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Ontario Tech acknowledges the lands and people of the Mississaugas of Scugog Island First Nation.

We are thankful to be welcome on these lands in friendship. The lands we are situated on are covered by the Williams Treaties and are the traditional territory of the Mississaugas, a branch of the greater Anishinaabeg Nation, including Algonquin, Ojibway, Odawa and Pottawatomi. These lands remain home to many Indigenous nations and peoples.

We acknowledge this land out of respect for the Indigenous nations who have cared for Turtle Island, also called North America, from before the arrival of settler peoples until this day. Most importantly, we acknowledge that the history of these lands has been tainted by poor treatment and a lack of friendship with the First Nations who call them home.

This history is something we are all affected by because we are all treaty people in Canada. We all have a shared history to reflect on, and each of us is affected by this history in different ways. Our past defines our present, but if we move forward as friends and allies, then it does not have to define our future.

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The development of a global tracer indicator to measure effective coverage for rehabilitation of low back pain

Background: At least 1 in 3 people globally will require rehabilitation at some point in their life and most of these needs are unmet. Globally and including in Canada, at least 2.4 billion people are in need of rehabilitation services and low back pain (LBP) is the most common reason for unmet rehabilitation needs. The World Health Organization (WHO) recognized this important problem and issued a call to strengthen access to rehabilitation. It is therefore critically important that people with LBP receive effective rehabilitation services from health care providers. However, no global indicator is currently available to measure effective coverage for LBP rehabilitation. To fill this critical gap, we are collaborating with the WHO Rehabilitation Programme to inform the development of this global indicator. Global indicators measure whether rehabilitation aligns with countries’ health profiles, and are of sufficient quality to produce health benefits for populations. One promising indicator is the WHO Disability Assessment Schedule (WHODAS), a questionnaire developed by the WHO to measure functioning across cultures and settings. However, the utility of WHODAS as an instrument to capture effective coverage for rehabilitation is not established.

Objectives: We aim to inform the development of a global indicator to measure effective coverage of LBP rehabilitation. The specific objectives are to: 1) conduct a systematic review to determine the psychometric properties (e.g., validity, reliability, responsiveness) and minimal clinically important difference (MCID) of the WHODAS-36 and WHODAS-12 in persons with non-specific LBP; and 2) conduct a scoping review to describe the pre-rehabilitation scores of functioning measured using the WHODAS-36 or WHODAS-12 in persons with non-specific LBP.

Implications: Our findings will determine the utility of WHODAS for measuring effective coverage of rehabilitation and monitoring the needs of persons with LBP worldwide. This will have global impact by informing the development of a WHO global tracer indicator of effective coverage for rehabilitation of LBP from health care providers. Importantly, this work will provide a much-needed metric that can be used in global impactful studies, such as the Global Burden of Disease Study. In collaboration with the WHO, our research aligns with the goal for all people to receive high-quality services and rehabilitation that they need to achieve optimal health and functioning.

Funding: This research is funded by the Canadian Chiropractic Research Foundation.

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Team Members:

  • Jessica Wong (Principal Investigator)
  • Pierre Côté (Co-principal Investigator)
  • Sheilah Hogg-Johnson (Co-investigator)
  • Wouter De Groote (WHO; Co-author)
  • Alarcos Cieza (WHO; Co-author)
  • Astrid DeSouza (Co-author)
  • Danielle Southerst (Co-author)
  • Melissa Belchos (Co-author)
  • Nadège Lemeunier (Co-author)
  • Stephanie Alexopulos (Co-author)
  • Hamid Varmazyar (Co-author)
  • Silvano Mior (Co-author)
  • Paula Stern (Co-author)
  • Margareta C. Nordin (Co-author)
  • Anne Taylor-Vaisey (Co-author)
  • Kent Murnaghan (Co-author)
  • Poonam Cardoso (Research Administration Officer)