@article{G\'{o}mez-Diaz2025,

title = {Reliability of the Modified Ashworth Scale in post-stroke spasticity assessment},

author = {Isabel Cristina G\'{o}mez-Diaz and Martha Patricia Cabralez-Guzm\'{a}n and Juan Carlos S\'{a}nchez-Delgado and Laura Natalia Prada-Sanabria and Lizzeth Fernanda Reyes-Moreno and Adriana Angarita-Fonseca},

doi = {10.5114/pq/200199},

issn = {2544-4395},

year  = {2025},

date = {2025-12-02},

urldate = {2025-12-02},

journal = {Physiother Quart.},

pages = {103--110},

publisher = {Termedia Sp. z.o.o.},

abstract = {\<jats:sec\>

                    \<jats:title\>Introduction\</jats:title\>

                    \<jats:p\>Spasticity evaluation in stroke survivors is crucial for effective rehabilitation. The Modified Ashworth Scale (MAS) is commonly used for this purpose, but its reliability when administered by less expe-rienced individuals like physiotherapy students remains understudied. Therefore, our objective is to assess the inter-observer reliability of the MAS among physiotherapy students for evaluating post-stroke lower limb spasticity.\</jats:p\>

                  \</jats:sec\>

                  \<jats:sec\>

                    \<jats:title\>Methods\</jats:title\>

                    \<jats:p\>Thirty-two patients (24 males, 65.2 ± 13.9 years) with hemiplegia/hemiparesis at least six months post-stroke were enrolled. Extensors and flexors in the hip, knee, and ankle of each participant were assessed independently by two trained final-year physiotherapy students, approximately 5 min apart. The Weighted Cohen’s Kappa Index (Kω) was calculated.\</jats:p\>

                  \</jats:sec\>

                  \<jats:sec\>

                    \<jats:title\>Results\</jats:title\>

                    \<jats:p\>The MAS showed substantial agreement for hip extensors (Kω = 0.78) and flexors (Kω = 0.70), knee flexors (Kω = 0.77), dorsiflexors (Kω = 0.64), and plantar flexors (Kω = 0.63), and fair agreement for knee extensors (Kω = 0.54).\</jats:p\>

                  \</jats:sec\>

                  \<jats:sec\>

                    \<jats:title\>Conclusions\</jats:title\>

                    \<jats:p\>Novice physiotherapy students demonstrated reliable application of the MAS when evaluating spasticity in the lower limbs of individuals recovering from strokes. Substantial agreement in most muscle groups examined supports the use of the MAS as a valid tool for assessment, even during the initial phases of clinical education.\</jats:p\>

                  \</jats:sec\>},

keywords = {Neurology, Reliability},

pubstate = {published},

tppubtype = {article}

}

@article{Angarita-Fonseca2025,

title = {Prehabilitation: Are There Sex- and Gender-Specific Issues in Surgery Preparation?},

author = {Adriana Angarita-Fonseca and Louise Pilote},

doi = {10.1159/000545024},

issn = {1421-9697},

year  = {2025},

date = {2025-08-06},

urldate = {2025-08-06},

journal = {Ann Nutr Metab},

volume = {81},

issue = {4},

pages = {250-254},

publisher = {S. Karger AG},

abstract = {\<jats:p\>\<p\>Background: Prehabilitation programs have advanced considerably; however, critical issues related to sex- and gender-specific factors remain largely unaddressed. Historically, research has been male-centered due to the underrepresentation of females in clinical trials, often attributed to concerns over hormonal variability. This focus has resulted in significant knowledge gaps and potential biases that impact effectiveness across sexes. We aim to highlight the need for integrating sex- and gender-specific considerations into prehabilitation to optimize surgical outcomes and promote equitable care for all patients. Summary: Both biological (sex-related) factors, such as differences in muscle mass, metabolism, and body composition, and social (gender-related) factors, such as caregiving roles and stress management, influence individuals’ responses to presurgical preparation. A review of the existing literature reveals a scarcity of data on sex and gender differences in prehabilitation, highlighting a major barrier to designing equitable and effective programs. Evidence underscores that comprehensive prehabilitation approaches, integrating physical, nutritional, and psychological elements, must account for these differences to optimize recovery outcomes. Key Messages: Sex- and gender-specific factors significantly shape patients’ responses to prehabilitation and should be systematically incorporated into program design. The current lack of research on these differences limits the effectiveness of prehabilitation strategies, emphasizing the need for focused investigations. Addressing these gaps will facilitate the development of tailored, equitable prehabilitation programs that enhance presurgical care and improve recovery outcomes for all patients. \</p\>\</jats:p\>},

