Research

The UBC Division of Physical Medicine and Rehabilitation is committed to rehabilitation research to improve outcomes for our patients and enhance the professional development of our members.

Members of the Division participate in a variety of national and international collaborative research projects. Members of the Division are supported by funds from national and international sources including: Michael Smith Foundation for Health Research, Heart and Stroke foundation of Canada, Disability Health Research Network, Rick Hansen Foundation and Christopher and Dana Reeve Foundation. Members are affiliated with research organizations that include the Vancouver Coastal Health Research Institute, ICORD, and the UBC Brain Centre.

Major interests

Spinal Cord Injury

Traumatic Brain Injury

Clinical use of BOTOX for focal spasticity

Evaluation of function in persons with disabilities

Fatigue in neurological and neuromuscular disorders

Evidence based treatment

Projects in progress

Acupuncture

Andrei Krassioukov MD, PhD, FRCPC
Professor, Div. Phys .Med. & Rehab.
Scientist, ICORD
Director of Autonomic Research, Dep. of Medicine, University of British Columbia, Vancouver, BC
Adjunct Professor, Dep. Phys. Med. & Rehab., University of Western Ontario, London, ON

ICORD, UBC
6270 University Blv.
Vancouver, BC, Canada, V6T 1Z4
email: krassioukov@icord.org
TEL: 604 822 2673
FAX: 604 822 2924

GF Strong Rehabilitation Centre
4255 Laurel St.
Vancouver, BC, Canada, V5Z 2G9
TEL: 604 714 4113
FAX: 604 737 6359
 

Fatigue in Acute Spinal Cord Injury

Hubert A. Anton, MD, FRPC
Clinical Associate Professor
Department of Medicine
University of British Columbia

Andrea F. Townson, MD, FRCPC
Clinical Associate Professor
Department of Medicine
University of British Columbia

 

CITY WIDE RESEARCH ROUNDS
UBC DIVISION OF PHYSICAL MEDICINE AND REHABILITATION
Research Activities Update
November 9, 2011
 
Dr. Hugh Anton
  • Involved with the PHSI Trauma Project
    • Headed by Dr. David Evans, this project is looking at trauma service delivery in the VCHA unit and NHA.
    • The aim is to improve trauma outcomes in BC and eventually throughout Canada as a whole
    • Hugh is involved with the processes of trauma working group (Dr. Townson is involved with the outcomes working group)
  • Hugh is also involved with a stroke outcomes project using data from the CIHI Rehab database (with Dr. Chris Grant), currently in the process of collecting data.
  • On November 30th, there will be combined city-wide rounds & research rounds- Dr. Susan Charlifue from Craig Hospital will be speak about living with SCI & long-term outcomes.
  • GF Strong Rehabilitation Research Day is coming up on May. 2, 2011
    • The preliminary announcement has been sent out
    • For further information or to be added to the mailing list, please contact Ms. Amber Backwell (amber.backwell@vch.ca)
  • The requirements for Resident research will soon be modified; they may be looking for help from clinical experts
    • Junior residents will be required to complete Case Presentations (consulting with a clinical expert) suitable for peer review & publication
    • Residents will be completing clinical evidence-based reviews of the literature focused on a specific clinical area; clinical experts may need to help them define questions, determine what literature should be reviewed, and perhaps help them review some papers
 
Dr. Ross Davidson
  • Researching the validation of the International Autonomic Standards for evaluating people with SCI
  • The standard neurological classification form does not assess autonomic function
    • A working group created an assessment tool for vascular, bowel, bladder, and sexual function and urodynamics for people with SCI
      • Now looking at validity (content validity) and reliability (inter-rater reliability) of form in chronic SCI population
      • $15 000 received from the BC Rehab Foundation
      • Ethics has been approved; awaiting VCHRI approval
 
Dr. Jaime Guzman
  • Is currently the Principal Investigator  on 3 projects: Worker Consequences of Injury, Accounting for all the Benefits, Measuring what Counts. He is also a co-investigator in the LEAP team grant
  • Also waiting to hear about 2 new potential grants
  • Worker Consequences of Injury: All of the data has been collected, good progress has been made, and a primary analysis will be coming soon
    • Looking at economic and Quality of Life indicators
    • Looking at Quality of Life over time
  • Accounting for all the Benefits: performing an economic analysis of occupational health & safety interventions
    • Lots of data has been collected so far, analysis is just starting
    • Secondary questions regarding the data are needed
    • Creation of 7 principles for economic evaluation
  • Measuring what Counts: looking at using technology (i.e. iPhones) to measure activity around town (looking at physical activity & community participation of children)
    • Recruitment is halfway through
    • iPhone app. has been developed
  • LEAP: looking at children, physical activity and arthritis
    • Study is just starting; recruitment starts in 2012 (looking for 900 children with JIA)
 
