Douglas P Gross

• Ph.D., BScPT
• Professor & Chair at University of Alberta

Background To promote rural practice and increase enrollment in the entry-level Master of Science Physical Therapy program at the University of Alberta, the Department of Physical Therapy developed a rural physical therapy satellite campus located in a farming region in central Alberta. A distributed learning format was used to connect the rural co...

Purpose: To identify research priorities related to COVID rehabilitation from the perspectives of persons with lived experiences, clinicians, researchers, community organization and policy representatives. Materials & methods: We conducted five international consultations to identify key issues and research priorities in COVID rehabilitation usi...

According to Cochrane Rehabilitation's recently published definition for research purposes, rehabilitation is inherently complex. Rehabilitation teams frequently implement multiple strategies concurrently, draw on input from a range of different health professionals, target multiple outcomes, and personalize therapeutic plans. The success of rehabi...

Purpose Telerehabilitation or hybrid delivery (i.e., a mixture of telerehabilitation and in-person care) was increasingly used to deliver posttraumatic stress injury (PTSI) rehabilitation in response to the COVID-19 pandemic. Limited research, however, has evaluated the use of telerehabilitation to deliver PTSI interventions, including exposure-bas...

Background and context of the study Neck pain is a prevalent and globally burdensome problem. Clinical practice guidelines have recommended conservative treatments such as education, exercise therapy (ET), manual therapy (MT), and pharmacological therapy (i.e., medication) to manage all types of neck pain based on the chronicity of the disease (acu...

Purpose Long COVID Physio (LCP) is an international peer support, education and advocacy, patient-led association of physiotherapists living with long COVID and allies. In 2022, LCP hosted an international forum. One of the aims of the forum was to identify priorities in long COVID and rehabilitation. Methods We conducted an international consulta...

Objective: We aimed to explore patient and provider perspectives of the impact of the COVID-19 pandemic on tuberculosis healthcare access and service delivery. Methods: We used Interpretive Description, a qualitative approach with the end-goal of informing decisions and actions in clinical practice. Levesque et al.’s “ Conceptual framework of acces...

Purpose Despite evidence of efficacy, the effectiveness of telerehabilitation in real-world clinical settings is still largely unknown. Telerehabilitation requires a substantial transformation of the organization and delivery of traditional services. Considering that a virtual setting can create unique challenges for providing physiotherapy service...

Introduction. Long COVID affects individuals labour market participation in many ways. While some cannot work at all, others may return to work (RTW) in a limited capacity. Determining what rehabilitation or related strategies are safe and effective for facilitating RTW is necessary. Objectives. To synthesize evidence on RTW interventions for peopl...

Background Sex-disparities in healthcare access were exacerbated during the COVID-19 pandemic. For respiratory conditions like asthma where females have poorer disease outcomes, it is unclear if the pandemic further worsened this sex-disparity. Thus, the objective of this study is to compare the impact of the pandemic on healthcare utilization, exa...

Purpose Major depressive disorder (MDD) is one of the leading causes of work-related disability, and accessing telehealth therapies can be a promising modality for workers with MDD. Barriers to accessing in-person mental healthcare, such as limited availability and accessibility in rural and remote communities, financial constraints, and stigma, ha...

Gender-based violence (GBV) in the academic job sector is a critical issue that intersects with broader systemic and structural inequities, but research is limited. To study the prevalence, effects, and prevention measures of interpersonal GBV within the academic job sector, a meta-analysis and systematic review was conducted in accordance with the...

Randomized controlled trials (RCTs) are considered the gold standard of evidence guiding intervention selection in rehabilitation. However, conduct of sufficiently powered RCTs in rehabilitation can be expensive, pose ethical and attrition concerns when participants are assigned to ineffective treatment as usual conditions, and are infeasible with...

Background Patient‐reported outcome measures (PROMs) are recommended to measure the impact of a health condition or intervention effectiveness as they aim to capture what is most meaningful to patients. Several PROMs are used to evaluate pelvic organ prolapse (POP)‐related domains, yet the measurement properties of these instruments have not been f...

Background Gender-based violence (GBV) disproportionately affects young women and LGBTQ+ individuals, and therefore, a systematic review and meta-analysis was carried out to i) qualitatively identify the prevalence and experience of GBV in virtual work environments and ii) evaluate the current workplace policies, interventions or tools to protect a...