keywords = {Gender Related Factors, Prehabilitation, Sex differences},

pubstate = {published},

tppubtype = {article}

}

@article{Angarita-Fonseca2024c,

title = {Effect of two different types of exercise volumes on exercise capacity, physical activity and quality of life in subjects undergoing percutaneous coronary intervention: a pilot study},

author = {Adriana Angarita-Fonseca and Adriana Marcela Jacome-Hortua and Andrea Juliana Ortiz-Pati\~{n}o and Zully Roc\'{i}o Rinc\'{o}n-Rueda and Carmen Juliana Villamizar-Jaimes and Erica Tatiana Paredes-Prada and Juan Carlos S\'{a}nchez-Delgado},

doi = {10.5114/pq/178246},

issn = {2544-4395},

year  = {2025},

date = {2025-01-01},

urldate = {2025-01-01},

journal = {Physiother Quart.},

volume = {33},

issue = {1},

pages = {50\textendash59},

publisher = {Termedia Sp. z.o.o.},

abstract = {\<jats:sec\>\<jats:title\>Introduction\</jats:title\>\<jats:p\>Phase II of cardiac rehabilitation includes 36 sessions of exercise developed over 12 weeks, an intervention format that seems to be based on historical practice and not on scientific evidence. The objective was to evaluate the effect of two types of exercise volumes on exercise capacity, physical activity levels, and quality of life in subjects undergoing percutaneous coronary intervention.\</jats:p\>\</jats:sec\>\<jats:sec\>\<jats:title\>Methods\</jats:title\>\<jats:p\>A randomized controlled clinical trial was performed in 17 subjects, who were randomly assigned to two groups. The first (\textit{n} = 7) was trained for eight consecutive weeks, and the second (\textit{n} = 10) for 12 weeks. The six-minute walk test, the International Physical Activity Questionnaire, and the SF-36 were applied before starting the cardiac rehabilitation program at 8 and 12 weeks.\</jats:p\>\</jats:sec\>\<jats:sec\>\<jats:title\>Results\</jats:title\>\<jats:p\>No significant differences were found between the intervention groups. The rise of VO2max was only significant in the 8-week group. Both groups improved the distance walked and sedentary behaviour. The 12-week intervention group improved the quality of life, specifically in physical functioning, and the 8-week intervention group in the domains of social function, physical, and emotional role. Additionally, the percentage of participants meeting physical activity recommendations was higher in the 12-week cardiac rehabilitation group.\</jats:p\>\</jats:sec\>\<jats:sec\>\<jats:title\>Conclusions\</jats:title\>\<jats:p\>The implication for the practice is that the exercise traditionally used in cardiac rehabilitation shows early changes in exercise capacity and quality of life. The results of the levels of physical activity and sedentary behaviour improved after 12 weeks of rehabilitation without the presence of adverse events.\</jats:p\>\</jats:sec\>},

keywords = {Angioplasty, Cardiac Rehabilitation, Physical Fitness, Secondary prevention},

pubstate = {published},

tppubtype = {article}

}

@article{Osagie2025,

title = {Impact of different acute low back pain definitions on the predictors and on the risk of transition to chronic low back pain: a prospective longitudinal cohort study},

author = {Rachael O. Osagie and Iulia Tufa and Adriana Angarita-Fonseca and M. Gabrielle Pag\'{e} and Ana\"{i}s Lacasse and Laura S. Stone and Pierre Rainville and Mathieu Roy and Pascal T\'{e}treault and Maryse Fortin and Guillaume L\'{e}onard and Hugo Mass\'{e}-Alarie and Jean-S\'{e}bastien Roy and Audrey V. Grant and Carolina B. Meloto},

