Luciana Macedo

• BPT, MScPT, PhD
• Professor (Assistant) at McMaster University

Purpose: To explore the impact of the online ENVISAGE program for parents of children with neurodevelopmental disabilities (NDD) on parents' perception of themself, their child with a disability, and their family, as well as to explore experiences of participating in the program in Croatia. Methods: In this before-after discourse analysis study,...

Purpose The aims of this study were to describe cultural diversity among physiotherapists, to understand the challenges to the delivery of physiotherapy to equity-seeking communities, and to measure and assess factors associated with cultural competency. Methods We conducted a cross-sectional survey (57-items) of Canadian physiotherapists that ass...

Objective To describe the characteristics associated with unmet rehabilitation needs in a sample of Canadians with long-term health conditions or disabilities during the first wave of the COVID-19 pandemic. Design Data from the Impacts of COVID-19 on Canadians – Living with Long-Term Conditions and Disabilities , a national cross-sectional survey...

Purpose This study is the second part of a cross-sectional questionnaire aiming to identify Canadian physiotherapists needs and strategies for physiotherapy associations to improve cultural competence in physiotherapy. Methods We conducted a descriptive qualitative analysis of one open-ended question of a cross-sectional questionnaire. We used ind...

Objective: We aimed to describe the prevalence of unmet rehabilitation needs among a sample of Canadians living with long-term conditions or disabilities during the first wave of the COVID-19 pandemic. Design: Cross-sectional survey. Setting: Individuals residing in Canada during the first wave of the COVID-19 pandemic. Participants: Eligibl...

Study design: Qualitative meta-ethnography. Pre-registered with OSF:10.17605/OSF.IO/UTZE6. Purpose: To understand the patient experience pre- and/or post-lumbar spine surgery. Methods: Literature search: A literature search was conducted in MEDLINE, EMBASE, EmCare and CINAHL from inception to October 17, 2022. Study selection criteria: Peer-re...

Background Musculoskeletal disorders (MSKDs) present a significant burden to health care systems worldwide. Evidence suggests that university students may have unique risk factors for developing MSKDs; however, research on the corresponding prevalence and risk factors of MSKDs in Canadian students is limited. Methods Using a multi-year cross-secti...

Background: There is a paucity of research assessing cultural competency among Canadian chiropractors. Therefore, the aims of this study were to (1) measure cultural competency among Canadian chiropractors, (2) understand chiropractors' perspectives of challenges and attitudes regarding the delivery of chiropractic services to equity-seeking commu...

Background Little is known about the diversity of the chiropractic profession with respect to gender, sexual orientation, race, ethnicity and community of practice. This knowledge is important as profession representation of key equity seeking groups may impact quality of care and access for vulnerable communities. The aim of this cross-sectional s...

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)...

Aberrant morphological changes in lumbar multifidus muscle (LMM) are prevalent among patients with low back pain (LBP). Motor control exercise (MCE) aims to improve the activation and coordination of deep trunk muscles (eg, LMM), which may restore normal LMM morphology and reduce LBP. However, its effects on LMM morphology have not been summarized....

Background Carpal tunnel syndrome (CTS) is the most common entrapment mononeuropathy of the upper extremity. The previous systematic review of the diagnostic tests for CTS was outdated. The objective of this study was to compile and appraise the evidence on the accuracy of sensory and motor tests used for the diagnosis of CTS. Methods MEDLINE, CIN...

Introduction While multiple pharmacological and non-pharmacological interventions treating chronic non-specific low back pain (CLBP) are available, they have been shown to produce at best modest effects. Interventions such as repetitive transcranial magnetic stimulation (rTMS), a form of non-invasive brain stimulation, have exhibited promising resu...

Purpose The objectives of this review were to: (a) explore the extent and nature of available research on non-custodial grandparents of children with physical, intellectual, or neurodevelopmental disabilities and (b) descriptively summarize the research findings from those studies. Methods We followed the five-stage scoping review methodology to i...

