Rehab Impact Fall/Winter 2009

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GLOBAL

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ISSUE 23 ยบ VOLUME 11 ยบ FALL/WINTER 09 FACULTY OF REHABILITATION MEDICINE ALUMNI MAGAZINE

REHAB IMPACT is published bi-annually by the University of Alberta Faculty of Rehabilitation Medicine. It’s distributed to over 4,500 rehabilitation alumni in physical therapy, occupational therapy, and speech language pathology, plus universities and friends of the Faculty.

External Relations Faculty of Rehabilitation Medicine 3-48 Corbett Hall University of Alberta Edmonton, Alberta CANADA T6G 2G4 T 780.492.2903 F 780.492.1626 www.rehabmed@ualberta.ca

WHAT’S Inside 4

Project Manager Laurie Wang Faculty of Rehabilitation Medicine T 780.492.9403 laurie.wang @ualberta.ca

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Writing & Editing Phoebe Dey Freelance Writer T 780.905.4242 pdey@shaw.ca Design & Production Helix Design Communications 2001 Inc. Creative Director James Shrimpton T 780.413.1822 james@helixdesigns.com

Contributing Photography University of Alberta, Creative Services Richard Siemens, Michael Holly Michael Brown Angela Libutti Printing Dejong Printing Michael Chesworth T 780.983.7701

CALLING 22

Dean Dr. Martin Ferguson-Pell

Contributing Writers Caitlin Crawshaw, Phoebe Dey, Mifi Purvis and Laurie Wang

UGANDA

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LEADING EDGE

JANA RIEGER

UPDATE ON ERIC PARENT

SELF-MADE

SPECIALIST

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MILITARY

MEDIC

DEAN’S Message

Dr. Martin Ferguson-Pell

Defining rehabilitation This fall we welcomed the occupational therapy, physical therapy and speech language pathology classes of 2012 to the Faculty of Rehabilitation Medicine.

We also welcomed back more than 60 alumni, including the PT class of 1959, at this year’s Open House reunion celebration.

Since 2004, the Faculty has grown by 30 per cent and now comprises 60 professors, 550 graduate students and three departments. In addition to our professional entry programs in PT, OT and SLP, we also offer thesis-based Master’s and PhD programs in Rehabilitation Science.

www.rehabmed.ualberta.ca

Martin Ferguson-Pell, PhD Dean, Faculty of Rehabilitation Medicine

DEAN’S MESSAGE

Our researchers continue to undertake great studies as they look to discover and improve rehabilitative treatments and technologies. Jana Rieger’s passion for better quality of life for patients is evident in her research comparing treatments for dry mouth for people with cancer going through radiation therapy (p. 22). Eric Parent looks at unanswered questions about back pain, a common ailment that 85 per cent of the Canadian population will face over the course of their lives (p. 16).

As the Faculty continues to grow, people look to us for our rehabilitation expertise and services. We are defining rehabilitation to meet the challenges of the changing health-care landscape in Alberta and beyond. As a student, professor, alumni or friend of the Faculty, you are helping to define the future of rehabilitation. I am very proud of our Faculty—and as you read the stories in this magazine, I hope you are too.

FALL/WINTER 09

The class of 1959 was arguably the loudest, most dynamic group at the U of A alumni dinner. Were they ever enthusiastic and full of energy! As they toured various labs and classrooms at Corbett Hall, they couldn’t help but notice how much change has taken place. They are right—from our clinical teaching to our research and rehabilitation service, we have come a long way since we opened our doors back in 1954. We are defining rehabilitation.

We were established initially as a Division of Physiotherapy 55 years ago in response to the large number of young people who contracted polio in the 1950s before the Salk vaccine had been developed. The PT course was then a 20-month diploma and was very intense so that students could graduate quickly to meet the needs of patients with polio.

Later, with the addition of OT and then SLP, we became a school and then in 1976, a freestanding Faculty. We are the only freestanding Faculty of Rehabilitation Medicine in North America.

