. The selection of candidates is finalized by the Associate Dean of the School of Graduate Studies.

Qualification Requirements:

For those pursuing the Master’s in Occupational Therapy (MSc OT) or Physiotherapy (MSc PT), the following prerequisites must be met:

For Applicants with a 4-year Bachelor’s Degree (120 units/credits):

• A minimum grade point average (GPA) of B, 75%, 3.0 out of 4, or 8 out of 12, calculated based on the final 60 units of university courses.
• Applicants can apply during their final year of the bachelor’s program.

For Applicants with a 3-year Bachelor’s Degree (90 units/credits):

• Completion of an additional 30 units/credits, totaling 120 units/credits, including:
  • At least 18 units/credits from senior-level (fourth-year or higher) courses.
  • A minimum GPA of B, 75%, 3.0 out of 4, or 8 out of 12, based on the last 60 units.

Specific Requirements for MSc PT:

• Successful completion of a biological or life science course (full or half credit) with a minimum grade as specified above.
• Completion of a social science or humanities course (full or half credit) with a minimum grade as specified above.

Recommended Prerequisite Courses:

Though specific science and humanities courses are not mandatory, courses in anatomy or physiology, and psychology or sociology are recommended. Applicants must be enrolled in these courses by the application deadline.

General Notes for All Candidates:

• Fourth-year students may apply but must provide proof of degree completion by June 30 of the application year.
• Graduate-level academic achievements are evaluated individually.
• Practicum courses and non-graded courses (e.g., pass/fail) are excluded from GPA calculations.
• Ontario Bachelor of Education degrees are not included in GPA calculations.
• Graduate coursework must be graded B- or higher.

Additional Program Details:

• Students are expected to travel for mandatory sessions and clinical placements, including rural and remote areas, at their own expense.
• Some clinical placements may require evening and weekend commitments.
• Students must fulfill clinical practicum hours to meet program requirements.

Evaluation of International Academic Records:

For applicants with non-U.S. international academic records:

1. Submit notarized English translations of all degree coursework and diplomas.
2. If available, include a grading scale explanation from the issuing university.
3. The Program Administrator will review these documents, with final approval by the Assistant Registrar.

TOEFL Requirement:

• Non-native English speakers must submit a TOEFL score: 600 (paper-based), 250 (computer-based), or 92 (iBT) with specific minimum scores in reading, speaking, listening, and writing.
• This requirement is waived for those who completed a university degree in Canada, the U.S., the U.K., Australia, or New Zealand.
• TOEFL scores must be recent (within two years) and sent directly to the university (McMaster code: 0936; Department codes: OT-44, PT-48).

Master’s Program in Occupational Therapy

Occupational Therapists play a vital role in assisting individuals to engage in meaningful activities, which include self-care, leisure, and community involvement. These activities are crucial for personal fulfillment and societal contribution.

Program Objective

Our Master of Science (Occupational Therapy) Program aims to equip students with the essential knowledge, skills, and professional attitudes necessary for beginning occupational therapists. The program’s scope extends to various settings, both institutional and community-based, across Canada and globally.

The curriculum emphasizes understanding the impact of family, society, culture, and the physical environment on occupational activities and health. This understanding spans across all ages and is framed within the concept of client-centered practice. Graduates will be equipped to work autonomously, collaborate in multidisciplinary teams, critically analyze research, advocate for change, lead within their field, and pursue lifelong learning.

Inquiries about the program can be directed to [email protected].

Patient-Rated Wrist Evaluation (PRWE) User Manual

The Patient-Rated Wrist Evaluation (PRWE) User Manual, updated in June 2011, serves as a comprehensive guide for assessing wrist joint pain and functional difficulties stemming from wrist injuries. This manual offers an in-depth exploration of the PRWE, including its creation, application, and the various domains it measures.

Introduction to the PRWE:

• The PRWE is a patient-reported questionnaire with 15 items, divided into two subscales: Pain (5 items) and Function (10 items, further split into specific and usual activities).
• It is designed to evaluate wrist-related musculoskeletal disability, aid in creating patient-focused treatment goals, predict patient prognosis, identify clinically significant changes, and effectively communicate the impact of wrist injuries.

Development and Purpose:

• The PRWE emerged due to the need for a patient-centered assessment tool focusing on life quality and functional status rather than just clinical outcomes like range of motion or muscle strength.
• Development involved a six-step process, starting with a survey of International Wrist Investigators, followed by item generation, reduction, questionnaire construction, pilot testing, and finally, testing for reliability and validity.

