Clinical Research Directory

Effects of Rehabilitation on Cesarean Scar Symptoms and Physical Recovery

Cesarean section is the most common inpatient surgical procedure worldwide, with rates continuing to rise; in Canada, approximately one in three births occur by cesarean. Despite its prevalence, there are no expectations for individuals who have undergone a cesarean section to seek out rehabilitation care. Physical recovery guidance and return to activity from a cesarean birth is poorly understood and inadequately supported, with most research focusing on immediate post-operative pain management within the hospital settings. Little attention has been given to long term physical recovery. Scar-related problems - such as tight or stuck scar tissue, sensitivity or discomfort around the scar, weakness in the abdominal muscles, and infertility or digestive complications - can severely affects the ability to complete daily activities and affect overall quality of life. Rehabilitation is a common and important part of recovery after most major orthopedic and abdominal surgeries. It can help reduce pain and complications, improve mobility, strength, and confidence in movement, and support a gradual return to physical activity. Just as importantly, rehabilitation helps individuals safely resume everyday responsibilities such as caring for their family, returning to work, and managing daily tasks. The purpose of this study is to examine whether one form of hands-on therapy results in greater improvements in scar comfort, mobility, and performance of daily activities compared with an alternative approach, when both are delivered alongside an identical exercise program. Participants will take part in an 8-week rehabilitation program following cesarean birth. Rehabilitation will be provided one-on-one by a qualified healthcare professional and will include a combination of in-person sessions and virtual (online) check-ins. In-person sessions will include education about recovery, hands-on therapy, and guided exercises. Virtual sessions will be used to answer questions, review progress, and ensure that exercises are being performed safely and correctly at home. To evaluate changes in recovery over time, participants will attend three assessment sessions: at baseline (week 0), mid-intervention (week 4), and post-intervention (week 8). During these sessions, researchers will collect information on: * How the scar looks and moves * The sensitivity or discomfort of the scar area * How easily participants can perform everyday movements, such as standing up from a chair * How participants feel about their scar, pain levels, and daily function There will be two forms off assessments. One that measures the objective changes: photographs of the scar, gentle pressure testing to measure sensitivity, simple movement tests, and ultrasound imaging, while the other form of assessment is patient reported questionnaires about how they feel they are improving. Ultrasound is a safe and painless technique that allows researchers to see how tissues under the skin are healing and moving. The anticipated benefit of this research is to improve understanding of physical recovery after cesarean birth. The results may help inform future rehabilitation recommendations and contribute to better support for individuals recovering from cesarean surgery.

Supplemental Mobility

This pilot study will evaluate the feasibility of a supplemental mobility intervention, the Safe Transfers And Mobility Program (STAMP). This program will be implemented in patients admitted to skilled nursing facilities (SNFs) following hospitalization. STAMP will be administered by a mobility aide who will support patients in increasing physical activity through walking and transfers outside of structured rehabilitation. Participants will either receive high-intensity rehabilitation (HIR) or usual care rehabilitation, combined with STAMP. The two main aims are: 1) determine the feasibility, acceptability, and safety of STAMP, and 2) evaluate the feasibility and variability of patient physical function outcome measures. The study will provide preliminary data on program delivery and safety to inform the design of a larger trial aimed at identifying the most effective strategies to optimize functional recovery in SNFs.

Upper Extremity Vascularized Composite Allotransplantation: A Study Evaluating Safety, Functional Outcomes, and Patient-Reported Psychosocial Outcomes

The primary objective of this study is to evaluate the 5-year (60-month) allograft survival rate of upper extremity vascularized composite allotransplantation performed under the standardized CONSORT clinical protocol.

Facial Vascularized Composite Allotransplantation: A Study Evaluating Safety, Functional Outcomes, and Patient-Reported Psychosocial Outcomes

The primary objective of this study is to evaluate the 5-year (60-month) allograft survival rate of facial vascularized composite allotransplantation performed under the standardized CONSORT clinical protocol.

Incidence of Chronic Pain in Patients Undergoing Knee Arthroplasty Within a Fast-Track Protocol

The goal of this study is to learn about pain after knee replacement surgery. The surgery uses a fast-recovery program called Enhanced Recovery After Surgery (ERAS). The main questions are: How many participants still have pain three months after surgery? How severe is the pain? How many participants still use strong pain medication (opioids)? Participants are adults undergoing knee replacement surgery at UZ Gent and following the ERAS program. Researchers will collect information on pain and recovery before surgery and for up to three months afterward. Participants will answer simple questions about their pain and daily activities. This study will help researchers understand post-surgical recovery and may help improve pain care in the future.

Inter- and Intra-Observer Reliability of the Iowa Level of Assistance Scale and the Effect of Staff Retraining

The aim of this study is to evaluate, in routine clinical practice, the inter- and intra-observer reliability of the Iowa Level of Assistance (ILoA) scale, which is regularly used to assess functional recovery in orthopedic patients. A secondary objective is to investigate the impact of a structured retraining program for healthcare staff on the use of the ILoA scale and to determine whether this intervention influences the reliability indices of the scale.

Implementation of Neuromuscular Electrical Stimulation After Total Knee Arthroplasty

Patients experience dramatic quadriceps strength loss after total knee replacement, which contributes to persistent weakness and reduced long-term function after surgery. Neuromuscular electrical stimulation (NMES) reduces quadriceps weakness and improves patient function after knee replacement, but it is drastically underused in rehabilitation practice. This randomized trial will examine the effectiveness and feasibility of a comprehensive strategy for implementing neuromuscular electrical stimulation after knee replacement in two large healthcare organizations.

Coupling of IPACK Block With Adductor Canal Block Versus Adductor Canal Block Alone on Pain, Functional Recovery and Inflammatory Response After Knee Replacement

The aim of this study is to compare the Competency of coupling of IPACK Block with Adductor Canal Block versus Adductor Canal Block Alone on Postoperative Pain after total knee replacement as well as Functional Recovery and Inflammatory Response and range of motion postoperatively.

Cervical TsDCS on Stroke Patients

The present project aims to evaluate the facilitatory modulation of motor responses of the limb upper limb by tsDCS in patients with arm/hand hyposthenia after cerebral ischemia to verify the possible therapeutic benefits that this type of stimulation can induce in terms of of strength, dexterity and effectiveness in acts of daily living.

Prognostic Recovery Observations and Guidance for Evaluating Stroke Survivors

This research delves into the acute prognostic factors influencing functional recovery in individuals who have experienced a stroke. The objective is to describe patterns of functional recovery after a stroke and identify new, clinically significant outcomes or metrics that can serve as predictive indicators for post-stroke functional recovery.