Clinical Research Directory

Gluteal Activation Plus Movement Retraining

The purpose of this study is to determine if an isometric gluteal activation home exercise program (HEP) combined with a movement retraining program utilizing feedback cues produces significant changes in scores on the Forward Step-Down Test (FSDT) in healthy young adults with movement coordination impairments. Aim 1: To determine if an isometric gluteal activation HEP with a movement retraining program with feedback cues produces significant changes on scores FSDT compared to the gluteal activation HEP alone. Aim 2: To determine if an isometric gluteal activation HEP followed with a movement retraining program with feedback cues produces significant changes on category FSDT compared to gluteal activation HEP alone. Aim 3: To determine if an isometric gluteal activation HEP with a movement retraining program with feedback cues produces changes in the peak activation of the gluteus medius (GMed) and gluteus maximus (GMax) during the FSDT compared to the gluteal activation HEP alone. Aim 4: To determine if an isometric gluteal activation HEP with a movement retraining program with feedback cues produces changes in the mean activation of the GMed and GMax during the FSDT compared to the gluteal activation HEP alone. Aim 5: To determine if HEP dose has an effect on the FSDT response, as measured by change in score on the FSDT.

The Safety and Efficiency of Endovascular Treatment of Acute or Subacute Thromboembolic Occlusions of Lower Extremity.

Based on the development of new tools, including drug coated balloon, paclitaxel eluting stent, interwoven stents, debulking tools, More and more acute or subacute thromboembolic occlusions of lower extremity included stage IIb were treated with endovascular procedures. Most guidelines suggests only stage I and stage IIa lesions are suitable for endovascular treatments. Therefore, a well-designed real-world study that track the safety and clinical relevant outcomes, are required to determine the optimal therapies for patients with acute or subacute thromboembolic occlusions of lower extremity.

Transfemoral Powered Foot and Physical Therapy Study

Individuals living with Transfemoral Amputation, enrolled equally at the Veterans Affairs New York Harbor Healthcare System (VANYHHS) and Walter Reed National Military Medical Center (WRNMMC), will be fit with a powered ankle-foot prosthesis. All subjects will undergo a full gait analysis, functional measures, neurocognitive/cognitive, and pain assessment at baseline utilizing their current passive prosthesis. Subjects will then be randomly assigned into 2 equal groups: Powered device with an 8-session intensive, device-specific PT intervention (Group A); or powered device with current standard of practice (Group B), with includes basic device education, but no PT intervention. Subjects in Group A will undergo a 4-week PT-based intervention, which will isolate the contribution of device specific effects from rehabilitation effects. Group B will receive the current standard of practice, which does not include any formal rehabilitation. All users will undergo a full gait analysis, functional measures, neurocognitive/cognitive, and pain assessment after 4- and 8-weeks of use.

Promotion of Nurses' Lower Extremity Health by Foot(at)Work Intervention

The quasiexperimental study aims to analyse the effecs of Foot(at)Work intervention on nurses' lower extremity health. The Foot(at)Work intervention is in electronic format consisting of 5 themes. The idea is that the participants familiarizes with the foot health -related content. The primary outcome is knowledge about lower extremity self-care. Secondary outcomes are work well-being, lower extremity health and musculoskeletal health. The outcomes are measured before the intervention (M0), after the intervention (M1), one month after the intervention (M2), six months after the intervention (M3) and 12 months after the intervention (M4). The purpose of the Foot(at)Work intervention is to support nurses ability to self-care their lower extremities. The intervention consists of text, videos, and pictures that educate nurses to self-care their lower extremities and to select proper footwear.

Multi-axis Assessment of Injured Workers

The percentage of loss time claims receiving Loss of Earnings benefits at 3 months has continued to rise amongst injured workers in Ontario despite the Workplace Safety and Insurance Board (WSIB) approach of "Better at Work". The primary health services to address loss time claims associated with musculoskeletal injuries include the evidenced-based programs of care, occupational health assessment program and musculoskeletal specialty programs, however, these are set to be revised and relaunched in Q1 2023. Across treatment protocols there are challenges that, at least in part, appear to contribute to the increasing percentage of workers on full loss of earnings at 3 months include (1) inconsistent early identification of workers who should be triaged to various health services and (2) reliable determination of the optimal timing of referral to the most targeted care to enable a safe and sustainable return to work. The investigators aim to develop and evaluate a predictive assessment model to triage workers to the best service within the first 8 weeks of their claim to increase the rate of early return to work, with the long-term goal that the triage protocol becomes part of a person-centric protocol that reduces the duration of work-related disability. The investigators will develop and evaluate an assessment protocol for injured workers that enter any of the musculoskeletal-specific WSIB programs of care, which have been consolidated into a single program as of 2023. This study will be a prospective inception cohort design using data collected from injured workers receiving WSIB musculoskeletal programs of care services at CBI Health clinics in Ontario Canada. Worker data will be collected at intake to the program of care service and again approximately four and eight weeks after intake (or earlier if a worker completes the program of care). The investigators will complete data analysis in three steps including descriptive and bivariate associations, Maximum Likelihood-based Latent Profile Analysis, and evaluation of results against successful work outcomes and secondary outcomes. Qualitative data will be mined for alternative indicators of recovery / non-recovery. The study recruitment goal is 300 - 350 workers with complete follow-up within a 2-year period.