Modification to PRWHE:

• The PRWE was adapted to the PRWHE (Patient-Rated Wrist/Hand Evaluation) to encompass hand conditions. The PRWHE retains the same items and scoring system as the PRWE but includes ‘wrist/hand’ in its terminology and two optional questions about hand aesthetics.

Administering and Scoring the PRWHE:

• The PRWHE is intended for self-administration or by healthcare professionals like physiotherapists or hand therapists. It uses a reference time-frame of one week, considering the acute nature of most wrist/hand injuries.
• Scoring involves summing up the responses, with the total score being out of 100. Higher scores indicate greater pain or functional disability. The manual also addresses common issues in scoring and suggests remedies.

Cultural Adaptation and Language Availability:

• The PRWE has been translated and culturally adapted into several languages, including Chinese, German, Swedish, Dutch, Japanese, and Hindi. This expansion ensures its applicability in diverse linguistic and cultural settings.

Significance and Impact:

• The PRWE and its modified version, the PRWHE, stand as critical tools in the assessment and management of wrist and hand conditions, offering valuable insights into patient experiences and aiding in effective treatment planning.

The McMaster Occupational Therapy Evidence-based Practice

The McMaster Occupational Therapy Evidence-based Practice group, led by Mary Law, Debra Stewart, Nancy Pollock, Lori Letts, Jackie Bosch, Muriel Westmorland, and Angela Philpot, is dedicated to integrating research evidence with clinical expertise to enhance the effectiveness of occupational therapy interventions. This approach to best practice involves collaborative partnerships with clients.

Key Initiatives and Contributions of the Group:

1. Program Evaluation Workbook Development: The group has created and published a workbook designed to assist therapists and rehabilitation teams in assessing the impact of their programs. This workbook, titled “A Programme Evaluation Workbook for Occupational Therapists: An Evidence-Based Practice Tool,” is accessible through the Canadian Association of Occupational Therapists.
2. Development of Review Protocols: The group has formulated and tested protocols for critically analyzing both quantitative and qualitative research articles. These protocols come with guidelines and have demonstrated high levels of agreement (75% and 86%) between researchers in testing. The review forms and guidelines are available in multiple languages, including English, Spanish, German, and Portuguese, and require Acrobat Reader for access.
3. Systematic Reviews: They have conducted systematic reviews on the effectiveness of two key interventions in occupational therapy: activity-based interventions for elderly individuals with dementia and cognitive-behavioral interventions for chronic pain. These comprehensive reviews are attached for reference.
4. Collaboration and Acknowledgments: The group acknowledges the support of the Canadian Occupational Therapy Foundation, particularly for its ‘Outcomes That Matter’ project. Additionally, they extend their gratitude to Mariela Nabergoi, Heidrun Becker, Marisa Mancini, and Dr. Craig Scanlan for providing translations of the review forms and guidelines in Spanish, German, Portuguese, and an adapted version in English, respectively.

For further information or inquiries about the Evidence-Based Practice group and their work, Mary Law can be contacted at [email protected].

Patient-Rated Wrist Evaluation (PRWE) questionnaire

The PRWE is a 15-item questionnaire that measures wrist pain and disability in activities of daily living. It has two subscales – Pain (5 items) and Function (Specific activities – 6 items, Usual activities – 4 items). Scores range from 0 (no disability) to 100 (worst disability), with pain and function weighted equally.

The PRWE was designed based on clinician surveys and patient/expert input to provide a standardized scale for assessing wrist outcomes. It underwent testing to establish strong reliability, validity and responsiveness properties.

The PRWE can be used to determine level of wrist disability, set treatment goals, evaluate changes over time, and communicate outcomes. It takes only a few minutes for patients to complete and for clinicians to score. Comparative data from studies using the PRWE are available.

Instructions are provided for patient completion, scoring subscales and the overall score, as well as interpretation. Guidance covers issues like handling missing data and dealing with activities a patient cannot perform.

Tables summarize evidence confirming PRWE properties like test-retest reliability in wrist fracture and other musculoskeletal disorder populations, correlations with other measures like the DASH and SF-36 to support validity, and responsiveness ratios showing sensitivity to change over time.

In summary, the PRWE is a rigorously developed, reliable and valid patient-reported scale for wrist disability assessment supported by substantial research. It offers a standardized way for clinicians to quantify patient wrist pain and function.