Introduction Exercise therapy is the most recommended treatment for chronic low back pain (LBP). Effect sizes for exercises are usually small to moderate and could be due to the heterogeneity of people presenting with LBP. Thus, if patients could be better matched to exercise based on individual factors, then the effects of treatment could be great...

Background Accurate diagnosis of carpal tunnel syndrome (CTS) is essential for directing appropriate treatment; and for making decisions about work injury claims. The Kamath and Stothard Questionnaire (KSQ) is a self-reported tool used for the diagnosis of CTS. Comprehensibility and comprehensiveness of this questionnaire are critical to diagnostic...

Objective: To summarize and evaluate research on the accuracy of clinical diagnostic scales, questionnaires and hand symptom diagrams/maps (HSD) used for diagnosis of carpal tunnel syndrome (CTS). Design: Systematic review of diagnostic test accuracy. Literature search: A comprehensive literature search of MEDLINE, CINAHL, and Embase databases...

Osteopathic manual practitioners in Canada use, and continue to be educated to use the term osteopathic lesion. This term is either derived from or directly drawn from the biomedical model; the overarching framework through which most healthcare is delivered. Use of the term illustrates the adoption and misappropriation of a biomedical term and fol...

Background Tenderness on palpation of the pelvic floor muscles (PFMs) is a clinical assessment tool used alongside other tests to identify PFM involvement in pelvic complaints including pelvic pain. Although reliability of PFM tenderness has been determined, validity has yet to be established. Objectives To assess convergent validity of PFM tender...

Background: Ineffective coping has been linked to prolonged pain, distress, anxiety, and depression after a hand and upper limb injury. Evidence shows that interventions based on cognitive behavioral therapy (CBT) may be effective in improving treatment outcomes, but traditional psychological interventions are resource intensive and unrealistic in...

Background: Only a small proportion of anterior cruciate ligament (ACL) tears are diagnosed on initial healthcare consultation. Current clinical guidelines do not acknowledge that primary point-of-care practitioners rely more heavily on a clinical history than special clinical tests for diagnosis of an ACL tear. This research will assess the accur...

Background: Low back pain (LBP) is one of the greatest contributors to disability in the world and there is growing interest on the role of biomarkers in LBP. To purpose of this review was to analyze available evidence on the relationship between inflammatory biomarkers, clinical presentation, and outcomes in patients with acute, subacute and chro...

Background: Only a small proportion of anterior cruciate ligament (ACL) tears are diagnosed on initial healthcare consultation. Current clinical guidelines do not acknowledge that primary point-of-care practitioners rely more heavily on a clinical history than special clinical tests for diagnosis of an ACL tear. This research will assess the accura...

Background: Symptomatic lumbar spinal stenosis (SLSS) is a condition in which narrowing of the spinal canal results in entrapment and compression of neurovascular structures. Decompressive surgery, with or without spinal fusion, is recommended for those with severe symptoms for whom conservative management has failed. However, significant persisten...

Background Only a small proportion of anterior cruciate ligament (ACL) tears are diagnosed on initial healthcare consultation. Current clinical guidelines do not acknowledge that primary point-of-care practitioners rely more heavily on a clinical history than special clinical tests for diagnosis of an ACL tear. This research will assess the accurac...

Background: Only a small proportion of anterior cruciate ligament (ACL) tears are diagnosed on initial healthcare consultation. Current clinical guidelines do not acknowledge that primary point-of-care practitioners rely more heavily on a clinical history than special clinical tests for diagnosis of an ACL tear. This research will assess the accura...

Background Low back pain is one of the leading causes of disability worldwide. Exercise therapy is widely recommended to treat persistent non-specific low back pain. While evidence suggests exercise is, on average, moderately effective, there remains uncertainty about which individuals might benefit the most from exercise. Methods In parallel with...

BACKGROUND Ineffective coping has been linked to prolonged pain, distress, anxiety and depression after a hand and upper limb injury. Evidence show that interventions based on cognitive and behavioral therapy may be effective to improve treatment outcomes, but traditional psychological interventions are resource-intensive and unrealistic in busy ha...

