Tara Packham

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Verified

Tara verified their affiliation via an institutional email.

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• PhD, OT(Reg)Ont
• Assistant Professor at McMaster University

Introduction The MacHAND performance assessment (MPA) is one of only 2 measures of dexterity and hand function based on the quality of the movement patterns and time to complete tasks. The MPA is easy to assemble, based on common grasp patterns, composed of cost-effective everyday objects and includes stereognosis tasks. However, it takes 20 mins t...

Poorly controlled chronic obstructive pulmonary disease (COPD) can negatively impact quality of life but mobile applications (apps) are popular digital tools that may mitigate these support needs. However, it is unclear if public mobile COPD apps are acceptable to healthcare professionals and patients, people living with COPD. Objectives: The prima...

Objective: To determine the falsifiability of the proposed etiology of static mechanical allodynia (SMA) as a paradoxical painful touch-evoked slight tactile HYPO-aesthesia caused by Aβ axonal lesions in patients treated for Complex Regional Pain Syndrome (CRPS) of the foot. Methods: This is a retrospective analysis of prospectively collected clini...

Background The current literature supports the effectiveness of exercise, education, and self-management interventions for the long-term management of persistent low back pain. However, there is significant uncertainty about the implementation of interventions related to barriers, facilitators, and patient’s preferences. This study will evaluate th...

Background: In Canada, internationally educated physiotherapists (IEPTs) and occupational therapists (IEOTs) may work as occupational/physical therapy assistants (OTAs/PTAs) while pursuing Canadian licensure. This experience presents personal and professional opportunities and challenges. Purpose: We explored a) the barriers and facilitators experi...

Brain fog is a phenomenon that is frequently reported by persons with chronic pain. Difficulties with cognition including memory impairments, attentional issues, and cloudiness are commonly described. The current medical literature demonstrates a similar cloudiness: there is no clear taxonomy or nomenclature, no well-validated evaluations and a dea...

Introduction A variety of techniques for measuring finger range of motion (ROM) are available for hand therapist use, however, there is no clear description of which finger ROM methods are preferred in practice. This study explored the preferred measurement techniques, the factors influencing clinical decision-making, and the clinical reasoning pro...

Background Knee arthritis is a leading cause of limited function and long-term disability in older adults. Despite a technically successful total knee arthroplasty (TKA), around 20% of patients continue to have persisting pain with reduced function, and low quality of life. Many of them continue using opioids for pain control, which puts them at ri...

Chat GPT is a modern artificial intelligence program: its recent introduction has created controversy in the academic world. This commentary discusses the utility of Chat GPT to explore healthcare issues such as chronic pain and associated conditions. To illustrate the potential application of brain fog, this commentary presents an example of Chat...

Background People with complex regional pain syndrome (CRPS) commonly report a fear of movement that can worsen symptoms and increase disability. The Tampa Scale of Kinesiophobia (TSK) is used to evaluate fear of movement and (re)injury, but findings have been inconsistent in different populations. Objective To evaluate the psychometric properties...

Background. There is a need for the occupational therapy profession to respond to the Truth and Reconciliation Commission of Canada Calls to Action and work towards supporting the health and well-being of Indigenous Peoples. Purpose. (1) To determine the knowledge gaps of occupational therapists about Indigenous health and (2) to create recommendat...

Background: Painful sensitivity in the hand is commonly seen with neuropathic pain, interfering with daily activities including rehabilitation. However, there are currently several terms used to describe the problem and a lack of guidance on what assessments should be used. Purpose: To gather expert opinion a) identifying current and common termino...

Background Our objective was to summarize, synthesize, and integrate the evidence evaluating the effectiveness of biophysical agents compared to other conservative treatments, for the management of carpal tunnel syndrome (CTS). Methods This was an overview of systematic reviews (SRs). We searched several online databases and obtained SRs relating...

Integration of mobile health (mHealth) applications (apps) into chronic lung disease management is becoming increasingly popular. MHealth apps may support adoption of self-management behaviors to assist people in symptoms control and quality of life enhancement. However, mHealth apps’ designs, features, and content are inconsistently reported, maki...

