Welcome to the Spring 2009 newsletter for the School of Rehabilitation Science (SRS) at McMaster University.

With the warmer spring weather, things begin anew but remain part of a larger continuous cycle. The SRS community’s recent efforts certainly epitomize this sequence. Our faculty and students have been particularly energized and industrious in their endeavours. Their ongoing work continues to reflect the spirit of the SRS.

We are dynamic
Our students continue to move forward and thrive. We have several upcoming SRS- and community-based events, including the 2009 alumni day on June 13 th.

We are focused
SRS faculty and research students have again received an impressive number of awards and research grants.

We are progressive
We will be collaborating with the DeGroote School of Business on a new Master's program in Health Management.

We are committed to helping others
Volunteers are needed for current research studies that will:

• help injured and disabled children gain better balance and mobility through active video games;
• assess the benefits of community-based education and exercise for people with chronic diseases;
• compare different methods to help stroke survivors regain their ability to walk;
• identify the critical factors that keep senior drivers safe, and
• tracking the effect of knowledge translation strategies in musculoskeletal practice

We are reflecting on both interim accomplishments and long-term goals as we count down to our 20 th anniversary.

Rain or shine, we hope to see you before summer. A great way to connect is the 14 th Annual Helen Saarinen Fun Run on June 13 th. Please help us honour Helen's memory as we raise money in her name for the Canadian Cancer Society.

Remember to stay connected and share your recent activities (including photos) with us.

As always, we welcome your feedback and stories – please send them to lruss@mcmaster.ca.

Remember to stay connected and share your recent activities with us.

With warm regards,

Mary Law, Associate Dean, School of Rehabilitation Science

UPCOMING EVENTS

Advancing OT in Mental Health: Positioning for the Future
Friday May 8, 2009
Hamilton, Ontario

The one-day OSOT Forum will focus on OT practice and innovation in Ontario's current mental health system and how OTs can best position themselves in the future. Internationally recognized researcher and advocate, Terry Krupa, Ph.D., M.Ed., B.Sc (OT), will give the keynote address on what occupational therapy can contribute to the mental health field.  Fifteen presentations and poster presentations that share "Innovations in Practice" will round out a stimulating morning.  Updates regarding key policy initiatives such as the province's mental health system review and strategy development, the work of the Mental Health Commission of Canada, and the developing regulation of psychotherapy will lend insight to opportunities and challenges in the mental health system of the future.

For more information, visit the forum website by clicking here

2009 OT Preceptor Workshop
Wednesday June 17, 2009

Click here for Preceptor Workshop Invitation

14th Annual Helen Saarinen Fun Run
Saturday, June 13, 2009: 10:00am – 1:00pm
Institute for Applied Health Science, McMaster University, Hamilton

On March 30, 1996 Helen Saarinen, the founding chair of McMaster's physiotherapy program, lost her courageous battle with cancer and the physiotherapy profession lost one of their strongest leaders.  Though many of the current physiotherapy students at McMaster University never had the privilege of knowing her, we have all benefited from her visionary work and will continue to do so as professionals.

The annual Helen Saarinen Fun Run, a 5 or 10 kilometer run/walk around McMaster Campus and the Royal Botanical Garden Trails, was created to honour her memory and raise money to raise funds for the Canadian Cancer Society.

Start Time: 10:00am
Start Location: IAHS Building
Registration Fee: $20
Registration: June 8-12, 2009 from 12-1 in IAHS lobby or the day of run before 9:45am 

For more information and to register, go to: < http://helensaarinenfunrun.com/ >

Alumni Day: 2009 Class Reunions
Saturday, June 13, 2009, 12:00pm – 2:00pm
Institute for Applied Health Science, McMaster University, Hamilton

This year, the OT and PT classes of 1994, 1999, and 2004, will celebrate their respective 15-, 10-, and 5-year reunions.  To register, please contact the Alumni Office either by email at alumni@mcmaster.ca or by phone at 905-525-9140, ext. 23900 or toll free at 1-888-217-6003.

