Undertaking Rehabilitation Research During the COVID-19 Pandemic: Emergent Strategies From a Trainee-Faculty Workshop

BackgroundThe COVID-19 pandemic has disrupted everyday rehabilitation research. Many academic institutions have halted in-person human research including rehabilitation sciences. Researchers are faced with several barriers to continuing their research programs. The purpose of this perspective article is to report the results of an interdisciplinary workshop aimed at understanding the challenges and corresponding strategies for conducting rehabilitation research during the COVID-19 pandemic.MethodsTwenty-five rehabilitation researchers (17 trainees and eight faculty) attended a 2-h facilitated online workshop in to discuss challenges and strategies they had experienced and employed to conduct rehabilitation research during the COVID-19 pandemic.ResultsRehabilitation researchers reported challenges with (1) pandemic protocol adjustments, (2) participant accessibility, and (3) knowledge dissemination, along with corresponding strategies to these challenges. Researchers experienced disruptions in study outcomes and intervention protocols to adhere to public health guidelines and have suggested implementing novel virtual approaches and study toolkits to facilitate offsite assessment. Participant accessibility could be improved by engaging community stakeholders in protocol revisions to ensure equity, safety, and feasibility. Researchers also experienced barriers to virtual conferences and publication, suggested opportunities for smaller networking events, and revisiting timeframes for knowledge dissemination.ConclusionThis perspective article served as a catalyst for discussion among rehabilitation researchers to identify novel and creative approaches that address the complexities of conducting rehabilitation research during the COVID-19 pandemic and beyond

Assessing cultural competency among Canadian chiropractors: a cross-sectional survey of Canadian Chiropractic Association members

Abstract 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 communities, and (3) assess contextual factors associated with cultural competency. Methods We conducted a cross-sectional survey of members of the Canadian Chiropractic Association (CCA) (May–July 2021). The survey instrument consisted of 57 questions related to demographics, cultural competency, perceptions about health disparities, and challenges in delivery of rehabilitation. Cultural competency was measured using the Cultural Awareness and Sensitivity and Cultural Competence Behaviours subscales of the Cultural Competence Assessment Instrument. We conducted a multivariate linear regression to assess factors that may be associated with cultural competency. Results A total of 3143 CCA members responded (response rate of 41%). Mean scores for the Cultural Awareness and Sensitivity subscale were 5.8/7 (95% CI 5.7; 5.8) and 4.2/7 (95% CI 4.1; 4.2) for the Cultural Competence Behaviour subscale. Most chiropractors (72–78%) reported observing important cultural health disparities across various care-related outcomes. Cost of services and language were identified as barriers to providing care to equity-seeking communities. Cultural Awareness and Sensitivity scores were weakly associated with gender (men), years of clinical practice, cultural health disparities, the statement “I think some people have an agenda to look for discrimination even where it does not exist (DEI attitudes),” race (Caucasian), and prior DEI training, (R2 = 0.15, p < 0.0001). Cultural Competence Behaviour scores were weakly associated with race (Caucasian), cultural health disparities, prior DEI training, increased years of clinical experience, and higher Cultural Awareness and Sensitivity scores (R2 = 0.19, p < 0.0001). Conclusion This study provides the first description of cultural competency within the chiropractic profession in Canada. Findings suggest a gap between knowledge and behaviour and uncover several barriers and challenges that may inform the development of profession-specific training in cultural competence

Presurgical rehabilitation program for patients with symptomatic lumbar spinal stenosis: A pilot randomized controlled trial protocol

ABSTRACTBackground 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) will evaluate the feasibility of an eHealth prehabilitation program for individuals undergoing SLSS surgery, and an embedded longitudinal qualitative study explores the perioperative patient experience and recovery trajectory.Methods Participants (n = 60) undergoing spine surgery for LSS will be randomized into the 8-week electronic health (eHealth) prehabilitation program or minimal intervention. The prehabilitation program will be delivered virtually using synchronous (one-on-one) and asynchronous (independent) sessions by an experienced clinician, consisting of motivational interviewing, exercise (graded activity), education, peer support groups, and a 6-week booster session. Participants in the minimal care group will receive usual care and will have access to educational videos. Primary outcomes will include (1) recruitment, (2) patient adherence, (3) acceptability of program content, (4) acceptability and compliance with study questionnaires, and (5) attrition. Outcomes will be assessed at baseline, after the intervention, and 3 and 12 months postoperatively. We will conduct semistructured interviews alongside the RCT with 12 to 15 participants.Discussion The proposed project will include the feasibility testing of an eHealth LSS prehabilitation program with potential to improve surgical outcomes. Results of this study will provide the foundation for future fully powered multicenter RCTs.Trial Registration clinicaltrials.gov NCT0507308