Rehabilitation Engineering Laboratory

Dr. Cesar Marquez-Chin - Brain-Machine Interfaces at the Toronto Rehabilitation Institute.
2016-12-08 12:00 - 13:00 (America/New_York) | Lyndhurst Center – Lecture Rooms A & B, 520 Sutherland Drive, Toronto, Ontario, M4G3V9, Canada
Abstract
Did you know that the Lyndhurst Centre has an active research program connecting brains and machines directly? In this talk I will introduce brain-computer interfaces, devices that can translate brain signals into control commands for electronic devices, share with you some of the work conducted in this field at the Toronto Rehabilitation Institute over the last decade, and discuss potential applications of this technology for rehabilitation after stroke and spinal cord injury.
About the Speaker
Dr. Márquez Chin is a scientist with the Neural Engineering and Therapeutics Team at the Toronto Rehabilitation Institute – University Health Network. A biomedical engineer by training, his professional activities have included clinical, research, and development settings. His primary research interests include the development and understanding of rehabilitation technologies and the interaction between these devices and their users, including consumers and care providers. Central to his work is the creation of systems that use brain signals to control electronic devices. His current areas of work include neurophysiological research, brain-machine interfacing, and rehabilitation robotics. Dr. Márquez Chin holds a PhD in biomedical engineering from the University of Toronto.

Dr. B Catharine Craven - Bone Health Services for SLOP: Myths, FAQ, & Program Self Evaluation
2017-01-12 12:00 - 13:00 | Lyndhurst Center – Lecture Rooms A & B, 520 Sutherland Drive, Toronto, Ontario, M4G3V9, Canada
Abstract
Objectives:
1) To discuss common myths and frequently asked questions regarding sublesional osteoporosis
2) Identify patients with spinal cord injury/disease & sublesional osteoporosis who require therapy
3) Select appropriate osteoporosis therapy based on the clinical scenario, patient’s fracture risk, and therapy side effect profile
4) Review the principles of post-fracture care
5) Complete a program Bone Health Self evaluation
About the Speaker
Dr. Craven is a Clinician Scientist appointed as an Associate Professor in the Department of Medicine, Division of Physical Medicine and Rehabilitation at the University of Toronto. She is a Senior Scientist within the Neural Engineering and Therapeutics Team at Toronto Rehabilitation Institute and the Medical Lead of the Spinal Cord Rehabilitation Program at Toronto Rehab’s Lyndhurst Centre within University Health Network.
Dr. Craven’s clinical and research expertise is in the prevention and treatment of secondary health conditions among individuals living with spinal cord injury and their related health service needs. Her recent work has focused on the associations between changes in body composition and multimorbidity among individuals with chronic spinal cord injury (PubMed).
Dr Craven led publication of the E-scan Atlas “Capturing Capacity in Canadian SCI Rehabilitation”. Dr. Craven, together with Dr. Bayley, co-leads the SCI-HIGH project aimed at developing structure, process and outcome indicators to advance SCI rehabilitation in Canada by 2020. She is also the project lead and driving force behind Toronto Rehab’s innovative Central Recruitment implementation, uniting clinicians and researchers around best-practice patient recruitment. Dr. Craven is the current Chair of the Rick Hansen Institute Care Committee; a recent recipient of a Craig H Neilsen Foundation senior scientist award; and the scientific co-chair of the 1-7th National SCI conference.

Dr. Milos R. Popovic - Electrical Stimulation: Improving walking, treating depression and controlling stem cell mobility.
2017-02-09 12:00 - 13:00 | Lyndhurst Center – Lecture Rooms A & B, 520 Sutherland Drive, Toronto, Ontario, M4G3V9, Canada
Abstract
In this lecture three different applications of electrical stimulation will be discussed. In one embodiment, the electrical stimulation is used as a tool to improve voluntary locomotion. In second embodiment, the electrical stimulation is used to change mood. And in third embodiment, the electrical stimulation is used to navigate stem cells and direct their movement. All three interventions have one thing in common. They use identical electrical stimulation pulses and identical software-hardware systems to deliver very different clinical interventions. These interventions belong to a broader spectrum of neuromodulation interventions. Hence, this entire lecture will be focused on presenting unique and unusual neuromodulation interventions of great relevance to the spinal cord injury population.
About the Speaker
Milos R. Popovic received his Ph.D. degree in mechanical engineering from the University of Toronto, Canada in 1996, and the Dipl. Electrical Engineer degree from the University of Belgrade, Serbia in 1990.
Dr. Popovic is the Associate Scientific Director at the Toronto Rehabilitation Institute – University Health Network and the Toronto Rehab Chair in Spinal Cord Injury Research. He is also a Professor (Tenured) in the Institute of Biomaterials and Biomedical Engineering at the University of Toronto, as well as Senior Scientist and the Neural Engineering and Therapeutics Team Leader at the Toronto Rehabilitation Institute. Dr. Popovic is also the founder and co-director of the CenteR for Advancing Neurotechnological Innovation to Application (CRANIA) at the University of Toronto and University Health Network.
Dr. Popovic’s fields of expertise are functional electrical stimulation, neuroprostheses, neuro-rehabilitation, neuromodulation, brain machine interfaces, physiological control systems, assistive technology, modeling and control of linear and non-linear dynamic systems, robotics, and signal processing.
In 1997, together with Dr. Keller, he received the Swiss National Science Foundation Technology Transfer Award – 1st place. In 2008, Dr. Popovic was awarded the Engineering Medal for Research and Development from the Professional Engineers of Ontario, and Ontario Society of Professional Engineers. In 2011, he was elected to the College of Fellows of the American Institute of Medical and Biological Engineering. In 2012, company MyndTec Inc., which Dr. Popovic co-founded in 2008, won the 1st Prize and the Best Intellectual Property Award at the annual TiEQuest Business Venture Competition. In 2013, he received the Morris (Mickey) Milner Award for outstanding contributions in the area of Assistive Technologies from the Health Technology Exchange. Also, in 2013, together with Drs. Prodic, Lehn, and Huerta-Olivares, and Mr. Tarulli, Dr. Popovic received the University of Toronto Inventor of the Year Award. In 2015, Dr. Popovic received the 2014 University Health Network’s Inventor of the Year Award.
Dr. Popovic is the co-founder and co-chair of the Canadian National Spinal Cord Injury Conference established in 2004.