Background: Chronic diseases are a leading cause of death and disease burden globally. Digital interventions could be an approach to improve patients' ability to find, evaluate, and use health information. Objectives: The main objective was to conduct a systematic review to determine the effect of digital interventions on digital health literacy...

Objectives: A rising number of systematic reviews have been conducted on various conservative ‎managements of CRPS targeting different rehabilitation interventions and objectives. To summarize and critically appraise the body of evidence on conservative management of the CRPS, and to provide an overall picture of the current state ‎of the literatu...

Introduction: Approximately 15% to 40% of persons with chronic pain as a primary disorder experience brain fog. Prior research has investigated the etiology of "brain fog" in conditions in which pain presents as a key feature (e.g., fibromyalgia). However, it remains understudied in the context of chronic 10 musculoskeletal pain. Following current...

Unlabelled: Mobile health applications (mHealth apps) may be able to support people living with chronic obstructive pulmonary disease (COPD) to develop the appropriate skills and routines for adequate self-management. Given the wide variety of publicly available mHealth apps, it is important to be aware of their characteristics to optimize their u...

Objective The purpose of this study was to summarize and evaluate the research on the accuracy of provocative maneuvers to diagnose carpal tunnel syndrome (CTS). Methods The MEDLINE, CINAHL, Cochrane, and Embase databases were searched, and studies that assessed the diagnostic accuracy of at least 1 provocative test for CTS were selected. Study ch...

Background: Knee arthritis is a leading cause of limited function and long-term disability in older adults. Despite a technically successful total knee arthroplasty (TKA), around 20% of patients continue to have persisting pain with reduced function, and low quality of life. Many of them continue using opioids for pain control, which puts them at r...

Objectives: To summarize and critically appraise the body of evidence on conservative management of complex regional pain syndrome (CRPS), we conducted a systematic review and meta-analysis of randomized controlled trials (RCTs). Methods: We conducted a literature search from inception to November 2021 in the following databases: Embase, Medline...

Objective: To determine the extent of agreement between the original CSI and the Rasch analyzed version (RC-CSI) and to explore the association of both versions with psychophysical tests and their respective sensitivity and specificity. Methods: Patients with knee OA enrolled in a multicenter cohort study in Montreal, Canada completed the origin...

Background. The occupational therapy profession needs to respond to the calls to action from the Truth and Reconciliation Commission (TRC) to engage in the process of reconciliation with Indigenous populations. Purpose. To inform development of a survey intended to determine the knowledge gaps of occupational therapists in relation to Indigenous he...

Background: Total knee arthroplasties are the second most common surgery in Canada. Most patients recover well, but 20% or more still suffer from persistent pain and opioid use. Though opioids are an important part of perioperative pain management, their potential for long-term adverse effects is well recognized. Limiting opioids may be insufficie...

Introduction/objective: Central sensitization (CS) is a known contributor to chronic pain in people with knee osteoarthritis (KOA) and is commonly measured by psychophysical testing or patient-reported methods such as the Central Sensitization Inventory (CSI). However, previous studies have shown a weak association between the two. We therefore so...

Abstract Background The brief Michigan Hand Questionnaire (brief MHQ) is a 12-item self-reported measure of hand function for patients with hand disorders which has been validated using Classical Test Theory. Rasch analysis can provide more detailed psychometric information. The purpose of this Rasch analysis is to assess the psychometric propertie...

Pulmonary rehabilitation (PR) is a multidisciplinary intervention forming the cornerstone of chronic respiratory disease management, improving individuals' exercise capacities and abilities to complete activities of daily living (ADLs). Although the occupational therapy (OT) scope of practice focuses on similar outcomes as PR, the tasks/roles and b...

Background: The COVID-19 pandemic has led to an increased reliance on virtual care in the rehabilitation setting for patients with conditions such as complex regional pain syndrome (CRPS). Aims: The aim of this study was to perform a quality improvement initiative to assess patient satisfaction and ensure that outcomes following virtual assessme...