11th Annual Helen Saarinen Lectureship
Tuesday, October 6, 2009 - 4:00 pm
Ewart Angus Centre, Room 1A6
Reception to follow

The Helen Saarinen Lectureship was established as a memorial to an outstanding colleague who was dedicated to the advancement of rehabilitation practitioners in general and physiotherapists in particular.

Helen devoted her professional life to the development of caring and capable clinicians in Canada and around the world. With the Mohawk-McMaster Program, and more recently the School of Rehabilitation Science, her leadership, knowledge and compassion served as a paradigm for two generations of students. Through this lectureship, current clinicians and future generations of rehabilitation professionals continue to benefit from Helen's devotion to her work.

The Helen Saarinen Lectureship Committee is pleased to announce that Julie Hard is the 2009 Helen Saarinen Lecturer

Julie Hard works at the Canadian Working Group on HIV and Rehabilitation providing clinical education to help support rehabilitation for people living with HIV.  She also continues to work as a physiotherapist at St. Michael's Hospital.  Currently, she is Chair of the International Health Division of the Canadian Physiotherapy Association.

She is also involved with the Kenya Working Group, a volunteer group within the International Centre for Disability and Rehabilitation at the University of Toronto to coordinate volunteer rehabilitation professionals and students to go to Kenya and provide services within resource-poor settings.”

An exhibit by photographer Michael Willekes will be in the Ewart Angus foyer with photos of the people, places, animals and landscapes that make the African continent such a unique place to visit. Also included are photos of disability and rehabilitation in Kenya. The photos were taken during a six-month trip by the Kenya Working Group in 2006.

More information on this year's lecture will be included in the next SRS newsletter.

STUDENTS

Healing Hands: Pair Open Advanced Physiotherapy Clinic

Back in 2001, Greater Sudburians Trina Tessaro Kolar and Tania Burton graduated together with physiotherapy degrees from McMaster University in Hamilton. After seven years of working for different private physiotherapy clinics in the Nickel Capital, the two women are back together under one roof.

In September, Tessaro Kolar and Burton, both 34, opened the Pro Physio Rehabilitation Centre in south Sudbury.

"We have gained some valuable experience, which was fantastic. But for both of us, it's been a professional goal of ours to be able to do this -- provide a unique way for physiotherapy," said Tessaro Kolar.

Both women have also taken courses to earn diplomas in the field of manual and manipulative therapy, adding another dimension to their practice. "Manual therapy is our specialty," said Burton. "It's the core of what a physiotherapist should be: hands on."

"Tania and I are very big on manual therapy," added Tessaro Kolar. "We believe in evaluation and treatment. We are familiar with many techniques. We both do acupuncture and core training."

Manual therapy, said Burton, involves going beyond an injury site. "It can be assessing the movability of a bone/joint," she explained. "Usually, it speeds up the recovery. It's more than passive treatment. When you assess a joint, you also look at the rest of the arm or leg, how that joint moves, how the muscles are doing."

"It's not simple," added Tessaro Kolar. "The more information we can get, the more we have to offer somebody." She also mentioned that as she and Burton have a wealth of experience in the local physiotherapy field, many of their patients simply moved over with them when they opened Pro Physiotherapy. The current patient roster includes people with spinal cord injuries, brain injuries and people recovering from motor vehicle accidents, "If they are happy with the service hey receive, they will follow you," When we started out here, the clients followed us."

Modest in nature, the new centre has five treatment rooms and a small training area featuring a stationary bike, a BOSU training unit for stability and balance work, a functional training machine and a treadmill. The two women said that if business takes off, they may add another physiotherapist and possibly a massage therapist.

No matter how busy the clinic gets, the focus will always be owners dealing directly with the clients, said Tessaro Kolar. “We take our time with people," "There's not a lot of wait time in our centre. If someone is in for 9 a. m., we have them to 9:30 a. m. We don't want 100 people waiting in different treatment rooms."

"What this has essentially done for us is allow the time for us to ensure our patients get the quality care they need. We enjoy that. The professional satisfaction at the end of they day. We have helped people to a good outcome."

--- Excerpt from Sudbury Star article (Dec. 13, 2008)

A Ray of Light in a Faltering Economy

Not even a year ago, I found myself nearing the end of my schooling and wondering what the world held for me. Graduating from school and embarking on a new career, a new life is both an exciting and scary time!

