Julia Schmidt
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Dr. Schmidt's research investigates the alteration in a person’s life and brain after traumatic brain injury. Specifically, she is interested in self-awareness and self-identity changes after injury and neurological underpinnings of injury and recovery. Additionally, she aims to determine effective rehabilitation strategies and mechanisms of recovery for people with brain impairment.
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Theses completed in 2010 or later are listed below. Please note that there is a 6-12 month delay to add the latest theses.
Background. Concussions are highly prevalent injuries, particularly among youth populations. Symptoms of concussion are broad and varied among individuals, across physical, cognitive, emotional, and sleep-related domains. Most people experience full recovery from concussions; however, approximately 30% of individuals continue to experience symptoms beyond the normal recovery period. Guidelines to manage concussion recovery indicate a gradual return to activity. However, there is limited evidence on how engagement in activity influences recovery and how to effectively promote activity re-engagement in youth with concussion. This thesis will build evidence to support the integration of activity following a concussive event in youth.Aims. 1) To examine the influence of physical and social activity on recovery in children and youth with concussions.2) To develop an intervention that will enable an early return to activity after a concussion in an effort to improve the recovery trajectory in youth.Methods. Two study designs were utilized to address our aims:1) A systematic review and meta-analysis was conducted to assess the influence of social and/or physical activity on concussion recovery in adolescents. All types of intervention studies investigating social and physical activity to improve concussion recovery in youth were identified. 2) An intervention mapping framework was used to design an intervention to improve activity engagement after concussion in youth, encompassing current return to activity guidelines and using a personalized rehabilitation approach. Results. Overall, engagement in activity positively influenced recovery concussion outcomes in youth, with results used to guide the development of a novel intervention. In the systematic review, 19 studies were included, of which 8 were RCTs. There was a significant effect of activity interventions on decreased symptom reporting (SMD = 0.39 [95% CI = 0.14 to 0.64], I2 = 0%, p = 0.002), but no significant effect on quality of life. The Concussion Coach intervention was developed to improve recovery outcomes after concussion in youth through a guideline-based, individualised, goal-oriented telerehabilitation approach. Conclusion. Findings from this thesis extend knowledge of concussion recovery in youth. This thesis indicated that activity-based interventions, individualized rehabilitation, and health delivery innovations may be important components for youth concussion interventions.
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Background: Traumatic Brain Injury (TBI) affects a substantial number of Canadians every year, with individuals experiencing changes to their everyday life. Objectives: This thesis aimed to 1) explore perceived changes in social participation and self-identity post-injury, and 2) characterise individuals displaying higher and lower levels of posttraumatic growth, in terms of their social participation, self-awareness, and self-identity. Methods: Study 1 used a constructivist grounded theory methodology. In study 2, a sequential explanatory/exploratory mixed-methods design was followed. For study 1, qualitative data were obtained from a semi-structured interview, conducted to explore the participants’ experiences of living with their TBI; for study 2, quantitative data were collected using questionnaires about social participation, self-awareness, and self-identity. Results: Participants were 16 adults with a moderate to severe TBI living in the community (average age= 49.8, male= 11). In study 1, an overarching theme ‘living in a reshaped reality’ was identified which comprised of three themes: 1) ‘there’s nothing that’s the same’ identified the daily challenges of living with a TBI, 2) ‘rebuilding and restarting’ described how participants navigated their post-injury life, and 3) ‘embrace it and run with it’ explored the participants’ responses to life with TBI. An explanatory model of these themes was developed, which illustrated how changes in social participation and self-identity may impact an individual’s post-injury life. In study 2, qualitative data were used to categorise individuals into two groups of higher (n=8) and lower (n=7) posttraumatic growth. The quantitative data were then used to characterise the two groups, indicating that participants portraying higher posttraumatic growth had greater social participation, more self-awareness, and fewer discrepancies in pre-and post-injury identities. Significance: This thesis builds understanding of the experience of life after TBI. Clinical rehabilitation could be framed to facilitate both social participation and positive self-identity changes given the explanatory model. Using the findings of posttraumatic growth characterisation, future research could explore the experiences of the development of posttraumatic growth after TBI.