Introduction Chronic pain has multiple aetiological factors and complexity. Pain theory helps us to guide and organize our thinking to deal with this complexity. The objective of this paper is to critically review the most influential theory in pain science history (the gate control theory of pain) and focus on its implications in chronic pain reha...

Background: The Critical Incident Inventory (CII) was developed to assess stressful exposures in firefighters and emergency service workers. The CII includes six subscales: trauma to self, victims known to fire-emergency worker, multiple casualties, incidents involving children, unusual or problematic tactical operations, and exposure to severe me...

Purpose To examine the associations between psychological factors (pain catastrophizing, pain-related anxiety, and fear of pain) and level of pain and disability in patients with complex regional pain syndrome (CRPS). Methods One hundred and two patients with CRPS were recruited from tertiary care centers with the different upper limb injuries wer...

Objectives The Michigan Hand Questionnaire (MHQ) is a commonly used evaluation for hand problems, but previous work reports conflicting evidence regarding the subscale structures. Rasch analysis uses probabilistic modeling of items and responses: if scale items can be fit to the Rasch model, it provides evidence of construct validity and interval-l...

Research on male intimate partner violence (IPV) survivors is limited. The sparse research on male IPV disclosure suggest males receive more negative and less helpful responses from potential sources of formal or informal support. Males may seek support on social networking sites (SNSs), hence, it is important to understand their emerging experienc...

To date research on intimate partner violence (IPV) has focused on the experience of females. The limited studies on male IPV survivors have shown that they are less likely to disclose their IPV experiences. Systemic biases may marginalize and silence male IPV survivors. The current study sought to explore the discourse around perceived systemic bi...

Objective The objectives of this study were to 1) assess the content validity of generic preference-based measures (GPBMs), and (2) examine the convergent validity of the EuroQol 5 Dimension 5 Level (EQ-5D-5L), against the Patient Generated Index (PGI) in Amyotrophic Lateral Sclerosis (ALS). Methods Participants were recruited from 3 clinical site...

Purpose: Among industrialized countries, Canada has the second-highest opioid prescribing rate for pain management. Physiotherapy and occupational therapy interventions are potential non-pharmacological alternatives. We undertook a scoping review to explore and summarize the current evidence describing the interventions included or used in physioth...

BACKGROUND Background: Chronic respiratory diseases are highly prevalent and compromise an individual’s ability to perform activities of daily living (ADLs) and participate in meaningful life roles. Pulmonary rehabilitation (PR) is a well-established intervention aiming at restoring an individual’s exercise capacity and improving their ability to c...

Background Chronic respiratory diseases are highly prevalent and compromise an individual’s ability to perform activities of daily living (ADLs) and participate in meaningful life roles. Pulmonary rehabilitation (PR) is a well-established intervention aimed at restoring an individual’s exercise capacity and improving their ability to complete their...

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...

Handtherapeuten begegnen sensiblen Störungen mit Sensibilitätstraining oder Desensibilisierungstechniken. Doch oft sind sowohl die Begrifflichkeiten als auch die entsprechenden Behandlungsmaßnahmen nicht klar voneinander abgegrenzt. Tara Packham erklärt die Unterschiede, prüft kritisch die vorhandene Evidenz und schlägt schließlich einen Algorithmu...

Background Dexterity impairments are common and disabling. Currently, there is no consensus on an operational definition to measure dexterity. Purpose This review aims to provide an overview of constructs measured by performance-based outcome measures of dexterity and hand function (PBOMD) validated for use in persons with musculoskeletal hand and...

Objective: To systematically locate, critically appraise and summarize clinical measurement research addressing the use of BPI-SF and SF-MPQ-2 in pain-related musculoskeletal (MSK) conditions. Methods: We systematically searched four databases (Medline, CINAHL, EMBASE & SCOPUS) and screened articles to identify those reporting the psychometric p...

Background: Patient participation is recognized as an important element of rehabilitation. However, few studies have used a qualitative lens to specifically examine factors influencing patient participation in stroke rehabilitation. Aim: The purpose of this study was to investigate patient perspectives of barriers and facilitators to participati...

