Adam Webber

Dalhousie University, Halifax, Nova Scotia, Canada

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Publications (7)13.53 Total impact

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    ABSTRACT: Auricular acupuncture (AA) is a widely accepted treatment option for substance abuse that is used in more than 700 treatment centers worldwide. Despite claims of perceived clinical benefits by patients and treatment staff, research efforts have failed to substantiate purported benefits, and the mechanism(s) by which AA serves in the treatment of addiction remain inconclusive. Numerous studies have shown AA to be an effective treatment for perioperative anxiety. In this study, we hypothesize that AA reduces the anxiety associated with withdrawal from psychoactive drugs. The study used a randomized, controlled design and included a sample of 101 patients recruited from an addiction treatment service. Subjects were assigned to one of three treatment groups (National Acupuncture Detoxification Association [NADA] AA, AA at sham points, or treatment setting control) and were instructed to attend treatment sessions for 3 days. The primary outcome measure state anxiety was assessed using a pretest-posttest treatment design. The study hypothesis was not confirmed. The NADA protocol was not more effective than sham or treatment setting control in reducing anxiety. The widespread acceptance of AA in the treatment of addiction remains controversial.
    Journal of substance abuse treatment 05/2011; 41(3):279-87. · 2.90 Impact Factor
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    ABSTRACT: Therapeutic massage has been proven to be an effective, nonpharmacologic, alternative for managing state and trait anxiety in a variety of clinical situations. However, no controlled study has investigated this effect in an addiction treatment setting. The aim of this study was to investigate the effectiveness of chair massage for reducing anxiety in persons participating in an inpatient withdrawal management program for psychoactive drugs. The design was a randomized, controlled clinical trial conducted from June 2008 to January 2009. Eighty-two (82) adult patients received inpatient treatment for psychoactive drug withdrawal (alcohol, cocaine, and opiates). This study was conducted at the Withdrawal Management Services at the Capital District Health Authority, Halifax, Nova Scotia. Subjects were randomly assigned to receive chair massage (n = 40) or a relaxation control condition (n = 42). Treatments were offered for 3 consecutive days. Standard counseling and pharmacologic management were also offered concurrently to patients in all conditions. The primary outcome measure was anxiety assessed using the Spielberger State-Trait Anxiety Inventory (STAI). State and trait anxiety scores were determined immediately prior to and following each treatment intervention. Analysis of STAI scores showed a significant reduction in state and trait anxiety for both interventions (p < 0.001). The magnitude in the reduction in state (p = 0.001) and trait (p = 0.045) anxiety was significantly greater in the chair massage group where the effect on state anxiety was sustained, at least in part, for 24 hours. Within the clinical context of this study, chair massage was more effective that relaxation control in reducing anxiety. Further investigation of chair massage as a potential nonpharmacologic adjunct in the management of withdrawal related anxiety is warranted.
    Journal of alternative and complementary medicine (New York, N.Y.) 09/2010; 16(9):979-87. · 1.69 Impact Factor
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    ABSTRACT: Diagnosed obstructive sleep apnea (OSA) affects 2% to 7% of middle-age persons worldwide and represents a substantial health care burden. The gold standard for treating OSA in adults is continuous positive airway pressure (CPAP) therapy. Compliance with this treatment is especially important in OSA patients experiencing concomitant acute and chronic disease or illness, and those undergoing procedures associated with sedation, analgesia and anesthesia. To describe the clinical characteristics and management of hospitalized OSA patients in Canada. Using the Canadian Institute for Health Information's hospital Discharge Abstract Database (fiscal year 2006⁄2007), a retrospective cohort study of all acute care patients discharged with a diagnosis that included OSA was performed. An examination of the discharge data of 2,400,245 acute care hospital abstracts identified 8823 cases of OSA. The mean age of OSA patients was 45.7 years and 66.5% were men. The most common comorbidities in the adult OSA population were obesity, cardiovascular disease, type 2 diabetes mellitus and chronic obstructive pulmonary disease. In adult OSA patients, the reported surgical intervention rate using uvulopalatopharyngoplasty (9.6%) was much higher than interventional CPAP therapy (4.8%). Only a small percentage of hospitalized OSA patients were documented as having received CPAP therapy during their stay. Issues relating to the accuracy, specificity and completeness of the Canadian Institute for Health Information's hospital Discharge Abstract Database specific to OSA and its management were identified. Practices pertaining to the reporting, coding and management of hospitalized adult OSA patients warrant further investigation and research.
    Canadian respiratory journal: journal of the Canadian Thoracic Society 01/2010; 17(5):213-8. · 1.29 Impact Factor
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    ABSTRACT: To test the hypothesis that, in comparison with a heavier, larger and more expensive manual tilt-in-space wheelchair, a lightweight manual wheelchair equipped with new rear antitip devices provides comparable mean sitting pressures in the tilted position, each of eight able-bodied participants sat for 8 mins in each wheelchair, upright, and tilted back (38-39 degrees). The mean (+/-SD) sitting pressures (of all active sensors in a force-sensing array) at the eighth minute in the upright and tilted positions with the new rear antitip device wheelchair were 58.6 (+/-14.0) and 45.8 (+/-9.3) mm Hg (a 20.7% reduction) (P = 0.005). For the tilt-in-space wheelchair, the mean values were 55.7 (+/-13.9) and 47.2 (+/-10.8) mm Hg (a 26.3% reduction) (P = 0.008). There were no significant differences between the wheelchairs in the upright (P = 0.843) or tilted (P = 0.624) positions. A lightweight manual wheelchair equipped with a new rear antitip device provides equivalent reductions of sitting pressures in the tilted position to a comparably tilted tilt-in-space wheelchair.