Dr. Julio C. Furlan - In the Age of Aging, what is actually the impact of older age on outcomes after traumatic spinal cord injury?
2017-03-09 12:00 - 13:00 | Lyndhurst Center – Lecture Rooms A & B, 520 Sutherland Drive, Toronto, Ontario, M4G3V9, Canada
Abstract
Despite an increasing incidence of traumatic spinal cord injury (tSCI) in the elderly worldwide, relatively little has been reported to date regarding the role of age on outcomes after tSCI.
This series of studies examined the potential effects of older age on: (1) survival, degree of impairment and disability within the first year after tSCI; (2) neuroinflammatory response to, oligodentrocyte apoptosis and axonal survival within the spinal cord white matter after tSCI using immunohistopathological examination of post-mortem spinal cord tissue; and (c) economic burden of the initial management of individuals with acute tSCI.
Overall, the results of those studies support the notion that older people can potentially have similar benefits of the ongoing translational studies focused on neuroprotective and rehabilitative strategies. Also, improved protocols for management of older people with tSCI could have a significant impact on their recovery, which in the long term, could potentially offset the increased healthcare costs during the initial management of the elderly with tSCI.
About the Speaker
Dr. Furlan is a staff neurologist and a Clinician Investigator in the Division of Physical Medicine and Rehabilitation and the SCI Rehabilitation Program at the Lyndhurst Centre, Toronto Rehabilitation Institute, University Health Network, and an Assistant Professor in the Department of Medicine, Division of Physical Medicine and Rehabilitation, University of Toronto. He recently completed five years of residency training in Adult Neurology at University of Toronto in June 2014. Most recently he completed a two-year clinical fellowship in Neurorehabilitation and Neural Repair at Toronto Rehabilitation Institute, Sunnybrook Hospital and the University of Toronto (2014 to June 2016).
Dr Furlan has extensive training and research expertise. He is a trained head and neck surgeon from Brazil, who holds a MBA degree in Health Administration, an MSc degree in Clinical Epidemiology, and a PhD degree in Neuroanatomy. In the past, Dr. Furlan has worked as an Associate Research Scientist in the Department of Genetics and Development, Toronto Western Research Institute, University Health Network from 2007 to 2012. Dr. Furlan has also been an Adjunct Scientist at Toronto Rehabilitation Institute, University Health Network from 2009-2016, inclusive.
Dr Furlan´s research has been focused on outcome measures (including clinical assessments, neuroimaging analysis, and neurophysiological assessments) and predictors of outcome (including sex and age) after traumatic and non-traumatic spinal cord injury. In addition he has interest and expertise in autonomic dysfunction after spinal cord injury and economic analyses. Dr. Furlan has published 75 peer-reviewed papers and 14 book chapters, and received 43 awards over the past 15 years.

Dr. Kei Masani - Balance control of upright posture
2017-04-13 12:00 - 13:00 | Lyndhurst Center – Lecture Rooms A & B, 520 Sutherland Drive, Toronto, Ontario, M4G3V9, Canada
Abstract
Compromised standing and walking functions in people with spinal cord injury critically limit the affected individuals’ ability to perform activities of daily living, and reduce their quality of life. The use of FES therapy to train impaired balance may be an effective approach to improve an individual’s ability to maintain balance of upright posture, and subsequently quality of life. Toward developing a clinically-feasible FES therapy for training impaired balance, we have been investigating the upright balance control system in humans. This lecture will summarize how humans control equilibrium of upright posture and will introduce our idea of using FES therapy for training standing balance.
About the Speaker
Kei Masani received a Ph.D. degree in physical and health education from the University of Tokyo. He is a Scientist at the Toronto Rehabilitation Institute, and an Assistant Professor at Institute of Biomaterials and Biomedical Engineering, the University of Toronto. Previously he was an Assistant Professor in Life Sciences, the University of Tokyo. He is a member of the International Society for Posture and Gait Research, the Society for Neuroscience, the International Society of Biomechanics, and the International Functional Electrical Stimulation Society. His research aims to improve the mobility of people who experience neurological impairment. His approach to investigating human movement is undertaken from a neuromechanical perspective, i.e. the union of neurophysiology and physics. With this in mind, he focuses specifically on developing accurate assessments and therapeutic tools using functional electrical stimulation for standing, walking and adapted exercise.

Dr. José Zariffa - Measuring Upper Limb Function in the Community Using Novel Wearable Technology
2017-05-11 12:00 - 13:00 | Lyndhurst Center – Lecture Rooms A & B, 520 Sutherland Drive, Toronto, Ontario, M4G3V9, Canada
Abstract
After cervical SCI, a key objective is to maximize the functional use of the upper limb in activities of daily living (ADL). Currently, we lack the ability to directly measure how a person uses their upper limb to perform ADLs once they have been discharged to the community. Doing so would be of great benefit in gauging the true impact of rehabilitation interventions. This talk will give an overview of our laboratory’s work in developing wearable technology capable of measuring how individuals with cervical SCI are using their hands outside of a laboratory or clinical environment. Our approach is based on the use of wearable cameras that record the user’s point of view (egocentric video). Work on quantifying both the quantity and quality of hand use will be discussed, as well as the privacy considerations associated with the use of wearable cameras.
About the Speaker
Dr. José Zariffa is a Scientist at the Toronto Rehabilitation Institute – University Health Network and an Assistant Professor at the Institute of Biomaterials and Biomedical Engineering at the University of Toronto.
Dr. Zariffa received his Ph.D. degree in electrical and biomedical engineering from the University of Toronto. He then completed post-doctoral fellowships at the International Collaboration On Repair Discoveries (ICORD) in Vancouver, Canada, and at the Toronto Rehabilitation Institute, where he was supported by Spinal Cord Injury Ontario.
His research interests are in neuroprosthetics and technology for upper limb neurorehabilitation, encompassing work in neural interfaces, wearable sensors, rehabilitation robotics, and electrophysiology.

Dr. Sukhvinder Kalsi-Ryan - Spontaneous Recovery and Opportunities for Neuro-Restoration
2017-09-14 12:00 - 13:00 | Lyndhurst Center – Lecture Rooms A & B, 520 Sutherland Drive, Toronto, Ontario, M4G3V9, Canada
Abstract
As the demographic and profile of the traumatic spinal cord injury (SCI) population changes, the approaches to treat the altering presentation of this disease must also evolve. The field in the past 15 years has observed among other factors that: almost 2/3 of all SCI are cervical; the prevalence of incomplete injuries has increased to almost 60%; and the mean age of the population at time of injury is increasing. Declined upper limb (UL) (arm and hand) function is one of the most devastating consequences of cervical SCI (tetraplegia) and it has been shown to be the priority of recovery for this sub-group. Both subtle and significant improvements in UL function can lead to increased independence in daily activities, improving independence and quality of life.
Researchers in the rehabilitation field have developed a number of upper limb interventions that can enhance independence, function and restore neurological deficit. Over the last three decades, various interventions such as: functional electrical stimulation, exercise, practice and training coupled with peripheral nerve stimulation and activity based restorative therapy, have evolved in an attempt to improve UL function in individuals with SCI.
Despite the efforts and discovery of new concepts and interventions, widespread uptake and translation remain limited for a number of reasons: 1) Incidence of SCI is low, meaning that studies are often-underpowered, and multi-site studies are needed to conduct randomized controlled trials with even modest sample sizes; 2) development is funded, however uptake and translation methods are not well thought out or funded. As a result, methods found to be promising in initial studies do not always receive the follow-up work needed to refine and deploy them.
Thus, an algorithm to facilitate clinical decision making and progression for uptake from an already existing body of knowledge was defined on three principles: 1) Recovery profiles of the upper limb post SCI; 2) Scoping of current practices in UL rehabilitation; 3) Established neuro-musculoskeletal restorative approaches; and 4) Knowledge translation and implementation strategies needed for uptake.
This talk will consider and review existing knowledge regarding recovery and innovation as well as define some of the gaps in and effort to establish a process to create concepts for improved uptake and KT of neuro-restorative techniques.
About the Speaker
Dr. Kalsi-Ryan gained her Bachelor of Science in Physical Therapy from the Department of Physical Therapy at the University of Toronto (UofT) in 1995. She has worked in a clinical capacity with many neurological populations through the acute and sub-acute phases of recovery. For the last 15 years she has worked specifically with the spinal population at the Toronto Western Hospital in the Krembil Neuroscience Program. She is a Licensed Physical Therapist who has been involved in the rehabilitation care of both ambulatory and non-ambulatory patients. In addition to her clinical work she gained a Master’s degree from the Graduate Department of Rehabilitation Science (GDRS) at UofT in 2006 where she studied her interest of upper limb recovery through the development of the Tetraplegia Hand Measure. Sukhvinder was awarded her PhD in 2011, again from GDRS at UofT. Her PhD work consisted of leading the GRASSP project; an international collaboration of six researchers who developed an upper limb measure that targets quantification of impairment post cervical SCI. She established the psychometric properties of the GRASSP along with the utility of the GRASSP in the current field. Sukhvinder continues research as a Post Doctoral Fellow at the Toronto Western Hospital, where she continues to develop the GRASSP measure (www.sci-grassp.org), and study upper limb recovery in the traumatic and non traumatic SCI population. Dr. Kalsi-Ryan continues to work on a number of clinical studies: she is currently leading the GRASSP Longitudinal Study and developing an objective measurement protocol specific for Cervical Spondylotic Myelopathy. In addition she currently works within the Neurorecovery Network and the North American Clinical Trials Network. She is a member of the Canadian Physiotherapy Association, North American Spine Society and AO Spine. Future plans for Dr. Kalsi-Ryan include moving into a clinician scientist role, that will service both the rehabilitation and neurosurgery departments

