Browsing by Author "Clark, Marcia L."
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Item Open Access An Intervention Program Designed to Improve Balance and Power in U14 Alpine Ski-Racers(2018-09-20) Kashluba, Kayla Amanda; Doyle-Baker, Patricia Katherine; Clark, Marcia L.; Emery, Carolyn A.; Jordan, Matthew J.; Westin, MariaPurpose: To investigate if a neuromuscular training (NMT) warm-up program during preseason improved lower limb balance and maximal muscular power compared to a standard preseason program in alpine ski-racers 10-13-years-old (U14) after 8-weeks. Methods: Quasi-experimental study design. Participants included n=73 skiers from five Alberta Alpine Ski Association (AASA) ski-clubs. Ski-clubs in the intervention group (n=3) completed 2 15-min coach-delivered NMT warm-ups a week, while the standard of care (SOC) (n=2) ski-clubs completed their standard training; NMT warm-up program included balance, strength, and agility exercises. Performance outcome measures completed at baseline and post –testing included: vertical jump (VJ), star excursion balance test (SEBT) reach distances, and predicted VO2max. Results: Participants in the intervention group demonstrated significant improvements on the VJ and SEBT. Conclusions: Dynamic balance and peak leg power improved post implementation of the NMT warm-up program in U14 alpine ski-racers.Item Open Access Harnessing the power of patient engagement in evaluating a novel brace for knee osteoarthritis: a co-produced commentary(2024-10-24) Bishop, Emily L.; Bonhomme, Justin; Baranec, Deb; Wamsley, Anita; Ronsky, Janet L.; Clark, Marcia L.Abstract Introduction Patient oriented research (POR) invites patients to partner with researchers, clinicians, and other stakeholders, incorporating diverse perspectives to generate scientific evidence meaningful to all parties involved. We adopted a POR approach for this study evaluating the feasibility of conducting a randomized control trial of a novel tri-compartment offloader brace for knee osteoarthritis. We involved patients as partners to enhance study design, implementation and interpretation of key outcomes. Approach Patient involvement consisted of two patient leaders and five patient advisors. Patients participated in 2 virtual focus groups to discuss study outcomes, protocol, results and knowledge translation. Patients were involved in all aspects of the research cycle. Outcomes Patient feedback resulted in changes to study design, documentation, participant recruitment, data collection, results interpretation and knowledge dissemination, improving the participant experience and aligning study outcomes with patient priorities. Study participants showed a high level of protocol adherence and follow-up rates were excellent. We experienced several unexpected benefits including genuine friendships, a deeper understanding of the patient experience, a more pragmatic approach to clinical research, and leadership opportunities for patients. Recommendations We agreed on POR “non-negotiables” to ensure a positive experience for everyone, including creating a safe and comfortable environment, being genuinely receptive to patient feedback, and providing appropriate supports for patients. We strongly recommend that researchers (1) involve patients as early as possible, (2) provide ample and equal opportunities for all patients to be involved, and (3) address system hierarchy by involving patients as equals and fully considering all patient ideas from the beginning of the project. Conclusions While POR is a learning process that is often more challenging than the traditional clinical research approach, the benefits are well worth the additional time and effort required to do it well. Over time, our team experienced a cultural shift and evolution from a top-down research approach to a more inclusive approach considering patient voices as equal to those of researchers. Patient involvement in all aspects of the research process, from question development to results interpretation and dissemination is integral to clinical research advancing equitably.Item Open Access Preliminary Evaluation of a New Orthotic for Patellofemoral and Multicompartment Knee Osteoarthritis(2021-09-07) Budarick, Aleksandra R.; Bishop, Emily L.; Clark, Marcia L.; Cowper-Smith, Christopher D.Purpose. Traditional knee osteoarthritis (OA) braces are usually indicated for a minority of patients with knee OA, as they are only suitable for those with unicompartmental disease affecting the tibiofemoral joint. A new assistive brace design is intended for use in a wider range of knee OA patients with heterogeneous symptoms characteristic of patellofemoral, tibiofemoral, or multicompartmental knee OA. The purpose of this case series was to explore whether the use of this novel “tricompartment offloader” (TCO) brace was associated with clinically relevant improvements in pain and function. Materials and Methods. A retrospective analysis of individuals with knee OA () was conducted to assess pain, function, physical activity, and use of medication and other treatments before and after brace use. Validated outcome measures including the Visual Analog Scale (VAS) and Lower Extremity Functional Scale (LEFS) were used to assess pain and physical function (primary outcome measures). Exploratory measures were used to quantify physical activity levels and use of medication and other treatments (secondary outcome measures). Results. Average total pain (VAS) scores decreased by 36.6 mm and physical function (LEFS) scores increased by 16.0 points following the use of the TCO brace. Overall, 70% of the participants indicated increased weekly physical activity and 60% reported a decrease in their use of at least one other treatment. Conclusions. Results from this case series suggest that the TCO brace shows strong potential to fill a conservative treatment gap for patients with heterogeneous symptoms of knee OA that are characteristic of patellofemoral or multicompartment disease. Further investigation is warranted.