This places our academic and scholarly accomplishments front and centre of the U of A’s mission and we have a provincewide responsibility for academic leadership and training in the rehabilitation disciplines.

Since 2004, the Faculty has grown by 30 per cent and now comprises 60 professors, 550 graduate students and three departments. In addition to our professional entry programs in PT, OT and SLP, we also offer thesis-based Master’s and PhD programs in Rehabilitation Science. Our facilities over the last two years have expanded considerably, with new research labs, a Student Commons, refurbished faculty offices, laboratories, student work areas throughout Corbett Hall, the newly renovated state-of-the-art speech therapy teaching lab, student clinics and specialist clinics for people of all ages.

For September 2010 we are establishing the Alberta Rural Rehabilitation Academic Hub at the U of A’s Augustana Campus in Camrose. We occupy prime space now in College Plaza with extensive facilities for the Institute for Stuttering Treatment and Research and our new Rehabilitation Medicine Satellite, a new area for one-on-one student-patient training and research.

We also boast impressive alumni, every graduate an ambassador for rehabilitation and improving quality of life for Albertans and beyond. Keith Ross (PT ’94) is one of the head physical therapists for the Canadian Forces at Edmonton Garrison (p. 26). Linda Miller (OT ’89) is a successful OT who runs her own private practice on ergonomics and worksite problems in Edmonton and Calgary (p. 19). Congratulations to Dr. Ann Hayes (PT ’61 and MD ’68) who won this year’s Distinguished Alumni Award for her extensive work in Uganda (p.4) . Margreta Spencer (PT ’59) has been working as a physical therapist in Israel since 1966 and continues to be involved at the Beersheba Hospital though she retired 15 years ago (p. 34). Rhonda Kajner, (SLP ’O2), is spearheading the adult speech communication program in Edmonton, a partnership between the Faculty and Alberta Health Services (p. 14).

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PROUD to Announce

Uganda calling

Ann Hayes

By Phoebe Dey

Former physio receives top university alumni award for her work abroad

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www.rehabmed.ualberta.ca

PROUD TO ANNOUNCE ANN HAYES

FALL/WINTER 09

Dr. Ann Hayes admits she knew “absolutely nothing” about Uganda before her first visit to the African nation in 1984. She had been on a safari vacation to neighbouring Kenya, but that trip did little to prepare her for the three-month stay she was about to undertake as a foreign pediatrician in Uganda’s Mulago Hospital.

“It was medical culture shock,” says Hayes, who was on sabbatical from St. Jude Children’s Research Hospital in Tennessee. “I was working at the ivory tower of pediatric oncology in the United States and had everything at my fingertips. Then I go to a place where getting an x-ray done was a big event.”

Hayes not only fell in love with Uganda but has become revered in parts of the African country for her work with its orphaned and poor girls. Hayes’ everlasting connection to Uganda was cemented when she returned from her second trip with an unexpected gift: an adopted, newborn daughter.

That bond led to the formation of Concern for the Girl Child, a non-governmental organization that increases access to basic needs such as education and health, while promoting the rights of children.

At the beginning Early on, Hayes knew her life would somehow involve medicine and children. In high school in Calgary, she considered a career in nursing but an older friend studying physical therapy couldn’t say enough about the field. So in 1959, she moved into Pembina Hall—and later the Delta Gamma Sorority House—to earn her two-year diploma from the Faculty of Rehabilitation Medicine.

“At that time, I was just looking at getting an education I could use to get a job with,” says Hayes. “I thought medical school was beyond my reach.”

But after a year of working as a physiotherapist at the U of A Hospital, she realized it wasn’t. She started medical school and worked summers as a physiotherapist. “My choice to go to medical school had nothing to do with not enjoying being a physio,” says Hayes. “And it sure made my life easier when I went to med school. The physiology and anatomy courses were the same as the ones I had taken in rehab, so my first year of medical school was a breeze.”

