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  1. Article ; Online: Learning and satisfaction in a student-led clinic.

    Niwa, Laura / MacLellan, Crystal L

    The clinical teacher

    2021  Volume 18, Issue 4, Page(s) 391–397

    Abstract: Background: Student-led clinics (SLCs) offer unique clinical placement experiences and address unmet community rehabilitation needs. There is growing evidence that SLCs provide high-quality experiential practice and adequate quality of patient care. The ...

    Abstract Background: Student-led clinics (SLCs) offer unique clinical placement experiences and address unmet community rehabilitation needs. There is growing evidence that SLCs provide high-quality experiential practice and adequate quality of patient care. The purpose of this study was to evaluate patient satisfaction with student-led care and students' perception of their learning experiences in a student-led physiotherapy clinic.
    Methods: Eight participants with total hip arthroplasty attended 6 weeks of student-led group exercise classes. As a marker of quality of care, we assessed key outcomes including walking speed and endurance, lower extremity function, falls risk and self-reported quality of life after 3 and 6 weeks. Patients completed a satisfaction survey at the end of the program. Ten students who completed a placement during this time shared their perception of learning in the SLC.
    Results: Student-led group exercise class was associated with improvements in walking speed and endurance, lower extremity function, a decrease in falls risk and improved quality of life. Patients were satisfied with their care. The SLC was a safe learning environment in which students felt well-supported to develop confidence and independence, were encouraged to reflect on performance and take responsibility for care provided.
    Conclusion: Patients are largely satisfied with the quality of care provided. High-quality authentic clinical learning opportunities provided in the SLC may offer pedagogical benefits over traditional practicums, and students are generally satisfied with their learning experiences. SLCs may provide a setting to expose students to research and gain appreciation for evidence-based practice.
    MeSH term(s) Education, Nursing, Baccalaureate ; Humans ; Learning ; Personal Satisfaction ; Quality of Life ; Students
    Language English
    Publishing date 2021-03-03
    Publishing country England
    Document type Journal Article
    ZDB-ID 2151518-9
    ISSN 1743-498X ; 1743-4971
    ISSN (online) 1743-498X
    ISSN 1743-4971
    DOI 10.1111/tct.13339
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    Zs.A 6678: Show issues Location:
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  2. Article ; Online: The Effect of Upper Cervical Mobilization/Manipulation on Temporomandibular Joint Pain, Maximal Mouth Opening, and Pressure Pain Thresholds: A Systematic Review and Meta-Analysis.

    Lam, Alan C / Liddle, Lane J / MacLellan, Crystal L

    Archives of rehabilitation research and clinical translation

    2022  Volume 5, Issue 1, Page(s) 100242

    Abstract: Objective: To evaluate the efficacy of upper cervical joint mobilization and/or manipulation on reducing pain and improving maximal mouth opening (MMO) and pressure pain thresholds (PPTs) in adults with temporomandibular joint (TMJ) dysfunction compared ...

    Abstract Objective: To evaluate the efficacy of upper cervical joint mobilization and/or manipulation on reducing pain and improving maximal mouth opening (MMO) and pressure pain thresholds (PPTs) in adults with temporomandibular joint (TMJ) dysfunction compared with sham or other intervention.
    Data sources: MEDLINE, CINAHL, EMBASE, and Cochrane Library from inception to June 3, 2022, were searched.
    Study selection: Eight randomized controlled trials with 437 participants evaluating manual therapy (MT) vs sham and MT vs other intervention were included. Two reviewers independently extracted data and assessed risk of bias.
    Data extraction: Two independent reviewers extracted information about origin, number of study participants, eligibility criteria, type of intervention, and outcome measures.
    Data synthesis: Manual therapy was statistically significant in reducing pain compared with sham (mean difference [MD]: -1.93 points, 95% confidence interval [CI]: -3.61 to -0.24,
    Conclusion: There appears to be limited benefit of upper cervical spine MT on TMJ dysfunction, but definitive conclusions cannot be made because of heterogeneity and imprecision of treatment effects.
    Language English
    Publishing date 2022-11-02
    Publishing country United States
    Document type Journal Article ; Review
    ISSN 2590-1095
    ISSN (online) 2590-1095
    DOI 10.1016/j.arrct.2022.100242
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  3. Article ; Online: Motor Rehabilitation Provides Modest Functional Benefits After Intracerebral Hemorrhage: a Systematic Review and Meta-Analysis of Translational Rehabilitation Studies.