Dr. Andrei Krassioukov
  • Has an autonomic research lab at ICORD, doing basic and clinical research
    • $1 523 000.00 is the lab budget at the current time (2011)
  • Lots of projects and grants currently underway at the present time (e.g. from the Heart & Stroke Foundation, Paralyzed Veterans of America, etc.)
    • 10 grant proposals were written this summer; still waiting to hear back from 4
  • Autonomic Dysreflexia (AD) Knowledge Translation Project underway
    • Issue: those not in rehab do not know how to deal with AD and SCI (i.e. emergency room physicians & paramedics)
    • Using a RHI grant, the team looked at knowledge and management of AD with ER physicians and paramedics across Canada
      • Found that 80% of ER physicians had “fair” or “poor” knowledge of how to treat AD in SCI
    • An education module to train doctors & paramedics on AD was created
      • Within 3-6 months, knowledge improved
    • A Paralyzed Veterans of America grant will provide an opportunity to recreate this educational module
    • CIHR Knowledge Translation grant just received to develop a curriculum and website to train paramedics (of BC, ON, and MB) on AD
    • Conclusion is that knowledge/guidelines on AD need to be delivered to colleagues outside of SCI rehabilitation
 
 
Dr. Patricia Lim
  • Is studying Temporal Stability & Sensitivity to Change of the Montreal Cognitive Assessment (MoCA) in Acquired Brain Injury
    • 1st objective: determine the magnitude of MoCA score change on repeat tests that represent statistically significant improvements (using chronic, community-dwelling individuals with ABI)
    • 2nd objective: how responsive is the MoCA to clinically meaningful improvements? (using subacute ABI patients in daily rehab.)
    • Money from BC Rehab Foundation has been awarded for this
    • Ethics has been approved; awaiting VCHRI approval
    • Recruitment will start in November or December
  • Future directions: Symbol Digit Modalities Test; occupational therapy assessments (looking at the Kettle Test)
 
Dr. Noah Silverberg
  • Is active in concussion research
  • Interested in: supervised exercise, cognitive-behavioural therapy, and self-management
  • Early psychological distress & maladaptive illness beliefs are good predictors of concussion outcomes (and they’re modifiable)
    • Looked at patients with these risk factors for poor outcomes; assessments before and after intervention
    • Study has been running for 2.5 years, wrapping up soon; no results yet
  • Also looking at the “nocebo” effect in mild traumatic brain injury
  • Other research on: MoCA, prospective memory rehab., and exercise during rehab
  • Looking at self-management, and if it’s helpful for people with maladaptive coping skills
    • RCT starts on this next month (pilot study)
 
Dr. Andrea Townson
  • Is involved with the Rick Hansen SCI Registry (RHSCIR)
    • Collecting prospective data on traumatic SCI patients
    • There are 31 sites across Canada so far; they finally have enough data to start some analysis
    • Access to Care and Timing (ACT) project stemmed from this
      • Rehab to community pathway model created
      • Comparison of BC’s health system to other health systems across Canada
      • “imaginary” patients run through model, outcomes looked at
  • SCIRE project still ongoing
    • Version 4.0 due out in May
    • Case studies now up (good for medical residents to use for practice)
  • Fatigue & L-carnitine project
    • Subject 1 (of 4) has finished and results look very promising
      • Subject had a significant drop in fatigue upon taking L-carnitine
      • Having difficulty with recruitment
  • Future directions: natural health products & SCI (attitudes, beliefs, usage)
 
 

Cardiovascular Health Clinic for 2010 Paralympic Athletes

Paralympian athletes are exposed to tremendous physical and emotional stress during training and competition, and athletes with spinal cord injury (SCI) have unique disadvantages during competition. One of these disadvantages is unstable blood pressure control. On a daily basis, individuals with SCI deal with either extremely low resting blood pressure, and/or uncontrolled episodes of high blood pressure.  The latter is called autonomic dysreflexia (AD).  Low blood pressure and a poor response from the heart results in significant fatigue and presents a serious problem for athletes during both training and competition. In contrast to low blood pressure, AD is a life-threatening situation whereby individuals with cervical and upper thoracic injuries experience a drastic increase in blood pressure. If left untreated, AD can lead to bleeding in the brain and/or death.

ICORD researcher Dr. Andrei Krassioukov is an expert in AD, and has just received funding from the Craig Neilsen Foundation to bring evidence-based clinical knowledge and crucial practical information on unstable arterial blood pressure control among athletes with SCI to Paralympians and their coaches at Vancouver’s 2010 Winter Paralympic Games.

This project is a collaboration between clinicians and scientists from ICORD, individuals with SCI in the BC Wheelchair Sports Association and former Paralympic athletes.

This project has been approved by the International Paralympic Committee (IPC) and recently received financial support from The Craig H. Neilsen Foundation.


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