Once she graduated, Hayes became part of the first group of interns at Calgary’s Foothills Hospital. She then moved to Halifax to study pediatrics at Dalhousie University and made one more pediatrics stop in Cincinnati before landing in pediatric hematology/oncology at Memphis’ St. Jude Hospital, where she stayed for 15 years. In 1984, Hayes was a visiting professor in Newfoundland when Drs. Don and Liz Hillman recruited her to go to the Mulago Hospital pediatric program. The Canadian couple was working with the Canadian International Development Agency (CIDA) and had run a similar program in Kenya. As soon as Hayes arrived, she noticed vast differences between the African hospital and what she was used to in the United States.

“It made you hone your clinical assessment skills, rather than calling the lab or ordering an x-ray and getting everything done for you,” says Hayes. “I saw diseases I had never seen before—wards full of children with measles and polio. It was a life-changing experience.”

So much so that the country beckoned her back two years later. In 1986, the AIDS epidemic ravaged Uganda, yet it was one of the most progressive African countries and started education campaigns on the use of condoms, abstinence and monogamy to control the epidemic. Although many outside groups had come in because of AIDS to establish labs and clinics, everyday pediatric care remained the same. “But still, they had a neonatal unit with tiny preemies who survived that might not have survived even in the U.S.,” she says. “There were pockets of expertise. It’s not that the doctors weren’t well trained, but the money just wasn’t available to them to build the kind of health-care facilities that were needed.”

FALL/WINTER 09

PROUD TO ANNOUNCE ANN HAYES

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PROUD to Announce

It was during that trip that Hayes met her daughter. Danielle was an orphan in the pediatric ward and the doctor “took her home for a weekend and kept her forever.”

Except it wasn’t that easy. At the time, Hayes was told that it was not possible for foreigners to foster or adopt Ugandan children. The baby’s social worker, Fred Kasozi, learned more about Hayes and was asked to write a report about the doctor and her motives for the High Court. He recommended the court order be made in favour of Hayes to foster and later adopt the baby, who Hayes named Danielle. “To be candid, Ann’s tears literally dried when the court order was signed and she legally became a foster mother of the baby,” says Kasozi. “I saw a lady full of passion for children who are in need.

“We continued communicating when she returned with the baby to the United States. Almost every month she would send me photographs of the baby. My confidence in her taking care of and according sincere love and affection to the baby grew all the time.”

Danielle, now 23, became the first child to be allowed out of Uganda with a non-Ugandan. Three years later Hayes would also adopt Erica, born in Tennessee.

In 2000, Hayes was coming to the end of a second career in the pharmaceutical industry when she decided she wanted to do something “for this fabulous child I had from Uganda.” Since she kept in touch with Kasozi he suggested doing something for orphaned girls to keep in line with the government’s policy of looking after the children while they are in their own communities. In Uganda, primary school is free but most poor and orphaned girls would not be able to continue onto secondary school once they had to start paying to attend. If any money was available, it usually went to the boys.

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PROUD TO ANNOUNCE ANN HAYES

FALL/WINTER 09

Meeting Danielle

So in January 2001, Concern for the Girl Child (CGC) was born. The program first sponsored 20 girls attending two of the poorest schools near Kumpala. Today, more than 400 girls have been sponsored by CGC. In 2005, three of the first students in the program qualified for university, so CGC decided to continue supporting them in their post-secondary studies at a cost of $1200 a year, including living expenses.

The three women graduated this year, realizing a dream they never thought would come true.

“Efforts that started as a mustard seed grew into a large tree,” says Kasozi. “It all started with the caring of an abandoned baby to assisting hundreds and hundreds of community needy children.” There are success stories of selfreliance and independence and the girls are already helping their families. About 30 girls have formed a CGC Alumni and are reaching out to other beneficiaries who are getting counseling and guidance services. “We are attributing all this to Ann Hayes and her family, whose tireless efforts to advocate and lobby for funds is highly appreciated and recommended.”

