Lisa Avery

University Health Network | UHN · Biostatistics

Introduction: Our aim was to describe episodic nature of disability among adults living with Long COVID. Methods: We conducted a community-engaged qualitative descriptive study involving online semistructured interviews and participant visual illustrations. We recruited participants via collaborator community organisations in Canada, Ireland, UK...

Despite more than 2 years having elapsed since the onset of SARS-CoV-2 pandemic, a level of hesitation around increased SARS-CoV-2 vaccine toxicity in cancer patients receiving immunotherapy (IO) remains. This hesitation stems from the idea that IO agents could elicit an overwhelming immune stimulation post vaccination and therefore increase the ri...

OBJECTIVES: To describe episodic nature of disability among adults living with Long COVID. METHODS: We conducted a community-engaged qualitative descriptive study involving online semi-structured interviews and participant visual illustrations. We recruited participants via collaborator community organizations in Canada, Ireland, United Kingdom, an...

Purpose: Measurement development is a reiterative process requiring refinements and revalidation. The purpose of this study was to examine structural validity and reliability of the Child Engagement in Daily Life Measure (Version 2) for parents of children with cerebral palsy (CP) across a broader age span. Methods: Participants were 1054 parent...

Background Despite more than 2 years having elapsed since the onset of SARS-CoV-2 pandemic, a level of hesitation around increased SARS-CoV-2 vaccine toxicity in cancer patients receiving immunotherapy (IO) remains. Here, we explore serological responses to SARS-CoV-2 vaccination in patients treated with IO and we describe blood cytokines, autoanti...

Objective Studies have highlighted the inequities between the Indigenous and non-Indigenous populations with respect to the burden of cardiovascular disease and prevalence of predisposing risks resulting from historical and ongoing impacts of colonization. The objective of this study was to investigate factors associated with cardiovascular disease...

Objective: During the height of the COVID-19 pandemic, personal support workers (PSWs) were heralded as healthcare 'heroes' as many of them cared for high-risk, vulnerable older populations, and worked in long-term care, which experienced a high number of COVID-19 outbreaks and deaths. While essential to the healthcare workforce, there is little u...

Background: The COVID-19 pandemic has highlighted the role of personal support workers (PSWs) in health care, as well as their work conditions. Our study aimed to understand the characteristics of the PSW workforce, their work conditions and their job security, as well as to explore the health of PSWs and the impact of precarious employment on the...

Background: Events associated with the COVID-19 pandemic, such as physical distancing, closure of community services, postponement of health appointments, and loss of employment can lead to social isolation, financial uncertainty, and interruption of antiretroviral adherence, resulting in additional health-related challenges (disability) experienc...

Objective To evaluate the construct validity and responsiveness of the Rapid Assessment of Physical Activity (RAPA) for measuring physical activity (PA) in adults living with HIV. Design Secondary analysis of an interrupted time-series intervention study. Setting Community-based fitness facility in Toronto, Canada. Participants Sixty-seven adult...

Purpose Our aim was to examine the impact of a community-based exercise (CBE) intervention on cardiorespiratory fitness, cardiovascular health, strength, flexibility, and physical activity outcomes among adults living with HIV. Methods We conducted a longitudinal intervention study with community-dwelling adults living with HIV in Toronto, Canada....

Background Events associated with the COVID-19 pandemic, such as physical distancing, closure of community services, postponement of health appointments, and loss of employment can lead to social isolation, financial uncertainty, and interruption of antiretroviral adherence, resulting in additional health-related challenges (disability) experienced...

Objective Respondent driven sampling (RDS) is an important tool for measuring disease prevalence in populations with no sampling frame. We aim to describe key properties of these samples to guide those using this method and to inform methodological research. Methods In 2019, authors who published respondent driven sampling studies were contacted w...

Abstract Background Disability is an increasingly important health-related outcome to consider as more individuals are now aging with Human Immunodeficiency Virus (HIV) and multimorbidity. The HIV Disability Questionnaire (HDQ) is a patient-reported outcome measure (PROM), developed to measure the presence, severity and episodic nature of disabilit...