doi = {10.1097/j.pain.0000000000003669},

issn = {1872-6623},

year  = {2025},

date = {2025-00-00},

urldate = {2025-00-00},

journal = {Pain},

volume = {166},

number = {11},

pages = {e577--e589},

publisher = {Ovid Technologies (Wolters Kluwer Health)},

abstract = {\<jats:title\>Abstract\</jats:title\>

          \<jats:p\>Inconsistencies in the identification of predictors for the transition from acute low back pain (aLBP) to chronic LBP (cLBP) may be attributed to the varying definitions of aLBP used in different studies. We investigated how adopting different aLBP definitions affects the set of predictors and the risk of transition to cLBP (LBP \> 3 months that caused a problem for at least half the days in the past 6 months). We leveraged data from the ongoing prospective Quebec Low Back Pain Study to compose 3 aLBP groups at baseline: \<jats:italic toggle="yes"\>nonchronic\</jats:italic\> (individuals not meeting the cLBP criteria, n = 788), \<jats:italic toggle="yes"\>acute\</jats:italic\> (LBP \< 3 months, n = 230), and \<jats:italic toggle="yes"\>new episode\</jats:italic\> (LBP \< 3 months preceded by ≥3 pain-free months, n = 182). The primary outcome was the transition to cLBP at 6 months. We built predictive models within groups using the minimum redundancy maximum relevance algorithm to identify key predictors, focusing on models discrimination and calibration. Risks of transition were 35.8%, 44.3%, and 45.6%, for the \<jats:italic toggle="yes"\>nonchronic, acute, and new episode\</jats:italic\> groups, respectively. Pain intensity, disability, and depression emerged as consistent predictors across definitions. The \<jats:italic toggle="yes"\>acute\</jats:italic\> and \<jats:italic toggle="yes"\>new episode\</jats:italic\> models, but not the \<jats:italic toggle="yes"\>nonchronic\</jats:italic\>, were considered clinically useful (area under the receiver operating characteristic curve \> 0.7), with the latter displaying better calibration and increased performance after adjustment to pain duration. These findings highlight the importance of standardizing aLBP definitions to improve risk stratification and targeted early interventions. Clearer definitions can enhance predictive accuracy, ensuring more effective resource allocation and preventive strategies for individuals at risk of developing chronic pain.\</jats:p\>},

keywords = {Back pain, Chronic Pain},

pubstate = {published},

tppubtype = {article}

}

@article{Bonet‐Collantes2024,

title = {Enhancing physiotherapists' knowledge and perceptions of telerehabilitation: A before‐after educational intervention study},

author = {Milena Bonet‐Collantes and Diana Marcela Ni\~{n}o‐Pinz\'{o}n and Angie Dayana Chaustre‐Porras and Yuli Andrea Salas‐Poloche and Adriana Angarita‐Fonseca},

doi = {10.1002/pri.2120},

issn = {1471-2865},

year  = {2024},

date = {2024-10-00},

urldate = {2024-10-00},

journal = {Physiotherapy Res Intl},

volume = {29},

number = {4},

publisher = {Wiley},

abstract = {\<jats:title\>Abstract\</jats:title\>\<jats:sec\>\<jats:title\>Background and purpose\</jats:title\>\<jats:p\>In the evolving landscape of healthcare, telerehabilitation is emerging as a pivotal modality, especially in delivering services to vulnerable populations. With the increasing reliance on digital health solutions, there is a pressing need for physiotherapists to be adequately trained in telerehabilitation. This training is essential for them to adapt to new technologies and methodologies, ensuring effective and efficient patient care. The aim of this study was to evaluate the effect of a telerehabilitation educational intervention on physiotherapists' knowledge and perceptions in Bucaramanga and its metropolitan area.\</jats:p\>\</jats:sec\>\<jats:sec\>\<jats:title\>Methods\</jats:title\>\<jats:p\>A group of 27 physiotherapists underwent an educational intervention focused on telerehabilitation. Before‐ and after‐intervention assessments were conducted to gauge their perceptions and knowledge.\</jats:p\>\</jats:sec\>\<jats:sec\>\<jats:title\>Results\</jats:title\>\<jats:p\>Participants generally held a positive perception of telerehabilitation both before and after the intervention [Before Median (Md) and interquartile range (IQR): Md = 2.5 (IQR = 2.1\textendash3); after: Md = 2.7 (IQR = 2.4\textendash3.1), \<jats:italic\>p\</jats:italic\> = 0.256]. A significant increase in their knowledge after‐intervention was observed [Before: Md = 55.5 (IQR = 33.3\textendash66.6)]; after: Md = 77.7 (IQR = 66.6\textendash88.8), \<jats:italic\>p\</jats:italic\> = \<0.001, emphasizing the potential benefits of targeted educational interventions.\</jats:p\>\</jats:sec\>\<jats:sec\>\<jats:title\>Conclusions\</jats:title\>\<jats:p\>The educational intervention significantly improved physiotherapists' knowledge of telerehabilitation, underscoring the importance of professional training in this domain. While perceptions remained consistently positive, the notable increase in knowledge suggests that such educational programs are crucial for enhancing the adoption and effective use of telerehabilitation in physiotherapy practice.\</jats:p\>\</jats:sec\>},