Dr. Thomas Janssen - Activating paralyzed muscle: necessary for optimal health?
2017-09-19 12:00 - 13:00 | Toronto Rehab University Center – Basement Lecture Theatre, 550 University Avenue, Toronto, Ontario, M5G2A2, Canada
Abstract
Individuals with a spinal cord injury (SCI) are commonly restricted to perform upper-body exercise, which, although beneficial in many ways, does not necessarily lead to optimal health. Inactivity of the paralyzed muscles can lead to many secondary medical complications, such as pressure sores, poor wound healing, and obesity. Activating paralyzed muscles using electrical stimulation (ES) might therefore be an essential additional tool to maintain optimal health in individuals with SCI. In this presentation, different ES-induced exercise and activity forms will be described and it will be discussed how they can contribute to promoting health and fitness and play a role during and after rehabilitation and/or (recreational) sport performance.
About the Speaker –
In 1988, Thomas Janssen received his master’s degree in exercise physiology and functional anatomy from the Faculty of Human Movement Sciences, VU University in Amsterdam. In 1994, he received a PhD degree in Human Movement Sciences on Physical Strain and Physical Capacity of Men with Spinal Cord Injuries. Between 1994 and 1998 he was a visiting scientist at and associate director of the Institute for Rehabilitation Research and Medicine, Wright State University School of Medicine in Dayton, Ohio, USA. Upon returning to the Netherlands, he took an assistant professorship at the VU University, performing rehabilitation research and teaching classes on exercise physiology and rehabilitation. At the same time, he started working as research coordinator of the Rehabilitation Center Amsterdam (current name: Reade). His main research interest lies in the field of exercise physiology and biomechanics applied to rehabilitation and exercise. Most profound research subjects are physical capacity, activity and health of wheelchair users with a spinal cord injury, electrical stimulation therapy of paralyzed muscles, and disability sports. Since 2008 he is professor in rehabilitation research at the VU University. He is currently chair of the Amsterdam Rehabilitation Research Center | Reade, scientifically responsible for the Center for Adapted Sports Amsterdam, and member of the steering group of the European Research Group in Disability Sports. He has (co-)authored over 140 publications on topics such as exercise and rehabilitation after spinal cord injury.

Susan Jaglal : Development and Validation of an Algorithm to Identify Cases of Non-traumatic Spinal Cord Injury Using Health Administrative Databases
2017-10-12 12:00 - 13:00 | Lyndhurst Center – Lecture Rooms A & B, 520 Sutherland Drive, Toronto, Ontario, M4G3V9, Canada
Abstract:
In a number of developed countries the incidence of non-traumatic spinal cord disorder (NTSCD) is reported to be greater than that for traumatic spinal cord injury (tSCI). Over the next twenty years, with the aging of the world’s population, it is expected that the higher incidence of non-traumatic spinal cord disorders compared to tSCI will become the norm in most countries. This will pose increased and unique demands on healthcare systems worldwide. To date, researchers and healthcare providers know little about the growth and demographics of non-traumatic spinal cord disorders. Without such information, policy-makers and healthcare providers are unable to make informed decisions about the resources and treatments necessary to care for this population in a cost-effective, timely and evidence-based manner. The purpose of this presentation is to describe the development, findings and validation of an algorithm to identify patients with NTSCD, in Canada, using health administrative data.
About the Speaker:
Dr. Jaglal holds the Toronto Rehabilitation Institute Chair at the University of Toronto where she is Associate Academic Director of Research. She is the Vice-Chair Research and Professor in the Department of Physical Therapy with cross-appointments in the Rehabilitation Sciences Institute and the Institute for Health Policy, Management and Evaluation and a Senior Scientist at the Institute for Clinical Evaluative Sciences. Dr. Jaglal has published and lectured widely in her areas of research, which include spinal cord injury and rehabilitation health services and osteoporosis and hip fracture with emphasis on utilization, appropriateness, self-management and knowledge transfer. She holds a PhD in Epidemiology from the University of Toronto.

Dr. Sivakumar Gulasingam - Classification in Para Sports
2017-11-23 12:00 - 13:00 | Lyndhurst Center – Lecture Rooms A & B, 520 Sutherland Drive, Toronto, Ontario, M4G3V9, Canada
Talk Objectives:

Current status of Para Sports
Introduction to Para Sports Classification
Conceptual Framework for Classification
International Standards for Classification
Classificatoin Pathway – Athlete and Classifier
National and International Opportunities
Knowledge Translation and Clinical Interaction

About the Speaker:
Dr. Sivakumar Gulasingam is a physiatrist attached to Toronto Rehabilitation Institute’s Brain & Spinal Cord Program, Cardiovascular Prevention & Rehabilitation Program and the LTLD Program at Bickle Centre. He is a Clinician Teacher and an Assistant Professor in the Department of Medicine, University of Toronto with expertise in Para Sports and Spinal Cord Injury. In the field of sports & sports medicine he have provided coverage at many national & international events including Korean Wheelchair Marathon, FESPIC Games, Commonwealth Games, Skate Canada, Panam & Para Panam Games and Invictus Games in addition to his ongoing involvement with Canadian wheelchair sports teams. He is a National Trainer & Para Athletics Classifier with Athletics Canada, Head of Classification for Para Dance Sport Canada, International Paralympic Committee Classifier for World Para Athletics and World Para Dance Sports. More recently, he was responsible for the development of first ever classification system for the Invictus Games (2017) in his role as the Classification Director and Head of Multisport Classification.