Tennis Elbow Self-Evaluation Form

This form is designed to assess the impact of your arm condition over the past week. You’ll rate your symptoms on a 0-10 scale, with 0 indicating no pain or difficulty, and 10 representing extreme pain or inability to perform an activity. Answer all questions, estimating if unsure. If an activity is not applicable to you, strike through the question.

Pain Assessment

Rate the average pain in your arm over the past week.

• At rest: 0-10
• During repetitive arm movements: 0-10
• Carrying a grocery bag: 0-10
• When pain was least: 0-10
• When pain was worst: 0-10

Functional Disability Evaluation

A. Specific Activities
Rate your difficulty in performing the following:

• Turning a doorknob or key: 0-10
• Carrying a bag by the handle: 0-10
• Lifting a cup to your mouth: 0-10
• Opening a jar: 0-10
• Pulling up pants: 0-10
• Wringing out a cloth: 0-10

B. Usual Activities
Rate difficulty in your regular activities:

1. Personal care (dressing, washing): 0-10
2. Household chores: 0-10
3. Work-related tasks: 0-10
4. Recreational or sports activities: 0-10

Comments:
(Add any additional remarks here)

Scoring Guide

• Pain Subscale: Sum of 5 items (0-50)
• Specific Activities: Sum of 6 items (0-60)
• Usual Activities: Sum of 4 items (0-40)
• Function Subscale: Average of Specific and Usual Activities (0-50)
• Total Score: Pain Subscale + Function Subscale (0-100)

Qualitative Review Form (Version 2.0)

Developed by: Letts, L., Wilkins, S., Law, M., Stewart, D., Bosch, J., & Westmorland, M., 2007 Institution: McMaster University

Study Purpose:

• Was the purpose and/or research question stated clearly? ☐ Yes ☐ No
• Outline the purpose of the study and/or research question:

Literature:

• Was relevant background literature reviewed? ☐ Yes ☐ No
• Describe the justification for the study. Was it clear and compelling?
• How does the study apply to your practice and/or to your research question? Is it worth continuing this review?

Study Design:

• What was the design? ☐ Phenomenology ☐ Ethnography ☐ Grounded Theory ☐ Participatory Action Research ☐ Other: ________
• Was the design appropriate for the study question? Explain:
• Was a theoretical perspective identified? ☐ Yes ☐ No
• Describe the theoretical or philosophical perspective for this study:

Method(s) used:

• ☐ Participant Observation ☐ Interviews ☐ Document Review ☐ Focus Groups ☐ Other: ________
• Describe the method(s) used to answer the research question:

Sampling:

• Was the process of purposeful selection described? ☐ Yes ☐ No
• Describe sampling methods used:
• Was sampling done until redundancy in data was reached? ☐ Yes ☐ No ☐ Not Addressed
• Are the participants described in adequate detail?

Data Collection:

• Descriptive Clarity:
  • Site: ☐ Yes ☐ No
  • Participants: ☐ Yes ☐ No
  • Role of researcher & relationship with participants: ☐ Yes ☐ No
  • Assumptions and biases of researcher: ☐ Yes ☐ No
• Procedural Rigour:
  • Procedural rigor in data collection? ☐ Yes ☐ No ☐ Not Addressed

Data Analyses:

• Analytical Rigour:
  • Data analyses were inductive? ☐ Yes ☐ No ☐ Not Addressed
  • Findings consistent with & reflective of data? ☐ Yes ☐ No
• Auditability:
  • Decision trail developed? ☐ Yes ☐ No ☐ Not Addressed
  • Process of analyzing data described adequately? ☐ Yes ☐ No ☐ Not Addressed
• Theoretical Connections:
  • Did a meaningful picture of the phenomenon under study emerge? ☐ Yes ☐ No

Overall Rigour:

• Evidence of trustworthiness components?
  • Credibility: ☐ Yes ☐ No
  • Transferability: ☐ Yes ☐ No
  • Dependability: ☐ Yes ☐ No
  • Confirmability: ☐ Yes ☐ No
• What meaning and relevance does this study have for your practice or research question?

Conclusions & Implications:

• Conclusions appropriate given the study findings? ☐ Yes ☐ No
• Did the findings contribute to theory development & future OT practice/research? ☐ Yes ☐ No
• What did the study conclude? What were the implications for occupational therapy? What were the main limitations in the study?