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Publications
- Capability, opportunity, motivation, and social participation after stroke (2022)
Topics in Stroke Rehabilitation, - Living in a reshaped reality: Exploring social participation and self-identity after TBI (2022)
Neuropsychological Rehabilitation, - Preliminary investigation of the student-delivered Community Outreach teleheAlth program for Covid education and Health promotion (COACH) (2022)
Family Practice, - Evidence of altered interhemispheric communication after pediatric concussion (2021)
Brain Injury, 35 (10), 1143--1161 - Activities of Daily Living and Leisure Skills: Theoretical and Practical Perspectives (2020)
Brain Injury Medicine, - An exploratory study of verbal feedback on occupational performance for improving self‐awareness in people with traumatic brain injury (2020)
Australian Occupational Therapy Journal, - Burden and Preparedness amongst Informal Caregivers of Adults with Moderate to Severe Traumatic Brain Injury (2020)
International Journal of Environmental Research and Public Health, 17 (17), 6386 - Daily Life Physical Activity and Concussion Symptoms in Adolescents (2020)
Canadian Journal of Occupational Therapy, , 000841742095322 - Moving Sport and Exercise Science Forward: A Call for the Adoption of More Transparent Research Practices (2020)
Sports Medicine, 50 (3), 449-459 - Engagement in daily life physical activity reduces self-reported symptoms in adolescent concussion (2019)
SportRxiv, - Assessments of Cognition in Older People After Traumatic Brain Injury: An Appraisal and Review. (2018)
New Zealand Journal of Occupational Therapy, - Imaging in pediatric concussion: A systematic review (2018)
Pediatrics, 141 (5) - Persistent symptoms and activity changes three months after mild traumatic brain injury (2018)
Australian Occupational Therapy Journal, - Submitting a successful abstract to the 2019 CAOT Conference (2018)
Occupational Therapy Now, - The role of physical activity in recovery from concussion in youth: A neuroscience perspective (2018)
Journal of Neurologic Physical Therapy, 42 (3), 155-162 - Are we armed with the right data? Pooled individual data review of biomarkers in people with severe upper limb impairment after stroke (2017)
NeuroImage: Clinical, 13, 310-319 - Do People With Severe Traumatic Brain Injury Benefit From Making Errors? A Randomized Controlled Trial of Error-Based and Errorless Learning (2017)
Neurorehabilitation and Neural Repair, 31 (12), 1072-1082 - Erratum to “Are we armed with the right data? Pooled individual data review of biomarkers in people with severe upper limb impairment after stroke” (NeuroImage: Clinical (2017) 13 (310–319), (S2213158216301735), (10.1016/j.nicl.2016.09.015)) (2017)
NeuroImage: Clinical, 15, 53-55 - Increasing the amount of usual rehabilitation improves activity after stroke: a systematic review (2016)
Journal of Physiotherapy, 62 (4), 182-187 - An occupation-based video feedback intervention for improving self-awareness: Protocol and rationale (2015)
Canadian Journal of Occupational Therapy, 82 (1), 54-63 - Maintenance of treatment effects of an occupation-based intervention with video feedback for adults with TBI (2015)
NeuroRehabilitation, 36 (2), 175-186 - Metacognitive occupation-based training in traumatic brain injury (2015)
International Handbook of Occupational Therapy Interventions, Second Edition, , 463-474 - Effects of case management after brain injury: A systematic review (2014)
NeuroRehabilitation, 35 (4), 635-641 - Comparison of error-based and errorless learning for people with severe traumatic brain injury: Study protocol for a randomized control trial (2013)
Trials, 14 (1) - Development and preliminary psychometric evaluation of the self-perceptions in rehabilitation questionnaire (SPIRQ) for brain injury rehabilitation (2013)
American Journal of Occupational Therapy, 67 (3), 336-344 - Video feedback on functional task performance improves self-awareness after traumatic brain injury: A randomized controlled trial (2013)
Neurorehabilitation and Neural Repair, 27 (4), 316-324 - Feedback interventions for improving self-awareness after brain injury: A protocol for a pragmatic randomised controlled trial (2012)
Australian Occupational Therapy Journal, 59 (2), 138-146 - Feedback interventions for impaired self-awareness following brain injury: A systematic review (2011)
Journal of Rehabilitation Medicine, 43 (8), 673-680
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