Background: Disability is an increasingly important health-related outcome to consider as more individuals are now aging with HIV and multimorbidity. The HIV Disability Questionnaire (HDQ) is a patient-reported outcome measure (PROM), developed to measure the presence, severity and episodic nature of disability among adults living with HIV. The 69-...

Aim: To create longitudinal trajectories and reference percentiles for frequency of participation in family and recreational activities for children with cerebral palsy (CP) by Gross Motor Function Classification System (GMFCS) level. Methods: 708 children with CP 18-months to 12-years of age and their families participated in two to five assessmen...

Purpose: To examine the opportunities, experiences, and outcomes of a transition program for youth with disabilities. Methods: Over three years, in a prospective study, 29 youth (17 males) attending residential immersive life skills programs reported on their experiences in 55 activity settings in which opportunities were also rated using standardi...

Aim: To examine self- and proxy-reported symptoms of depression in children with epilepsy. Method: This was a prospective longitudinal cohort study of children with epilepsy. Participants were treated at six Canadian tertiary-care centers and followed over 28 months with repeated assessments of child self-reported symptoms of depression using th...

Purpose: This project aimed to determine whether change occurs over time for impairments of balance, range of motion, endurance, and strength of children with cerebral palsy, by Gross Motor Function Classification System (GMFCS) levels. Methods: Measurements were completed in 77 children at 2 sessions (T1, T2) on average 5.8 years apart. Mean ag...

Background: It is unclear whether weighted or unweighted regression is preferred in the analysis of data derived from respondent driven sampling. Our objective was to evaluate the validity of various regression models, with and without weights and with various controls for clustering in the estimation of the risk of group membership from data coll...

Background: Respondent-driven sampling (RDS) is an increasingly popular method of recruiting participants from hard to reach populations and has traditionally been used to estimate the prevalence of HIV among marginalized populations. The STROBE-RDS guidelines were published in 2015 to improve the reporting of these studies. We aim to determine th...

Aim: To examine the impact of engagement in a self-chosen community-based activity on three relevant body functions (motor, cognitive, and affective) as well as on the performance of the selected activity. Method: An individual-based interrupted time series design with multiple baselines was used. Seven young people (four males, three females) a...

Date Presented 04/04/19 This study demonstrates the effectiveness of a novel, client-centered OT intervention, named PREP, for improving the participation of youth with disabilities. By removing environmental barriers, OTs enabled 28 youth to successfully take part in the activities they identified, such as shopping with friends, riding a bike, and...

Aim: To explore the relationship between rehabilitation therapies and development in children with cerebral palsy (CP). Method: We conducted a prospective, longitudinal study involving 656 children with CP (mean age [SD] 6y [2y 8mo] at study entry; 1y 6mo-11y 11mo; 287 females, 369 males), and their parents. Children were assessed two to five ti...

Aims: To create longitudinal trajectories and reference percentiles for performance in self-care of children with cerebral palsy (CP). Methods: Participants were 708 children with CP, 18 months through 11 years of age and their parents residing in 10 regions across Canada and the United States. Gross Motor Function Classification System (GMFCS) lev...

Purpose: To re-validate stability and hierarchal ordering of items, test–retest reliability, and construct validity of the Ease of Caregiving for Children measure for parents of children with cerebral palsy (CP) up to 11 years of age. Methods: Participants were 613 parents of children with CP between 1.5 and 11 years of age. Parents completed Ease...

Objectives: To study the extent to which parents are able to serve as true proxies for their children with epilepsy using a more granular approach than has been found in any study to date. Methods: Proxy resemblance to the child was based on discrepancy in z-centered child minus parent scores of matching quality-of-life (QOL) domains for 477 dya...

Background: Children with cerebral palsy (CP) frequently present with secondary impairments in spinal alignment and extremity range of motion, endurance for activity, and muscle strength. Creation of developmental trajectories for these impairments will help guide clinical decision-making. Objective: For children in each level of the Gross Motor...

