{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T12:38:49Z","timestamp":1786451929134,"version":"build-2736575974"},"reference-count":45,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T00:00:00Z","timestamp":1786406400000},"content-version":"unspecified","delay-in-days":10,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Canadian Chiropractic Research Foundation","award":["2024-02"],"award-info":[{"award-number":["2024-02"]}]},{"DOI":"10.13039\/501100024505","name":"Canadian Memorial Chiropractic College","doi-asserted-by":"publisher","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}],"id":[{"id":"10.13039\/501100024505","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,7,27]]},"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>This study aims to explore use trajectories of rehabilitation services among ageing Canadians (45\u201385 years) with osteoarthritis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>We will conduct a population-based cohort study using data from the Canadian Longitudinal Study on Aging (CLSA). We will describe rehabilitation use among respondents with osteoarthritis of the knee, hip or hand at baseline, 3-year and 6-year follow-up. Rehabilitation service use is measured via a single self-reported item capturing contact with a physiotherapist, occupational therapist or chiropractor in the past 12 months. We will use latent class growth analysis to identify 6-year trajectories of rehabilitation use, assigning participants to a single trajectory based on their highest probability of trajectory membership. All analyses will be stratified by income and within each income bracket by sex, gender and age. CLSA sampling weights will be applied to produce population estimates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>Ethics approval for this study was obtained from the Research Ethics Board of Western University (REB #128991), Ontario Tech University (REB #17980) and the Canadian Memorial Chiropractic College (REB# 242014). Informed consent was obtained from all CLSA participants at the time of recruitment. Findings will be disseminated through peer-reviewed publications and presentations at national and international conferences, with relevance for researchers, clinicians and policymakers working to improve equitable access to rehabilitation for ageing Canadians.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-116009","type":"journal-article","created":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T12:05:29Z","timestamp":1786449929000},"page":"e116009","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Trajectories of rehabilitation use among ageing adults with osteoarthritis in Canada: protocol for a population-based cohort study with latent class growth analysis of Canadian Longitudinal Study on Aging data"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4560-5877","authenticated-orcid":false,"given":"Nooralhuda","family":"Bakaa","sequence":"first","affiliation":[{"name":"Institute for Disability and Rehabilitation Research, Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6986-6676","authenticated-orcid":false,"given":"Pierre","family":"C\u00f4t\u00e9","sequence":"additional","affiliation":[{"name":"Institute for Disability and Rehabilitation Research, Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada"},{"name":"Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather M","family":"Shearer","sequence":"additional","affiliation":[{"name":"Institute for Disability and Rehabilitation Research, Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada"},{"name":"Division of Research and Innovation, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6138-8510","authenticated-orcid":false,"given":"Andrea D","family":"Furlan","sequence":"additional","affiliation":[{"name":"Toronto Rehabilitation Institute, Toronto, Ontario, Canada"},{"name":"Department of Medicine, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasdeep","family":"Dhir","sequence":"additional","affiliation":[{"name":"School of Rehabilitation Sciences, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5593-0238","authenticated-orcid":false,"given":"Jessica J","family":"Wong","sequence":"additional","affiliation":[{"name":"School of Physical Therapy, University of Western Ontario, London, Ontario, Canada"},{"name":"Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada"},{"name":"Populations & Public Health Research Program, ICES Western, London, UK"},{"name":"Graduate Studies, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,8,11]]},"reference":[{"key":"2026081105051034000_16.8.e116009.1","doi-asserted-by":"crossref","DOI":"10.21037\/atm.2020.02.175","article-title":"Global low back pain prevalence and years lived with disability from 1990 to 2017: estimates from the Global Burden of Disease Study 2017","volume":"8","author":"Wu","year":"2020","journal-title":"Ann Transl Med"},{"key":"2026081105051034000_16.8.e116009.2","doi-asserted-by":"crossref","first-page":"2006","DOI":"10.1016\/S0140-6736(20)32340-0","article-title":"Global estimates of the need for rehabilitation based on the Global Burden of Disease study 2019: a systematic analysis for the Global Burden of Disease Study 2019","volume":"396","author":"Cieza","year":"2020","journal-title":"Lancet"},{"key":"2026081105051034000_16.8.e116009.3","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.180698"},{"key":"2026081105051034000_16.8.e116009.4","unstructured":"Organization WH . 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