Leaving a legacy Hayes’ program is now involved with the four secondary schools that receive CGC students. Besides paying tuition for the girls in the program, CGC has supported the schools by installing bookshelves in libraries, buying desks and textbooks, building teacher’s housing and donating water-harvesting facilities, which means the students no longer have to walk miles each way to collect safe water. CGC also provides social support with health counseling and career counseling in the schools.

“The best part is that aside from me, it is run by Ugandans,” says Hayes. “We have a dedicated group of people who are making sure CGC succeeds in its mission. It has gone beyond my expectations and has been life-altering for the girls we have sponsored. Most thought they would never have the opportunity to go to high school, never mind vocational schools or university.”

Hayes remains the major donor but has support from friends and family doing their part to raise funds. She visits the country once or twice a year and has made sure her daughters are involved with the program with the hope that they will eventually take over. “When I’m gone, I want this relationship to continue and I know my girls will make sure of that,” says Hayes. “Concern for the Girl Child is very dear to my heart and I will spend the rest of my life making sure I establish a strong donor pool to make sure these girls are provided with the basic right of an education. It means so much to me.”

During reunion weekend, Hayes was presented the Distinguished Alumni Award, the U of A Alumni Association’s most prestigious award recognizing graduates whose achievements have earned them national or international prominence. For further information about Concern for the Girl Child visit the web site at www.concernforgirlchild.or.ug

Dr. Ann Hayes with her daughters Erica (L) and Danielle (R) Danielle (third from left) with girls from CGC >>

Ann Hayes

FALL/WINTER 09

PROUD TO ANNUONCE ANN HAYES

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NEW Faces

Please join us in

welcoming

Ming Zhang, Associate Professor, Speech Pathology & Audiology

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www.rehabmed.ualberta.ca

NEW FACES

FALL/WINTER 09

Otolaryngologist Ming Zhang obtained his clinical fellow certificates at the University of Zurich and University of Iowa. To learn the mechanisms of ENT disorders, he obtained his PhD in Iowa using systems measurements. Then he moved onto Northwestern University and the House Ear Institute where he did fellowships in cellular and molecular origins of the systems measures. He has developed graduate courses in cochlear implants, clinical disorders and auditory electrophysiology as a faculty member in an audiology program, chaired the thesis of AuD and PhD students in communication disorders, and developed a cochlear implant program as a director of a brain mapping centre and an ENT faculty member.

Now with the Faculty’s Department of Speech Pathology and Audiology, Zhang’s role is to perform research, teach and supervise student researchers, and help develop the audiology program. As a researcher reporting to the Director, Research and Technology Development, Glenrose Rehabilitation Hospital, his role is to provide the Glenrose Hospital Audiology with his knowledge and perform clinical research.

Laurie Wang, Communications Manager Laurie Wang comes to us from the University of Calgary where she was the Internal Relations Manager for the Faculty of Medicine. As Communications Manager, she will be providing leadership and expertise in communications and media relations activities and initiatives in the Faculty.

“There are so many great things going on in Corbett Hall and it continues beyond these four walls—from research, to teaching, to clinical care. I look forward to getting those stories out there, for more people to know what we’re doing and how we’re impacting the community here in Alberta and worldwide.”

Wang has a BA in English from the University of Alberta and a diploma in Journalism, yet admittedly, she says she doesn’t know another word for “thesaurus.”

Geoff Bostick, Assistant Professor, Physical Therapy Prior to joining the Faculty, Geoff Bostick was a full-time PhD student in the rehabilitation science doctoral program. He began the program in September 2006 and continues to work on his thesis project—examining pain beliefs after whiplash injury—under the supervision of Dr. Douglas Gross and Dr. Linda Carroll. Before arriving at Corbett Hall, he worked in various orthopedic clinics in Saskatoon, Victoria and Edmonton where he developed an interest in manual therapy and completed the Diploma of Advanced Manual and Manipulative Therapy in 2005.