Background: Children with cerebral palsy (CP) characteristically present with impairments in balance. Currently, the pattern and timing of the development of balance ability have not been described for children with CP of varying Gross Motor Function Classification System (GMFCS) levels. Objective: The purpose of this study was to document longi...

Purpose: This study aims to present developmental trajectories for physical activity (PA) and walking performance for children with cerebral palsy (CP). Materials and methods: Seventy-nine children with CP, 39 (49%) female, Gross Motor Functional Classification System levels I–V, and mean age 91.3 months (+/−27.7 SD) participated. Participants in l...

Purpose: The purposes of this study were to document longitudinal developmental trajectories in 6-minute walk test (6MWT) distances and to develop age-specific reference percentiles for children across different Gross Motor Function Classification System (GMFCS) levels. Methods: A TOTAL OF: 456 children with cerebral palsy ages 3 to 12 years of,...

Aim First, to describe the impact of health conditions on daily activities over time in children with cerebral palsy (CP) and to create age‐specific reference centiles. Second, to determine the amount of change typical over a 1‐year period, across Gross Motor Function Classification System (GMFCS) levels. Method A prospective, cohort design, with...

In this Perspective, we suggest a process to improve physical and occupational therapists' and families' collaboration to provide appropriate, efficient, and effective evidence-based services to improve motor function, self-care performance, and participation in family and recreation activities for children with cerebral palsy (CP). This process is...

Aim To determine the stability of the Gross Motor Function Classification System (GMFCS), Manual Ability Classification System (MACS), and Communication Function Classification System (CFCS) over 1‐year and 2‐year intervals using a process for consensus classification between parents and therapists. Method Participants were 664 children with cereb...

Aim: This study examined the effectiveness of the Pathways and Resources for Engagement and Participation (PREP) intervention in improving the participation of adolescents in community-based activities. Method: Twenty-eight adolescents (14 males, 14 females), aged 12 to 18 years (mean 14y 6mo, SD 21.6mo) with moderate physical disabilities parti...

Objective: To describe the developmental trajectories of quality of life (QoL) in a large cohort of children with epilepsy, and to assess the relative contribution of clinical, psychosocial, and sociodemographic variables on QoL trajectories. Methods: Five assessments during a 28-month prospective cohort study were used to model trajectories of...

Aim: To examine participation-preference congruence, regional differences in participation-preference congruence, and predictors of whether children with cerebral palsy participate in preferred activities. Method: The sample (n=236) included 148 males and 88 females aged 10 to 13 years, living in Victoria, Australia (n=110), Ontario (n=80), or Q...

Introduction: Measures of interprofessional (IP) socialization are needed to capture the role of interprofessional education in preparing students and health practitioners to function as part of IP health care teams. The aims of this study were to refine a previously published version of the Interprofessional Socialization and Valuing Scale (the I...

Aims: To describe the focus of therapy practices in occupational and physical therapy for school-aged children with cerebral palsy, and better understand whether it is congruent with recommended practices. Methods: A Canada-wide Web-based survey was completed by 62 occupational and 61 physical therapists to identify problems, assessments, and tr...

Purpose: The aim was to create an expanded version of a published observer-rated Measure of Environmental Qualities of Activity Settings (MEQAS-32). Method: Testing was conducted using a diverse sample of activity settings. Raters completed the original MEQAS questionnaire (MEQAS-66) for 76 youth leisure and life skills activity settings. Scales...

The Ease of Caregiving for Children is a parent-completed measure of how difficult it is for them to safely help their children participate in activities of daily living. The objectives of this study were to determine the internal consistency, test–retest reliability, and construct validity (known groups methods) of the Ease of Caregiving for Child...

Purpose: The objectives of this study were to determine the: (1) internal consistency and test-retest reliability of the Child Engagement in Daily Life measure; (2) construct validity of the measure (known groups methods), that is, the ability of the measure to discriminate participation in family and recreational activities and self-care among yo...

To test the effect of personal and environmental factors on children's participation across three different settings (home, school and community) and to ascertain the inter-relations between these factors. In this secondary analysis study, three models, one for each setting, were proposed and tested using Structural Equation Modeling. Survey, cross...