Andres Lozano - A proposal to treat patients with spinal cord injury by stimulating locomotor areas in the brainstem
2017-12-07 12:00 - 13:00 | Lyndhurst Center – Room B10, 520 Sutherland Drive, Room B10, Toronto, Ontario, M4G3V9, Canada
Abstract
Disturbances in gait function are characteristic of a number of disorders including Parkinson’s disease and spinal cord injury. The introduction of Deep Brain Stimulation (DBS) has allowed its examination for its possible role in facilitating gait in patients with gait impairment. We have implanted the brainstem locomotor area in patients with Parkinson’s disease and applied deep brain stimulation to improve certain aspects of gait. There is compelling animal data that the same approach could also be of use in spinal cord injury. The seminar will examine the possibility of deep brain stimulation in brainstem locomotor areas to help gait in patients who have had spinal cord injury.
About the Speaker
Dr. Lozano received his MD degree at the University of Ottawa and his neurosurgical training and PhD degree in Neurobiology at McGill. He received post-doctoral training in movement disorders at Queens Square, London, UK and in cell and molecular biology in Toronto. He is the Professor and Chairman of Neurosurgery at the University of Toronto and holds both the RR Tasker Chair in Functional Neurosurgery at the University of Toronto and the Toronto Western Hospital and a Tier 1 Canada Research Chair in Neuroscience. He has an active laboratory dedicated to the study of neuronal degeneration and regeneration and Functional Neurosurgery.
Dr. Lozano has over 500 publications, serves on the board of several international organizations and is a founding member of the scientific advisory board of the Michael J. Fox Foundation. He is the most cited neurosurgeon in the world according to Thompson Reuters. He has received a number of awards including the Olivecrona Medal and the Pioneer in Medicine award, has been elected a Fellow of the Royal Society of Canada and the Canadian Academy of Health Sciences, has received the Order of Spain, has been recognized as an Officer of the Order of Canada.
He is best known for his work in Deep Brain Stimulation (DBS). He has been involved in training over one hundred physicians from throughout the world, with the hope that this will mean better access for patients to neurosurgical treatments to alleviate some of the debilitating effects of Neurological and Psychiatric disorders.

Brian Chan - Mo’ money, mo’ problems: economic analyses in spinal cord injury
2018-01-11 12:00 - 13:00 | Lyndhurst Center – Lecture Rooms A & B, 520 Sutherland Drive, Toronto, Ontario, M4G3V9, Canada
Abstract
In a financially constraint health care environment, economic analyses are becoming increasingly important to health care administrators and decision-makers. Unfortunately, the concepts, methods and application of health economics are not clearly understood by most clinicians and scientists. In this lecture, I will present a high level overview of economic evaluations in health care, explore the landscape of economic analyses in spinal cord injury and highlight ongoing and future research in this area by the Neural Engineering and Therapeutics team at Toronto Rehab Institute.
About the Speaker
Brian Chan is a Post-doctoral Fellow with the Neural Engineering and Therapeutics Team at Toronto Rehabilitation Institute. He received his Doctorate of Philosophy from the Department of Pharmaceutical Sciences and Bachelor and Masters of Science degrees from the Department of Pharmacology at the University of Toronto. His Doctoral work examined the “Economic burden of chronic ulcers”. Brian’s research interests are in economic analyses of spinal cord injury. His strengths are in decision modelling, developing cost-of-illness studies and economic evaluations using administrative health care data and translating economic evidence to stakeholders. Brian is currently co- supervised by Dr Cathy Craven and Dr Walter Wodchis.

Aimee J. Nelson - Changes in the organization of the motor cortex that follow incomplete spinal cord injury; insights for rehabilitative strategies
2018-03-08 12:00 - 13:00 | Lyndhurst Center – Lecture Rooms A & B, 520 Sutherland Drive, Toronto, Ontario, M4G3V9, Canada
Abstract
Movement training for improving upper limb control is an essential component of rehabilitation for individuals with spinal cord injury (SCI). Understanding the cortical representation of arm muscles in SCI is fundamental to designing more effective movement training regimes. In uninjured individuals, the primary motor cortex (M1) contains overlapping muscle representations, an organization that reflects muscle synergies. This organizational feature has yet to be studied in SCI yet is considered a key element that defines the coordinated action of multiple muscles during human movement. Using Transcranial magnetic stimulation (TMS), we investigated the bilateral representation and overlapping distribution of muscles of the upper limb in chronic cervical SCI and aged-matched controls (n=9, each group). Muscles studied included the abductor pollicus brevis (APB), flexor carpi radialis (FCR) and biceps brachii (BB) and the cortical territory (cm2), overlapping territory (cm2) of the target muscles, and center of gravity were computed. Results indicate a reduction in the cortical territory dedicated to all three muscles in SCI (i.e. reduced complete overlap) compared to uninjured controls. Further, SCI had greater cortical territory dedicated to a single or dual muscle representation. These data indicate that overlapping organization is preserved in the motor cortex of SCI, however, the overlapping representation does not extend to all three muscles. The implication from these data is that movement training emphasizing synergies that incorporate all three muscles (APB, FCR, BB) may promote greater representational overlap (similar to uninjured controls) and provide functional gains in motor control.
About the Speaker
Aimee J. Nelson (PhD) is Associate Professor in the Department of Kinesiology at McMaster University and a Canada Research Chair (Tier 2) in Sensorimotor control. Her research laboratory investigates neural plasticity within sensorimotor spinal and motor cortical circuits for the ultimate purpose of improving human movement in individuals with neurological injury and/or disease. Her neurophysiology and neuroimaging research aims to understand the neural mechanisms that underpin plasticity-inducing interventions including non-invasive brain stimulation and exercise.

Dr. Bastien Moineau - Development of a garment-based technology to deliver functional electrical stimulation after acquired neurological impairment
2018-04-12 12:00 - 13:00 | Lyndhurst Center – Lecture Rooms A & B, 520 Sutherland Drive, Toronto, Ontario, M4G3V9, Canada
Abstract
Functional electrical stimulation (FES) has been used for individuals with spinal cord injury (SCI) to retrain impaired neural circuits and regain compensatory uses of their paralyzed muscles (FES therapy). We believe that the therapeutic impact of these FES treatments could be higher if they were applied routinely and/or during activities of daily living. However, delivering complex FES therapy in the community is limited by the available equipment. We aim to solve this issue by developing stimulation devices that can be easily used at home, without professional assistance. We are developing wearable devices, the stimulation garments, to deliver FES on multiple predefined muscles without the use of conductive gel. We first compared these fabric electrodes with standard gel electrodes in able bodied individuals, and are now testing the usability of the FES-shirt with neurologically impaired individuals. We are also conducting focus groups with potential end-users to integrate in future designs the features that would make the stimulation garments more practical and relevant to these populations. I am looking forward to discussing with you our first results and the future direction for research and development.
About the Speaker
After obtaining my physiotherapist diploma in 2010, I completed my PhD degree at Grenoble-Alpes University in France in 2014, during which I acquired training in engineering, data acquisition and computing while working on biomedical application for individuals with lower-limb amputation. Before and after my doctoral training, I worked as a physiotherapist in a post-acute stroke rehabilitation center, at the Grenoble-Alpes University Hospital. These initial phases of my career developed my understanding of patients’ challenges and needs when facing impaired motor function. These experiences increased my interest in clinical research, particularly for evaluation and intervention technology in the neuro-rehabilitation field. I joined the Rehabilitation Engineering Laboratory of Milos Popovic as a post-doctoral fellow in early 2016, looking forward to applied clinical research leading to delivery of methods and devices that answer patient’s needs.