    Fedor, Britt A / Sander, Noam H / MacLaren, Maxwell / Liddle, Lane J / MacLellan, Crystal L / Colbourne, Frederick

    Translational stroke research

    2023  

    Abstract: Few certainties exist regarding the optimal type, timing, or dosage of rehabilitation after stroke. Despite differing injury mechanisms and recovery patterns following ischemic and hemorrhagic stroke, most translational stroke research is conducted after ...

    Abstract Few certainties exist regarding the optimal type, timing, or dosage of rehabilitation after stroke. Despite differing injury mechanisms and recovery patterns following ischemic and hemorrhagic stroke, most translational stroke research is conducted after ischemia. As we enter the era of personalized medicine, exploring subtype-specific treatment efficacy is essential to optimizing recovery. Our objective was to characterize common rehabilitation interventions used after in vivo preclinical intracerebral hemorrhage (ICH) and assess the impact of post-ICH rehabilitation (vs. no-rehabilitation) on recovery of motor function. Following PRISMA guidelines, a systematic review (Academic Search Complete, CINAHL, EMBASE, Medline, PubMed Central) identified eligible articles published up to December 2022. Risk of bias (SYRCLE) and study quality (CAMARADES) were evaluated, and random-effects meta-analysis was used to assess treatment efficacy in recovery of forelimb and locomotor functions. Thirty articles met inclusion criteria, and 48 rehabilitation intervention groups were identified. Most used collagenase to model striatal ICH in young, male rodents. Aerobic exercise, enriched rehabilitation, and constraint-induced movement therapy represented ~ 70% of interventions. Study quality was low (median 4/10, range 2-8), and risk of bias was unclear. Rehabilitation provided modest benefits in skilled reaching, spontaneous impaired forelimb use, and locomotor function; however, effects varied substantially by endpoint, treatment type, and study quality. Rehabilitation statistically improves motor function after preclinical ICH, but whether these effects are functionally meaningful is unclear. Incomplete reporting and variable research quality hinder our capacity to analyze and interpret how treatment factors influence rehabilitation efficacy and recovery after ICH.
    Language English
    Publishing date 2023-11-20
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2541897-X
    ISSN 1868-601X ; 1868-4483
    ISSN (online) 1868-601X
    ISSN 1868-4483
    DOI 10.1007/s12975-023-01205-w
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: A critical appraisal of experimental intracerebral hemorrhage research.

    MacLellan, Crystal L / Paquette, Rosalie / Colbourne, Frederick

    Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism

    2012  Volume 32, Issue 4, Page(s) 612–627

    Abstract: The likelihood of translating therapeutic interventions for stroke rests on the quality of preclinical science. Given the limited success of putative treatments for ischemic stroke and the reasons put forth to explain it, we sought to determine whether ... ...