Objective: The aim of this review was to synthesize the psychometric properties of generic preference-based measures (PBMs) of health-related quality of life (HRQL) in Amyotrophic Lateral Sclerosis (ALS). Methods: A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Fou...

Objective To investigate the targeting, scaling, and structural validity of the Work Limitation Questionnaire (WLQ) by Rasch analysis. Design Secondary data analysis Setting Tertiary care hospital. Participants The data were sourced from an upper limb specialty clinic of injured workers by convenience sampling method and from a national randomiz...

The Revised Short McGill Pain Questionnaire Version-2 (SF-MPQ-2) is a multidimensional outcome measure designed to capture, evaluate and discriminate pain from neuropathic and non-neuropathic sources. A recent systematic review found insufficient psychometric data with respect to musculoskeletal (MSK) health conditions. This study aimed to describe...

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...

This 1st English edition of Atlas of cutaneous branch territories of the human body stemming the 3rd French edition, deals with clinical anatomy of the somatosensory nervous system. As the clinic gives us opportunity to observe many more axonal lesions (axonotmesis) than complete transections (neurotmesis), the resultant cutaneous hypoaesthetic ter...

In order to outline a hypoaesthetic territory, some basic material is needed: nylon filaments of different diameters (Semmes-Weinstein/von Frey) named aesthesiometers because they are used to objectify and measure the sense of touch. Four different aesthesiometers are theoretically enough to assess the different parts of the body with four differen...

Introductory Summary This domain roughly corresponds to the upper part of the neck. It includes the cutaneous origins of the greater occipital and third occipital nerves behind, and of the lesser occipital and great auricular nerves laterally. The former directly convey the tactile information into the posterior branches of C2 and C3 while the latt...

The tactile sensitivity is transmitted from the skin of the face by the three divisions of the trigeminal nerve (ophthalmic, maxillary and mandibular nerves) over the trigeminal ganglion to the spinal trigeminal nucleus, which extends from the upper cervical segments of the spinal cord to the lower brain-stem

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...

The 3142 patients included in this research were recruited prospectively and consecutively from July 2, 2004 to August 21, 2019. They are patients experiencing chronic neuropathic pain referred to the Somatosensory Rehabilitation Centre. In order to study a group as homogeneous as possible, we restricted this topographical research to patients whos...

This atlas of clinical anatomy strives to confirm קבלה [Qabbala ≡ tradition] from a “new” afferent point of view. This recognising is NOT a fight against the clinical anatomy tradition. It is built on the listening of daily patient’s complaints. Since July 2004, instead of being disturbed by the possible discrepancies between the description of the...

The skin sensitivity of the thorax and of the anterior surface of abdomen is relayed to the intercostal and subcostal nerves that feed into the anterior branches of the thoracic nerves. The tactile sensitivity of the back is transmitted to the posterior branches of the thoracic nerves

The skin of the middle and distal thirds of the anterior surface is sending its information over the anterior branches of the femoral nerve. The medial surfaces of the foot, leg and knee emit their impulses towards the saphenous nerve. The tactile information of the lateral surface of the knee is sending, as well, its impulse to the saphenous nerve...

The skin sensory information from hand, forearm, elbow, arm and axilla is emitted towards the brachial plexus along the musculocutaneous, medial cutaneous of arm, medial cutaneous of forearm, median, ulnar, radial and axillary nerves. These seven nerves first converge into three cords, then intermingle their fibres that ultimately merge into a supe...

The skin of the lateral surface of the thigh feeds its sensory impulses into the lateral cutaneous nerve of thigh, while the genitofemoral nerve receives by its femoral branch similar impulses from the proximal anterior surface of the thigh and by its genital branch similar impulses from the proximal medial surface of the thigh. The middle third of...

This tactile sensitivity from the lower part of the neck’s skin is forwarded by the cervical plexus (transverse cervical and supraclavicular nerves) and by the direct posterior branches of the 4th, 5th, 6th, 7th and 8th cervical nerves towards the cervical segments of the spinal cord

The middle clunial nerves carry their impulses from the middle part of the buttocks’ skin to the posterior branches of the sacral and coccygeal spinal nerves. The lowest part of the buttocks’ cutaneous cover and the thigh’s posterior surface forward their sensory impulses to the sacral plexus via the inferior clunial nerves and the posterior cutane...