Anne Bryden - Advanced Assessment of the Upper Limb in Tetraplegia: A Three-Tiered Approach to Characterizing Paralysis
2018-07-19 12:00 - 13:00 | Lyndhurst Center – Lecture Rooms A & B, 520 Sutherland Drive, Toronto, Ontario, M4G3V9, Canada
Abstract
Background: More than half of all individuals who sustain a spinal cord injury (SCI) experience some degree of impairment in the upper limb. Functional use of the arm and hand is of paramount importance to these individuals. Fortunately, the number of clinical trials and advanced interventions targeting upper limb function are increasing, generating optimism for improved recovery and restoration after SCI. New interventions for restoring function and improving recovery require more detailed examination of the motor capacities of the upper limb. Objectives: The purpose of this presentation is to introduce a three-tiered approach to evaluating motor function, with specific attention to the characteristics of weak and fully paralyzed muscles during acute rehabilitation. The three tiers include (1) evaluation of voluntary strength via manual muscle testing, (2) evaluation of lower motor neuron integrity in upper motor neuron–paralyzed muscles using surface electrical stimulation, and (3) evaluation of latent motor responses in paralyzed muscles that exhibit a strong response to electrical stimulation, using surface electromyographic recording electrodes. These characteristics contribute important information that can be utilized to mitigate potential secondary conditions such as contractures and identify effective interventions such as activity-based interventions or reconstructive procedures. The goal is to encourage frontline clinicians, occupational and physical therapists who are experts in muscle assessment, to consider a more in-depth analysis of paralysis after SCI. Conclusion: Given the rapid advancements in SCI research and clinical interventions, it is critical that methods of evaluation and classification evolve. The success or failure of these interventions may depend on the specific characteristics identified in the three-tiered assessment. Without this assessment, the physiological starting point for each individual is unknown, adding significant variability in measuring the outcomes of these interventions.
About the Speaker
Anne Bryden, MA, OTR/L is the Director of Clinical Trials and Research for the Institute for Functional Restoration (IFR) at Case Western Reserve University. The IFR is a non-profit organization with the mission of translating science and technological research interventions targeted toward spinal cord injury and other paralytic conditions into clinical programs to help people with these conditions. The IFR is closely affiliated with The Cleveland FES Center.
Anne received her Bachelor of Science in Occupational Therapy from Cleveland State University in 1991. She has a Master’s degree in Sociology and is currently a doctoral candidate in Sociology at Case Western Reserve University. Anne has over twenty years of experience specializing in upper extremity care of people with cervical spinal cord injury. Anne leads the functional assessment program for upper extremity neuroprosthetics and reconstructive surgeries at The Cleveland FES Center. Currently she is responsible for leading the multi-center pivotal clinical trial for the networked neuroprosthesis, the latest innovation developed at the Cleveland FES Center. Her research interests include upper extremity assessment, surgical interventions, outcomes measurement, and the social determinants of health and wellness in people with chronic physical disability. Additionally, she is exploring the experiences of navigating health and social resources following SCI through the lens of human rights, by measuring barriers and facilitators to obtaining services necessary for quality of life. She is also conducting research on the human rights knowledge base of health professionals and other stakeholders involved in the care of people with SCI.
Anne has authored and co-authored several peer-reviewed publications on the topic of spinal cord injury. She is the recipient of the 2015 Neilsen Foundation Allied Health Professional Research Award of the American Spinal Injury Association (ASIA). Currently Anne is the Chair of the Rehabilitation Standards Committee of ASIA. Additional professional memberships include The American Occupational Therapy Association, The American Sociological Association and the International Spinal Cord Society.

Teresa Valenzano - Respiratory-Swallow Coordination in Spinal Cord Injury
2018-09-13 12:00 - 13:00 | Lyndhurst Center – Lecture Rooms A & B, 520 Sutherland Drive, Toronto, Ontario, M4G3V9, Canada
Abstract
Respiratory-swallow coordination is vital for preventing the aspiration of foreign material into the airway. In healthy adults, respiration ceases during the expiratory phase of breathing for the duration of the swallow. However, for individuals with respiratory impairments, these two systems may become discoordinated, leading to increased risk of aspiration and related negative sequelae. This lecture will present the mechanics of respiratory-swallow coordination and discuss the implications of this discoordination in the spinal cord injury population.
About the Speaker
Teresa Valenzano is a practicing speech-language pathologist, with an interest in swallowing function in neurological disorders. She completed her Doctorate of Philosophy from the Rehabilitation Sciences Institute and Master’s of Health Science from the Department of Speech-Language Pathology at the University of Toronto. Her doctoral work research focused on characterizing the physiology of swallowing in those who have experienced a traumatic spinal cord injury, and investigating the relationship between respiration and swallowing in this population. Teresa currently works for the Interprofessional Practice Based Research program at St. Michael’s Hospital, helping bridge the gap between research and clinical practice.

Dr. Sarah Munce - The SCI&U Story (so far): Developing an online self-management program for people with spinal cord injury
2018-10-11 12:00 - 13:00 | Lyndhurst Center – Lecture Rooms A & B, 520 Sutherland Drive, Toronto, Ontario, M4G3V9, Canada
About the Speaker
Dr. Sarah Munce, PhD is a scientist at Toronto Rehab in the LIFEspan Service and an assistant professor (status only) at the University of Toronto in Department of Occupational Science & Occupational Therapy with cross-appointments in the Rehabilitation Sciences Institute and the Institute of Health Policy, Management & Evaluation. Broadly, her program of research focuses on developing, implementing, and evaluating transitional care programs, including self-management and peer support programs, for individuals with neurological conditions. She uses knowledge syntheses and mixed qualitative and quantitative methods to carry out this research. She is the Membership Chair for the Mixed Methods International Research Association.

Matheus Joner Wiest - Traditional electrical stimulation is so 1700s: meet interleaved stimulation
2018-11-08 12:00 - 13:00 | Lyndhurst Center – Lecture Rooms A & B, 520 Sutherland Drive, Toronto, Ontario, M4G3V9, Canada
About the Speaker
With a BSc in Physical Education and a MSc in Human Movement Sciences, Dr Wiest focused the initial phases of his career on understanding sports biomechanics and human postural control. During his PhD at the University of Alberta, his main focus moved towards improving the use of neuromuscular electrical stimulation for rehabilitation and training. His current research interests as a postdoctoral fellow at the Toronto Rehabilitation Institute are related to:
1) Understanding and improving muscle-bone function and health after spinal cord injury, and
2) Improving the quality of rehabilitation care for people living with a spinal cord injury.

Jean-François Lemay - Using wearable sensors to document gait stability in individuals with spinal cord injury: preliminary results
2018-12-13 12:00 - 13:00 | Lyndhurst Center – Lecture Rooms A & B, 520 Sutherland Drive, Toronto, Ontario, M4G3V9, Canada
Abstract
Most individuals with a motor incomplete spinal cord injury (SCI) will eventually recover the ability to walk. However, they will also present a higher risk of falling than that of an elderly population. For this reason, performing an evaluation of balance capability in this population is warranted. Wearable inertial sensors have been successfully used for that purpose in other populations and parameters derived from these devices have utility for identifying fall risk. In this lecture I will present data from a multi-center research project on walking stability as measured by wearable sensors on both SCI and able-bodied individuals.
About the Speaker
Jean-François Lemay is a physical therapist and a clinical professor at the school of rehabilitation of the Université de Montréal. He was a postdoctoral fellow at the Toronto Rehabilitation Institute – Lyndhurst Centre and was supported by a postdoctoral fellowship research grant from the Craig H Nielsen Foundation. He received a B.Sc. in Physical Therapy from McGill University and worked as a clinician for over 15 years of experience as a physical therapist working with a spinal cord injury (SCI) population. He also holds a Master’s degree in Biomedical Sciences and a PhD in Rehabilitation Science from the University of Montreal. His postgraduate studies mainly focused on the evaluation of standing postural control following a spinal cord injury using both clinical and biomechanical assessments.

