Rehabilitation Engineering Laboratory

Dr. Arash Arami - Personalized Assistive Robotics: Modelling Human Neuromechanics For Personalization
2019-05-09 12:00 - 13:00 (America/New_York) | 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 | Ontario

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

Dr. Cathy Craven, KITE-UHN
2020-01-09 12:00 - 13:00 | Ontario
Abstract
1. This presentation will address common myths related to bone health after spinal cord injury
2. The 2019 ISCD position statements on SCI and bone density testing will be reviewed and the implications for clinical and research practice discussed in detail.
About the Speakers
Dr. Cathy Craven is the Toronto Rehabilitation Institute/ University of Toronto Chair in Spinal Cord Injury SCI Rehabilitation. She is an Associate Professor in the Division of Physical Medicine and Rehabilitation, Department of Medicine with cross appointments in the Institutes of Health Policy Management and Evaluation and Rehabilitation Sciences at the University of Toronto. Dr. Craven is a Senior Scientist and Team Leader of the Neural Engineering and Therapeutics Research Team at KITE and Medical Director of the Spinal Cord Injury Rehabilitation Program at University Health Network. Dr. Craven leads the field with her clinical and research expertise in the prevention and management of osteoporosis and health service innovation for individuals living with spinal cord injury. Dr. Craven has published over 200 articles on related topics.
(http://www.ncbi.nlm.nih.gov/pubmed?cmd=PureSearch&term=Craven%20BC%20%5Bauthor%5D)

Dr. Cathy Craven - A Review of Bone Health Myths
2020-01-09 12:00 - 13:00 | Lyndhurst Center – Lecture Rooms A & B, 520 Sutherland Drive, Toronto, Ontario, M4G3V9, Canada
Abstract

This presentation will address common myths related to bone health after spinal cord injury
The 2019 ISCD position statements on SCI and bone density testing will be reviewed and the implications for clinical and research practice discussed in detail.

Biography
Dr. Cathy Craven is the Toronto Rehabilitation Institute/ University of Toronto Chair in Spinal Cord Injury SCI Rehabilitation. She is an Associate Professor in the Division of Physical Medicine and Rehabilitation, Department of Medicine with cross appointments in the Institutes of Health Policy Management and Evaluation and Rehabilitation Sciences at the University of Toronto. Dr. Craven is a Senior Scientist and Team Leader of the Neural Engineering and Therapeutics Research Team at KITE and Medical Director of the Spinal Cord Injury Rehabilitation Program at University Health Network. Dr. Craven leads the field with her clinical and research expertise in the prevention and management of osteoporosis and health service innovation for individuals living with spinal cord injury. Dr. Craven has published over 200 articles on related topics.
(http://www.ncbi.nlm.nih.gov/pubmed?cmd=PureSearch&term=Craven%20BC%20%5Bauthor%5D)

Dr. Andrea Bandini : Measuring Hand Use In The Home After Spinal Cord Injury (SCI) Using Egocentric Videos
2020-02-13 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.
Biography
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. Jane Hsieh, Dr. Cathy Craven and Louise Brisbois: The Challenges and Opportunities of Recruitment in Rehabilitation Research
2020-03-12 12:00 - 13:00 | Toronto Rehab University Center – Basement Lecture Theatre, 550 University Avenue, Toronto, Ontario, M5G2A2, Canada
Abstract
Objectives:
1. To highlight common challenges associated with clinical trial recruitment in general, and with interventions for people with spinal cord injury (SCI), specifically.
2. To provide an overview of the recruitment processes currently in use within the Toronto Rehabilitation Institute (TRI) and the international Spinal Cord Injury Trial Toolkit (SCITT).
3. To reflect on how this discussion might influence recruitment procedures in your research setting using case based discussions
About the Speakers

Jane Hsieh, M.Sc. has over 30 years in spinal cord injury (SCI) research through affiliations in academia, industry, and non-profit organizations. Her current role as Executive Director of the Accelerated Translational Program of Wings for Life includes managing a portfolio requiring up to date knowledge of SCI clinical trials from both scientific and operational perspectives. Involvement in large multi-centre drug trials in chronic SCI and many smaller but highly complex multi-centre trials in acute, chronic, drug, device, and biologic therapeutics has afforded Jane extensive experience in all aspects and types of clinical trials. This experience provides informed participation in Spinal Cord Outcomes Partnership Endeavor (SCOPE), Spinal Cord Injury Trials Toolkit (SCITT) and Spinal Trials Understanding Design and Implementation (STUDI).