Before studying at McMaster, I had an undergraduate and graduate degree from the University of Guelph. I had been working in healthcare for 3 years before deciding that I wanted something more. Physiotherapy is a profession that offers so much variety and opportunity. At the start of the program, I knew there would be a world of possibility waiting for me at the other end. One of the benefits of the physiotherapy program is the clinical placements, which divide up the academic terms.

Placements are a tremendous opportunity to discover your area of interest, to meet potential employers and to get your foot in the door. This is how I wound up with my dream job at Hamilton General Hospital in the Intensive Care Unit. After spending 6 weeks there for my winter placement, I learned of a position opening up in the ICU. With the support of my then preceptor and other physiotherapists at the General, I applied, interviewed and got the job! Many of my classmates were in similar positions applying for jobs at clinics where they had completed placements. Many of us knew where we were going to be working before we even finished school.

I feel fortunate to have landed a job before I graduated and to have entered the working world moments before the devastating economic downturn. Initially, it appeared that health professions like physiotherapy would not be affected. Healthcare has always been thought of as the safe port in the storm when it comes to job prospects and protection against a faltering economy. But as we continue in this state, it is evident that no one, in any profession, anywhere in the world feels safe. Hospitals and private clinics alike are starting to feel the crunch of the time and while we are likely safer than some other professions, we are by no means immune.

Amidst this doom and gloom, however, being a physiotherapist is a ray of light. Unlike any other profession that I am aware of, the array of options available to therapists are virtually limitless. Clinical practice offers work in hospitals to clinics to nursing homes, schools and businesses. Teaching, researching and consulting are just a few of the other opportunities available. You can go anywhere in the world with this profession. With so many discrete facets, if one door closes, three or four others will open. With that in mind, in these unprecedented times, I feel comfortable that being a physiotherapist, I will be able to weather the storm. We are truly fortunate, so for those of you about to enter the profession, you should do so with confidence, optimism and enthusiasm!

--- Author Julie Reid graduated from the PT Master's program in September 2008.

Three Hours north of Thunder Bay:
My Northwestern Ontario Placement Experience

My choice to attend McMaster, (beyond the superb occupational therapy program), was because of the Northwestern Ontario Stream opportunity. To maximize my chances of obtaining this northern post I applied to do the program during what I thought would be the coldest weather, which I perceived to be a deterrent to my fellow classmates. In addition to my delight in being accepted into NOSM for term 2 (March-April 2009), I soon learned that one of my fellow classmates was also heading to the exact same preceptor, which meant I would not be alone in my travels into the great white North. So many fascinating learning opportunities presented themselves within and outside the hospital walls, making my stay enlightening and rewarding.

We arrived in the middle of the night and it had been several hours since we last saw any signs of the city life, which could only mean one thing: we were in the middle of nowhere. Geraldton, Ontario is three hours north of Thunder Bay and one hour south of Nakina, which is where the roads literally end. Geraldton was a booming town until a few years ago when the closure of mines and the decline in the forestry industry drastically reduced the population.

Lucky for us, we had our placements at the Geraldton District Hospital (GDH), which was merely steps away from our front door, so commuting was no longer an issue. For those who do commute rush hour in Geraldton meant that there was more than one car on the road.

The hospital provided varied learning experiences some of which were unique to the area such as Tele-health, working with travelling health care professionals, and working with First Nations people. Tele-health is used in Geraldton for consultation with specialists as well as conference calls between health care professionals because of the remote geographical location. Tele-health is a glimpse into the future of medical accessibility, because it can provide services to those who are physically unable to make it into a central location based on varying environmental barriers. One challenge of working in the great white north is the lack of health care professionals. Currently, GDH survives by having “traveling” health care professionals come into town for short-term stays, which is great but it does complicate client follow up when the physician has left town. One of the greatest learning experiences was hearing and seeing the impact that residential schools have had on the First Nations people. It is inspiring to witness how they are still trying to move on and live in harmony once again.