    Abstract The likelihood of translating therapeutic interventions for stroke rests on the quality of preclinical science. Given the limited success of putative treatments for ischemic stroke and the reasons put forth to explain it, we sought to determine whether such problems hamper progress for intracerebral hemorrhage (ICH). Approximately 10% to 20% of strokes result from an ICH, which results in considerable disability and high mortality. Several animal models reproduce ICH and its underlying pathophysiology, and these models have been widely used to evaluate treatments. As yet, however, none has successfully translated. In this review, we focus on rodent models of ICH, highlighting differences among them (e.g., pathophysiology), issues with experimental design and analysis, and choice of end points. A Pub Med search for experimental ICH (years: 2007 to 31 July 2011) found 121 papers. Of these, 84% tested neuroprotectants, 11% tested stem cell therapies, and 5% tested rehabilitation therapies. We reviewed these to examine study quality (e.g., use of blinding procedures) and choice of end points (e.g., behavioral testing). Not surprisingly, the problems that have plagued the ischemia field are also prevalent in ICH literature. Based on these data, several recommendations are put forth to facilitate progress in identifying effective treatments for ICH.
    MeSH term(s) Animals ; Brain Ischemia/pathology ; Brain Ischemia/physiopathology ; Brain Ischemia/therapy ; Cerebral Hemorrhage/pathology ; Cerebral Hemorrhage/physiopathology ; Cerebral Hemorrhage/therapy ; Disease Models, Animal ; Humans ; PubMed ; Rodentia ; Stroke/pathology ; Stroke/physiopathology ; Stroke/therapy
    Language English
    Publishing date 2012-02-01
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 604628-9
    ISSN 1559-7016 ; 0271-678X
    ISSN (online) 1559-7016
    ISSN 0271-678X
    DOI 10.1038/jcbfm.2012.8
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 1663: Show issues Location:
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  5. Article ; Online: Prolonged, 24-h delayed peripheral inflammation increases short- and long-term functional impairment and histopathological damage after focal ischemia in the rat.

    Langdon, Kristopher D / Maclellan, Crystal L / Corbett, Dale

    Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism

    2010  Volume 30, Issue 8, Page(s) 1450–1459

    Abstract: The incidence of infection among stroke patients is alarmingly high and both acute and delayed infections increase morbidity and mortality. Experimental studies support the acute clinical data, but little attention has focused on delayed systemic ... ...

    Abstract The incidence of infection among stroke patients is alarmingly high and both acute and delayed infections increase morbidity and mortality. Experimental studies support the acute clinical data, but little attention has focused on delayed systemic infections. Here, we investigated the effects of prolonged systemic inflammation either before or 24-h after ischemia. Systemic inflammation was induced by injecting rats with three separate doses of lipopolysaccharide (LPS; 50 mug/kg, i.p.) with core temperature monitoring for 48-h after middle cerebral artery occlusion (MCAo). Lipopolysaccharide injected before MCAo increased injury by approximately 30%, whereas delayed injection increased injury by approximately 85% (30-day survival). Proinflammatory cytokines assessed repeatedly for 72 h were significantly and persistently elevated with inflammation. This was accompanied by increases in microglia/macrophage and infiltrating leukocyte numbers in delayed LPS-treated animals. Behavioral assessments at 7 and 30 days revealed approximately 15% deficit in hindlimb function in animals treated with LPS 24-h after ischemia. Clearly, delayed and prolonged postischemic systemic inflammation has devastating effects on stroke outcome, in the absence of a prolonged febrile response. These findings, together with corroborative clinical data, emphasize the importance of early intervention to counteract the deleterious consequences of stroke-associated inflammation and infection.
    MeSH term(s) Animals ; Body Temperature ; Infarction/pathology ; Infarction, Middle Cerebral Artery/complications ; Infarction, Middle Cerebral Artery/immunology ; Infarction, Middle Cerebral Artery/pathology ; Infarction, Middle Cerebral Artery/physiopathology ; Inflammation/chemically induced ; Inflammation/complications ; Inflammation/immunology ; Interleukin-1beta/immunology ; Interleukin-6/immunology ; Lipopolysaccharides ; Male ; Microglia/immunology ; Microglia/pathology ; Rats ; Rats, Sprague-Dawley ; Tumor Necrosis Factor-alpha/immunology ; Walking
    Chemical Substances Interleukin-1beta ; Interleukin-6 ; Lipopolysaccharides ; Tumor Necrosis Factor-alpha
    Language English
    Publishing date 2010-03-24
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 604628-9
    ISSN 1559-7016 ; 0271-678X
    ISSN (online) 1559-7016
    ISSN 0271-678X
    DOI 10.1038/jcbfm.2010.23
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  6. Article ; Online: Use of telemetry blood pressure transmitters to measure intracranial pressure (ICP) in freely moving rats.