Background: Ineffective coping has been linked to prolonged pain, distress, anxiety, and depression after a hand and upper limb injury. Evidence shows that interventions based on cognitive behavioral therapy (CBT) may be effective in improving treatment outcomes, but traditional psychological interventions are resource intensive and unrealistic in...

Background: There are inconsistencies in findings regarding the relationship of occupational loading with spinal degeneration or structural damage. Thus, a systematic review was conducted to determine the current state of knowledge on the association of occupational loading and spine degeneration on imaging. Methods: We performed electronic sear...

Background. There is evidence to suggest that a large proportion of individuals seeking care for lumbopelvic pain also have pelvic floor muscle dysfunction (PFMD). Because the majority of physical therapists do not have the requisite training to adequately assess pelvic floor musculature, determining predictors of PFMD could be clinically useful. O...

Background: There is evidence to suggest that a large proportion of individuals seeking care for lumbopelvic pain also have pelvic floor muscle dysfunction (PFMD). Because the majority of physical therapists do not have the requisite training to adequately assess pelvic floor musculature, determining predictors of PFMD could be clinically useful....

Purpose: A 2014 study found that the Lumbar Spine Instability questionnaire predicts response to two different types of exercise therapy. This is the first decision tool that has predicted response to exercise for chronic low back pain. The objective of this study was to evaluate the Lumbar Spine Instability questionnaire using Rasch analysis. Meth...

Background: Postoperative nausea and vomiting (PONV) is one of the most commonly reported adverse experiences after surgery. PONV is a major risk factor for delayed patient mobilization and consequently increased length of hospital stay. Objectives: The primary objective was to compare the effectiveness of scheduled versus as-needed administrati...

Low back pain (LBP)varies over time. Consumers, clinicians, and researchers use various terms to describe LBP fluctuations, such as episodes, recurrences and flares. Although “flare” is use commonly, there is no consensus on how it is defined. This study aimed to obtain consensus for a LBP flare definition using a mixed-method approach. Step 1 invo...

Background: Low back pain (LBP) is one of the most debilitating conditions among older adults. Unfortunately, existing LBP outcome questionnaires are not adapted for specific circumstances related to old age, which may make these measures less than ideal for evaluating LBP in older adults. Objective: To explore the necessity of developing age-spec...

BACKGROUND Low back pain (LBP) is one of the most debilitating conditions among older adults. Unfortunately, existing LBP outcome questionnaires are not adapted for specific circumstances related to old age, which may make these measures less than ideal for evaluating LBP in older adults. OBJECTIVE To explore the necessity of developing age-specif...

Background Investigations on the causes of patellar tendinopathy should consider impairments at the hip and foot/ankle because they are known to influence movement patterns and affect patellar tendon loading. Objectives To investigate hip and foot/ankle impairments associated with patellar tendinopathy in volleyball and basketball athletes using c...

Introduction: Distal radius fracture (DRF) is the most common upper-extremity problem encountered in emergency orthopedic care. Although, many patients recover well after one year, up to 30% and 30% of individuals with DRF continue to have prolonged pain and disability respectively. There has been growing recognition of psychosocial risk factors su...

Study design: Systematic review. Objective: To evaluate the effectiveness of motor control exercise in patients with non-specific low back pain. Summary of background data: Motor control exercise (MCE) is a common form of exercise used for managing low back pain (LBP). MCE focuses on the activation of the deep trunk muscles and targets the res...

Background: In routine clinical practice, the presence of lumbar spinal stenosis (LSS) is assessed on axial magnetic resonance images (MRI) typically acquired using a pre-selected spine sagittal angle. Given the natural lordosis of the lumbar spine, not all axial slices will be parallel to the disc and perpendicular to the spinal canal and, thus,...