“I am excited to join the Faculty and work with such an accomplished group at Corbett Hall and around campus, including researchers in musculoskeletal spinal pain disorders, one of my areas of interest,” says Bostick, whose role is to continue to develop and coordinate the Corbett Hall student physical therapy clinic. In addition, his teaching responsibilities will be primarily in the orthopedic arm of the program, specifically in manual therapy courses.

His goals include running the student clinic year round to provide opportunities for students to gain authentic learning experiences; implementing ‘cutting edge’ ideas generated from the research group into practice; developing new ways to teach clinical skills and reasoning; and providing high quality rehabilitation to those attending the clinic. “As for teaching, I aim to embrace developing teaching technology to provide an exciting and effective learning environment for our students. I also endeavour to continue to build foundations for a clinical research program in the psychosocial domain of musculoskeletal spinal pain disorders through collaboration with colleagues within Corbett Hall and at the University of Alberta Pain Clinic.”

Outside the walls of Corbett Hall, Bostick has happily embraced ‘daddyhood’ as he and his wife welcomed baby girl Quin to their family in August. When he’s not on baby duty or at work, he enjoys road cycling and likes to camp and hike with his wife on Vancouver Island as much as possible.

NEW FACES www.rehabmed.ualberta.ca

Jacqueline Cummine comes to the Faculty from the University of Saskatchewan where she received her PhD in Psychology in September. An assistant professor in the Department of Speech Pathology and Audiology, Cummine’s area of specialization is basic language processes with particular training in cognitive neuroscience. Specifically, she investigates ways that we can integrate behavioural and functional (fMRI) data, and basic and applied areas of research, to help further our understanding of normal and impaired language processes.

“One of my roles within the department is to launch my program of research, which complements the existing research diversity among the faculty members in addition to providing another facet to the department’s research profile for current and future students to explore,” says Cummine. “In the coming months, I will be working on establishing my laboratory, commencing research projects and hope to get involved in the exciting research that is already taking place at the University of Alberta with collaborations both in the department and across campus.

“I am eager to explore the many opportunities that are available within the Faculty of Rehabilitation Medicine and at the University of Alberta.”

FALL/WINTER 09

Jacqueline Cummine, Assistant Professor, Speech Pathology & Audiology

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NEW Faces

Chris Zarski, Co-ordinator, Augustana; Satellite/Sessional Instructor, Physical Therapy

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www.rehabmed.ualberta.ca

NEW FACES

FALL/WINTER 09

Following graduation from his BSc PT at the U of A in 2003, Chris Zarski worked in private practice in Edmonton and Sherwood Park. During that time, he also completed locum work in long-term care, home care and plastics. In early 2008, the opportunity to develop community-based health and wellness programming along with leadership in the physical therapy profession attracted him to the former East Central Health region. There, he worked as a community health therapist at the multi-disciplinary Healthy Living Centre, and as a professional practice lead.

His first teaching experience with the university came as a sessional instructor in the spring of 2009.

“Originally I was committed to the private practice and orthopedic and sports world of physical therapy, but my newfound passion is in the areas of communitybased physical therapy, health promotion and seniors’ health,” says Zarski.

To meet the growing demand for physical therapists, the Department of Physical Therapy has embarked on a pilot project to establish a satellite Master’s of Science in Physical Therapy (MScPT) program at the Augustana Campus in Camrose, Alberta.

This program will circumvent space issues on the main campus and address the department’s desire to establish a rural presence for physical therapy education.

As the coordinator of this project, Zarski will be responsible for planning, designing and implementing the satellite program at the Augustana Campus. Using the latest communication technologies, lectures will be broadcast to students in Camrose from Corbett Hall and vice versa. Zarski will work as the on-site faculty member in Camrose. He will be the clinical lab instructor and curriculum coordinator and teach courses in aging and health promotion.

“My goals include developing a successful and effective distributed education program in Camrose,” says Zarski. “I also hope to promote clinical applications to the learning process and engrain healthy living and healthy aging principles into the daily practice of future physical therapists.”

