ORCID Profile
0000-0001-7860-9463
Current Organisations
Toronto Rehabilitation Institute
,
University of Toronto
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Publisher: Elsevier BV
Date: 12-2008
DOI: 10.1016/J.APMR.2008.09.551
Abstract: To examine the influence of cognitive reserve-related moderator variables on recovery trajectories during the first year after traumatic brain injury (TBI). Using mixed effects models, we measured (1) the level of cognitive function at 2 and 12 months postinjury and (2) the trajectories of cognitive recovery during the first 12 months postinjury. Repeated-measures design with neuropsychological testing at 2, 5, and 12 months postinjury. Large, urban inpatient neurorehabilitation program. Patients (N=75) with moderate-to-severe TBI. Not applicable. neuropsychological composite scores including simple speed of processing, complex speed of processing, memory, untimed executive functions, and attention span. Primary predictors: age, estimated premorbid intelligence quotient (IQ), and years of education. Only age significantly moderated trajectories. Decreasing age significantly enhanced recovery of speed of processing, both simple (2-12mo postinjury, P<.001) and complex (2-12mo postinjury, P<.05 5-12mo postinjury, P<.005). Decreasing age and increasing estimated premorbid IQ were associated with higher performance at 2 and 12mo postinjury for simple speed of processing (premorbid IQ, 2 and 12mo), complex speed of processing (age, 2 and 12mo), untimed executive functions (premorbid IQ, 2 and 12mo), and memory (premorbid IQ, 2 and 12mo). Recovery of speed of processing (both simple and complex) was favorably moderated by younger age. Older age is associated with more neuronal loss and less integrity of white matter, and speed of processing is associated with white matter networks. The recuperative effects of younger age may therefore be attributable to greater reserve capacity (as indexed by white matter integrity). Lower age and higher estimated premorbid IQ were associated with higher functioning on a variety of cognitive outcomes. This may reflect the buffering effects of reserve capacity or premorbid differences in age and IQ-related cognitive functioning. Implications for rehabilitation and recovery mechanisms are discussed.
Publisher: Elsevier BV
Date: 12-2008
DOI: 10.1016/J.APMR.2008.10.002
Abstract: To ascertain patterns of cognitive recovery during the first year after traumatic brain injury (TBI). Specifically, differential recovery across cognitive domains was investigated. Prospective, longitudinal, naturalistic, 1-year follow-up study. Large, urban inpatient neurorehabilitation program. Patients (N=75) with moderate to severe TBI. Not applicable. Patients with TBI were followed over the course of 1 year, during which participants' neuropsychological status was repeatedly evaluated at 3 time points (2, 5, and 12 months postinjury). Multilevel modeling results were consistent with previous research, demonstrating that recovery in the first year postinjury is asymptotic in nature, with more accelerated recovery occurring during the first 5 to 6 months. Importantly, results also suggest that recovery is not uniform across cognitive domains. From 2 to 5 months postinjury, steeper recovery curves were revealed for indices of memory, speeded executive function, verbal abstraction, and manual dexterity relative to untimed tests of executive function and word knowledge. Recovery trajectories did not significantly vary as a function of cognitive domain over the course of the last 5 to 12 months. These results are the first to explore trajectories of recovery directly as a function of multiple cognitive domains. They are expected to have implications for rehabilitative efforts as well as our understanding of the architecture of natural recovery after TBI.
Publisher: JMIR Publications Inc.
Date: 29-07-2022
DOI: 10.2196/37243
Abstract: The Stroke Recovery in Motion Implementation Planner guides teams through the process of planning for the implementation of community-based exercise programs for people with stroke, in alignment with implementation science frameworks. The purpose of this study was to conduct a field test with end users to describe how teams used the Planner in real-world conditions describe the effects of Planner use on participants’ implementation-planning knowledge, attitudes, and activities and identify factors influencing the use of the Planner. This field test study used a longitudinal qualitative design. We recruited teams across Canada who intended to implement a community-based exercise program for people with stroke in the next 6 to 12 months and were willing to use the Planner to guide their work. We completed semistructured interviews at the time of enrollment, monitoring calls every 1 to 2 months, and at the end of the study to learn about implementation-planning work completed and Planner use. The interviews were analyzed using conventional content analysis. Completed Planner steps were plotted onto a timeline for comparison across teams. We enrolled 12 participants (program managers and coordinators, rehabilitation professionals, and fitness professionals) from 5 planning teams. The teams were enrolled in the study between 4 and 14 months, and we conducted 25 interviews. We observed that the teams worked through the planning process in erse and nonlinear ways, adapted to their context. All teams provided ex les of how using the Planner changed their implementation-planning knowledge (eg, knowing the steps), attitudes (eg, valuing community engagement), and activities (eg, hosting stakeholder meetings). We identified team, organizational, and broader contextual factors that hindered and facilitated uptake of the Planner. Participants shared valuable tips from the field to help future teams optimize use of the Planner. The Stroke Recovery in Motion Implementation Planner is an adaptable resource that may be used in erse settings to plan community-based exercise programs for people with stroke. These findings may be informative to others who are developing resources to build the capacity of those working in community-based settings to implement new programs and practices. Future work is needed to monitor the use and understand the effect of using the Planner on exercise program implementation and sustainability.