The sensory information from the skin of groin and antero-lateral genitals is delivered to the lateral and abdominal cutaneous branch of the iliohypogastric nerve to the ilio-inguinal nerve via its abdominal and anterior labial/scrotal branches, and eventually to the Lumbar plexus and the posterior roots of its spinal nerves. Each of those branches...

The skin covering the dorsum of foot sends its tactile information to the superficial peroneal nerve, except a small area in the first inter-digital space that feeds into the deep peroneal nerve. The tibial nerve collects the tactile impulses from the sole and the medial border of foot. The lateral surface of heel and of foot emits its impulses tow...

Finally, the 2c level of evidence-based practice - to treat Complex Regional Pain Syndrome of the upper extremity with SRM (cohort n=48) – suggests that this method is a good alternative to other conservative treatments (Packham et al., 2018). As to medical malpractice in nerve injury (Krauss et al., 2020), rehabilitation of neuropathic pain should...

Th is atlas is the result of research involving over 3,000 patients consecutively recruited since 2004. Clinical practice gives the opportunity to observe many more Aβ axonal lesions (axonotmesis) than transections (neurotmesis), consequently the mapped hypo aesthetic territories are partial. Th erefore, the authors defi ne for each cutaneous nerve...

Study Design This is a systematic review performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses standards. Introduction Diverse approaches based on tactile stimulation are used in hand rehabilitation settings to treat touch-evoked dysesthesias. However, there is a lack of literature synthesis on the descripti...

There is every reason to believe it is an inflammation: a red, swollen, warmer hand or foot with boiling-burning sensations in the joint. All these appalling symptoms leaving the person exhausted following a night of restless sleep. In Budapest, after three days of deliberations, a consensus meeting of 38 experts validated the precise diagnostic cr...

Purpose: Rates of prosthetic device abandonment are dramatically high; however, the reasons behind abandonment are less understood. A scoping review was conducted to explore the current state of the literature on why individuals abandon upper limb prosthetic devices and consider how these reasons have evolved historically. Materials and methods: A...

Purpose: Occupational therapist assistants and physiotherapist assistants work on inter-professional teams in both institutional and community settings to facilitate patients’ rehabilitation and recovery. Examination of how the assistant role is viewed by assistants and other inter-professional team members is needed to inform how to support and su...

Purpose/Aim: Allodynia is a common feature of neuropathic pain with few validated clinical evaluation options. We identified a need to estimate the measurement properties of the standardised evaluation procedure for static mechanical allodynia severity popularised by the somatosensory rehabilitation of pain method, known as the rainbow pain scale....

Background: The Brief Pain Inventory-Short Form (BPI-SF) and Revised Short-Form McGill Pain Questionnaire Version-2 (SF-MPQ-2) are generic pain assessment tools used in research and practice for pain assessment in musculoskeletal (MSK) conditions. A comprehensive review that systematically analyses their measurement properties in MSK conditions ha...

Background: The Revised Short McGill Pain Questionnaire Version-2 (SF-MPQ-2) is a multidimensional outcome measure designed to evaluate neuropathic and non-neuropathic pain. A recent systematic review found insufficient psychometric data with respect to musculoskeletal health conditions. Aims: To describe the reproducibility (reliability and agreem...

Objective: There is a need for reliable and valid clinical assessment tools for quantifying allodynia in neuropathic pain. Allodynography has been proposed as a useful standardized procedure for clinical assessment of mechanical allodynia. This study (www.clinicaltrials.gov NCT02070367) undertook preliminary investigation of the measurement proper...

Background: Dexterity impairments are common and disabling. Currently, there is no consensus on an operational definition to measure dexterity. Purpose: This review aims to provide an overview of constructs measured by performance-based outcome measures of dexterity and hand function (PBOMD) validated for use in persons with hand and wrist conditi...

The authors propose a definition of dexterity to improve the clarity of the concept: dexterity, in communication and its application to clinical assessment in hand and upper limb rehabilitation.