Rehabilitation Research:School of Physical & Occupational Therapy

McGill University

…from disability to possibility

Context of Rehabilitation Research• Medical and surgical advancesdramatic 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

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

Rehabilitation Research at the School

Dynamic cycle of rehabilitation researchPopulation

health

Consequences of disease

Mechanisms

Determinants of health

Health services

Knowledge exchange

Clinical interventions

Rehabilitation Rx

…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

…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

…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

…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

…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

…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

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

California, Delaware, Florida,

Illinois,Massachusetts,

Missouri, New Jersey,

Pennsylvania, Texas, Vermont & Washington DC

AlbertaU.

Alberta

Manitoba

Manitoba U.

Nova Scotia

Dalhousie U.QuébeQuébecc

U.S.A.U.S.A.

OntarioQueens U., U. Ottawa,U. Toronto,U. Windsor

British Columbia

UBC

QuébecU. Laval,

U. Montréal,UQÀM,UQO,

U. Sherbrooke

California, Delaware,

Florida, Illinois,Massachusetts,

Missouri, New Jersey,

Pennsylvania, Texas, Vermont & Washington

DC

BC & Alberta

Manitoba& Ontario

Nova Scotia

QuébecQuébec

Australia

Brazil

United Kingdom

Spain

France

ItalyGreec

e

Israël

Germany

The Netherlands

Belgium

Denmark

China

Austria

Thailand

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

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

Rehabilitation Research:School of Physical & Occupational Therapy

McGill University