Deborah Palmer, Administrative Professional Officer, Physical Therapy Deborah Palmer is a University of Alberta alumna (BA `95, MA `05) who has worked in an administrative/communications capacity in theatre, government and most recently, the Office of External Relations at the University of Alberta. Having spent a number of years within the fundraising portfolio of the university, she is pleased to take on the role of Administrative Professional Officer in the Department of Physical Therapy and now be involved in the dynamics of a teaching and research focused department.

FACULTY AWARDS in Brief

Doug Gross, PhD, has just been awarded a new grant from WorkSafeBC. Gross and his team, including Michele Crites-Battié, PhD, as well as two colleagues from Public Health, will be investigating Return to Work assessment strategies in a project entitled: The Return-to-Work Assessment Study: Evaluating Methods for Evaluating Abilities.

The International Society for the Study of the Lumbar Spine (ISSLS) named Tapio Videman, PhD, as the ISSLS Wiltse Lifetime Achievement Award recipient for his contribution to the advancement of knowledge in the field of spinal disorders. Videman challenged the notion of “wear and tear” and the impact it has on degenerative disease of the lumbar spine. Videman is responsible for the revisionary conceptualization that spinal daily living accounts for most of the influence forces on the pathogenesis of this degenerative disease. “In short, the women and men who have devoted their lives to understanding disorders of the lumbar spine and to treating those who suffer its disorders owe Tapio Videoman a great deal of gratitude,” says Dr. Nortin Hadler, professor of medicine and microbiology/immunology at the University of North Carolina, in his nomination letter. “The awarding of the ISSLS Wiltse distinction is so very deserved but a small token of that gratitude.”

David Bennett’s application to the Canadian Institutes of Health Research (CIHR) was successful in the March competition. Bennett, PhD, and his team have received a five-year operating grant from CIHR entitled, Neuronal mechanisms of muscle spasms after spinal cord injury.

Publication Mail Agreement No. 40064303 Return Undeliverable addresses to the Faculty of Rehabilitation Medicine, 3-48 Corbett Hall, University of Alberta, Edmonton, Alberta T6G 2G4

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Lauren Beaupre, PhD, received the Alberta Heritage Foundation for Medical Research Population Health Investigator Award for her research on hip fractures and rehabilitation programs.

The Faculty of Rehabilitation Medicine Internal Research Grant Competition funded four proposals this year. Iain Muir, MSc, and Doug Gross, PhD, will investigate usage patterns of and beliefs about therapeutic ultrasound among Alberta’s physical therapists.

Margie McNeely, PhD, will launch a pilot study examining the efficacy of compressions systems in the treatment of breast cancer related lymphedema. Eric Parent, PhD, in collaboration with Greg Kawchuk, PhD, will examine measurement methods for spinal stiffness in patients with adolescent idiopathic scoliosis.

Yagesh Bhambhani, also in collaboration with Greg Kawchuk, will investigate the effect of whole body vibration on muscle oxygenation and electromyographic responses during aerobic and anaerobic exercise.

FACULTY AWARDS IN BRIEF

Karim Fouad, PhD, has received a new grant from Wings for Life Spinal Cord Research Foundation in Austria. Fouad’s project is entitled “Multi-component treatment to promote axonal regeneration: rat studies to parallel primate experiments.”

Yagesh Bhambhani

FALL/WINTER 09

The Alberta Centre for Child, Family and Community Research (ACCFCR) has given Cary Brown, PhD, an award to examine health literacy skills in occupational therapists who work with children experiencing pain or sleep disorders.

Martin Ferguson-Pell

Martin Ferguson-Pell, PhD, and his colleagues have just been awarded a CIHR planning and dissemination grant to study the results of a workshop on Bariatric Rehabilitation. Among his colleagues in this endeavour is Yagesh Bhambhani, PhD. Dr. Arya Sharma from the Faculty of Medicine and Dentistry is co-principal investigator and other team members are drawn from the Canadian Obesity Network.