Background: Concussion and communication researchers have yet to study how post-concussion communication changes affect youths’ daily lives. The lack of attention paid to how young people respond to communication changes during concussion recovery constitutes a significant gap in current concussion management research and practices. Aims: To e...

Purpose Despite evidence of efficacy, the effectiveness of telerehabilitation in real-world clinical settings is still largely unknown. Telerehabilitation requires a substantial transformation of the organization and delivery of traditional services. Considering that a virtual setting can create unique challenges for providing physiotherapy service...

Rationale: Existing work suggests that patients with COPD (pwCOPD) presented less frequently to the emergency department (ED) and were less likely to be hospitalized during the COVID-19 pandemic but it is unclear if this was due to improved health and disease management or to increased barriers/avoidance of healthcare. The objective of this study...

Background Nurses experience elevated rates of operational stress injuries (OSIs). This can necessitate taking leave from work and subsequently engaging in a workplace reintegration process. An unsuccessful process can have long term impacts on a nurse's career, affecting the individual, their family, and broader community, while contributing to nu...

Gender-based violence (GBV) poses a significant concern in the construction and natural resources industries, where women, due to lower social status and integration, are at heightened risk. This systematic review aimed to identify the prevalence and experience of GBV in the construction and natural resources industries. A systematic search across...

Perceptions and biases influence how we interact with and experience the world, including in professional roles as researchers. Weight bias, defined as negative attitudes or perceptions towards people that have large bodies, can contribute to weight stigma and discrimination leading to negative health and social consequences. Weight bias is experie...

As researchers in communication sciences and related disciplines continue to embrace qualitative research methodologies, there will be a corresponding need for innovative methods and strategies for data collection and generation, reflexivity and knowledge translation to make qualitative research methods more inclusive. Historically, those who commu...

Rehabilitation providers and policymakers need valid evidence to make informed decisions about the healthcare needs of the population. Whenever possible, these decisions should be informed by randomized controlled trials (RCTs). However, there are circumstances when evidence needs to be generated rapidly, or when RCTs are not ethical or feasible. T...

Objective To examine the feasibility and preliminary construct validity of a novel sports-related concussion (SRC) balance assessment battery; the Functional Assessment of Balance in Concussion (FAB-C). Design Cross-sectional study. Setting University laboratory and physiotherapy clinic. Participants Forty uninjured individuals (12 female; media...

Purpose To evaluate the effectiveness of telerehabilitation for promoting return-to-work (RTW) among injured workers. Methods We conducted a pragmatic, quasi-experimental study comparing telerehabilitation, in-person, or hybrid services. Descriptive statistics analyzed demographics, occupational factors, and patient-reported outcome measures (PROM...

BACKGROUND: Posttraumatic stress injury (PTSI) is a term used to describe a range of psychiatric difficulties which arise following exposure to a psychologically traumatic event. The impact of being diagnosed with multiple psychiatric conditions on the return-to-work (RTW) outcomes of individuals with PTSI has not been adequately researched. OBJECT...

Purpose The aim of this qualitative study is to understand the need for, access to, and quality of rehabilitation services for people living with Long COVID. Little is known about the experiences of people living with Long COVID accessing rehabilitation services. Therefore, we explored health concerns leading people living with Long COVID to seek h...

Background: COVID-19 infection can result in persistent symptoms, known as long COVID. Understanding the provider experience of service provision for people with long COVID symptoms is crucial for improving care quality and addressing potential challenges. Currently, there is limited knowledge about the provider experience of long COVID service del...

Background Understanding of Long COVID has advanced through patient-led initiatives. However, research about barriers to accessing Long COVID services is limited. This study aimed to better understand the need for, access to, and quality of, Long COVID services. We explored health needs and experiences of services, including ability of services to...

Introduction Health professional regulators have a mandate to ensure ongoing competence of their regulated members (registrants). Programs for monitoring and assessing continuing competence are one means of assuring the public of the quality of professional services. More regulators are adopting programs for continuing competence that require regis...

Chronic primary low back pain (CPLBP) is a prevalent and disabling condition that often requires rehabilitation interventions to improve function and alleviate pain. This paper aims to advance future research, including systematic reviews and randomized controlled trials (RCTs), on CPLBP management. We provide methodological and reporting recommend...

Purpose Evaluate benefits and harms of education/advice for chronic primary low back pain (CPLBP) in adults to inform a World Health Organization (WHO) standard clinical guideline. Methods Electronic databases were searched for randomized controlled trials (RCTs) assessing education/advice compared with placebo/sham, usual care, or no intervention...