Publisher: Springer Science and Business Media LLC
Date: 19-12-2022
DOI: 10.1186/S13643-022-02147-4
Abstract: Young people with stroke (YPwS) persistently experience challenges with disability, social reintegration, employment, and financial stability to provide for themselves and their families. The aims of this scoping review are to (1) identify and collate information resources for YPwS and evidence-based self-managements programs and (2) identify gaps in age-specific resources available for YPwS after traditional rehabilitation services have ended and/or who are returning to live in the community. We will include both qualitative and quantitative studies, including all study designs. Participants will be community-dwelling adults aged between 18 and 65 years with a clinical diagnosis of stroke. We will include information resources and evidence-based self-managements programs for YPwS. Search terms will include stroke, young people, and community dwelling. We will search electronic databases such as MEDLINE. The reference lists of included studies, systematic reviews, and stroke guidelines and stroke-specific websites will also be searched. We will also contact Stroke Support Organizations and international/national allied health professional organisations to gather information resources about YPwS. We will also conduct a comprehensive environmental scan of additional resources using the search engine Google. The titles, abstracts, full-text articles, and contents of the resources identified by the search will be assessed against the inclusion and exclusion criteria to identify potentially relevant resources. Existing resources and self-management programs will be collated and categorized according to the type of needs addressed such as physical, emotions, activities of daily living, information, relationships, and social needs as well as the key gaps identified.
Publisher: JMIR Publications Inc.
Date: 29-07-2022
DOI: 10.2196/37189
Abstract: As more people are surviving stroke, there is a growing need for services and programs that support the long-term needs of people living with the effects of stroke. Exercise has many benefits however, most people with stroke do not have access to specialized exercise programs that meet their needs in their communities. To catalyze the implementation of these programs, our team developed the Stroke Recovery in Motion Implementation Planner, an evidence-informed implementation guide for teams planning a community-based exercise program for people with stroke. This study aimed to conduct a user evaluation to elicit user perceptions of the usefulness and acceptability of the Planner to inform revisions. This mixed methods study used a concurrent triangulation design. We used purposive s ling to enroll a erse s le of end users (program managers and coordinators, rehabilitation health partners, and fitness professionals) from three main groups: those who are currently planning a program, those who intend to plan a program in the future, and those who had previously planned a program. Participants reviewed the Planner and completed a questionnaire and interviews to identify positive features, areas of improvement, value, and feasibility. We used descriptive statistics for quantitative data and content analysis for qualitative data. We triangulated the data sources to identify Planner modifications. A total of 39 people participated in this study. Overall, the feedback was positive, highlighting the value of the Planner’s comprehensiveness, tools and templates, and real-world ex les. The identified areas for improvement included clarifying the need for specific steps, refining navigation, and creating more action-oriented content. Most participants reported an increase in knowledge and confidence after reading the Planner and reported that using the resource would improve their planning approach. We used a rigorous and user-centered process to develop and evaluate the Planner. End users indicated that it is a valuable resource and identified specific changes for improvement. The Planner was subsequently updated and is now publicly available for community planning teams to use in the planning and delivery of evidence-informed, sustainable, community-based exercise programs for people with stroke.
Publisher: American Chemical Society (ACS)
Date: 14-02-2018
DOI: 10.1021/ACS.ANALCHEM.7B05341
Abstract: Upconversion nanoparticles (UCNPs) are new optical probes for biological applications. For specific biomolecular recognition to be realized for diagnosis and imaging, the key lies in developing a stable and easy-to-use bioconjugation method for antibody modification. Current methods are not yet satisfactory regarding conjugation time, stability, and binding efficiency. Here, we report a facile and high-yield approach based on a bispecific antibody (BsAb) free of chemical reaction steps. One end of the BsAb is designed to recognize methoxy polyethylene glycol-coated UCNPs, and the other end of the BsAb is designed to recognize the cancer antigen biomarker. Through simple vortexing, BsAb-UCNP nanoprobes form within 30 min and show higher (up to 54%) association to the target than that of the traditional UCNP nanoprobes in the ELISA-like assay. We further demonstrate its successful binding to the cancer cells with high efficiency and specificity for background-free fluorescence imaging under near-infrared excitation. This method suggests a general approach broadly suitable for functionalizing a range of nanoparticles to specifically target biomolecules.