I signed up for the Northwestern Ontario Stream so that I could experience life in the great white north and so we fully embraced the culture of the community after 4pm when the hospital hours finished. After work, we ventured out into the wilderness where we discovered many forms of entertainment such as snow shoeing, cross-country skiing, ice fishing, bonfires and tracking (following the paw prints of animals into the woods). The cold weekends brought many together for socialization whether it was a curling match, hockey game, local charity dance, or even a meat draw. Beyond a doubt, Geraldton captured my heart and my experiences there will never be forgotten.

--- Author Cynthia Rutters is a first year Student Occupational Therapist

SRS NEWS

SRS-DeGroote Collaboration for New Masters Program

The School of Rehabilitation Science and the DeGroote School of Business have partnered to develop a new MSc in Health Management.

The proposed MSc (Health Management) degree is intended to provide regulated health professionals with a combination of core management skills (accounting, finance, marketing, human resource management) and a broad understanding of the Canadian health care policy development and service delivery environments (health system design, health policy analysis, and evidence based decision-making). Students will gain the knowledge, skills and abilities necessary to excel as a middle or senior manager within both the public and private spheres of Canada's health care sector. The program will be of particular interest to regulated health professionals wishing to gain the skills and credential that will facilitate their advancement within the non-profit health care system (hospitals, long-term care facilities) or for those health professionals who are currently working, or plan to work, in the for-profit health care system either in private practice or as part of a larger corporate entity.

The degree MSc. Health Management would consist of 8 half credits (5 core courses, 1 elective, and a 2 credit scholarly paper).

The program is scheduled to launch in the Fall of 2009, pending OCGS approval.

For more information, please contact:

Salina Jaffer
Program Administrator
School of Rehabilitation Science
jaffers@mcmaster.ca
905.525.9140 x 27801

MacHANd 2008 Report

The MacHANd Group was established in 2007 as a partnership and collaboration between the School of Rehabilitation Science and the Department of Surgery at McMaster University.  MacHANd's interest in hand and upper limb related injuries, diseases, disorders, and conditions brings together a multi-disciplinary team of clinicians and researchers with expertise in hand and upper limb research and clinical service.  MacHANd is co-directed by Drs. Carolyn Levis (Plastic Surgery) and Joy MacDermid (Rehabilitation Science).

2008 has been marked with many successes for MacHANd. Education highlights include our interdisciplinary Grand Rounds and our first Faculty of Health Sciences PIPER Grant, as well as an oversubscribed and sold-out attendance for our first continuing professional health education event, “MacHANd Day of Evaluation and Management of Disorders of the Upper Extremity”, held on November 5, 2008.  The research of the group continues to build momentum with the commencement of multiple funded projects.

For more information on the MacHANd Group, please see the website at: < http://www.machand.ca/ >

SRS Pilot Project to Prepare Internationally Trained OT Students

The School of Rehabilitation Science received $519,000 from the Government of Ontario to create a pilot project aimed at supporting internationally educated occupational therapists preparing for their Canadian certification exam.

The first iteration of the Occupational Therapy Examination Preparation Program (OTepp) ran this fall, before the national certification exam. A second session, running from April to June, will coordinate with the July exam.

“There are people living in this country who can do the work, but they can't get the credential,” said Sue Baptiste, a professor at the School of Rehabilitation Science and principal investigator for the project.

The goal of OTepp is to help bridge that gap.

Baptiste and Mary Law, associate dean of the School of Rehabilitation Science, developed an informal program to support internationally trained occupational therapists about a decade ago. OTepp is the first formal offering of that initiative.

Baptiste said her research shows that occupational therapists who train abroad are more likely to pass their Canadian exams when they are supported and mentored.

Thirty-four people enrolled in the fall session of OTepp with many of those students participating from elsewhere in Ontario or overseas, Baptiste said.

“I'm expecting that on an annual basis we're looking at about 60 to 70 people taking it,” she said.

Her hope is partnerships can be formed with other rehabilitation schools across the country to further enhance the accessibility of the program. Currently, the University of British Columbia and the regulatory college for occupational therapy in that province are working with the OTepp investigative team to become the first distance site with funding from the B.C. government. The program is currently offered through traditional and distance education courses. The pilot runs until October 2009.