Dr. Cathy Craven is the Toronto Rehabilitation Institute/ University of Toronto Chair in Spinal Cord Injury SCI Rehabilitation. She is an Associate Professor in the Division of Physical Medicine and Rehabilitation, Department of Medicine with cross appointments in the Institutes of Health Policy Management and Evaluation and Rehabilitation Sciences at the University of Toronto. Dr. Craven is a Senior Scientist and Team Leader of the Neural Engineering and Therapeutics Research Team at KITE and Medical Director of the Spinal Cord Injury Rehabilitation Program at University Health Network. Dr. Craven leads the field with her clinical and research expertise in the prevention and management of osteoporosis and health service innovation for individuals living with spinal cord injury. Dr. Craven has published over 200 articles on related topics. (http://www.ncbi.nlm.nih.gov/pubmed? cmd=PureSearch&term=Craven%20BC%20%5Bauthor%5D)

Louise Brisbois has been working in the area of rehabilitation research and spinal cord injury for 10 years. Prior to that her background was in both pharmaceutical marketing to consumers, and bioethics. At TRI her focus has been on delivering an innovative program called Centralized Recruitment along with Dr. Craven. This program enables patients to engage with research in a voluntary and equitable manner, and enables researchers to identify and recruit patients to become participants in research. This research matching service began at TRI Lyndhurst Centre with spinal cord injured patients, and she led the implementation across all TRI inpatient clinics to all researchers. She is also the site coordinator for the Rick Hansen Spinal Cord Injury Registry at TRI –Lyndhurst, the largest site contributing to this national database about traumatic SCI. Outside of TRI, she is an active board member of the Veritas REB (12 years) and prior to that a member of the Sick Kids Hospital REB for 10 years, as well as a member of the CIHR Research Integrity Committee for 4 years.

Dr. Hardeep Singh - Hitting A Moving Target: Understanding The Complexities Of Falls And Fall Prevention After Spinal Cord Injury
2020-06-11 12:00 - 13:00 | Ontario
Biography
Hardeep Singh is a Post-doctoral Fellow at the Lunenfeld-Tanenbaum Research Institute-Sinai Health System and The Institute for Better Health-Trillium Health Partner and an occupational therapist by training. Hardeep recently completed her PhD in the SCI Mobility Lab at the Lyndhurst Centre under the supervision of Dr. Kristin Musselman. In her PhD research, she examined the causes and psychosocial consequences of falls and fall prevention among wheelchair users with spinal cord injury.
Zoom Information
Join Zoom Meeting
https://us02web.zoom.us/j/84586475198?pwd=[REDACTED]
Meeting ID: 845 8647 5198
Password: [REDACTED]
One tap mobile
+16473744685,,84586475198#,,1#,706925# Canada
+16475580588,,84586475198#,,1#,706925# Canada

Dial by your location
+1 647 374 4685 Canada
+1 647 558 0588 Canada

Jane Hsieh - The Challenges and Opportunities of Recruitment in Rehabilitation Research
2020-09-24 12:00 - 13:00 | Ontario
Biography
Jane Hsieh, M.Sc. has over 30 years in spinal cord injury (SCI) research through affiliations in academia, industry, and non-profit organizations. Her current role as Executive Director of the Accelerated Translational Program of Wings for Life includes managing a portfolio requiring up to date knowledge of SCI clinical trials from both scientific and operational perspectives. Involvement in large multi-centre drug trials in chronic SCI and many smaller but highly complex multi-centre trials in acute, chronic, drug, device, and biologic therapeutics has afforded Jane extensive experience in all aspects and types of clinical trials. This experience provides informed participation in Spinal Cord Outcomes Partnership Endeavor (SCOPE), Spinal Cord Injury Trials Toolkit (SCITT) and Spinal Trials Understanding Design and Implementation (STUDI).
Abstract
Objectives:
1. To highlight common challenges associated with clinical trial recruitment in general, and with interventions for people with spinal cord injury (SCI), specifically.
2. To provide an overview of the recruitment processes currently in use within the Toronto Rehabilitation Institute (TRI) and the international Spinal Cord Injury Trial Toolkit (SCITT).
3. To reflect on how this discussion might influence recruitment procedures in your research setting using case based discussions
Zoom Details
You are invited to a Zoom meeting.
When: Sep 24, 2020 12:00 PM Eastern Time (US and Canada)
Register in advance for this meeting:
https://us02web.zoom.us/meeting/register/tZ0vcOGrqjgtHt2itNcHQr1edAMt4HI07CE0
After registering, you will receive a confirmation email containing information about joining the meeting.