Publisher: SAGE Publications
Date: 29-06-2015
DOI: 10.1111/IJS.12557
Abstract: Every year, approximately 62 000 people with stroke and transient ischemic attack are treated in Canadian hospitals, and the evidence suggests one-third or more will experience vascular-cognitive impairment, and/or intractable fatigue, either alone or in combination. The 2015 update of the Canadian Stroke Best Practice Recommendations: Mood, Cognition and Fatigue Module guideline is a comprehensive summary of current evidence-based recommendations for clinicians in a range of settings, who provide care to patients following stroke. The three consequences of stroke that are the focus of the this guideline (poststroke depression, vascular cognitive impairment, and fatigue) have high incidence rates and significant impact on the lives of people who have had a stroke, impede recovery, and result in worse long-term outcomes. Significant practice variations and gaps in the research evidence have been reported for initial screening and in-depth assessment of stroke patients for these conditions. Also of concern, an increased number of family members and informal caregivers may also experience depressive symptoms in the poststroke recovery phase which further impact patient recovery. These factors emphasize the need for a system of care that ensures screening occurs as a standard and consistent component of clinical practice across settings as stroke patients transition from acute care to active rehabilitation and reintegration into their community. Additionally, building system capacity to ensure access to appropriate specialists for treatment and ongoing management of stroke survivors with these conditions is another great challenge.
Publisher: JMIR Publications Inc.
Date: 30-10-2023
DOI: 10.2196/50463
Publisher: SAGE Publications
Date: 14-04-2016
Abstract: Stroke rehabilitation is a progressive, dynamic, goal-orientated process aimed at enabling a person with impairment to reach their optimal physical, cognitive, emotional, communicative, social and/or functional activity level. After a stroke, patients often continue to require rehabilitation for persistent deficits related to spasticity, upper and lower extremity dysfunction, shoulder and central pain, mobility/gait, dysphagia, vision, and communication. Each year in Canada 62,000 people experience a stroke. Among stroke survivors, over 6500 in iduals access in-patient stroke rehabilitation and stay a median of 30 days (inter-quartile range 19 to 45 days). The 2015 update of the Canadian Stroke Best Practice Recommendations: Stroke Rehabilitation Practice Guidelines is a comprehensive summary of current evidence-based recommendations for all members of multidisciplinary teams working in a range of settings, who provide care to patients following stroke. These recommendations have been developed to address both the organization of stroke rehabilitation within a system of care (i.e., Initial Rehabilitation Assessment Stroke Rehabilitation Units Stroke Rehabilitation Teams Delivery Outpatient and Community-Based Rehabilitation), and specific interventions and management in stroke recovery and direct clinical care (i.e., Upper Extremity Dysfunction Lower Extremity Dysfunction Dysphagia and Malnutrition Visual-Perceptual Deficits Central Pain Communication Life Roles). In addition, stroke happens at any age, and therefore a new section has been added to the 2015 update to highlight components of stroke rehabilitation for children who have experienced a stroke, either prenatally, as a newborn, or during childhood. All recommendations have been assigned a level of evidence which reflects the strength and quality of current research evidence available to support the recommendation. The updated Rehabilitation Clinical Practice Guidelines feature several additions that reflect new research areas and stronger evidence for already existing recommendations. It is anticipated that these guidelines will provide direction and standardization for patients, families/caregiver(s), and clinicians within Canada and internationally.
Publisher: SAGE Publications
Date: 18-08-2017
Abstract: A Very Early Rehabilitation Trial (AVERT) was a Phase 3 randomized trial with over 2100 subjects post stroke that had unexpected results with better outcomes for usual care than those receiving very early mobilization. This review of published stroke clinical practice guidelines highlights that recommendations for mobilization have changed after publication of AVERT but also that developers have struggled to provide recommendations for appropriate dose, duration and intensity of mobilization in the acute post stroke period with available analyses from AVERT and other literature. This review highlights the priority research questions about early rehabilitation post stroke that need to be addressed through future large scale randomized controlled trials.
Publisher: SAGE Publications
Date: 05-01-2018
Abstract: Clinical practice guidelines are essential for driving evidence-based clinical care to patients. In an era of ever-increasing research evidence, keeping guidelines up to date is a challenging and resource-intensive process. Advances in technological platforms provide opportunities to develop new models of guideline development that will allow for continuous, rapid updates to recommendations as new evidence emerges. As Australia and other countries begin to develop these models, we have an opportunity to work more closely together to ensure the most efficient use of resources.
Publisher: JMIR Publications Inc.
Date: 02-07-2023
No related grants have been discovered for Mark Bayley.