Rehabilitation Research: School of Physical & Occupational Therapy McGill University

1. Rehabilitation Research:School of Physical & Occupational TherapyMcGill University …from disability to possibility

2. Context of Rehabilitation Research • Medical and surgical advancesdramatic decline in mortality • Survivors of complex health conditions now face chronic health issues and disabilities • 7.7% Canadian children have a disability (NICU survivors) • 300,000 Canadians live with stroke-related impairments • Increasing vigilance and acumen in the medical diagnosis of disorders with associated disabilities • Autism, attention deficit hyperactivity disorder, low back pain, chronic pain syndromes, obesity, depression • Growing demand for rehabilitation services and expertise across the lifespan

3. Importance of Rehabilitation Research • Growing evidence supporting the effectiveness of: • health promotion and disability prevention strategies • targeted identification and therapeutic strategies, interventions and programs • Building research capacity and core knowledge urgently needed to ensure that rehabilitation is appropriate, scientifically-based, and cost-effective in maximizing health and well-being

4. Rehabilitation Research at the School Population health Consequences of disease Dynamic cycle of rehabilitation research Mechanisms Determinants of health Health services Knowledge exchange Clinical interventions Rehabilitation Rx

5. …understanding the underlying mechanisms of disease that limit human functioning and health • Prenatal/perinatal brain injury using novel MRI technologies • Mechanisms of language acquisition and representation • Processes of disordered movement and posture that impact on locomotion, balance, arm and hand use • Influence of pain on movement, factors affecting pain perception • Recovery and resilience following CNS injury

6. …developing novel tools…technologic innovation • Assessments: • Neurologic integrity in the preterm neonate • Feeding • Speech and language skills • 60-second chair rise • Health-related quality of life • New technologies: • Mechanical ventilators • Assistive devices for arm mobility

7. …effectiveness of targeted rehabilitation strategies, interventions and programs • Virtual reality • Functional mobility • Alleviate pain • Motor learning • Forced-use therapy, feedback • Treatments to minimize hypertrophic scarring post-burns • Aquatherapy for lymphedema • Recreational physical activities in the elderly • Feeding interventions in the NICU

8. …effectiveness of targeted rehabilitation strategies, interventions and programs • Pre-habilitation to optimize surgical recovery • Driving rehabilitation programs • Cost-effectiveness of novel early intervention programs • Quality of health services • Factors influencing rehab service utilization • Service resource needs to support independence and integration

9. …intrinsic and extrinsic factors influencing integration and quality of life • Progression and evolution of disease processes • Impact on health and functioning • Determinants • Outcomes such as: • Mobility, feeding • Reintegration to school, work • Participation in leisure • Health-related quality of life

10. …enhancing the uptake and utilization of evidence by key stakeholders • National practice guidelines • Burns, stroke, low back pain • KT to address gaps between science and practice: • e-learning • StrokeEngine, SCORE • CPEngine • BurnEngine • Childhood-Disability-LINK • Professional education • Mentoring by novice learners • Enhancing learning in novel settings • Promoting inter-professional practice

11. Participants…fetus to frail elderly …..Alzheimer’s disease …attention deficit disorder …autism …breast cancer …burns …cerebral palsy …chronic obstructive pulmonary disease …chronic pain syndromes …congenital heart defects …fetus …fibromyalgia …frail elderly …global delay …HIV …lung cancer …multiple sclerosis …muscular dystrophy …obesity …orthopedic injuries …Parkinson’s disease …preterm …psychosis …schizophrenia …specific language impairment …spinal cord injury …stroke …traumatic brain injury …vestibular dysfunction …whiplash ….. ICU …hospital …rehabilitation centre …work …school …community sites …home

12. Ontario Queens U., U. Ottawa, U. Toronto, U. Windsor Québec U. Laval, U. Montréal, UQÀM, UQO, U. Sherbrooke British Columbia UBC Manitoba Manitoba U. Alberta U. Alberta Nova Scotia Dalhousie U. Québec U.S.A. California, Delaware, Florida, Illinois, Massachusetts, Missouri, New Jersey, Pennsylvania, Texas, Vermont & Washington DC

13. Denmark BC & Alberta Manitoba & Ontario Belgium The Netherlands United Kingdom Germany Québec Austria Nova Scotia France Spain China Israël Italy Greece Thailand California, Delaware, Florida, Illinois, Massachusetts, Missouri, New Jersey, Pennsylvania, Texas, Vermont & Washington DC Australia Brazil

14. Benefits to our students • Research knowledge and expertise are readily integrated into our professional program curricula • Research-intensive faculty promotes: • Evidence-based practice • Critical thinking • Lifelong learning • The best preparation for tomorrow is to do today's work superbly well.…William Osler

15. Benefits to Canadians • Research efforts directed at unraveling the bio-psychosocial sources of disability • New discoveries regarding the mechanisms and determinants of disability • New tools and technologies for clinical application • New treatments and programs to optimize functioning in target populations • New vehicles for knowledge exchange and enhanced professional education • To promote “best practice” that will ensure individuals with disabling health conditions are autonomous, employed, socially integrated, and experience a good quality of life

16. Rehabilitation Research:School of Physical & Occupational TherapyMcGill University