Background: Motor control exercise (MCE) is used by healthcare professionals worldwide as a common treatment for low back pain (LBP). However, the effectiveness of this intervention for acute LBP remains unclear. Objectives: To evaluate the effectiveness of MCE for patients with acute non-specific LBP. Search methods: We searched MEDLINE, EMBASE, t...

Study design: Delphi. Objective: Obtain an expert consensus on which history factors are most important in the clinical diagnosis of LSS. Summary of background data: Lumbar spinal stenosis (LSS) is a poorly defined clinical syndrome. Criteria for defining LSS are needed and should be informed by the experience of expert clinicians. Methods:...

Background: Non-specific low back pain (LBP) is a common condition. It is reported to be a major health and socioeconomic problem associated with work absenteeism, disability and high costs for patients and society. Exercise is a modestly effective treatment for chronic LBP. However, current evidence suggests that no single form of exercise is sup...

Background. Current treatments for low back pain have small effects. A research priority is to identify patient characteristics associated with larger effects for specific interventions. Objective. The aim of this study was to identify simple clinical characteristics of patients with chronic low back pain who would benefit more from either motor co...

Background. Current treatments for low back pain have small effects. A research priority is to identify patient characteristics associated with larger effects for specific interventions. Objective. The aim of this study was to identify simple clinical characteristics of patients with chronic low back pain who would benefit more from either motor co...

There is no clear picture of pathoanatomy in clinically diagnosed LSS. Findings in the literature regarding imaging in LSS are heterogeneous. Characterize the pathoanatomy of LSS, as reported in the radiology reports, for a large community-based sample of patients with the clinical diagnosis of LSS. Retrospective review of clinical radiology report...

Walking capacity is a primary outcome indicator for individuals with lumbar spinal stenosis (LSS). Therefore, there is a demand for psychometrically sound measures of walking that are responsive to change. The primary objective of this study was to examine longitudinal construct validity of the Physical Function Scale of the Swiss Spinal Stenosis Q...

Because of symptoms, people with lumbar spinal stenosis (LSS) are often inactive, and this sedentary behaviour implies risk for diseases including obesity. Research has identified body mass index as the most powerful predictor of function in LSS. This suggests that function may be improved by targeting weight as a modifiable factor. An e-health lif...

It has been suggested that low back pain (LBP) is a condition with an unpredictable pattern of exacerbation, remission and recurrence. However, there is an incomplete understanding of the course of LBP and the determinants of the course. To identify clusters of LBP patients with similar fluctuating pain patterns over time and investigate whether de...

The Pain Self-Efficacy Questionnaire (PSEQ) is used by physiotherapists both clinically and in research. However, current understanding of the PSEQ's measurement properties is incomplete, such that we cannot be confident it provides unbiased information on someone's self-efficacy. Our objective was to investigate the scale properties of the PSEQ us...

Physical therapy (PT) is commonly prescribed for patients with lumbar spinal stenosis (LSS); however, little is known about its effectiveness. To systematically review randomized controlled trials (RCT), controlled trials and cohort studies evaluating the effectiveness of PT for LSS. Studies were searched on electronic databases to January 2012. In...

highlights the findings and application of Cochrane reviews and other evidence pertinent to the practice of physical therapy. The Cochrane Library is a respected source of reliable evidence related to health care. Cochrane systematic reviews explore the evidence for and against the effectiveness and appropriateness of interventions - medications, s...

Background Implementation strategies for clinical guidelines have shown modest effects in changing health professional’s knowledge and practice, however, targeted implementations are suggested to achieve greater improvements. This study aimed to examine the effect of a targeted implementation strategy of the Australian whiplash guidelines on health...

Study Design. A total of 200 patients with low back pain (LBP) completed an English and Marathi Oswestry Disability Index (ODI) questionnaires (100 each), visual analogue scale, and Roland-Morris Disability Questionnaire. Objective. To validate the English and Marathi versions of ODI (version 2.1a). Summary of Background Data. Patient-orientated as...

Background Several studies have investigated differences in paraspinal muscle morphology between patients with low back pain (LBP) and control patients. However, inconsistencies in the results of some of these studies may limit generalizations. Objective The purpose of this study was to systematically review studies evaluating paraspinal muscle mo...

