Functional and Physiological Determinants of Perceived Disability in Individuals Diagnosed with Osteoarthritis of the Hip

Objectives: The main objective of this pilot study was to investigate which standardized functional and physiological test best predicted perceived disability in a single group of 21 individuals diagnosed with osteoarthritis of the hip. Design: Men and women between 60 and 70 years old with osteoarthritis of the hip were selected. If participants passed study criteria, the Western Ontario McMaster University questionnaire (WOMAC), 6 Minute Walk Test (6MWT) and Timed up and Go (TUG), strength testing and aerobic testing were obtained in one single assessment. Results: Regression analysis revealed that wait time, hip abduction strength of the affected side, Aerobic Capacity (VO2 Peak), hip Extension Peak Torque, hip Flexion Peak Torque, TUG and 6MWT were significantly correlated with the WOMAC. Yet, the 6MWT had the highest significant correlation (r = -0.86, p ≤ 0.0001); R2 = 0.75 or 75% with the WOMAC total scores, (r = -0.82, p ≤ 0.0001); R2 = 0.67 or 67% with the WOMAC function and (r = -0.60, p = .002); R2 = 0.36 or 36% with the WOMAC stiffness. While the VO2 Peak revealed the highest significant correlation (r = 0.76, p ≤ .0001); R2 = 0.57 or 57% with the WOMAC pain. Conclusions: The 6MWT and the VO2 Peak seem to be essential functional and physiological assessment tools to determine perceived disability in individuals with hip OA. The perceived disability may provide new or comprehensive knowledge of the disability problems experienced by individuals with osteoarthritis of the hip, and the association of patient perception with objective measures of functional and physiological capacity might strengthen the clinical value of this knowledge.

Examining Cognitive Processing in Children with an Arithmetic Disability

Currently there is no consensus as to the specific cognitive impairments that characterize mathematical disabilities (MD) or specific subtypes such as an arithmetic disability (AD). The present study sought to address this concern by examining cognitive processes that might undergird AD in children. The present study utilized archival data to conduct two investigations. The first investigation examined the executive functioning and working memory of children with AD. An age-matched achievement-matched design was employed to explore whether children with AD exhibit developmental lags or deficits in these cognitive domains. While children with AD did not exhibit impairments in verbal working memory or colour word inhibition, they did demonstrate impairments in shifting attention, visual-spatial working memory, and quantity inhibition. As children with AD did not perform more poorly than their younger achievement-matched peers on any of these tasks, impairments in specific areas of executive functioning and working memory appeared to reflect a developmental lag rather than a cognitive deficit. The second study examined the phonological processing performance of children with AD compared to children with comorbid disabilities in arithmetic and word recognition (AD/WRD) and to typically achieving (TA) children. Results indicated that, while children with AD did demonstrate impairments on all isolated naming speed tasks, trail making digits, and memory for digits, they did not demonstrate impairments on measures of phonological awareness, nonword repetition, serial processing speed, or serial naming speed. In contrast, children with AD/WRD demonstrated impairments on measures of phonological awareness, phonological short-term memory, isolated naming speed, serial processing speed, and the alphabet a-z task. Overall, results suggested that phonological processing impairments are more prominent in children with a WRD than children with an AD. Together, these studies further our understanding of the nature of the cognitive processes that underlie AD by focusing upon rarely used methods (i.e., age-matched achievement-matched design) and under-examined cognitive domains (i.e., phonological processing).

Disability in the Digital Age: Reconfiguring Access, Inclusion and Equality

There is an abundance of research that examines disability and technology in the context of computers and the Internet, however few have examined disability and mobile devices. Also largely absent from existing literature are the voices of disabled people themselves. This dissertation draws upon science and technology studies (STS) and disability studies to address these gaps by conducting in-depth qualitative research that examines disabled people’s experiences using smartphones and tablets. At its core, this dissertation aims to provide insight on the following: 1) an understanding of how disability is perceived in the digital age and the subjective meanings of access, inclusion and equality; 2) the ways in which mobile devices impact the lived experience of disability; and 3) how perspectives in disability studies and STS can be applied to understand the relationship between the body, disability and technology. The empirical contribution of this research draws from participant diaries and interviews with disabled people, as well as from open-ended questionnaires completed by mobile app developers. The concept of ‘subjectivities of disability’ is introduced to refer to the uniquely personal and individual experience of disability. Findings reveal that mobile device use amongst disabled people redefines their subjectivities of disability through socio-technical interactions whereby disabled people use their devices in ways that are integrated into their everyday lives and positively shapes how they view themselves in relation to their experience of disability. The responses from app developers reveal that there is a place for disability in the mobile market and that disabled people play a key role in making apps accessible. The data suggests that mobile devices facilitate access, inclusion and equality by integrating the body in ways that recognize and accommodate diversity. The results furthermore make it clear that the interaction between disabled people and mobile devices takes on an embodied and social characteristic. This research concludes that both on an individual level and collectively, disabled people are engaging with digital artifacts in ways that promote agency and independence as well as reshaping how disability is experienced and perceived in the digital age.