Purpose To evaluate benefits and harms of transcutaneous electrical nerve stimulation (TENS) for chronic primary low back pain (CPLBP) in adults to inform a World Health Organization (WHO) standard clinical guideline. Methods We searched for randomized controlled trials (RCTs) from various electronic databases from July 1, 2007 to March 9, 2022. E...

Purpose Evaluate benefits and harms of structured exercise programs for chronic primary low back pain (CPLBP) in adults to inform a World Health Organization (WHO) standard clinical guideline. Methods We searched for randomized controlled trials (RCTs) in electronic databases (inception to 17 May 2022). Eligible RCTs targeted structured exercise p...

As commissioned by the WHO, we updated and expanded the scope of four systematic reviews to inform its (in development) clinical practice guideline for the management of CPLBP in adults, including older adults. Methodological details and results of each review are described in the respective articles in this series. In the last article of this seri...

Purpose Evaluate benefits and harms of needling therapies (NT) for chronic primary low back pain (CPLBP) in adults to inform a World Health Organization (WHO) standard clinical guideline. Methods Electronic databases were searched for randomized controlled trials (RCTs) assessing NT compared with placebo/sham, usual care, or no intervention (compa...

Purpose To evaluate the effectiveness of telerehabilitation for promoting return-to-work (RTW) among injured workers. Methods We conducted a pragmatic, quasi-experimental study comparing telerehabilitation, in-person, or hybrid services. Descriptive statistics analyzed demographics, occupational factors, and patient-reported outcome measures (PROM...

Objective: Motor skill assessment is part of the fetal alcohol spectrum disorder (FASD) multidisciplinary assessment. Some clinicians opt to exclude assessment of the subcomponents of visual-motor integration (visual perception and motor coordination), on the assumption that challenges will be revealed based on the assessment of visual-motor integ...

Background: The number of older adults living with companion animals (pets) is increasing worldwide. While evidence revealing positive relationships between companion animals and healthy aging is well established, there is a dearth of research regarding companion animal death and subsequent human grieving. Some emerging research suggests that grief...

Background: Sustainable employability is increasingly important with current socio-economic challenges. Screening for resilience could contribute to early detection of either a risk, or a protector for sustainable employability, the latter being operationalized as workability and vitality. Objective: To study the predictive value of Heart Rate V...

Approximately 15% of adult Canadians with SARS-CoV-2 infection develop lingering symptoms beyond 12 weeks post-acute infection, known as post-COVID condition or long COVID. Some of the commonly reported long COVID cardiovascular symptoms include fatigue, shortness of breath, chest pain, and palpitations. Suspected long-term cardiovascular complicat...

Single case experimental design (SCED) is a family of experimental methods that can be used to examine the efficacy of interventions by testing a small number of patients or cases. This article provides an overview of SCED research for use in rehabilitation as another option along with traditional group-based research when studying rare cases and r...

Purpose To utilize natural language processing (NLP) of MRI reports and various clinical variables to develop a preliminary model predictive of the need for surgery in patients with low back and neck pain. Such a model would be beneficial for informing clinical practice decisions and help reduce the number of unnecessary surgical referrals, streaml...

Introduction: Musculoskeletal injury (MSI) contributes to global health burdens. Effective MSI prevention is necessary. MSI risk factor screening tools can be used by employers to identify and mitigate occupational hazards. Rigorous synthesis of the effectiveness of these tools has not taken place. We synthesized literature on effectiveness of MSI...

Objective The aging workforce influences employability and health of the working population, with new challenges emerging. The focus has shifted from return to work only, to enhancing ability to stay at work. It is unclear whether factors that influence return to work (RTW) also apply to preserving health and helping workers stay at work (SAW). Stu...

Background Understanding of Long COVID has advanced through patient-led initiatives. However, research about barriers to accessing Long COVID services is limited. This study aimed to better understand the need for, access to, and quality of, Long COVID services. We explored health needs and experiences of services, including ability of services to...

This paper is supported and co-published by the following journals, and their Editors in Chief: Annals of Physical and Rehabilitation Medicine − Dominic Pérennou American Journal of Physical Medicine & Rehabilitation − Walter Frontera Developmental Neurorehabilitation − Wendy Machalicek European Journal of Physical and Rehabilitation Medicine − Ste...