    Silasi, Gergely / MacLellan, Crystal L / Colbourne, Frederick

    Current neurovascular research

    2009  Volume 6, Issue 1, Page(s) 62–69

    Abstract: Stroke and traumatic brain injuries often lead to cerebral edema and persistent elevations in intracranial pressure (ICP) that can be life threatening. Thus, rodent models would benefit from a simple and reliable method to measure ICP in awake, mobile ... ...

    Abstract Stroke and traumatic brain injuries often lead to cerebral edema and persistent elevations in intracranial pressure (ICP) that can be life threatening. Thus, rodent models would benefit from a simple and reliable method to measure ICP in awake, mobile animals. Up to now most techniques have been limited to anesthetized or immobile animals, which is not practical for following the prolonged elevations in ICP that follow stroke and traumatic brain injury. With an initial set of data, we describe a simple method that uses blood pressure telemetry sensors, which are commercially available (Data Sciences Int.) to measure ICP in freely moving rats for several days following implantation. Basically, an epidural cannula is secured to the skull and connected to the catheter of the telemetry probe, which is then secured inside a protective plastic shield on the skull. We confirm the sensitivity of our measurements by experimentally modifying ICP by either the Valsalva maneuver (abdominal compression) or a large ischemic brain injury. The Valsalva maneuver caused a small brief spike in ICP (lasting about 2-3 sec), whereas a transient middle cerebral artery occlusion substantially increased ICP (up to 50 mmHg) for approximately 3 days post-surgery. In summary, the current method allows for ICP to be continuously monitored in rats for several days, and thus is suitable for studies investigating mechanisms of raised ICP and in testing experimental treatments that mitigate it.
    MeSH term(s) Animals ; Blood Pressure/physiology ; Disease Models, Animal ; Intracranial Pressure/physiology ; Male ; Monitoring, Physiologic/instrumentation ; Monitoring, Physiologic/methods ; Rats ; Rats, Sprague-Dawley ; Respiration ; Stroke/pathology ; Stroke/physiopathology ; Telemetry/instrumentation ; Telemetry/methods ; Wakefulness/physiology
    Language English
    Publishing date 2009-03-12
    Publishing country United Arab Emirates
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2296350-9
    ISSN 1875-5739 ; 1567-2026
    ISSN (online) 1875-5739
    ISSN 1567-2026
    DOI 10.2174/156720209787466046
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    Zs.A 6646: Show issues Location:
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  7. Article ; Online: A model of persistent learned nonuse following focal ischemia in rats.

    MacLellan, Crystal L / Langdon, Kristopher D / Botsford, Alex / Butt, Stephanie / Corbett, Dale

    Neurorehabilitation and neural repair

    2013  Volume 27, Issue 9, Page(s) 900–907

    Abstract: Background: After hemiplegic stroke, people often rely on their unaffected limb to complete activities of daily living. A component of residual motor dysfunction involves learned suppression of movement, termed learned nonuse.: Objective: To date, no ...

