Students: Sarah Wright and Melissa Hayden
Supervisors: Virginia Wright, Trish Geisler, Janet Woodhouse, Kelly Brewer, and Amie Kron
Background: The Community Mobility Assessment-2 (CMA-2) is used by occupational and physical therapists to determine youths’ ability to access their community safely after an acquired brain injury. Currently, training for the CMA-2 is only available on-site at one location, limiting dissemination of this tool. Purpose: To evaluate a training program consisting of online plus simulation (SIM) training in terms of its effectiveness at increasing accuracy and confidence in scoring the CMA-2, and its acceptability to clinicians. Method: 7 clinicians scored a community outing video before and after online training, and after SIM training, and completed questionnaires about the training formats. Findings: Scoring accuracy significantly improved following online, but not SIM, training. No significant increase in scoring confidence was found following online or SIM training. Participants found both training types to be acceptable learning methods. Implications. Online training shows promise as a learning method, and could improve dissemination of the CMA-2.

Students: Adi Sheinberg and Celine Gaghadar
Supervisors: Rosalie Wang and Debbie Hebert
Introduction: Dressing challenges impact women living with post-stroke hemiparesis. Difficulty with donning and doffing a brassiere specifically, can be addressed by gathering information on women’s dressing experience and strategies and using these data to develop adaptive brassieres. Currently, no comprehensive work explores the bra-specific dressing experience for this population with the goal of informing fashion designs. Objectives: (1) To determine the current strategies used by women with post-stroke hemiparesis to don and doff a brassiere by identifying relevant person, occupation and environment factors (2) To gain an understanding of women’s perspectives and challenges with their brassiere-specific dressing experience. Methods: A qualitative descriptive study was done. Twelve women with post-stroke hemiparesis were recruited. Women were video-recorded donning and doffing their brassieres. A tabular task analysis guided structured observations which were analyzed using conventional content analysis. The Person-Environment-Occupation model guided analysis of the factors that impacted dressing strategy. Semi-structured interviews exploring dressing experiences were transcribed, coded and thematically analyzed. Results: Women who have experienced a stroke have difficulty donning and doffing a brassiere but often feel that wearing one is a necessity and are wary of receiving assistance with this occupation. Participants tended to show a shifted preference towards clothing that is functional, easy to don and doff and comfortable and these factors take priority over fashion and aesthetics for most women when choosing clothing. Two main dressing strategies were observed however the choice of strategy appeared to be independent of factors such as type of bra, Chedoke-McMaster level and years post-stroke.  Conclusions: The findings of this study can help to fill the existing gaps in both the literature and adaptive clothing market regarding the unique dressing needs of this population. Additionally, these findings can inform rehabilitation guidelines with regards to stroke patients and dressing.

Students: Julia Qiuping Liu and Zoey Cheng Fang Wong
Supervisors: Debbie Hebert and Rosalie Wang
Introduction: Unilateral spatial neglect (USN) affects 23-46% of individuals post-stroke and impacts their ability to attend and respond to stimuli in the contralesional space. The use of video games for improving neglect shows preliminary evidence of being more motivating than conventional therapy. Through intense repetition, robot-assisted therapy has demonstrated improvements in upper limb motor recovery. However, rehabilitation has not explored the effectiveness of video gaming with the use of robotics to improve USN and ADL performance in individuals post-stroke. Objective: This study aims to explore the preliminary effectiveness and feasibility of robot-assisted gaming therapy to improve USN post-stroke and independence with ADLs. Methods: This study uses a quantitative quasi-experimental one group pretest posttest design. 15 participants with USN, will be recruited from the community and participate in one-hour sessions of therapy twice a week for five weeks. Outcome measures assessing USN will be collected through a line bisection test, Bell’s test, and Dynavision assessment. The Catherine Bergego scale will be used to assess ADL performance changes. The study’s feasibility will be evaluated using the Intrinsic Motivation Inventory to assess participants’ motivation and interest during therapy, along with the cost and time required to complete the intervention. Practice Implications: Findings from this study will help provide direction for future research regarding the use of robot-assisted gaming therapy in rehabilitation settings. Conclusions: Rehabilitation therapists can incorporate the use of robot-assisted gaming therapy with their clients, one that is more motivating than the conventional forms of therapy, to improve attention and ADL performance.

Students: Stephanie Venema and Imran Ghaznawi
Supervisors: Rosalie Wang and Debbie Hebert
Background: Hemiparesis is a disabling sequela of stroke that can limit movement control, range of motion, and hand dexterity, which can impact one’s dressing ability. Women are more often concerned with appearance and affected by clothing challenges than men. Adaptive clothing is available for persons living with disabilities; however, garments such as winter coats, do not meet the functional, expressive and aesthetic needs of women post-stroke. Furthermore, designs are often deemed unfashionable, can be stigmatizing and create barriers to social participation. Using design principles derived from structured observations of women (n=12) donning and doffing their own coat, and qualitative analysis of semi-structured interviews regarding dressing and clothing experiences, a prototype coat was developed to address their needs. Objective: The aim of this study was to create adaptive clothing design principles for women with hemiparesis and evaluate an adaptive coat prototype coat against these design principles. Methods: A mixed methods design was used. Data were collected from semi-structured interviews, donning and doffing videos, satisfaction questionnaires, and field trial observation worksheets. Interview and dressing video data from twelve women with hemiparesis was transcribed. Field trial dressing videos, observational worksheets, and satisfaction questionnaires were thematically analyzed and compared to previously defined design principles. Results: Six of the seven design principles developed by Story et al. (1998) were identified by the target population in Phase 1: equitable use, flexibility in use, simple and intuitive use, tolerance for error, low physical effort, and size and space for approach and use. Each principle had multiple guidelines, which the adaptive coat prototype either supported, semi-supported, or did not support. Implications: This research demonstrates a systematic way in which to build and test design principles for constructing adaptive outerwear for women with hemiparesis based on identifying functional, expressive, and aesthetic features desired by consumers. Conclusions: Findings from this study will contribute to the limited literature available on the adaptive clothing needs of women with hemiparesis and will help establish design principles and guidelines for future clothing development for this population.