--- Reprinted from McMaster Network, Fall 2008

RECENT AWARDS

Mary Forhan received the 2008 COTF Goldwin Howland scholarship for her doctoral research on is the impact of class III obesity on participation in the occupations of everyday living.

Joy MacDermid  became president of the American Society of Hand Therapists in January 2009. She is the first Canadian to hold this position.

Pat Miller is a recipient of the 2008 Silver Quill Award for Knowledge Transfer from the Canadian Physiotherapy Association for her article “Self-Assessment: The Disconnect between Research and Rhetoric,” published in Physiotherapy Canada last year. This article arose from one of the papers in her PhD comprehensive examination. This award is one of three given each year to recognize excellence in scientific writing in the three categories: qualitative and quantitative research, knowledge transfer, and student research.  The award will be presented at the Canadian Physiotherapy Association's 2009 Congress in Edmonton in May. 

Sandra Moll received the 2008 COTF Thelma Cardwell scholarship for her doctoral research on Workplace Mental Health.

Kelly O'Brien, a physiotherapist who is currently a post-doctoral fellow at the School of Rehabilitation Science was one of the two inaugural recipients of the Michael G. DeGroote Post-Doctoral Fellowship Award for her research on the disability experienced by adults living with HIV/AIDS.

Jodie Steele (1997 PT Alumni) is a recipient of the 2009 McMaster Alumni Associate (MAA) Arch Awards for her work in developing a non-profit program for people with cancer. The awards are presented to recent graduates for success in career endeavours and notable contributions to society.

Linda Woodhouse and Paul Stratford were members of the research team that won the People's Choice Award for Best Poster Display " in the Category: Rehabilitation Research at the Patient, Provider, Organizational, System or Policy Levels at the Sixth Annual GTA Rehab Network 2009 Best Practices Day on April 9th in Toronto.  

Their research project entitled:  " Assessing the Home Environment (The ‘At Home' Study) In Patients Undergoing Hip And Knee Replacement" i nvolved the development and evaluation of a self-report questionnaire for use to determine whether the home environment and support systems are adequate to safely discharge these patients home. The ` At Home ` study compared the accuracy of the patient self-report questionnaire to the findings during a preoperative in-home visit by a therapist.  Overall, there was moderate to substantial agreement (Kappa 0.41-0.73) between the patient and therapist regarding support for activities of daily living. However, patients' and therapists' responses to questions about concerns expressed differed in over 30% of the cases. Agreement was only fair to moderate for key functional abilities such as the ability to lift and carry 10 lbs (mean+95% Confidence Interval: 0.23+0.38) or walk 400 meters (0.58+0.32), and 12% of the patients had below normal clock drawing scores (cognitive function).  Preliminary findings suggest that a self-report questionnaire alone may not be sufficient to determine safety of the home environment for patients undergoing total hip or knee replacement surgery.

Kilroy, C, Woodhouse L, Nguyen C, Dickson P, Rivington-Law b, Ritcey S, Stratford P.  This work represents a collaboration between Sunnybrook's Holland Orthopaedic and Arthritic Centre, Closing the Gap Community Rehabilitation Services and the School of Rehabilitation Sciences at McMaster University.

RECENT RESEARCH GRANTS

SRS Faculty Receive CIHR Grant for Distal Radius study (2009)
Principal investigators Joy MacDermid and Ruby Grewald, along with co-investigators, Norma McIntyre and Julie Richardson, have received a one-year CIHR grant to study the “ Identification of Risk of Adverse Activity Transition Following a Distal Radius Fracture.”