Dr. Anthony Burns and Heather Flett - Determining Pressure Injury Risk Following Spinal Cord Injury
2019-01-10 12:00 - 13:00 | Lyndhurst Center – Lecture Rooms A & B, 520 Sutherland Drive, Toronto, Ontario, M4G3V9, Canada
Abstract
Pressure injury (PI) is a serious and common complication following spinal cord injury (SCI). The risk of PI begins early after SCI and persists during inpatient rehabilitation and community reintegration. Over a quarter of patients will develop a PI prior to inpatient rehabilitation. During inpatient SCI rehabilitation, the reported incidence has ranged between 10% and 48%. Individuals who develop PIs during SCI rehabilitation also have poorer rehabilitation outcomes, longer lengths of stay, and an increased risk of future PIs. In long-term, longitudinal studies, 5.5% to 11% of mortalities have been attributed to infections related to PIs. Unfortunately, despite medical advances, ongoing efforts, and the expenditure of significant resources over the past three decades, PI incidence in the SCI population has improved little since the late 1970s. The early identification of individuals at risk for PI development will facilitate the immediate implementation of preventative measures, and help improve clinical efficiency and cost-effectiveness by directing finite clinical resources toward those who truly need them.
About the Authors
Anthony S. Burns graduated from the Yale University School of Medicine in 1994, and afterwards completed combined residency training in Internal Medicine and Physical Medicine & Rehabilitation at the Johns Hopkins University, followed by a SCI fellowship at the University of Alabama at Birmingham. He is a past participant in the Rehabilitation Medicine Scientist Training Program, funded by the U.S. National Institutes of Health. From 2000 through 2007, he was Assistant Professor, Department of Rehabilitation Medicine, Thomas Jefferson University, Philadelphia PA; Assistant Director of the Regional SCI Center of the Delaware Valley; and adjunct Assistant Professor, Department of Neurobiology and Anatomy, Drexel University College of Medicine, Philadelphia PA. Since 2007, Dr. Burns has held a clinical appointment in the University Health Network – Toronto Rehabilitation Institute Spinal Cord Rehabilitation Program, the largest program of its kind in Canada. He is also an Associate Professor in the Division of Physiatry, Department of Medicine, University of Toronto. His clinical and research interests focus on the clinical management of spinal cord injury and related secondary complications.

Heather Flett is the Advanced Practice Leader for Spinal Cord Rehabilitation at University Health Network in Toronto. She has 20 years of experience in the field of spinal cord rehabilitation working as a Physical Therapist for 8 years prior to her current role. In her Advanced Practice Leader role, Heather supports clinical research integration and leads projects to advance best practices in SCI rehabilitation. She is a Lecturer in the Department of Physical Therapy at University of Toronto and completed an MSc in the Graduate Department of Rehabilitation Science focusing on walking outcomes following incomplete spinal cord injury. Heather is the co-lead of the Teach Back SCI PODS initiative and is the Toronto site co-lead of SCI Knowledge Mobilization Network which focuses on best practice implementation in the prevention of secondary complications following SCI. She is also a Toronto site co-investigator for the Rick Hansen Spinal Cord Injury (SCI) Registry and the SCI High projects.

Dr. Dalton Wolfe, Stephanie Marrocco & Dr. Deena Lala - Enhanced clinical decision-making for activity-based therapies for persons with SCI
2019-02-14 12:00 - 13:00 | Lyndhurst Center – Lecture Rooms A & B, 520 Sutherland Drive, Toronto, Ontario, M4G3V9, Canada
Abstract
The Parkwood Program for Rehabilitation Innovations in Mobility Enhancement (PRIME) is a multi-faceted initiative undertaken by the Research 2 Practice (R2P) team at Parkwood Institute. The ultimate objective of PRIME is to develop a clinical decision support system that serves as the basis of a health learning system to support therapists in their decision-making associated with different therapeutic activities to enhance mobility in persons with SCI or ABI. The approach involves systematically characterizing, implementing and documenting therapeutic activities and then examining the relationship of these activities with outcomes. A variety of analytic techniques will be used to examine these relationships. This process involves taking a very participatory approach that incorporates implementation science along with a complementary approach between practice-based research and clinical research methods. The presentation will share the PRIME journey to date and describe some preliminary findings and benefits to participants and the rehabilitation program.
About the Speakers
Dr. Dalton L. Wolfe, PhD
Dr. Dalton Wolfe is the leader of the R2P (Research 2 Practice) team at Parkwood Institute that integrates clinical and research efforts to improve care and clinical outcomes. His primary research interest is in the area of knowledge mobilization and best practice implementation across rehabilitation and community settings. As part of the Parkwood Rehabilitation Innovations in Mobility Enhancement (PRIME) initiative he is focused on enhancing clinical decision-making to improve locomotor and other movement-related outcomes with more integration of activity-based therapies such as robotic, manual and FES-assisted therapies. In addition, Dalton and colleagues are exploring the use of online technologies and patient-reported outcomes to facilitate self-management skills that enable persons with chronic conditions such as SCI and ABI to prevent and better manage secondary complications.
Position: Scientist
Organization: Parkwood Institute Research, Lawson Health Research Institute
Email: dwolfe@uwo.ca
Phone: 519-685-4292 ext 42957
Ms. Stephanie Marrocco, MSc
Ms. Stephanie Marrocco is a research coordinator with the R2P team at Parkwood Institute. Ms. Marrocco completed a MSc from Western University examining gait laterality in persons with stroke. She has recently begun a PhD and is interested in better understanding rehabilitation processes associated with persons with neurological impairments. In particular, Stephanie is interested in examining variations in rehabilitation practice patterns and has developed different analysis and visualization approaches to examine research questions within this area.
Position: PhD Student / Coordinator
Organization: Western University / Parkwood Institute Research, Lawson Health Research Institute
Email: stephanie.marrocco@sjhc.london.on.ca
Phone: 519-685-4292 ext 42631
Dr. Deena Lala, PT, PhD
Dr. Deena Lala is a postdoctoral fellow with the Research to Practice (R2P) Team and a Physiotherapist in the Rehab Program at Parkwood Institute. She recently completed the combined PhD/MPT program at Western University in August 2018. She was highly involved in the E-Stim Collaboration Project, where she examined the difficulties of implementing pressure injury best practices like E-Stim for treating pressure ulcers in community dwelling persons with SCI. Currently, she is working closely in the PRIME initiative with a key interest in examining the feasibility and value of using wearable sensors (developed in Zurich, Switzerland) by clinicians and patients with spinal cord injury during inpatient and outpatient rehabilitation.
Position: Research Fellow / Staff Physiotherapist
Organization: Western University / Parkwood Institute, SJHC
Email: deena.lala@sjhc.london.on.ca
Phone: 519-685-4292 ext 42078

Heather Baltzer, Paul Binhammer & Larry Robinson - Improving Function in Patients with Complex Nerve Injuries through Interdisciplinary Surgical and PM&R Clinics
2019-04-18 12:00 - 13:00 | Lyndhurst Center – Lecture Rooms A & B, 520 Sutherland Drive, Toronto, Ontario, M4G3V9, Canada
Abstract
Objectives:

Distinguish which patients would be good candidates for surgical interventions
Recognize surgical options to improve function in our patients
Develop EMG skills required of complex clinics

About the Speakers
Dr. Larry Robinson is Professor and Department Division Director (DDD) for Physical Medicine and Rehabilitation at the University of Toronto and holds the John and Sally Eaton Chair in Rehabilitation Sciences. Dr. Robinson is based at Sunnybrook Health Sciences Centre where he serves as Program Chief for Rehabilitation and Program Research Director. He came to Toronto in 2014 from the University of Washington where he served as Chair of the Department of Rehabilitation Medicine and later as Vice Dean for Clinical Affairs and Post Graduate Medical Education. Dr. Robinson has published extensively on rehabilitation and electrodiagnosis with >140 publications in the peer-reviewed literature. He is creator of the Combined Sensory Index (CSI or Robinson Index) and recently was awarded the Lifetime Achievement Award from the American Association of Electrodiagnostic and Neuromuscular Medicine (AANEM). He is American but is aspiring to be Canadian soon.
Dr. Paul Binhammer graduated from residency in 1992 from Toronto and did head fellowships in France and Salt Lake City. He returned to Sunnybrook with a practice of hand and wrist surgery and lower extremity reconstruction. His academic interests are in international education and outcomes in hand surgery.
Dr. Baltzer is the Interim Director of the Toronto Western Hand program. She is a clinician investigator at University Health Network and Krembil Research Institute. After her plastic surgery residency in Toronto, she went to Mayo Clinic in Rochester, Minnesota for her Hand, Wrist and Microsurgery fellowship. She is currently pursuing a post-graduate degree in Health Services Research in the Institute for Health Policy, Management and Evaluation at the University of Toronto.