Rehabilitation Strategies for COVID-19 Patients

Phase 1 – Assessing Risk: It’s crucial to evaluate the potential consequences of delaying rehabilitation for a patient, like the risk of prolonged hospitalization. Before interacting with a patient, perform a point-of-care risk assessment (PCRA).

Phase 2 – Minimize Direct Contact: Avoid entering isolation zones just for patient screening. Instead, use remote methods to gather necessary information, such as patient history and discharge plans. Utilize secure digital tools like tablets and baby monitors for remote assessment and communication, which can be effective for evaluating issues like swallowing difficulties, communication, mobility, and cognitive functions.

Phase 3 – Personal Protective Equipment (PPE) Decision Based on PCRA: Determine the necessary PPE based on the assessment. Aerosol Generating Procedures (AGPs) demand airborne precautions, while other procedures might only need droplet and contact protection. AGPs include high-flow nasal oxygen, non-invasive ventilation, nebulizer treatments, and certain tracheostomy procedures. Also, activities that can lead to sputum expectoration require airborne precautions.

Additional Precautions Before Direct Contact:

1. Follow a detailed protocol for putting on and taking off PPE to prevent contamination.
2. Determine the least number of personnel needed for a safe session.
3. Coordinate bundled care with other healthcare professionals for efficiency.
4. Carefully manage equipment use and consult with infection control on decontamination protocols. Prefer single-use, disposable equipment where possible.

Purpose of the Guide: This document, which synthesizes current evidence and clinical input, aims to direct rehabilitation practices during the COVID-19 pandemic.

Specific Guidelines for Different Rehabilitation Disciplines:

• Occupational Therapy: Focuses on delirium prevention, physical and cognitive impairment management, optimizing positioning, ADLs management, assistive devices, and addressing mental health.
• Physical Therapy: Involves exercise and functional capacity assessment, monitoring comorbid conditions, and exercise training.
• Speech-Language Pathology: Emphasizes on dysphagia and cognitive communication rehabilitation, respiratory strength management, and tracheostomy care.

Critical Review Guide for Qualitative Studies (Version 2.0)

Citation Details

• Include comprehensive citation: full title, authors’ last names and initials, complete journal title, publication year, volume, and page range.
• This detail ensures the article is easily retrievable by others.

Study Purpose

• Assess if the purpose or research question is explicitly stated, typically found in the abstract and introduction.
• A distinct purpose or question helps in evaluating the study’s relevance and interest.
• Summarize the purpose or question in the comments for quick reference.

Literature Review

• Check for a relevant background literature review.
• The review should synthesize pertinent information like previous research and its clinical significance.
• It should highlight gaps in current knowledge and justify the study’s necessity.
• Assess the study’s relevance to occupational therapy practice.

Study Design

• Identify the type of qualitative research design used.
• Common types in rehabilitation research include Phenomenology, Ethnography, Grounded Theory, and Participatory Action Research (PAR).
• Evaluate the appropriateness of the chosen design based on its features and relevance to the research question.

Specific Design Types

1. Phenomenology: Explores the essence of personal experiences.
2. Ethnography: Studies the culture of a group or individuals in a specific setting.
3. Grounded Theory: Aims at developing theories grounded in real-world observations.
4. Participatory Action Research (PAR): Involves participants in the research process for social change.
5. Other Designs: Includes various qualitative research methods from different disciplines.

Appropriateness of Study Design

• The chosen design should align with the researcher’s worldview, desired outcomes, depth of understanding needed, and inductive reasoning.
• Theoretical perspectives of the researchers should be clear and influence the study’s framework.

Qualitative Methods

• Methods include Participant Observation, Interviews, Document Review, Focus Groups, and others.
• Each method has its advantages and drawbacks, and the choice should suit the study’s focus.

The Patient-Rated Tennis Elbow Evaluation (PRTEE)

The Patient-Rated Tennis Elbow Evaluation (PRTEE)© User Guide explains the PRTEE, originally named the Patient-Rated Forearm Evaluation Questionnaire (PRFEQ). This 15-question survey assesses forearm pain and disability in patients with lateral epicondylitis (tennis elbow). It enables patients to self-rate their pain and disability on a scale from 0 to 10. The PRTEE includes two parts: a pain subscale (5 items, 0=no pain, 10=worst pain) and a function subscale, further divided into specific (6 items) and usual activities (4 items). A composite score out of 100 is calculated, giving equal weight to pain and functional issues.