Abstract: Distal radius (wrist) fractures (DRF) are common and thought to be inconsequential, but can cause significant disability. We see DRF as a signal event where some people are at-risk of transitioning from an active lifestyle to inactivity and subsequent health risks. This study will establish the reliability/validity/variability of bone quality, mobility, and activity measures in patients 50-80 years of age under active treatment for a DRF and determine the relative importance of baseline physical impairments, activity level, social support and personal/injury factors on loss of activity/participations after a DRF. Research design: Prospective cohort (embedded reliability study at 0 and 6 months). Subjects: 195 patients aged 50-80 years of age who have incurred a wrist fracture (no previous history of humeral, hip or vertebral fracture). Reliability retest sample= 50. Follow-up: baseline fracture clinic visit, 2, 3, 6, 12 months following fracture. Potential Predictors: Bone densitometry, lower extremity strength, 6-minute walk, pre-injury activity level, balance, self-efficacy, fear avoidance, wrist pain, comorbidity, social support. Outcomes: Primary: Change in Activity/Participation at 6 months; Secondary: Patient-rated-wrist evaluation (fracture outcome), Changes in Balance, 6-minute walk, Comorbidity, Strength. Controls over bias: use of independent assessor, standardized measures and follow-up intervals, use of inception cohort, multiple procedures to reduce loss to follow-up. Analysis: We will establish inter-occasion reliability using ICCs and SEM; quantitative changes in outcome measures using repeated measures ANOVA and use multiple linear stepwise regression to identify predictors of loss of activity and participation following DRF. This work will help launch a large cohort study and research program on helping older adults successful resume a healthy lifestyle following DRF. 

MacHANd Interprofessional Evidence-based Clinical Education Grant (2009)
Principal investigators Joy MacDermid and Carolyn Levis, received a one-year PIPER grant to conduct a four-component  interprofessional program for trainees specializing in anaesthesia, orthopaedic surgery, physical medicine and rehabilitation, plastic surgery, radiology, sports medicine, occupational therapy, physical therapy, kinesiologists, and nursing.  The main components of this program are: 1) interdisciplinary Grand Rounds; 2) a joint annual education symposium; 3) interdisciplinary clinical experiences; and 4) interdisciplinary clinical research projects.  Grand Rounds are held three times a year and led by different interdisciplinary teams who have content knowledge on the topic.  Each Grand Round will discuss the content, timing, and effectiveness of approaches by different disciplines.  The annual educational symposium will include lectures and panel discussions where different disciplines discuss their perspective on how roles/collaboration would affect management of cases.  Interdisciplinary clinical experiences will be provided by MacHANd members who will accept trainees from a different discipline into their clinical environment.  MacHANd members will also co-supervise clinical and graduate trainees who will work together with students and mentors from different disciplines to define their clinical question and a research methodology that would address this issue.  The MacHANd interprofessional program will be evaluated through: number of trainees and disciplines attending the events; number of interdisciplinary research projects initiated/completed; number of interdisciplinary clinical experiences arranged; survey feedback; and focus groups with trainees and MacHANd mentors.

STUDIES IN PROGRESS

Where there's a Wii, there's a Way
Video Games can help Kids in Therapy: Researcher

How can Wii help?

A McMaster University researcher believes it's possible that injured and disabled children can play their way to better balance and mobility by using popular electronic gaming systems for physiotherapy.

In what many kids would consider a dream laboratory, Danielle Levac is hard at work measuring the therapeutic value of active video games.

Levac, a children's physiotherapist and PhD candidate in rehabilitation science, believes game systems such as Nintendo's Wii (pronounced "wee") and Wii Fit, and Sony's Eye Toy, hold tremendous potential for helping children. She is starting to test how well they can work.

She hopes gaming could get kids more engaged in their therapy, and believes that the right blend of movement-based games could offer effective treatment at a reasonable cost.

"Sometimes therapy can be a little bit boring," she said. "This is fun, it's motivating and it also gets kids moving."

The games that hold the greatest potential for physiotherapy seem to be the ones that require the most movement, such as boxing, baseball and tennis, plus the balancing games of Wii Fit, Levac said.

She is lining up healthy volunteers ages 7 to 12 to play in her lab for an hour, while she gets baseline readings on how they balance and move while playing active virtual-reality games.

Each volunteer plays while standing on a floor plate and wearing a sensor on the waist to measure shifts in weight and centre of gravity.

So far, Levac said, she has had plenty of kids who are already Wii experts, but she is short on volunteers who are not familiar with Wii and similar gaming systems.

Interested in volunteering?

