Rehabilitation Engineering Laboratory

Matheus Joner Wiest - Traditional electrical stimulation is so 1700s: meet interleaved stimulation
2018-11-08 12:00 - 13:00 (America/New_York) | 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.

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.

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.

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.

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.

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.

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.

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.

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.

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. 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.

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. 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. 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. 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. 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. 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. Cesar Marquez-Chin - Brain-Machine Interfaces at the Toronto Rehabilitation Institute.
2016-12-08 12:00 - 13:00 | 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. Kristin Musselman & Dr. Alison Oates
2016-11-10 12:00 - 13:00 | Lyndhurst Center – Lecture Rooms A & B, 520 Sutherland Drive, Toronto, Ontario, M4G3V9, Canada
Falls After Spinal Cord Injury: Causes, Consequences And Creative Solutions.
Abstract
Each year about 75% of community-dwelling individuals with incomplete spinal cord injury (SCI) will fall; this is a higher fall incidence than that seen in other neurological conditions, such as Parkinson’s disease. Falling can have many adverse consequences, such as injury, hospital admission, reduced mobility and participation in daily activities, to name a few. Despite the high risk of falling, little is known about the causes and consequences of falls, or how fall risk can be reduced, in the SCI population. Drs. Oates and Musselman will discuss their joint work that aims to address these gaps in our knowledge and result in more effective fall prevention strategies for the SCI population.
Speaker Information
Dr. Kristin Musselman
Kristin Musselman, PT PhD, is a Scientist with the Neural Engineering and Therapeutics Team at TRI-UHN, an Assistant Professor in the Dept. of Physical Therapy at the University of Toronto, and an Adjunct Professor in the School of Physical Therapy at the University of Saskatchewan. Her research is focused on the rehabilitation for adults and children with neurological conditions, including methods of training gait, balance and upper limb function.
Dr. Alison Oates
Alison Oates PhD is an Assistant Professor in the College of Kinesiology at the University of Saskatchewan. Her research focuses on sensorimotor integration during walking and walking balance in populations with instability. Alison will discuss collaborative research with Dr. Musselman investigating reactive and proactive balance during walking in individuals with incomplete SCI. She will also highlight the Biomechanics of Balance And Movement (BBAM) Lab of which she is a co-director.

Dr. Angelo All - A novel biomedical approach for rehab post-SCI.
2016-11-02 12:00 - 13:00 | Lyndhurst Center – Lecture Rooms A & B, 520 Sutherland Drive, Toronto, Ontario, M4G3V9, Canada
Abstract
We have investigated the properties of a novel UpConverting Nanoparticles (UCNPs) that are able to emit visible light by stimulating them with LED based Near Infra-Red (NIR) system. These UCNPs could upconvert within the biological window of 740nm, which reduces heat and toxicity to cells, and activate the light-sensitive ion channels known as Channelrhodopsin (ChRs) in transfected neuropathways deep in the CNS. These semi-invasive techniques can be used for Rehabilitation post-Spinal Cord Injury and for Deep Brain Stimulation.
Speaker Information
Angelo ALL, M.D., MBA, is an Assistant Professor at the Departments of Biomedical Engineering and Neurology, Johns Hopkins School of Medicine. He also holds a position as an Assistant Professor at the Departments of Orthopedic Surgery and Biomedical Engineering, National University of Singapore. Dr. All is the Research Director of the Spinal Cord Injury, Repair and Regeneration Research Laboratory.

Dr. Kara K Patterson - I’ve got rhythm, I’ve got music, who could ask for anything more?
2016-09-13 12:00 - 13:00 | Lyndhurst Center – Lecture Rooms A & B, 520 Sutherland Drive, Toronto, Ontario, M4G3V9, Canada
Abstract
Walking, balance and mobility are almost invariably affected by neurological conditions. Gait and balance impairments have a profound impact on an individual’s ability to perform activities of daily living and consequently, quality of life and improvement of gait function is a commonly stated goal by individuals undergoing neurologic rehabilitation. Improvements in gait, mobility and balance are made with neurological rehabilitation. However, despite these gains, balance and gait remain significantly impaired compared to healthy or neurotypical adults. New therapeutic approaches and interventions for balance, mobility and gait are needed. The use of rhythmic cues during gait training and dance instruction are emerging interventions that may address this need. In this talk I will discuss 1) the potential link between rhythmic abilities (e.g. perception and production) and the rhythmicity of gait and 2) the use of dance for the rehabilitation of gait in neurological populations. Although the primary focus of my research is stroke, I will discuss potential applications in other patient populations such as spinal cord injury and multiple sclerosis.
About the SPeaker
Dr. Patterson is an Assistant Professor in the Department of Physical Therapy at the University of Toronto and a Scientist with Toronto Rehab. She received her physiotherapy training from Queen’s University and practiced clinically in Canada and the United States before returning to Canada to pursue graduate studies. She received her MSc and PhD in Rehabilitation Science from UofT and completed postdoctoral training at McGill. The overall goal of Dr. Patterson’s research program (which takes place in the RELEARN lab) is to advance neurorehabilitation practice to improve balance and mobility outcomes for people living with neurological conditions. She is currently investigating the process of motor re-learning after stroke, the link between rhythm perception and gait and the use of dance to improve walking and balance post-stroke. Her work is funded by CIHR, the Heart and Stroke Foundation and the Physiotherapy Foundation of Canada.