    Abstract Background: After hemiplegic stroke, people often rely on their unaffected limb to complete activities of daily living. A component of residual motor dysfunction involves learned suppression of movement, termed learned nonuse.
    Objective: To date, no rodent stroke model of persistent learned nonuse has been described that can facilitate understanding of this phenomenon and test interventions to overcome it.
    Methods: Rats were trained in the staircase skilled-reaching and limb use asymmetry (cylinder) tasks. Endothelin-1 was injected into the cortex and striatum to create focal ischemia. Starting 7 days poststroke, half of the rats (ipsilateral training; n = 15) were trained to reach for food reward pellets in the tray-reaching task with the ipsilateral forelimb. Training lasted 20 days. Rats in the control group (control; n = 15) did not receive training. All rats then remained in their home cages for an additional 30 days. Performance on the cylinder and staircase tasks was assessed ~2 months poststroke.
    Results: Ischemia caused significant functional impairments in all rats. Significant contralateral forelimb skilled-reaching recovery was evident in the control group at 2 months but not the ipsilateral training group. There was no difference in performance in the cylinder task. Similarly, the volume of brain injury (~66 mm(3)) was similar between groups. Ipsilateral forelimb training reduced poststroke motor recovery.
    Conclusion: This rodent model of persistent nonuse after stroke may be used to further understand mechanisms of learned nonuse as well as to evaluate pharmacological and rehabilitation treatments to overcome it.
    MeSH term(s) Animals ; Brain/drug effects ; Brain/pathology ; Brain Ischemia/pathology ; Brain Ischemia/physiopathology ; Disease Models, Animal ; Endothelin-1/toxicity ; Learning ; Male ; Motor Skills/physiology ; Rats ; Rats, Sprague-Dawley ; Stroke/pathology ; Stroke/physiopathology
    Chemical Substances Endothelin-1
    Language English
    Publishing date 2013-11
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1491637-x
    ISSN 1552-6844 ; 1545-9683 ; 0888-4390
    ISSN (online) 1552-6844
    ISSN 1545-9683 ; 0888-4390
    DOI 10.1177/1545968313496323
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    Zs.B 3096: Show issues Location:
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  8. Article ; Online: Rodent models of intracerebral hemorrhage.

    MacLellan, Crystal L / Silasi, Gergely / Auriat, Angela M / Colbourne, Frederick

    Stroke

    2010  Volume 41, Issue 10 Suppl, Page(s) S95–8

    Abstract: The collagenase and whole blood intracerebral hemorrhage (ICH) models are widely used to identify mechanisms of injury and to evaluate treatments. Despite preclinical successes, to date, no treatment tested in phase III clinical trials has benefited ICH ... ...

    Abstract The collagenase and whole blood intracerebral hemorrhage (ICH) models are widely used to identify mechanisms of injury and to evaluate treatments. Despite preclinical successes, to date, no treatment tested in phase III clinical trials has benefited ICH patients. These failures call into question the predictive value of current ICH models. By highlighting differences between these common rodent models of ICH, we sought to help investigators choose the more appropriate model for their study and to encourage the use of both whenever possible. For instance, we previously reported substantial differences in the bleeding profile, progression of cell death, and functional outcome between these models. These and other differences influence the efficacy and mechanisms of action of various treatment modalities. Thus, in this review, we also summarize neuroprotective and rehabilitation findings in each model. We conclude that differences between ICH models along with our current inability to identify the more clinically predictive model necessitate that preclinical assessments should normally be done in both. Such an approach, coupled with better assessment practices, will likely improve chances of future clinical success.
    MeSH term(s) Animals ; Cerebral Hemorrhage/pathology ; Cerebral Hemorrhage/physiopathology ; Disease Models, Animal ; Disease Progression ; Rats
    Language English
    Publishing date 2010-10
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 80381-9
    ISSN 1524-4628 ; 0039-2499 ; 0749-7954
    ISSN (online) 1524-4628
    ISSN 0039-2499 ; 0749-7954
    DOI 10.1161/STROKEAHA.110.594457
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    Zs.A 448: Show issues Location:
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  9. Article ; Online: Use of prolonged hypothermia to treat ischemic and hemorrhagic stroke.

    MacLellan, Crystal L / Clark, Darren L / Silasi, Gergely / Colbourne, Frederick

    Journal of neurotrauma

    2009  Volume 26, Issue 3, Page(s) 313–323

    Abstract: Therapeutic (induced) hypothermia (TH) has been extensively studied as a means to reduce brain injury following global and focal cerebral ischemia, intracerebral hemorrhage (ICH), and subarachnoid hemorrhage (SAH). Here, we briefly review the clinical ... ...