Researcher Danielle Levac is looking for healthy children ages 7 to 12, particularly those with no experience playing Wii and similar games, for one-hour testing sessions at McMaster in May and early June.

Contact: levacde@mcmaster.ca or call 905-525-9140 ext. 21458.

---- Reprinted from the Hamilton Spectator (Apr 15, 2009)

Dual Study on Community-Based Education and Exercise

Linda Woodhouse has partnered with Hamilton Health Sciences (HHS) and the YMCA to evaluate the effectiveness of offering community-based educational and exercise programs for patients suffering from chronic diseases. Both the Total Bone and Joint Health program and the Canwell pilot project received grant funding from the Ministry of Health and Long Term Care as part of the Health Force Ontario initiative.

The Total Bone and Joint Health is 10 weeks of education and an individualized exercise program designed for patients awaiting total hip or knee joint replacement surgery. Results demonstrated a high level of satisfaction (91% rated their overall satisfaction with the program as 5/5), excellent compliance (average attendance of 2.4 hours/week), and a surprisingly high rate of retention (79% continued their YMCA membership beyond the program! Participants recommended that this program be expanded to other YMCA locations (i.e. beyond Flamborough) so that participants would not have to travel so far (some travelled up to 40 km to participate). This program has been expanded to the new Les Charter YMCA that opened a few weeks ago on the Mountain here in Hamilton.

For more information or to register, contact Linda Woodhouse at (905) 525-9140 x. 22597 or woodhou@mcmaster.ca.

The CanWell pilot project was developed by Linda Woodhouse in partnership with the YMCA, HHS and the Juravinski Cancer Centre. The purpose of this research work is to promote optimal physical wellness for well survivors of cancer through the creation of an evidence-based, innovative, self-sustaining, client-centered, community exercise and education program. We have developed a 12 week supervised exercise and education program, have trained the YMCA personnel who will help to deliver the program and have just started to recruit participants for this study as of April 1, 2009.

For more information or to register for either program, contact Linda Woodhouse at (905) 525-9140 x. 22597 or woodhou@mcmaster.ca.

Gearing up for an Aging Population:
Study to address the Critical Factors that Keep Seniors Driving Safely
Dr. Brenda Vrkljan, an Occupational Therapist and Assistant Professor in the School of Rehabilitation Science will be collaborating with older drivers in Hamilton to identify components, such as vision, muscle strength, judgement, and reaction time; all key ingredients for safe driving. The research is important given that one of every 5 driers will be aged 65 and older by 2026. Statistics indicate seniors have more collisions per kilometre driven and are at the highest risk for injury and fatality if involved in a collision.

As one of eight national sites, 125 Hamilton drivers, aged 70 and older will be assessed annually on these components. Researchers will then track accidents or infractions as well as reasons why participants stop driving. As well, another sub-project will involve identifying key vehicle features, including technology, that will help seniors identify vehicles that are a good fit with their driving needs.

"It will be like a living experiment," said Vrkljan, who will lead the research as part of the Canadian Driving Research Initiative for Vehicular Safety in the Elderly (CanDRIVE) team that is funded by the Canadian Institutes for Health Research.

The project is set to launch in the spring of 2009.

If you would like to participate or know of an individual (aged 70 and older) who would like to take part in this exciting, proactive initiative - please call 1-866-233-1133 for more information.

For more information specific to aging and driving:

• www.candrive.ca
• www.caa.ca/agingdrivers/tips

Rehabilitation Study Aims to Improve Recovery of Walking in Stroke Survivors

A group of researchers from McMaster University and St. Joseph's Healthcare Hamilton are leading a research study to compare two novel approaches to retrain walking after a stroke. This study has received funding through the Government of Ontario's Ontario Stroke System.

As a result of a stroke, people may experience balance problems, weakness on one side of their body, dizziness, fatigue, and vision problems. Difficulty walking is one of the most common and disabling effects reported by individuals with a history of stroke. While some people recover the ability to walk in their own homes, many have long-term difficulty walking outdoors and in the community. Through the use of more effective walking training techniques, physiotherapists may help stroke survivors make greater improvements in their mobility and their self-confidence, allowing them to return to the everyday activities they enjoyed before having a stroke.