The PRTEE, adapted from the Patient-Rated Wrist Evaluation (PRWE), was developed to evaluate tennis elbow supports for a master’s thesis. It integrated insights from a prior study on outcome measures for lateral epicondylitis. The pain subscale borrows four items from the PRWE, substituting “arm” for “wrist”. The “usual activities” section mirrors that of the PRWE, while “specific activities” reflect those impacted by tennis elbow. The questionnaire is concise, with five pain and ten function questions, allowing for an even scoring out of 100.

Testing of the PRTEE showed excellent test-retest reliability in a study involving 47 patients with unilateral lateral epicondylitis. The pain, function, and total scores all displayed high reliability (ICC > 0.75). The PRTEE’s validity was also confirmed by correlating its scores with pain-free grip strength, showing a moderate correlation.

Recently, the questionnaire’s name was changed from the Patient-Rated Forearm Evaluation Questionnaire to the Patient-Rated Tennis Elbow Evaluation, to better reflect its focus. Minor adjustments in item wording were also made for clarity.

Scoring the PRTEE involves summing the pain and function subscale scores, with a maximum score of 100 indicating the greatest pain and disability. For missing data, the mean subscale score is used. Patients are advised to estimate difficulty for rarely performed tasks and to leave items blank for tasks they never do.

ICF Linkage Indicator Defintitions

These guidelines provide a framework for raters to determine the relevance of an outcome measure’s content to the International Classification of Functioning, Disability and Health (ICF) codes. The process involves using established rules and training materials, along with updates from the ICF branch. The content is then summarized using specific indicators that compare the items to the ICF or its Core Sets, where applicable. The indicators, which exclude non-codable content, offer a descriptive analysis of how a measure relates to the ICF and its core sets. They should be used alongside other methods for a comprehensive understanding of measures.

1. Measure to ICF Linkage: This indicator shows the proportion of a measure’s items that correlate with ICF codes. It quantifies how much of a measure’s content aligns with ICF coding. Formula: (Number of items linked to ≥1 ICF code / Total items) × 100%
2. Measure to Core Set Absolute Linkage: This indicates the percentage of measure items that align with codes in a relevant Brief or Comprehensive Core Set. Formula: (Items linked to Core Set codes / Total items) × 100%
3. Measure to Core Set Unique Linkage: This measures the percentage of unique ICF codes from a measure’s items, showing the diversity of content represented in the core set. Formula: (Items linked to unique Core Set codes / Total items) × 100
4. Core Set Representation: This reflects the percentage of core set codes represented in the measure’s linked ICF codes, indicating how comprehensively the measure covers the core set’s scope. Formula: (Unique ICF codes in measure found in Core Set / Total Core Set codes) × 100%
5. Core Set Unique Disability Representation: This shows the percentage of unique disability codes from the core set covered by the measure’s linked ICF codes. It assesses the extent to which the measure captures the disability aspect defined by the core set. Formula: (Unique disability codes in measure found in Core Set / Total disability codes in Core Set) × 100%

Patient-Rated Tennis Elbow Evaluation

The following questions are intended to understand the level of difficulty you have experienced with your arm in the past week. Please describe your average arm symptoms over the past week on a scale of 0-10. Answer all questions. Circle “10” if you did not perform an activity due to pain or inability. Estimate if unsure and only leave items blank if you never perform the activity. Indicate this by drawing a line through the question.

1. PAIN in your affected arm:
Rate the average pain in your arm over the past week on a scale from 0 (no pain) to 10 (worst pain imaginable).

• At rest: 0 1 2 3 4 5 6 7 8 9 10
• During repeated arm movement: 0 1 2 3 4 5 6 7 8 9 10
• When carrying a plastic bag of groceries: 0 1 2 3 4 5 6 7 8 9 10
• When pain was at its least: 0 1 2 3 4 5 6 7 8 9 10
• When pain was at its worst: 0 1 2 3 4 5 6 7 8 9 10

Please turn the page…

2. FUNCTIONAL DISABILITY:
A. Specific Activities
Rate the difficulty of each task over the past week from 0 (no difficulty) to 10 (unable to do).