Dr. Michael Willand - Using electrical stimulation to enhance functional recovery following peripheral nerve injury
2016-09-08 12:00 - 13:00 | Lyndhurst Center – Lecture Rooms A & B, 520 Sutherland Drive, Toronto, Ontario, M4G3V9, Canada
Abstract
Recovery following peripheral nerve injuries is often incomplete. Injured nerves regenerate at a rate of approximately 1mm/day, but the longer they are without a functional connection the more diminished their capacity to regenerate becomes. In traumatic injuries, the gold standard treatment is surgical nerve repair performed immediately or shortly after injury. To date, there are no additional treatments that are used to enhance functional recovery. In this talk I will outline ongoing experiments investigating a clinically translatable daily electrical muscle stimulation paradigm in rats following nerve injury. I will also discuss a treatment of brief electrical nerve stimulation performed at the time of nerve repair that is used to accelerate nerve outgrowth across the injury site. Taken together, these two therapies may form a synergistic front used to enhance recovery following peripheral nerve injuries.
About the Speaker
Dr. Michael Willand is currently a post-doctoral research fellow in the Department of Plastic Surgery at the Hospital for Sick Children in Toronto. Mike previously completed MASc and PhD degrees in biomedical engineering at McMaster University in Hamilton, Ontario. He specialized in the design and development of novel electrical stimulators and investigated combining surgical modalities with electrical muscle stimulation to enhance functional recovery following peripheral nerve injury. His current work focuses on examining how different paradigms of electrical muscle stimulation affect reinnervation following nerve injury and repair. He is also investigating the role that electrical stimulation has in synkinetic reinnervation and the molecular basis for enhancement of reinnervation following chronic muscle stimulation.

Trunk impairment and how to improve sitting balance after spinal cord injury
2016-09-01 08:00 - 17:00 | Lyndhurst Center – Lecture Rooms A & B, 520 Sutherland Drive, Toronto, Ontario, M4G3V9, Canada
Abstract
Spinal cord injury (SCI) could result in paralysis of the trunk and lower limb muscles which can significantly impair trunk stability and sitting balance. However, very little is known about the complex neuromuscular coordination of the trunk muscles and the effects of SCI. Currently, chest straps and trunk braces are used to stabilize the trunk and correct sitting after SCI. In addition to these passive devices, functional electrical stimulation (FES) could be used to artificially contract trunk muscles and regulate sitting balance. In this talk, I will present: (1) what we know about trunk muscle coordination; (2) how SCI affects trunk muscle coordination during sitting; and (3) how we can use FES to improve sitting balance. Understanding trunk muscle impairment in combination with the use of FES can provide important implications for optimizing sitting balance rehabilitation.
Biography
Matija Milosevic is an NSERC Postdoctoral Research Fellow at the University of Tokyo in Japan. Prior to moving to Tokyo, Matija completed his PhD in biomedical engineering at the Institute of Biomaterials and Biomedical Engineering, University of Toronto and the Rehabilitation Engineering Laboratory, Toronto Rehabilitation Institute-UHN. His main research was related to postural control and neuromuscular modelling of sitting and standing balance, and use of functional electrical stimulation. Matija’s current research is focused on exploring neurophysiology and neuroplasticity during motor control tasks as a way to enhance the function of individuals with neurological and physical impairments as well as to maximize the performance of athletes. Matija’s research expertise includes biomechanics, biomedical instrumentation, neurophysiology, neuroprostheses, modeling, signal processing and rehabilitation.