keywords = {Education, Health services, Rehabilitation},

pubstate = {published},

tppubtype = {article}

}

@article{Jacome-Hortua2024,

title = {Effects of a WhatsApp-Assisted Health Educational Intervention for Cardiac Rehabilitation: A Randomized Controlled Clinical Trial Protocol},

author = {Adriana Marcela Jacome-Hortua and Zully Rocio Rincon-Rueda and Diana C. Sanchez-Ramirez and Adriana Angarita-Fonseca},

doi = {10.3390/mps7020035},

issn = {2409-9279},

year  = {2024},

date = {2024-04-00},

urldate = {2024-04-00},

journal = {MPs},

volume = {7},

number = {2},

publisher = {MDPI AG},

abstract = {\<jats:p\>Although the effectiveness of cardiac rehabilitation (CR) programs in secondary prevention is well-recognized, there is a lack of studies exploring the potential of mobile health to enhance educational interventions within CR. The objective is to assess the impact of a structured WhatsApp-assisted health educational intervention, in conjunction with the usual care, compared to the usual care alone among participants enrolled in a CR program. The trial will recruit 32 participants enrolled in a CR program, who will be randomly assigned to a structured WhatsApp-assisted health educational intervention plus usual care or usual care alone group. The intervention will span 4 weeks, with assessments at baseline, 4 weeks, and 3, 6, and 12 months. The primary outcome measure is the cardiovascular risk factors knowledge score. Secondary outcomes include physical activity levels, anxiety and depression, and quality of life. Expected results include improved knowledge of cardiovascular risk factors, increased physical activity levels, and better mental health outcomes in the intervention group. Additionally, an enhancement in the overall quality of life is anticipated. These findings are expected to underscore the value of integrating mHealth with traditional CR methods, potentially shaping future approaches in chronic disease management and prevention.\</jats:p\>},

keywords = {Cardiac Rehabilitation, Cardiovascular Diseases, Education, Health Education, Knowledge, Physiotherapy},

pubstate = {published},

tppubtype = {article}

}

@article{Kaur2024,

title = {Sex Differences in the Association of Age at Hypertension Diagnosis With Brain Structure},

author = {Amanpreet Kaur and Adriana Angarita Fonseca and Rikki Lissaman and Hassan Behlouli and M. Natasha Rajah and Louise Pilote},

doi = {10.1161/hypertensionaha.123.22180},

issn = {1524-4563},

year  = {2024},

date = {2024-02-00},

urldate = {2024-02-00},

journal = {Hypertension},

volume = {81},

number = {2},

pages = {291--301},

publisher = {Ovid Technologies (Wolters Kluwer Health)},

abstract = {\<jats:sec\>

            \<jats:title\>BACKGROUND:\</jats:title\>

            \<jats:p\>Sex differences exist in the likelihood of cognitive decline. The age at hypertension diagnosis is a unique contributor to brain structural changes associated with cerebral small vessel disease. However, whether this relationship differs between sexes remains unclear. Therefore, our objective was to evaluate sex differences in the association between the age at hypertension diagnosis and cerebral small vessel disease\textendashrelated brain structural changes.\</jats:p\>

          \</jats:sec\>

          \<jats:sec\>

            \<jats:title\>METHODS:\</jats:title\>

            \<jats:p\>We used data from the UK Biobank to select participants with a known age at hypertension diagnosis and brain magnetic resonance imaging (n=9430) and stratified them by sex and age at hypertension diagnosis. Control participants with magnetic resonance imaging scans but no hypertension were chosen at random matched by using propensity score matching. For morphological brain structural changes, generalized linear models were used while adjusting for other vascular risk factors. For the assessment of white matter microstructure, principal component analysis led to a reduction in the number of fractional anisotropy variables, followed by regression analysis with major principal components as outcomes.\</jats:p\>