    Abstract Therapeutic (induced) hypothermia (TH) has been extensively studied as a means to reduce brain injury following global and focal cerebral ischemia, intracerebral hemorrhage (ICH), and subarachnoid hemorrhage (SAH). Here, we briefly review the clinical and experimental evidence supporting the use of TH in each condition. We emphasize the importance of systematically evaluating treatment parameters, especially the duration of cooling, in each condition. We contend that TH provides considerable protection after global and focal cerebral ischemia, especially when cooling is prolonged (e.g., >24 h). However, there is presently insufficient evidence to support the clinical use of TH for ICH and SAH. In any case, further animal work is needed to develop optimized protocols for treating cardiac arrest (global ischemia), and to maximize the likelihood of successful clinical translation in focal cerebral ischemia.
    MeSH term(s) Animals ; Body Temperature/physiology ; Brain/blood supply ; Brain/metabolism ; Brain/physiopathology ; Brain Ischemia/metabolism ; Brain Ischemia/physiopathology ; Brain Ischemia/therapy ; Cerebral Hemorrhage/metabolism ; Cerebral Hemorrhage/physiopathology ; Cerebral Hemorrhage/therapy ; Disease Models, Animal ; Humans ; Hypothermia, Induced/methods ; Hypothermia, Induced/standards ; Hypothermia, Induced/trends ; Stroke/metabolism ; Stroke/physiopathology ; Stroke/therapy ; Time Factors ; Treatment Outcome
    Language English
    Publishing date 2009-03
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 645092-1
    ISSN 1557-9042 ; 0897-7151
    ISSN (online) 1557-9042
    ISSN 0897-7151
    DOI 10.1089/neu.2008.0580
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    Zs.A 2016: Show issues Location:
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  10. Article: Skilled reaching impairments follow intrastriatal hemorrhagic stroke in rats.

    MacLellan, Crystal L / Gyawali, Selina / Colbourne, Frederick

    Behavioural brain research

    2006  Volume 175, Issue 1, Page(s) 82–89

    Abstract: The infusion of autologous blood into the brain of rats is a widely used model of intracerebral hemorrhage (ICH). Careful assessment of functional recovery is an essential part of preclinical testing (e.g., putative cytoprotectants). However, few tests ... ...

    Abstract The infusion of autologous blood into the brain of rats is a widely used model of intracerebral hemorrhage (ICH). Careful assessment of functional recovery is an essential part of preclinical testing (e.g., putative cytoprotectants). However, few tests detect long-term deficits in this model. In this study, we used the staircase and single pellet tests to characterize skilled reaching ability after striatal ICH. Rats were trained to reach for food pellets in these tasks before ICH, which was created by infusing 100muL of autologous blood into the striatum. We assessed reaching success in both tasks for 5 days starting 7 and 28 days after ICH. We counted the number of reaching attempts made with each forelimb in the staircase task and performed kinematic analysis of reaching in the single pellet task. The contralateral (to lesion) forelimb reaching success was significantly impaired in the staircase task 1 week after ICH, but this recovered to pre-surgical levels thereafter. Reaching deficits in the single pellet task were more severe and persistent. Detailed analysis of reaches on day 11 revealed several abnormalities in the following movement components: pronation, grasping, supinating the paw and releasing the pellet. At 1 month, only digit opening and supination were impaired. Accordingly, the single pellet task is better at detecting long-term skilled reaching impairments in the whole blood model of ICH. Thus, the single pellet task seems suited to cytoprotection and rehabilitation studies.
    MeSH term(s) Animals ; Behavior, Animal ; Cerebral Hemorrhage/complications ; Cerebral Hemorrhage/pathology ; Conditioning, Operant/physiology ; Corpus Striatum/pathology ; Disease Models, Animal ; Male ; Motor Skills Disorders/etiology ; Motor Skills Disorders/pathology ; Rats ; Rats, Sprague-Dawley ; Reaction Time/physiology ; Recovery of Function/physiology ; Time Factors
    Language English
    Publishing date 2006-11-25
    Publishing country Netherlands
    Document type Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 449927-x
    ISSN 1872-7549 ; 0166-4328
    ISSN (online) 1872-7549
    ISSN 0166-4328
    DOI 10.1016/j.bbr.2006.08.001
    Database MEDical Literature Analysis and Retrieval System OnLINE

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