• Turn a doorknob or key: 0 1 2 3 4 5 6 7 8 9 10
• Carry a grocery bag or briefcase by the handle: 0 1 2 3 4 5 6 7 8 9 10
• Lift a full coffee cup or glass of milk to your mouth: 0 1 2 3 4 5 6 7 8 9 10
• Open a jar: 0 1 2 3 4 5 6 7 8 9 10
• Pull up pants: 0 1 2 3 4 5 6 7 8 9 10
• Wring out a washcloth or wet towel: 0 1 2 3 4 5 6 7 8 9 10

B. Usual Activities
Rate the difficulty of your usual activities from 0 (no difficulty) to 10 (unable to do any).

1. Personal activities (dressing, washing): 0 1 2 3 4 5 6 7 8 9 10
2. Household work (cleaning, maintenance): 0 1 2 3 4 5 6 7 8 9 10
3. Work (your job or everyday work): 0 1 2 3 4 5 6 7 8 9 10
4. Recreational or sporting activities: 0 1 2 3 4 5 6 7 8 9 10

Scoring Instructions:

• Pain Subscale: Sum of 5 items. Best score = 0; Worst score = 50
• Specific Activities: Sum of 6 items. Best score = 0; Worst score = 60
• Usual Activities: Sum of 4 items. Best score = 0; Worst score = 40
• Function Subscale: (Specific Activities + Usual Activities) / 2. Best score = 0; Worst score = 50
• Total Score: Pain Subscale + Function Subscale. Best Score = 0; Worst Score = 100

Upper Limb and Neck Research: Innovations and Developments

Research in the field of physical impairment and disability, specifically focusing on the upper limb and neck, is a critical area of medical science. This field encompasses a broad range of conditions affecting these body parts, striving to improve clinical assessment methods, treatment strategies, and understanding of the underlying factors contributing to pain and disability.

Key Research Themes:

1. Neck Pain:

Studies in this area are multifaceted, including development of clinical methods for assessing neurological changes, validation of outcome measures for neck pain, exploration of the biological-functional relationship, clinical trials focusing on various treatments, including manual therapies, prognosis studies on chronic pain and work loss, and comprehensive systematic reviews.

2. Shoulder Disorders:

Research here targets assessment techniques for strength and functional endurance, validating outcome measures specific to shoulder disorders, understanding the interplay between biological aspects and functional outcomes, clinical trials investigating both surgical and rehabilitation approaches, studies on the impact of surgery waiting times, prognosis regarding work-related outcomes, and systematic reviews to consolidate findings.

3. Elbow Conditions:

This includes research on clinical methods for assessing pain and disability in conditions like tennis elbow, the biological-functional relationship in elbow disorders, clinical trials for surgical and rehabilitation treatments, especially for tennis elbow, prognosis studies on chronic pain and employment impacts, and systematic reviews to summarize research findings.

4. Wrist/Hand Conditions:

Key focus areas include clinical assessment methods for impairments and pain in wrist/hand conditions, validation of outcome measures for these conditions, research modeling physical, social, and environmental factors influencing post-fracture disability, clinical trials assessing treatment effectiveness, systematic reviews for a comprehensive understanding, investigations into physical impairment and disability in rheumatoid arthritis (RA) and osteoarthritis (OA), and preventive strategies for post-fracture risks leading to loss of independence.

Critical Review Form for Quantitative Studies: A Guide for Clinicians and Researchers

The 1998 guidelines by Law et al. for the Critical Review Form for Quantitative Studies, created by the McMaster University Occupational Therapy Evidence-Based Practice Research Group, are a detailed resource designed for clinicians, students, and researchers. These guidelines aim to facilitate a deeper understanding and critical assessment of quantitative research articles in occupational therapy and related fields.