Dr. Arash Arami - Personalized Assistive Robotics: Modelling Human Neuromechanics For Personalization
2019-05-09 12:00 - 13:00 | Lyndhurst Center – Lecture Rooms A & B, 520 Sutherland Drive, Toronto, Ontario, M4G3V9, Canada
Abstract
Human locomotion results from a complex interaction between the central nervous system, sensory and musculoskeletal systems. The force generated, reflexes and programmable viscoelasticity of our muscles play an essential role in obtaining a stable and smooth interaction with the environment during locomotion. Devastating neurological conditions such as stroke and spinal cord injury affect millions of individuals annually, alter their neuromechanical control of motion and impede their mobility. The effect of these conditions on the walking control is not well understood, but observed to be different across individuals. My goal is to design personalized assistive robotics systems as well as gait training and rehabilitation programs tailored to the altered neuromechanics of each individual to improve their motor function and quality of life.
The first part of my presentation describes the techniques I developed for movement analysis based on implantable and wearable sensors, which can be used for motor assessment and outcome evaluation of assistive devices. I will then present my recent research to identify and model the neuromechanics of healthy and SCI subjects including joint mechanical impedance and spasticity. Finally, I will describe how these models are used in the design a patient-specific cooperative control of lower limb exoskeletons.
About the Speaker
Arash Arami received his Ph.D. degree from Ecole Polytechnique Fédérale de Lausanne (EPFL), Switzerland, in 2014 in electrical engineering. From 2014 to 2015, he was a Postdoctoral Researcher at the Laboratory of Movement Analysis and Measurement at EPFL. He was a Research Associate in Human Robotics Group at Imperial College London, from August 2015 to November 2017. In December 2017, Arash joined the University of Waterloo as an Assistant Professor. He is with the Department of Mechanical and Mechatronmics Engineering and leads the Neuromechanics and Assistive Robotics Lab. His research has contributed to the design of instrumented orthopedic implants, biomechanical robotic systems, wearables and algorithms for kinematic-based monitoring during the activities of daily life, neuromechanical modelling and cooperative control of lower limb exoskeletons for individuals with neurological conditions such as incomplete spinal cord injury.

Dr. Allan Levi - Novel treatment strategies for spinal cord and peripheral nerve injury
2019-05-30 12:00 - 13:00 | Lyndhurst Center – Lecture Rooms A & B, 520 Sutherland Drive, Toronto, Ontario, M4G3V9, Canada
About the Speaker
ALLAN LEVI currently serves as Chairman of Neurosurgery at the University of Miami (UM) MILLER School. Dr. Levi combines a busy neurosurgical spine and peripheral practice and an active, complementary clinical and basic translational research program. The department is also home for staff scientists at the Miami Project to Cure Paralysis. Our clinical and research divisions are internationally recognized. Our comprehensive spine service includes the latest surgical technologies such as minimally invasive spine, robotics and complex spinal reconstructions. The majority of our spinal cord and spine research is powered by the groundbreaking research of our world-renowned scientists and investigators who work within The Miami Project. Our cranial neurosurgeons perform minimally invasive, endoscopic and skull base approaches to resect both benign and malignant tumors of the brain and collaborate with UHealth Otolaryngologists and Sylvester Comprehensive Cancer Center’s Radiation Oncologists to provide multidisciplinary care. Our top-notch vascular and endovascular colleagues can cure vascular diseases with either open or catheter-based approaches. Finally, our functional, neuro–trauma, peripheral nerve and pediatric services are also major strengths of the program. Our experienced faculty participates in clinical trials, publishes peer-reviewed articles and operates one of the largest neurosurgical training programs in the country.

Dr. Laura Teague
2019-06-13

Laura Teague - Surgical Closure of Pelvic Pressure Ulcers in Spinal Cord Injured Adults: Case Identification, Costs, Health Care Utilization and Risk Factors for Surgical Complications
2019-06-13 12:00 - 13:00 | Lyndhurst Center – Lecture Rooms A & B, 520 Sutherland Drive, Toronto, Ontario, M4G3V9, Canada
Abstract
Pressure ulcers, also known as pressure injuries (PI), are a common and serious complication of spinal cord injury (SCI). Impaired wound healing in SCI patients contributes to the progression of these ulcers to more severe stages, which are increasingly more difficult to manage. Best practice guidelines suggest that surgical reconstruction with a flap is an option for chronic stage IV PIs that have failed to heal with more conservative measures. However, little is known about the epidemiology of surgically reconstructed PIs in SCI patients. Despite efforts to select suitable patients for this procedure, the rate of surgical wound complications remains high and the cost of management is extensive. Accordingly, it is important to establish a systematic approach for identifying SCI patients with surgically reconstructed PIs to facilitate the study of predictors of sustained wound closure, quantify the cost of surgical reconstruction, and evaluate the efficiency of treatment and recovery options.
To address gaps in the literature, this study aimed to achieve four objectives: (1) To estimate the hospital costs of surgical reconstruction of stage IV PIs in SCI patients and characterize the relationship of demographics, socioeconomic status and lifestyle factors to cost at discharge from SMH, (2) To determine a standardized method of identifying cases of surgically reconstructed PIs in SCI patients from large databases, (3) To identify and validate risk factors for complications of surgical reconstructed stage IV PIs in SCI patients at discharge from SMH wound care follow-up and (4) to identify long term cost and health care utilization of persons with SCI who have undergone surgical flap closure at SMH in the ICES database.
About the Speaker
Laura Teague is has started working in her new role as Nurse-Practitioner-Clinical and Academic Lead for wound care at the Sinai Health System in Toronto, Ontario.
From 1987 to 2016, Laura worked in various clinical and leadership positions as a registered nurse, clinical nurse specialist and nurse practitioner – wound care at a teaching hospital in downtown Toronto. She lead and grew an interdisciplinary team to address wound prevention and treatment at this hospital. In the role of clinical nurse specialist and nurse practitioner, Laura lead annual hospital point prevalence studies for pressure injuries for 13 years. Results from these studies leveraged changes in practice, education, products, supply chain and devices to mitigate avoidable and unavoidable injury.
Laura’ passion for quality improvement and development of standards of practice has been driven through her experience in the wound prevention and treatment field. She has been directly involved with development of best practice guidelines through the RNAO. Laura has provided continuous leadership through development of the Ontario Woundcare Interest Group as the founding president and membership on the executive. Through this interest group, she lead 3 health technology assessment applications and one Ontario Drug Benefit review application. Laura also successfully negotiated an educational clinical institute focused on best practices in wound prevention and treatment with the RNAO, which is in its 11thyear.
Laura is currently completing her thesis in the PhD program at McMaster University, Faculty of Health Sciences, School of Nursing. Her thesis work involves a cohort study of spinal cord injured persons who have undergone surgical closure for pressure ulcers. This study is funded by the Ontario Neuro-trauma Foundation.