          \</jats:sec\>

          \<jats:sec\>

            \<jats:title\>RESULTS:\</jats:title\>

            \<jats:p\>Males but not females with a younger age at hypertension diagnosis exhibited lower brain gray and white matter volume compared with normotensive controls. The volume of white matter hyperintensities was greater in both males and females with hypertension than normotensive controls, significantly higher in older females with hypertension. Compared with normotensive controls, white matter microstructural integrity was lower in individuals with hypertension, which became more prominent with increasing age.\</jats:p\>

          \</jats:sec\>

          \<jats:sec\>

            \<jats:title\>CONCLUSIONS:\</jats:title\>

            \<jats:p\>Our study demonstrates that the effect of hypertension on cerebral small vessel disease\textendashrelated brain structure differs by sex and by age at hypertension diagnosis.\</jats:p\>

          \</jats:sec\>},

keywords = {adults, Cardiovascular Diseases, Epidemiology},

pubstate = {published},

tppubtype = {article}

}

@article{pmid39781552,

title = {Perceived Risk of Medical Cannabis and Prescribed Cannabinoids for Chronic Pain: A Cross-Sectional Study Among Quebec Clinicians},

author = {Gwenaelle De Clifford-Faug\`{e}re and Adriana Angarita-Fonseca and Hermine Lore Nguena Nguefack and Marim\'{e}e Godbout-Parent and Claudie Audet and Ana\"{i}s Lacasse},

doi = {10.26828/cannabis/2024/000263},

issn = {2578-0026},

year  = {2024},

date = {2024-01-01},

urldate = {2024-01-01},

journal = {Cannabis},

volume = {7},

number = {3},

pages = {120--133},

abstract = {OBJECTIVE: An increase in medical cannabis and prescribed cannabinoids use for chronic pain management has been observed in Canada in the past years. This study aimed to: 1) Describe clinicians' perceived risk associated with the use of medical cannabis and prescribed cannabinoids for the management of chronic pain; and 2) Identify sociodemographic and professional factors associated with perceived risk of adverse effects.nnMETHOD: A web-based cross-sectional study was conducted in Quebec, Canada in 2022. A convenience sample of 207 clinicians was recruited (physicians/pharmacists/nurse practitioners). They were asked to rate the risk of adverse effects associated with medical cannabis (e.g., smoke, or oil) and prescribed cannabinoids (e.g., nabilone) on a scale of 0 to 10 (0: no risk, 10: very high risk), respectively. Multiple linear regression was performed to identify factors associated with perceived risk.nnRESULTS: Average perceived risk associated with medical cannabis and prescribed cannabinoids were 5.93 ± 2.08 (median:6/10) and 5.76 ± 1.81 (median:6/10). Factors associated with higher medical cannabis perceived risk were working in primary care (β = 1.38,  = .0034) or in another care setting (β = 1.21,  = .0368) as compared to a hospital setting. As for prescribed cannabinoids, being a pharmacist (β = 1.14,  = .0452), working in a primary care setting (β = 0.83,  = .0408) and reporting more continuing education about chronic pain (β = 0.02,  = .0416) were associated with higher perceived risk. No sex differences were found in terms of perceived risk.nnCONCLUSIONS: Considering the clinician's experience provide insights on cannabis risk as these professionals are at the forefront of patient care when they encounter adverse effects.},

keywords = {Chronic Pain, Pharmacoepidemiology},

pubstate = {published},

tppubtype = {article}

}

@article{Angarita-Fonseca2023,

title = {Gender-related Factors Associated with Outcomes of Acute Coronary Syndrome in Young Females},