Purpose: To examine geographical variation in the leisure participation of children/youth with cerebral palsy (CP), using Children's Assessment of Participation and Enjoyment (CAPE) data from Australia, Canada (Ontario and Quebec) and the U.S. Method: Data from 1076 children/youth ages 6-20 years with CP were included. Analyses examined CAPE div...

The aim of this study was to compare the accuracy of two abbreviated approaches for estimating Gross Motor Function Measure 66 (GMFM-66) scores against the full GMFM-66 and to explore their strengths and limitations. An existing dataset (n=224) comprising children aged 1 to 13 years (mean age 6y 11mo, SD 4y 6mo; 132 males, 92 females) with cerebral...

The use of measurement tools is an essential part of good evidence-based practice; however, physiotherapists (PTs) are not always confident when selecting, administering, and interpreting these tools. The purpose of this study was to evaluate the impact of a multifaceted knowledge translation intervention, using PTs as knowledge brokers (KBs) to fa...

Table S1: Characteristics of the Motor Growth Measures. The additional file provides a brief description of the four measurement tools (GMFCS, GMFM-88, GMFM-66 and the Motor Growth Curves) and their measurement characteristics.

To explore associations between clinical variables and decline in motor capacity in adolescents with cerebral palsy (CP). Participants included 76 males and 59 females, whose mean age at the beginning of the study was 14 years 6 months (SD 2.4, range 11.6-17.9); 51 at Gross Motor Function Classification System (GMFCS) level III, 47 at level IV, and...

To develop an algorithmic approach to identify item sets of the 66-item version of the Gross Motor Function Measure (GMFM-66) to be administered to individual children, and to examine the validity of the algorithm for obtaining a GMFM-66 score. An algorithmic approach was used to identify item sets of the GMFM-66 (GMFM-66-IS) using data from 95 mal...

This paper reports the construction of gross motor development curves for children and youth with cerebral palsy (CP) in order to assess whether function is lost during adolescence. We followed children previously enrolled in a prospective longitudinal cohort study for an additional 4 years, as they entered adolescence and young adulthood. The resu...

This paper reports the construction of gross motor development curves for children and youth with cerebral palsy (CP) in order to assess whether function is lost during adolescence. We followed children previously enrolled in a prospective longitudinal cohort study for an additional 4 years, as they entered adolescence and young adulthood. The resu...

To describe the Rasch analysis of the Gross Motor Function Measure (GMFM-88) and to demonstrate how the assumptions of unidimensionality, sample-free measurement, and test-free measurement were validated to create an interval level measure. Cross-sectional and longitudinal (12-mo) data from a prospective study of motor development in children with...

Avery LM, Russell DJ, Raina PS, Walter SD, Rosenbaum PL. Rasch analysis of the Gross Motor Function Measure: validating the assumptions of the Rasch model to create an interval-level measure. Arch Phys Med Rehabil 2003;84:697-705.

Improved scaling of the gross motor function measure for children with cerebral palsy: evidence of reliability and validity [Physical Therapy 2000;80(9):873-85] Achtergrond en doel. In deze studie werden de betrouwbaarheid, validiteit en gevoeligheid voor veranderingen onderzocht van gegevens verkregen uit een uit 66 onderdelen bestaande versie va...

This study examined the reliability, validity, and responsiveness to change of measurements obtained with a 66-item version of the Gross Motor Function Measure (GMFM-66) developed using Rasch analysis. The validity of measurements obtained with the GMFM-66 was assessed by examining the hierarchy of items and the GMFM-66 scores for different groups...

Background and Purpose. This study examined the reliability, validity, and responsiveness to change of measurements obtained with a 66-item version of the Gross Motor Function Measure (GMFM-66) developed using Rasch analysis. Subjects and Methods. The validity of measurements obtained with the GMFM-66 was assessed by examining the hierarchy of item...

"September 2004". Thesis (M. Sc.)--University of Otago, 2005. Includes bibliographical references.