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Lamontagne M.-E.,University of Montréal | Lamontagne M.-E.,University of Québec | Swaine B.R.,University of Montréal | Lavoie A.,University of Québec | Careau E.,Center Interdisciplinaire Of Recherche En Readaptation Et En Integration Sociale
Brain Injury | Year: 2011

Networks are an increasingly popular way to deal with the lack of integration of traumatic brain injury (TBI) care. Knowledge of the stakes of the network form of organization is critical in deciding whether or not to implement a TBI network to improve the continuity of TBI care. Goals of the study: To report the strengths, weaknesses, opportunities, and threats of a TBI network and to consider these elements in a discussion about whether networks are a suitable solution to fragmented TBI care. Methods: In-depth interviews with 12 representatives of network organization members. Interviews were qualitatively analyzed using the EGIPSS model of performance. Results: The majority of elements reported were related to the network's adaptation to its environment and more precisely to its capacity to acquire resources. The issue of value maintenance also received considerable attention from participants. Discussion: The network form of organization seems particularly sensitive to environmental issues, such as resource acquisition and legitimacy. The authors suggest that the network form of organization is a suitable way to increase the continuity of TBI care if the following criteria are met: (1) expectations toward network effectiveness to increase continuity of care are moderate and realistic; (2) sufficient resources are devoted to the design, implementation, and maintenance of the network; (3) a network's existence and actions are deemed legitimate by community and organization member partners; and (4) there is a good collaborative climate between the organizations. © 2011 Informa UK Ltd All rights reserved.


Martel Sauvageau V.,Center Interdisciplinaire Of Recherche En Readaptation Et En Integration Sociale | Roy J.-P.,Laval University | Cantin L.,CHU de Quebec Hopital de lEnfant Jesus | Prud'Homme M.,CHU de Quebec Hopital de lEnfant Jesus | And 2 more authors.
Parkinson's Disease | Year: 2015

Purpose. To investigate the impact of deep brain stimulation of the subthalamic nucleus (STN DBS) and levodopa intake on vowel articulation in dysarthric speakers with Parkinson's disease (PD). Methods. Vowel articulation was assessed in seven Quebec French speakers diagnosed with idiopathic PD who underwent STN DBS. Assessments were conducted on- and off-medication, first prior to surgery and then 1 year later. All recordings were made on-stimulation. Vowel articulation was measured using acoustic vowel space and formant centralization ratio. Results. Compared to the period before surgery, vowel articulation was reduced after surgery when patients were off-medication, while it was better on-medication. The impact of levodopa intake on vowel articulation changed with STN DBS: before surgery, levodopa impaired articulation, while it no longer had a negative effect after surgery. Conclusions. These results indicate that while STN DBS could lead to a direct deterioration in articulation, it may indirectly improve it by reducing the levodopa dose required to manage motor symptoms. These findings suggest that, with respect to speech production, STN DBS and levodopa intake cannot be investigated separately because the two are intrinsically linked. Along with motor symptoms, speech production should be considered when optimizing therapeutic management of patients with PD. © 2015 Vincent Martel Sauvageau et al.


PubMed | Center Interdisciplinaire Of Recherche En Readaptation Et En Integration Sociale, CHU de Quebec Hopital de lEnfant Jesus, University of Québec and Laval University
Type: | Journal: Parkinson's disease | Year: 2015

Purpose. To investigate the impact of deep brain stimulation of the subthalamic nucleus (STN DBS) and levodopa intake on vowel articulation in dysarthric speakers with Parkinsons disease (PD). Methods. Vowel articulation was assessed in seven Quebec French speakers diagnosed with idiopathic PD who underwent STN DBS. Assessments were conducted on- and off-medication, first prior to surgery and then 1 year later. All recordings were made on-stimulation. Vowel articulation was measured using acoustic vowel space and formant centralization ratio. Results. Compared to the period before surgery, vowel articulation was reduced after surgery when patients were off-medication, while it was better on-medication. The impact of levodopa intake on vowel articulation changed with STN DBS: before surgery, levodopa impaired articulation, while it no longer had a negative effect after surgery. Conclusions. These results indicate that while STN DBS could lead to a direct deterioration in articulation, it may indirectly improve it by reducing the levodopa dose required to manage motor symptoms. These findings suggest that, with respect to speech production, STN DBS and levodopa intake cannot be investigated separately because the two are intrinsically linked. Along with motor symptoms, speech production should be considered when optimizing therapeutic management of patients with PD.


Poulin V.,University of Quebec at Trois - Rivieres | Poulin V.,Center Interdisciplinaire Of Recherche En Readaptation Et En Integration Sociale | Korner-Bitensky N.,McGill University | Bherer L.,Concordia University at Montréal | And 2 more authors.
Disability and Rehabilitation | Year: 2015