There is growing evidence that under the right conditions, the brain has the ability to reorganize itself after an injury like a stroke. This ‘brain plasticity' creates an important opportunity for therapists to help stroke survivors regain as much function as possible. “It is well documented that physiotherapy helps individuals improve their ability to walk after a stroke,” says Vince DePaul, Physiotherapist, graduate student, and Principal Investigator on this project. “While we know therapy is helpful, we still do not know the specific ingredients of the most effective therapy approach. The results of this study will ultimately aid physiotherapists in providing the best treatment for their clients and patients in the community.”

Participants in the study will receive one of two different therapy programs: the Motor Learning Walking Program or Body Weight Supported Treadmill Training. In the Motor Learning Walking Program, participants practice numerous and varied overground “real life” walking activities. In this therapy, tasks are chosen, and feedback is provided in a manner that optimally engages the participant in the learning process. In Body Weight Supported Treadmill Training, participants practice walking on a treadmill while receiving support through a specialized overhead harness system. Through the use of over head support as well as liberal physical guidance from the physiotherapist, this intervention focuses on providing participants the experience of high repetitions of near ‘perfect' walking. Both programs include fifteen one hour sessions provided by specially trained physiotherapists. The results from the study will help identify the most effective rehabilitation treatment for people who have walking problems after a stroke.

Vince DePaul, an alumnus of the Mohawk-McMaster Physiotherapy program (1990) has worked at St. Joseph's Healthcare Hamilton as a physiotherapist since 1990. He is currently a full time Ph.D. Student in the Rehabilitation Science program at McMaster. Co-investigators on this study include Dr. Laurie Wishart, Dr. Julie Richardson, Julie Moreland, Dr. Lehana Thabane and Dr. Tim Lee. The investigators are collaborating with therapists, physicians and stroke survivor groups in Hamilton, Halton and Niagara to recruit participants into this unique study.

The investigators are looking for adults, 40 years or older, who have had a stroke within the previous year and who are experiencing any difficulties walking since their stroke. The study is slated to complete by the summer of 2010.

For more information or to enroll in this study, please call Vince at 905-522-1155 ext. 32902 or depaulv@mcmaster.ca.

The Effect and Mediators of Two Knowledge Translation Strategies
Study in “Defining the effect and mediators of two knowledge translation strategies designed to alter knowledge, intent and clinical utilization of rehabilitation outcome measures”

Principal investigator Joy MacDermid, along with co-investigators Mary Law, Patty Solomon, and Paul Stratford, were given a two-year CIHR grant in 2007 to compare the effectiveness and mediators of two different knowledge transfer (KT) interventions in terms of their impact on changing knowledge and behaviour (utilization and clinical reasoning) related to health outcome measures. 

Physical and occupational therapists in musculoskeletal practice were recruited and allocated through minimization to one of two different KT interventions with the same curriculum: 1) Stakeholder-Hosted Interactive Problem-Based Seminar (SHIPS), and 2) Online Problem-Based course (e-PBL). SHIPS consisted of face-to-face problem-based learning (PBL) for 2 1/2 days with outcome measure developers as facilitators, using six problems generated in consultation with participants.

The e-PBL consisted of a 6-week web-based course with six generic problems developed by content experts. Participants were block-allocated by a minimization procedure to either of the two interventions to minimize prognostic differences. Trained evaluators at each site conducted chart audits and chart-stimulated recall. Trained interviewers conduct semi-structured interviews focused on identifying critical elements in KT and implementing practice changes.

Interviews were transcribed verbatim. Baseline predictors measured demographics, knowledge, attitudes/barriers regarding outcome measures, and Readiness to Change assessed by self-report. Immediately post-intervention and 6 months evaluations were performed. SHIPS were conducted in three urban centers in Canada (London, Calgary, Halifax). Preliminary qualitative and quantitative evaluations are completed.  SHIPS and e-PBL sessions will be conducted this fall in Hamilton. 

While this study began in 2007, the investigators are currently looking for local OT and PT clinicians in participate in the Hamilton area later this year. Please contact Margaret Lomotan at lomotam@mcmaster.ca for further information.

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