Repetitive-use tendinopathy is a major cause of repetitive strain injury (RSI). An estimated one-third of workers’ compensation costs in industry are due to RSI of soft tissues, particularly tendons. In order to establish new treatments for RSI, Dr. Alex Scott established an innovative tendinopathy research program, funded through a MSFHR Scholar award from 2011 to 2019. His lab discovered that injured tendon tissue loses its toughness compared to healthy tendons. The lab then developed a new exercise program which uses real time biofeedback to achieve the key goal of regaining tendon toughness. This project will develop a home-based version of this exercise (see workplan for picture of prototype).
Our goal is to bring this new exercise intervention out of the lab and into the real world. The specific objective of this project is to engage in a collaborative co-design process with clinicians and patients to optimize our working model of the biofeedback exercise system and associated user interface (phone or tablet app). By engaging with patients and clinicians, as well as insurers and regulatory agencies, we believe that the end-product will better suit real-world needs and will be suitable for testing in a future efficacy study.
Team members: Chris Napier (Sports Physiotherapy Canada); Kohle Merry (UBC); Jackie Whittaker (UBC); Rob Morgan (Independent Contractor); Carol Kennedy (Treloar Physiotherapy Clinic); Megan MacPherson (UBC); Bilal Al Momani (Internet of Things Lab, Mohawk College); Brad Wheeler (UBC); Pierre Guy (Vancouver Coastal Health); Dianne Millette (College of Physical Therapists of BC); Maya Butterfield (RA/QA Consulting); Joan Weir (Canadian Life and Health Insurance Association)
Regular physical activity is known to produce significant physical and mental health benefits, yet only 15% of Canadian adults meet the recommended guidelines. Running is one of the most popular leisure-time physical activities and is effective even in low doses. However, runners sustain a high rate of musculoskeletal injury, with up to 50% suffering an injury annually. Many injuries are due to abnormal running form. The emergence of wearable technology has presented an opportunity not only to collect information on running form outside of a research lab setting, but also remotely. This project aims to develop and evaluate an innovative remote gait assessment system using wearable technology that will allow clinicians to measure, monitor, and reassess patients with gait impairments remotely. This tool has the potential for physiotherapists to assess running injuries clinically in a way that currently is only possible in research settings. The development of a clinical assessment tool to objectively measure running gait outside of a lab is an exciting opportunity especially as COVID-19 is reshaping the way health care is delivered and increasing telehealth options for clinicians to work remotely.
- Matt Herman
BC Ministry of Health
A large proportion of Canadians are approaching older age. Those older than 65 will comprise more than 30 percent of Canada’s population by 2050. An increasing number of older adults are unable to sustain their health and are negatively affected by chronic disease, social isolation or mobility issues.
Despite the inextricable link between physical activity and chronic disease prevention, older adults are the least active Canadians. Thus, strategies that effectively enhance physical activity are key for preserving older adults’ health and independence.
In partnership with the BC Ministry of Health, the team developed an effective health promotion intervention for older adults called Choose to Move (CTM) that was scaled-up across BC. In CTM, older adults work with an activity coach to choose physical activities they like and are able to do. The scale-up study demonstrated that CTM increased older adults’ physical activity, mobility and social connectedness.
For this project, the team will focus on a part of implementation science called the “scale-out” which is defined as an extension of “scale-up”; it refers to the use of strategies to implement an evidence-based intervention to new populations and/or through new delivery systems. Simply speaking, the team will adapt CTM so that it can be implemented by different community organizations (delivery partners) in 16 rural and remote communities across BC, as well as with older adults of low income in Vancouver. With delivery partners, the team will monitor changes that enable a “best fit” for CTM in older adults who live in different communities across BC. The team is guided by the Framework for Successful Implementation.
The project’s specific research objectives are to:
- Describe implementation strategies that support CTM at scale-out.
- Describe how CTM is adapted for scale-out.
- Assess the impact of CTM on older adults’ physical activity, mobility, social connectedness and loneliness.
The guideline document that will be created through this project will be able to be used to direct processes, strategies and evaluation of health promotion initiatives for other programs and practices within public health and health services sectors.
- Matt Herman
BC Ministry of Health
In Canada, there are more older adults than children, and the proportion of seniors is projected to exceed 30% by the year 2050. Despite the inextricable link between physical activity and chronic disease prevention, older adults are the least active Canadians. Thus, strategies that effectively enhance physical activity are key for preserving older adults’ health and independence.
In partnership with BC Ministry of Health, the Choose to Move (CTM) program was designed and implemented. CTM is an evidence-based, scalable upstream solution that effectively enhances older adult physical activity and mobility and reduces social isolation.
Two delivery partners were engaged who had the experience and reach to deliver CTM in primarily urban centres across BC. Together we implemented CTM in urban centres, but there is a dearth of literature about how best to effectively scale out health promotion strategies outside of urban centres.
The aim of this project is to evaluate ‘scale out’ of CTM adapted for rural, remote and small urban communities across BC. This work will build upon lessons learned in CTM and engage an array of community organizations to assist in creating an implementation strategy and action plan.
The overall research objectives are to:
- Describe adaptation, and factors that promote or inhibit scale out of CTM.
- Describe contextual factors that influence implementation of CTM at scale out sites.
- Create a general guideline document that supports effective implementation of upstream health initiatives in remote and rural settings.
- Assess the health impact of the CTM program adapted for rural, remote and small urban settings.
Our target rural, remote and small urban communities are those who were in receipt of Choose to Move community grants (2018-2020), from the tiny, rural Village of Granisle near Smithers, to transport-limited older adults on Hornby and Denman Islands and marginalized elders from Mission’s Seabird Island Band.