Key elements of these guidelines

1. Complete Bibliographic Citation: Emphasizing the importance of including full bibliographic details like the title, authors, journal title, year, volume, and page numbers. This ensures that others can easily locate and reference the same article.
2. Clarity of Study Purpose: The guidelines stress the importance of a clearly stated study purpose, typically found in the article’s abstract and introduction. A well-defined purpose helps determine the study’s relevance, importance, and applicability to occupational therapy practice. If the purpose is not aligned with the reader’s needs or interests, it suggests moving on to another article.
3. Literature Review Assessment: Examining whether the article includes a comprehensive review of relevant background literature. This aspect is crucial as it provides context, highlights previous research, and discusses the clinical significance of the study topic. A good literature review should identify gaps in current knowledge, thereby justifying the need for the study.
4. Research Design Overview: Outlining various research designs commonly used in rehabilitation research, such as Randomized Controlled Trials (RCTs), cohort studies, case-control studies, before-after designs, cross-sectional studies, and single subject/case research. Each design is detailed in terms of its essential features, benefits, and limitations. For instance, RCTs are described as involving random allocation of subjects to different groups for treatment comparison, highlighting their advantages in reducing confounding variables but noting their potential ethical and cost issues.
5. Evaluation of Methodology: The guidelines provide insights on how to assess the appropriateness of a study’s methodology and design. This includes considering the level of existing knowledge about the topic, the nature of the outcomes being studied, ethical considerations surrounding the research, and the specific purpose of the study. For example, RCTs are preferred for studies aiming to test treatment effectiveness, while exploratory designs like case studies or cross-sectional studies are suitable for areas with limited existing research.
6. Identification of Biases: A critical component of the guidelines is the identification of common biases in research studies. These biases include sample selection biases, which may affect the representativeness of the study population; measurement biases related to how outcomes are assessed; and intervention biases concerning the execution of the treatment. Understanding these biases is crucial for evaluating the validity and reliability of the study’s findings.
7. Practical Examples and Diagrams: The guidelines also include practical examples and diagrams to illustrate different study designs and their applications, particularly in evaluating the effectiveness of various occupational therapy interventions.
8. Direction for Further Information: Lastly, the guidelines direct readers to additional resources for more detailed information on specific aspects like biases in research, enhancing the utility of the guidelines as a comprehensive reference tool.

Volunteer/Referral Bias

People who volunteer or are referred to a study often differ from non-volunteers and non-referrals. For example, volunteers tend to be more motivated and concerned about their health, which usually favors the treatment group in terms of more positive outcomes.

Seasonal Bias

Conducting subject recruitment and treatment all at one time of year means results may be influenced by that timing. Specifically, the article notes seniors tend to be healthier in summer than winter. So for studies focused on seniors that take place only in summer, results may show a more positive effect that partially reflects seasonal health changes rather than just the treatment impact. This type of bias could favor either the treatment or control group depending on timing.

Attention Bias

Study participants’ awareness of the research purpose can lead them to provide more favorable self-assessments or display better performance due merely to the attention rather than any real gains from treatment. Using an attention control group helps account for this effect.

Number of Outcomes

Using only one outcome measure introduces bias related to what elements that measure captures. For example, an ADL scale focusing just on dressing, eating and toileting could miss changes in areas like grooming or meal preparation that would also indicate effects of treatment. Too many outcomes for the sample size is problematic statistically, reducing ability to detect significant differences between groups that may exist.

Masked/Independent Evaluation

Lack of masking whereby the evaluators know which group each subject is in opens the possibility of influence on results. Knowledge of treatment allocation often skews evaluation in favor of the treatment group. This issue is particularly relevant when the evaluator is part of the overall research team.

Recall or Memory Bias

Use of self-report outcomes relies on subject’s memories, which are often more biased towards recalling positives over negatives. Such bias tends to skew results to favor the treatment group.

Sample

The sample description should provide clear detail on: the number of subjects, appropriate characteristics (e.g. age, gender, diagnosis) for the study purpose and target population, total size as well as group sizes for multiple arm trials, specifics on recruitment approaches and selection criteria to assess selectivity and bias potential, and baseline similarities between groups when applicable. Justifying and describing the methods for determining sample size, whether determined statistically or pragmatically bases on available subject pool, lends confidence results are powered sufficiently to detect effects. Noting ethics procedures like obtaining informed consent, even briefly, further validates overall methodology.

Results

To enable interpretation of findings, results should highlight which outcomes showed statistically significant differences between groups as well as discussing what amount of change or group differences may be clinically or practically meaningful regardless of statistical significance. Justifying analysis approaches based on study purpose (compare interventions or explore variable interrelationships) and nature of outcomes (type and number) helps confirm appropriate analytic plan.

Dropouts

Reporting the absolute number of dropouts from a study arm or the entire sample, reasons for dropout when discernable, and imputation strategies or analytical approaches to account for missing data protects against skewed interpretation and permits clearer conclusions.

Discussion/Conclusion

The strength of causal inferences permitted by study design factors into what conclusions are reasonable. Randomized controlled trials allow stronger statements that observed outcomes stem from the interventions in question. Non-randomized or single arm designs limit conclusions predominantly to observing associations or within-group changes rather than making definitive pronouncements that treatments caused outcomes. The implications of results and findings to applied practice should be addressed, situating the current study into the broader literature condensing current knowledge state and gaps requiring more research.