Background : Symptomatic lumbar spinal stenosis (SLSS) is the most common diagnosis associated with spine surgery for those over the age of 55 years. There is a lack of quality research on the effectiveness of prehabilitation on pain, function, and quality of life in patients undergoing surgery for SLSS. This pilot randomized controlled trial (RCT)...

Background Emerging evidence suggests that worldwide, between 30% and 50% of those who are infected with COVID-19 experience long COVID (LC) symptoms. These symptoms create challenges with return-to-work (RTW) in a high proportion of individuals with LC. To tailor rehabilitation programs to LC sequelae and help improve RTW outcomes, more research o...

Objective: This study aimed to study risk factors for developing concurrent posttraumatic stress injury (PTSI) among workers experiencing work-related musculoskeletal injury (MSI). Methods: A case-control study was conducted using workers' compensation data on injured workers undergoing rehabilitation programs for concurrent MSI and PTSI (cases)...

Purpose The focus of SPINE20 is to develop evidence-based policy recommendations for the G20 countries to work with governments to reduce the burden of spine disease, and disability. Methods On September 17–18, 2021, SPINE20 held its annual meeting in Rome, Italy. Prior to the meeting, the SPINE20 created six proposed recommendations. These recomm...

BACKGROUND Emerging evidence suggests that globally, between 30-50% of those who are infected with Coronavirus Disease 2019 (COVID-19) experience Long COVID (LC) symptoms. These symptoms create challenges with return-to-work (RTW) in a high proportion of individuals with LC. In order to tailor rehabilitation programs to LC sequelae and help improve...

Aim To determine the relationship between motor abilities and intelligence in children and young people with prenatal alcohol exposure (PAE) being assessed for fetal alcohol spectrum disorder (FASD). Method This was a cross‐sectional correlational study of children and young people with PAE being assessed for FASD. The relationship between motor a...

Purpose Low back pain is associated with disability and lost productivity due to inability of workers to return to work. Personal recovery expectation beliefs may be associated with return to work outcomes in those with low back pain at high risk for chronic disability. We aimed to (1) assess whether workers’ expectations for return to work, follow...

Introduction: Musculoskeletal injury (MSI) remains the most common reason for disability and work loss globally. Effective prevention of MSI is necessary. MSI Risk Factor screening tools can be used by employers and health care providers to identify and mitigate hazards. A rigorous synthesis of effective application of these tools had not previousl...

Purpose The therapeutic relationship between a patient and physiotherapist has been associated with improved physiotherapy outcomes. However, there is no agreed upon measure of therapeutic relationship in physiotherapy. This paper describes a validation study of a new patient-reported measure, the Physiotherapy Therapeutic Relationship Measure (P-T...

Purpose Public safety personnel (PSP) are at risk of developing posttraumatic stress injury (PTSI) due to exposure to traumatic experiences and accidents. Rehabilitation programs are available, but their success varies. We studied: (1) characteristics of PSP undergoing PTSI rehabilitation in comparison to non-PSP workers; and (2) predictive value o...

Jean, LMY, Gross, DP, and Chiu, LZF. Knee extensor strength in anterior cruciate ligament-deficient individuals following normal and modified squats: a randomized controlled trial. J Strength Cond Res 36(1): 47-54, 2022-Training with barbell squats, which load the quadriceps, increases knee extensor strength. Anterior cruciate ligament (ACL) injury...

Clinician-scientists play a valuable role in bridging the gap between patient care and clinical research. However, there are no clear guidelines that describe how to handle the day-to-day ethical and methodological questions that arise when navigating the competing responsibilities of practitioner and researcher—a situation that can easily leave th...

The “therapeutic relationship” in physiotherapy refers to the beneficial or healing relationship between the patient and physiotherapist. Interest in researching therapeutic relationships in physiotherapy is growing and there is a need for a measure of therapeutic relationship with a strong conceptual foundation. Body of paper:We begin with a gene...

Walking is the most common and preferred way for people with multiple sclerosis (MS) to be active. Consumer-grade wearable activity monitors may be used as a tool to assist people with MS to track their walking by counting the number of steps. The authors evaluated the validity of Fitbit One activity tracker in individuals with MS by comparing step...

Background: There is no clinical tool that assesses multiple components of postural control potentially impacted by sport-related concussion (SRC). Objective: To develop and assess the feasibility and construct validity of the Functional Assessment of Balance in Concussion (FAB-C) battery. Study design: Cross-sectional study. Methods: Tests...