author = {A. Angarita-Fonseca and A. Peebles and L. Pilote},

doi = {10.1016/j.cjco.2023.11.019},

issn = {2589-790X},

year  = {2024},

date = {2024-01-01},

journal = {CJC Open},

volume = {6},

issue = {2},

pages = {370-379},

publisher = {Elsevier BV},

abstract = {Acute Coronary Syndrome (ACS) remains a significant global health concern, with a growing recognition of its impact on young adults, particularly young females. While gender-related factors, defined as a social construct that encompasses four distinct dimensions (gender roles, gender identity, gender relations, and institutionalized gender) are undoubtedly relevant across age groups, young females with ACS face specific challenges and disparities in outcomes compared to other populations. This narrative review examines the role of gender-related factors - specifically gender roles, gender identity, gender relations, and institutionalized gender - in influencing objective and subjective ACS outcomes in young females. In the five manuscripts identified, the objective outcomes included hospital readmission, door-to-ECG time, and coronary atherosclerosis progression. Subjective outcomes such as physical and mental functional status, quality of life, physical limitations, and vital exhaustion were also examined. Employment status, a gender role, emerged as a protective factor against hospital readmission. Gender identity factors like depression and stress correlated with negative outcomes, while anxiety influenced door-to-ECG times. Institutional factors, including income disparities, affected readmission likelihood. Strong social support improved physical limitations post-ACS, whereas financial challenges and lower education negatively impacted quality of life and vital exhaustion. These findings underscore the intricate interplay of gender dimensions in shaping ACS outcomes among young females. Integrating these insights into clinical practice and research can enhance care, mitigate disparities, and foster improved cardiovascular health in this vulnerable population.},

keywords = {Cardiology and Cardiovascular Medicine, Cardiovascular Diseases, Women's health},

pubstate = {published},

tppubtype = {article}

}

@article{Lovo2024,

title = {Effectiveness of an interprofessional assessment and management approach for people with chronic low back disorders delivered via virtual care: A randomized controlled trial pilot intervention},

author = {Stacey Lovo and Biaka Imeah and Nazmi Sari and Megan E O’Connell and Steve Milosavljevic and Adriana Angarita-Fonseca and Brenna Bath},

doi = {10.1177/20552076241260569},

issn = {2055-2076},

year  = {2024},

date = {2024-01-00},

urldate = {2024-01-00},

journal = {DIGITAL HEALTH},

volume = {10},

publisher = {SAGE Publications},

abstract = {\<jats:sec\>\<jats:title\>Objective\</jats:title\>\<jats:p\> Virtual care for chronic conditions has seen uptake due to COVID-19. Evaluation of virtual models is important to ensure evidence-based practice. There is a paucity of research in the use of virtual care for management of chronic back disorders. The objective of this study was to evaluate effectiveness of a team-based virtual care model for back disorder assessment where a physical therapist uses virtual care to join a nurse practitioner and patient in a rural Saskatchewan, Canada community. \</jats:p\>\</jats:sec\>\<jats:sec\>\<jats:title\>Methods\</jats:title\>\<jats:p\> Sixty-four rural adults with chronic back disorders were randomly allocated to receive either: (1) team-based virtual care ( n = 24); (2) care from an urban physical therapist travelling to community ( n = 20); or (3) care from a rural nurse practitioner ( n = 20). The team-based care group involved a nurse practitioner located with a rural patient, and a physical therapist joining using virtual care. The physical therapist alone and the nurse practitioner alone groups received in-person assessments. Groups with a physical therapist involved had follow-up treatments by in-person physical therapy. Outcomes over six months included pain, disability, back beliefs, satisfaction, quality-adjusted health status and management-related costs. \</jats:p\>\</jats:sec\>\<jats:sec\>\<jats:title\>Results\</jats:title\>\<jats:p\> There were no significant differences for pain, disability, back beliefs and satisfaction between groups. The average cost per patient for implementing in-person physical therapist assessment ($135) was higher compared with the team over virtual care ($118) and NP care ($59). \</jats:p\>\</jats:sec\>\<jats:sec\>\<jats:title\>Conclusion\</jats:title\>\<jats:p\> Primary outcomes were not different by group. Physical therapist alone was more costly than other groups. Future research should include more participants, longer follow-up time and refined cost parameters. \</jats:p\>\</jats:sec\>\<jats:sec\>\<jats:title\>Trial Registration\</jats:title\>\<jats:p\> ClinicalTrials.gov NCT02225535; https://clinicaltrials.gov/ct2/show/NCT02225535 (Archived by WebCite at http://www.webcitation.org/6lqLTCNF7 ). \</jats:p\>\</jats:sec\>},

keywords = {Chronic Pain, Rehabilitation},

pubstate = {published},

tppubtype = {article}

}