Study design: Cross-sectional cohort study. Objective: To evaluate the diagnostic value of the sedimentation sign further by assessing its performance on the differential diagnosis of patients with lumbar spinal stenosis (LSS) and other lumbar conditions with similar clinical presentations. Summary of background data: Recently, a new test usin...

Observational study nested within a randomized controlled trial. To evaluate the feasibility of using short message service (SMS) within a clinical trial of low back pain. Technological advances have transformed communication technologies and opened the way for their use in clinical studies. SMSs have been tested for use in data collection for diff...

Motor control exercises to improve control and coordination of trunk muscles and graded activity under the principles of cognitive-behavioral therapy are 2 commonly used exercise therapies, yet there is little evidence to support the use of one intervention over the other. The objective of this study was to compare the effectiveness of motor contro...

It is often assumed that patients with pain-related disability due to low back pain (LBP) will have reduced physical activity levels, but recent studies have provided results that challenge this assumption. The aim of our systematic review was to examine the relationship between physical activity and disability in LBP. The literature search include...

The aim of this study was to present and compare the content of (inter)national clinical guidelines for the management of low back pain. To rationalise the management of low back pain, evidence-based clinical guidelines have been issued in many countries. Given that the available scientific evidence is the same, irrespective of the country, one wou...

Several versions of the 24-item Roland Morris Disability Questionnaire (RMDQ) have been proposed; however, their responsiveness has not been extensively explored. The objective of this study was to compare the responsiveness of four versions of the RMDQ. Perceived disability was measured using the 24-item, two 18-item and an 11-item RMDQ on 1,069 l...

Background: Graded activity and graded exposure are increasingly being used in the management of persistent low back pain; however, their effectiveness remains poorly understood. The aim of this study was to systematically review randomized controlled trials that evaluated the effectiveness of graded activity or graded exposure for persistent (>6 w...

To evaluate the convergent and construct validity of the Physiotherapy Evidence Database (PEDro) scale used to rate the methodological quality of randomized trials in physiotherapy. PEDro total scores and individual-item scores were extracted from 9,456 physiotherapy trials indexed on PEDro. Convergent validity was tested by comparing PEDro total s...

The purposes of this study were to investigate whether age influences passive range of motion (PROM) in women and to compare obtained values with other available data. Ninety healthy Caucasian women from 18 to 59 years of age had the PROM of their ankle, knee, hip, shoulder, elbow, and wrist measured by using a standard goniometer. Data were analyz...

Previous systematic reviews have concluded that the effectiveness of motor control exercise for persistent low back pain has not been clearly established. The objective of this study was to systematically review randomized controlled trials evaluating the effectiveness of motor control exercises for persistent low back pain. Electronic databases we...

The objective of this study was to compare ranges of motion (ROM) between dominant and nondominant sides for the joints of the upper and lower extremities. Ninety healthy white women from 18 to 59 years of age were measured in this study. Active and passive ROM were measured for the ankle, knee, hip, shoulder, elbow, and wrist using a standard goni...

The methodological quality of randomized controlled trials (RCTs) is commonly evaluated in order to assess the risk of biased estimates of treatment effects. The purpose of this systematic review was to identify scales used to evaluate the methodological quality of RCTs in health care research and summarize the content, construction, development, a...

Chronic low back pain remains a major health problem in Australia and around the world. Unfortunately the majority of treatments for this condition produce small effects because not all patients respond to each treatment. It appears that only 25-50% of patients respond to exercise. The two most popular types of exercise for low back pain are graded...

RESUMO Contexto: A tendinose é uma condição degenerativa do tendão causada por estresse excessivo, que pode evoluir para uma ruptura total. Alterações do alinhamento patelar e/ou anormalidades estruturais do pé são consideradas fatores de risco para tendinose patelar, entretanto, não foram demonstradas relações entre essas alterações e a patologia....