    American journal of physical medicine & rehabilitation / Association of Academic Physiatrists 11/2008; 88(1):61-5. · 1.56 Impact Factor
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    ABSTRACT: To test the hypothesis that, in comparison with a commercially available tilt-in-space wheelchair, a lightweight manual wheelchair equipped with a new, rear anti-tip device (Arc-RAD) provides caregivers with improved wheelchair-handling performance, less exertion, and greater satisfaction. Within-participant comparisons. Rehabilitation center. Able-bodied participants (n=19) simulating caregivers and simulating wheelchair users (n=7). Caregiver participants were trained (50-75 min) in wheelchair-handling skills. Each participant was tested in both wheelchairs, in random order. To evaluate wheelchair-handling skills, we used the total percentage score on the Wheelchair Skills Test (WST), version 3.2. For exertion, we used a visual analog scale (in percent). For satisfaction, we used the Quebec Users' Evaluation of Satisfaction with assistive Technology (QUEST; range of values, 8-40), version 2. Mean percentage WST scores +/- SD for the Arc-RAD and tilt-in-space wheelchairs were 95.9%+/-4.2%, and 91.9%+/-4.8%, respectively (P=.008). The mean perceived exertions during Arc-RAD and tilt-in-space wheelchair use were 26.1%+/-20.4% and 46.6%+/-23.2% (P=.003). The mean total QUEST satisfaction scores for the Arc-RAD and tilt-in-space wheelchairs were 35.1+/-3.8 and 28.4+/-4.7 (P=.002). In comparison with the larger and heavier tilt-in-space wheelchair, a lightweight manual wheelchair equipped with a new rear anti-tip design allows 4.4% better wheelchair-handling performance, 44% less exertion, and 23.6% greater wheelchair satisfaction.
    Archives of physical medicine and rehabilitation 10/2008; 89(9):1811-5. · 2.18 Impact Factor
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    ABSTRACT: The primary objective of this study was to test the hypotheses that a wheelie training method that begins in a high-rolling-resistance (RR) setting (1) improves the success rate and (2) reduces the training time. Our secondary objectives were to assess the effects of other factors (e.g., age, gender) on training time and to acquire data on the perceptions of the participants that would assist us in refining our training methods. Randomized controlled study including 48 able-bodied participants with no significant wheelchair experience. Each participant was taught the wheelie skill, using up to five training sessions. Participants in the conventional group did all of their training on a smooth, level, tile surface. The RR group began training in a high-RR setting (rear wheels initially prevented from moving at all, progressing to being on 12-cm-thick foam that permitted some movement) before moving to the tile surface. Outcome measures were success rate (%), training time (mins) to achieve wheelie competence (defined as the ability to perform two consecutive 30-sec wheelies within a 1.5-m-diameter circle, assessed at least 2 days after training), and a questionnaire. The success rates for those in the conventional and RR groups were 96% and 100%, respectively (P = 1.000). The mean (+/-SD) training times for the conventional and RR groups were 55.9 mins (+/-27.1) and 51.8 mins (+/-18.7) (P = 0.549). Training time was not significantly affected by trainer or age, but it was affected by sex, with women requiring an average of 21.4 mins more than men (P = 0.002). Perceptions of participants in both groups about the training were positive. Of the participants in the RR group, 14 (74%) perceived the RR technique as "very effective," and five (26%) perceived it as "moderately effective." Neither success rate nor training time for wheelie skill acquisition by able-bodied learners are improved by a training method using high RR. Women require more time to learn than men. Learners using the RR technique perceive it to be effective. These results have implications for training practices.
    American Journal of Physical Medicine & Rehabilitation 04/2008; 87(3):204-11; quiz 212-4. · 1.73 Impact Factor
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    ABSTRACT: To test the hypotheses that, compared with participants using manual wheelchairs equipped with conventional rear anti-tip devices (C-RADs), those using a new RAD design that deploys through an arc (Arc-RAD) perform RAD-relevant wheelchair skills better and as safely. A randomized controlled study. A rehabilitation center. Participants (N=30) including 16 able-bodied and 14 wheelchair users. Participants were provided with wheelchair skills training (up to 2.4h). Total percentage score on a set of 23 RAD-relevant skills of the Wheelchair Skills Test (WST, version 3.2) administered a minimum of 3 days after training. For the C-RAD and Arc-RAD groups, the mean +/- standard deviation RAD-relevant WST scores were 32.3%+/-8.5% and 85.1%+/-18.9% (Kruskal-Wallis, P<.001). Of the 23 RAD-relevant individual skills, the success rates for the Arc-RAD group were at least 20% higher (the criterion we set for clinical significance) in 17 (74%). For the C-RAD group, the success rate was 0% for the 12 wheelie-dependent skills, the 13-cm-high obstacle, and the 15-cm level change ascent. There were no serious adverse effects in either group. The new RAD design allows much better performance on relevant wheelchair skills than the conventional design without compromising safety.
    Archives of physical medicine and rehabilitation 03/2008; 89(3):480-5. · 2.18 Impact Factor