Background Companion animal death is a common source of grief, although the extent and context of that grief is poorly understood, especially in older adulthood. The aim of this multiple-methods study was to develop a greater understanding of the impact of companion animal death on older women living alone in the community, as older women are a dis...

Purpose The Coronavirus Disease (COVID-19) pandemic resulted in dramatic changes to avoid virus spread. In Canada, following provincial legislation the Workers’ Compensation Board of Alberta (WCB-Alberta) stopped in-person rehabilitation services on March 23, 2020. On April 1, training began on remote service delivery using videoconferencing or tel...

Objectives To develop an evidence‐based guideline for the non‐invasive management of soft tissue disorders of the shoulder (shoulder pain), excluding major pathology. Methods This guideline is based on high‐quality evidence from seven systematic reviews. Multidisciplinary experts considered the evidence of effectiveness, safety, cost‐effectiveness...

The editorial "Commemorating the 30th Anniversary of the American's with Disabilities Act" by Patricia Findley and Douglas P. Gross was inadvertently omitted from the special section "Americans with Disabilities Act 30" in the December Issue (https://link.springer.com/journal/10926/volumes-and-issues/30-4).

Living with a companion animal (CA or “pet”) often has a positive impact on quality of life and well-being. Research also highlights potential benefits of CA relationships for populations accessing social housing, which commonly includes individuals with a low income, disabilities, those at risk of homelessness, and seniors. However, it appears tha...

Background: Accurate clinical decision support tools may help clinicians select appropriate interventions for patients with spinal conditions. The Orebro Musculoskeletal Pain Questionnaire (OMPQ) is a screening questionnaire extensively studied as a predictive tool. The Work Assessment Triage Tool (WATT) is a clinical decision support tool develop...

Purpose To describe the development of a new measure of therapeutic relationship for use in physiotherapy – the Physiotherapy Therapeutic RElationship Measure (P-TREM). Methods We adopted the methodology of Devellis in Scale Development: Theory and Applications for constructing the P-TREM. We developed a measurement framework based on Miciak’s Phy...

Musculoskeletal disorders (MSDs) are characterized by pain and reduced physical functioning that often results in decreased quality of life. Work-related musculoskeletal disorders (WRMDs) are health problems in which working conditions (ie, physically demanding or repetitive activities or a poor work environment) significantly contribute to the ons...

There is increasing concern among researchers about collecting data on sex and gender variables, yet many researchers are unsure of how to deal meaningfully with these variables. Drawing on literature that tests the psychometric properties of sex and gender demographic questions, we present considerations for collecting sex and gender demographic d...

Purpose The Work Assessment Triage Tool (WATT) is a clinical decision support tool developed using machine learning to help select interventions for patients with musculoskeletal disorders. The WATT categorizes patients based on individual characteristics according to likelihood of successful return to work following rehabilitation. A previous vali...

Purpose To summarize progress of functional capacity evaluation (FCE) research based on the proceedings of the Fourth International FCE Research Conference held in Switzerland on September 21 and 22, 2018. Methods A scientific committee identified key issues in FCE research and developed the program including key note presentations, a call for abst...

Introduction: Occupational rehabilitation often involves functional capacity evaluations (FCE) that use simulated work tasks to assess work ability. Currently, there exists no single, streamlined solution to simulate all or a large number of standard work tasks. Such a system would improve FCE and functional rehabilitation through simulating reachi...

Purpose Computer algorithms and Machine Learning (ML) will be integrated into clinical decision support within occupational health care. This will change the interaction between health care professionals and their clients, with unknown consequences. The aim of this study was to explore ethical considerations and potential consequences of using ML b...

Objective: To identify and categorize barriers, facilitators, and strategies to boost exercise therapy adherence in youth with musculoskeletal conditions to inform research and clinical practice. Design: Scoping review. Literature search: MEDLINE, CINAHL, SportDiscus, SCOPUS, PEDro and ProQuest from inception to October 1, 2019. Study selecti...

Rapid development in computer technology has led to sophisticated methods of analyzing large datasets with the aim of improving human decision making. Artificial Intelligence and Machine Learning (ML) approaches hold tremendous potential for solving complex real-world problems such as those faced by stakeholders attempting to prevent work disabilit...

Introduction Cancer-related fatigue negatively impacts 50–90% of cancer survivors. In North America, approximately 50% of return-to-work interventions initially fail for survivors, with cancer-related fatigue often cited as a barrier to workability. Occupational therapy-driven cancer-related fatigue work-related programming for survivors is sparse,...