Dr. Olinda Habib Perez - Falls and Balance Control after Spinal Cord Injury
2019-09-12 12:00 - 13:00 | Lyndhurst Center – Lecture Rooms A & B, 520 Sutherland Drive, Toronto, Ontario, M4G3V9, Canada
Abstract
Dr. Olinda Habib Perez will be presenting the initial findings of a 2-year prospective study that examines the causes and consequences of falls in individuals with subacute spinal cord injury. She will also present findings on the balance control of individuals with chronic spinal cord injury.
Biography
Dr. Olinda Habib Perez completed her B.Sc. in Kinesiology at the University of Ottawa and is a Registered Kinesiologist. She continued her M.Sc. at the University of Ottawa, which examined the adaptation of infant bouncers in different jolly jumper environments. Olinda joined the SCI-Mobility Lab in late 2017 as a Post-Doctoral Fellow after completing her PhD from the University of Toronto. Her doctoral work focused on understanding inter-limb coordination in balance control and how this was altered in individuals with traumatic brain injury. She has been leading a study that investigates the causes and consequences of falls across the continuum of care in individuals with subacute spinal cord injury, and has examined the balance control in individuals with chronic spinal cord injury.

Chip Rowan - VIP4SCI: Pilot testing a web-based platform created for individuals with spinal cord injury living in the community.
2019-10-10 12:00 - 13:00 | Lyndhurst Center – Lecture Rooms A & B, 520 Sutherland Drive, Toronto, Ontario, M4G3V9, Canada
Abstract
Individuals living with chronic spinal cord injury (SCI) often face challenges accessing timely and effective health services and the economic burden associated with SCI has led to exploration of non-traditional avenues to meet the complex health needs of individuals with SCI. This trend inspired the creation of the Virtual Integration Platform for SCI (VIP4SCI), a web-based tool, developed in partnership with, Spinal Cord Injury Ontario (SCIO), ForaHealthyMe Inc. (FAHM), and the Mobility Clinic. This presentation will highlight the findings and lessons learned from the design, deployment, and evaluation of the VIP4SCI platform. Considerable attention will be given to the usability and satisfaction of the platform among VIP4SCI clients and SCIO staff users plus its potential for economic / organizational impact.
About the Speaker
Chip is passionate about health and education. After undergraduate work in Lifesciences and Phys Ed at Queen’s University, his initial graduate work at York University focused on physically demanding occupations (firefighting, police, corrections), persons with chronic disease, and elite athletes. His doctoral work at York focused on the detection of prediabetes and physical activity intervention delivery with the goal of improving various physiological outcomes.
Chip previously worked at Lyndhurst as Team Leader of the Fitness Centre and became involved with various research initiatives under the supervision of Dr. Cathy Craven before returning in his role as a Postdoctoral Fellow. Chip is committed to promoting health and enhancing the quality of care for persons living with SCI through innovative and applied research.

Dr. Andrea Bandini - Measuring Hand Use In The Home After Spinal Cord Injury (SCI) Using Egocentric Videos
2019-11-14 12:00 - 13:00 | Lyndhurst Center – Lecture Rooms A & B, 520 Sutherland Drive, Toronto, Ontario, M4G3V9, Canada
Abstract
The functional use of the upper limbs is one of the top recovery priorities of individuals with cervical spinal cord injury (cSCI). Wearable cameras and computer vision methods have recently emerged as technological solutions to extract objective outcome measures that reflect hand function in a natural context, overcoming the limitations of accelerometer-based devices. However, previous studies conducted in a highly controlled environment may not be indicative of the actual hand use of individuals with cSCI living in the community. Thus, the validation of this technology in a home environment is necessary. This presentation will focus on the first results obtained in an uncontrolled environment, where participants with cSCI recorded videos at home during their normal daily activities. Moreover, particular attention will be given to the pitfalls of using this technology at home.
About the Speaker
Dr. Bandini received his PhD in Bioengineering from the University of Bologna (Italy) in 2016. He has been a postdoctoral research fellow at KITE @ University Health Network since September 2016, working with the Communication and NET teams. His research aims to develop novel and objective tools for the assessment and rehabilitation of motor signs associated with neurological disorders (spinal cord injury, stroke, amyotrophic lateral sclerosis, and Parkinson’s disease), by using computer vision and machine learning techniques. In the last three years, he has been awarded two postdoctoral grants (Heart and Stroke Foundation – Canadian Partnership for Stroke Recovery and Age Well NCE) for his research on video-based face tracking in patients post-stroke.

Dr. Sara Guilcher, Lauren Cadel and Amanda Everall - How can we improve medication management for persons with spinal cord injury/ dysfunction?
2019-12-12 12:00 - 13:00 | Lyndhurst Center – Lecture Rooms A & B, 520 Sutherland Drive, Toronto, Ontario, M4G3V9, Canada
Abstract
Persons with spinal cord injury and dysfunction (SCI/D) often experience multimorbidity and secondary complications. Pharmacological treatments are often used to manage these conditions and complications. Funded by the Craig H. Neilsen Foundation, we used mixed methods to better understand medication management for persons with spinal cord injury and dysfunction (SCI/D). Using administrative health data, we described the prevalence and risk factors associated with polypharmacy and opioid use for persons with traumatic spinal cord injuries and non-traumatic spinal cord dysfunction. Using qualitative semi-structured interviews, we explored the experiences of healthcare and service providers and persons with SCI/D with medication (self-) management. We will discuss the findings and implications for research, practice/everyday life, and policy.
About the Speakers

Dr. Sara Guilcher is an Assistant Professor at the Leslie Dan Faculty of Pharmacy, and cross-appointed with the Rehabilitation Sciences Institute (RSI), University of Toronto. Dr. Guilcher is also an Adjunct Scientist at the Institute for Clinical Evaluative Sciences, and an Affiliate Scientist at the Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael’s Hospital. As a physical therapist and clinical epidemiologist, Dr. Guilcher’s research vision is to improve health service delivery and quality of care across the continuum, specifically for marginalized populations with complex health and social needs. Dr. Guilcher holds a Canadian Institutes of Health Research (CIHR) Embedded Clinician Salary Award working with Health Quality Ontario to optimize transitions of care among persons with complex needs.
Often using multi-methods (e.g., administrative health claims, qualitative methods, survey research), Dr. Guilcher’s research relates to clinical/social epidemiology, health equity, disability and multimorbidity.

Lauren Cadel (MSc) is a Research Coordinator at the Leslie Dan Faculty of Pharmacy and a Research Associate at the Institute for Better Health at Trillium Health Partners. In 2019, Lauren completed her Masters in Pharmaceutical Sciences at the University of Toronto under the supervision of Dr. Sara Guilcher. Her thesis focused on exploring the attitudes, beliefs and experiences of persons with spinal cord injury/ dysfunction pertaining to the management of prescribed and unprescribed medications.

Amanda Everall (MSc) is a Research Coordinator at the Leslie Dan Faculty of Pharmacy. She completed her Masters in Pharmaceutical Sciences at the University of Toronto in 2018. Her thesis research used a multi-case study approach to describe the community pharmacy enablers (structures and processes) that supported best practice adherence-focused medication review services. Her research resulted in the development of a conceptual definition