Purpose This pilot partially randomised controlled trial compared the feasibility and preliminary efficacy of two promising interventions for persons with executive dysfunction post-stroke: (1) occupation-based strategy training using an adapted version of the Cognitive Orientation to daily Occupational Performance (CO-OP) approach; and (2) Computer-based EF training (COMPUTER training). Method Participants received 16 h of either CO-OP or COMPUTER training. We assessed feasibility and acceptability of each intervention, and change in intervention outcomes at baseline, post-intervention and one-month follow-up. Performance and satisfaction with performance in self-selected everyday life goals were measured by the participant and the significant other-rated Canadian Occupational Performance Measure (COPM). Other intervention outcomes included changes in EF impairment, participation in daily life and self-efficacy. Results Six participants received CO-OP and five received COMPUTER training: one in each group discontinued the intervention for medical reasons unrelated to the intervention. The remaining nine participants completed all 16 sessions. Participants expressed high levels of satisfaction with both interventions. Both treatment groups showed large improvements in self and significant other-rated performance and satisfaction with performance on their goals immediately post-intervention and at follow-up (CO-OP: effect sizes (ES) = 1.6–3.5; COMPUTER: ES = 0.9–4.0), with statistically significant within-group differences in CO-OP (p < 0.05). The COMPUTER group also showed large improvements in some areas of EF impairment targeted by the computerised tasks (ES = 0.9–1.6); the CO-OP group demonstrated large improvements in self-efficacy for performing everyday activities (ES = 1.5). Conclusions Our findings provide preliminary evidence supporting the feasibility of using both CO-OP and COMPUTER training with patients with executive dysfunction post-stroke.Implications for RehabilitationComputerised executive function training and occupation-based strategy training are feasible to deliver and acceptable to persons with executive dysfunction post-stroke.Preliminary evidence suggests that both interventions have a positive impact on real-world outcomes; and, that CO-OP might have a greater impact on improving self-efficacy for performing everyday activities. © 2015 Taylor & Francis


Joyal M.,Center Interdisciplinaire Of Recherche En Readaptation Et En Integration Sociale | Joyal M.,University of Québec | Joyal M.,Laval University | Bonneau A.,Center Interdisciplinaire Of Recherche En Readaptation Et En Integration Sociale | And 5 more authors.
Psychiatry Research | Year: 2016

Individuals with schizophrenia display speech and language impairments that greatly impact their integration to the society. The aim of this systematic review was to identify the importance of speech and language therapy (SLT) as part of rehabilitation curriculums for patients with schizophrenia emphasizing on the speech and language abilities assessed, the therapy setting and the therapeutic approach. This article reviewed 18 studies testing the effects of language therapy or training in 433 adults diagnosed with schizophrenia. Results showed that 14 studies out of 18 lead to improvements in language and/or speech abilities. Most of these studies comprised pragmatic or expressive discursive skills being the only aim of the therapy or part of it. The therapy settings vary widely ranging from twice daily individual therapy to once weekly group therapy. The therapeutic approach was mainly operant conditioning. Although the evidence tends to show that certain areas of language are treatable through therapy, it remains difficult to state the type of approach that should be favoured and implemented to treat language impairments in schizophrenia. © 2016 Elsevier Ireland Ltd.


Joyal M.,Center Interdisciplinaire Of Recherche En Readaptation Et En Integration Sociale | Joyal M.,University of Québec | Joyal M.,Laval University | Fecteau S.,Center Interdisciplinaire Of Recherche En Readaptation Et En Integration Sociale | And 2 more authors.
Brain Stimulation | Year: 2016

Background: Semantic processing allows us to use conceptual knowledge about the world. It has been associated with a large distributed neural network that includes the frontal, temporal and parietal cortices. Recent studies using transcranial direct current stimulation (tDCS) also contributed at investigating semantic processing. Objective/hypotheses: The goal of this article was to review studies investigating semantic processing in healthy individuals with tDCS and discuss findings from these studies in line with neuroimaging results. Based on functional magnetic resonance imaging studies assessing semantic processing, we predicted that tDCS applied over the inferior frontal gyrus, middle temporal gyrus, and posterior parietal cortex will impact semantic processing. Methods: We conducted a search on Pubmed and selected 27 articles in which tDCS was used to modulate semantic processing in healthy subjects. We analysed each article according to these criteria: demographic information, experimental outcomes assessing semantic processing, study design, and effects of tDCS on semantic processes. Results: From the 27 reviewed studies, 8 found main effects of stimulation. In addition to these 8 studies, 17 studies reported an interaction between stimulus types and stimulation conditions (e.g. incoherent functional, but not instrumental, actions were processed faster when anodal tDCS was applied over the posterior parietal cortex as compared to sham tDCS). Results suggest that regions in the frontal, temporal, and parietal cortices are involved in semantic processing. Conclusions: tDCS can modulate some aspects of semantic processing and provide information on the functional roles of brain regions involved in this cognitive process. © 2016 Elsevier Inc.


St-Pierre C.,Center Interdisciplinaire Of Recherche En Readaptation Et En Integration Sociale | Dionne C.E.,Laval University | Desmeules F.,University of Montréal | Roy J.-S.,Center Interdisciplinaire Of Recherche En Readaptation Et En Integration Sociale | Roy J.-S.,Laval University
Journal of Hand Therapy | Year: 2015

Study design Clinical measurement. Purpose Several questionnaires assess symptoms and functional limitations following shoulder disorders, but few are available in French. The purposes were to translate and culturally adapt the Western Ontario Rotator Cuff (WORC) index into Canadian French and to evaluate its validity, reliability and responsiveness. Methods In accordance with standard procedure, the WORC original version was translated and cross-culturally adapted into Canadian French (WORC-CF). Then, 87 patients with rotator cuff (RC) disorders completed the WORC-CF on three occasions: baseline, two days later to evaluate reliability, and four weeks later to evaluate responsiveness. Results Cross-cultural adaptation was performed without problems with content or language. WORC-CF was found to be reliable (Intraclass Correlation Coefficient = 0.96), valid (high correlation with Disability of the Arm, Shoulder and Hand [DASH]) and responsive (Standardized Response Mean = 1.54). Conclusion WORC-CF can now be used to assess functional impairment in patients with RC disorders. Level of evidence Not applicable. © 2015 Hanley & Belfus.

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