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NEWS in Brief

Presenting

in Paris

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www.rehabmed.ualberta.ca

NEWS IN BRIEF

FALL/WINTER 09

Three PhD students presented their research at the esteemed International Association on Gerontology and Geriatrics (IAGG) conference in Paris this past summer.

Held every four years, the conference hosted teams of experts from around the world who discussed their research and presented new data from recent findings in the fields of aging.

Faculty of Rehabilitation Medicine PhD students Christine Daum, Helen Gough and Natasha Yuill presented at the prestigious event.

Daum presented the findings of a critical review of participatory research with people aged 80 and over. Although a recent review found that older adults are increasingly involved as partners in health research to inform policies and services, she found only eight published papers in the last 13 years that involved people aged 80-plus as active research partners.

Researching with, rather than on, communities is continually promoted, but few studies engage with the oldest population as active partners.

Gough is interested in factors that enhance the post-war adaptation and well-being of aging combat veterans. Previous quantitative studies have indicated the potential of social supports in alleviating some effects of war memories for aging veterans. In this qualitative systematic review Gough found four major supports: comradeship, family, organized veteran associations and community appreciation. She concludes that what is needed is rigorous qualitative research on non-medical, particularly social, supports for veterans.

Yuill presented evidence on the effectiveness of Cognitive Stimulation Therapy (CST), a person-centred group program for optimizing cognitive function through reality orientation and reminiscence therapy. Yuill analyzed the 12 papers that met the inclusion criteria and results confirm that cognitively stimulating programs appear to be effective in optimizing residual cognitive functioning for individuals with mild to moderate dementia and may improve overall quality of life. The strength of evidence suggests that CST and related interventions may provide a useful structural framework on which to build rehabilitation programs for individuals with mild to moderate dementia.

Colombian partnership Founded 350 years ago, Rosario University in Bogota, Colombia, is the oldest and most respected university (the only Colombian university to be recognized by the European Union for its scholarship) in the country.

It has renowned research and teaching programs in many areas, including medicine and law and 30 of the 60 presidents of the country of Colombia have graduated from Rosario.

The rehabilitation programs in OT, PT and SLP there have strong teaching programs, but they have not developed significant research. That’s where the U of A fits in. A Memorandum of Understanding between the Faculty of Rehabilitation Medicine and Rosario will address this issue, calling for Rosario researchers to come to the U of A for PhD study, for students from each institution to have the opportunity to study and learn at the sister institution and for U of A faculty to offer seminars, short courses and other teaching in Colombia or via distance learning. Al Cook, PhD, helped create and develop this partnership. The goal is that joint research programs in rehabilitation will emerge as well. The first two Rosario faculty members, Liliana Alvarez and Adriana Rios, will begin their OT PhD programs in September 2010. They visited for two weeks last summer when Cook and Kim Adams hosted. Alvarez and Rios worked with Dave Magee, PhD, to develop the MOU. Dean Martin Ferguson-Pell will be visiting Colombia in the near future to continue to strengthen our relationship with Rosario.

NEWS in Brief

Olympic student PhD student tops This year’s crop of students is sharing its hallways with an Olympian. Matt Rose, who will finish his studies in physical therapy next fall, swam the 50m backstroke and 50m freestyle at the 2004 Athens Games.

His distinguished swimming career includes World Championships, Commonwealth Games and Pan Pacific Championships.

When Edith Pituskin received an e-mail from the Alberta Cancer Research Institute (ACRI) telling her she won the Graduate Studentship award, her first reaction was disbelief.

NEWS IN BRIEF www.rehabmed.ualberta.ca

“Applications are weighted according to student performance, the proposed project, the supervisor’s support and reference letters,” says the Rehabilitation Medicine PhD student. “It was a great feeling to know I won.” Pituskin will receive $40,000 over two years for her study.

The ACRI award goes to the strongest candidates who have shown support and promotion in the cancer research field. Pituskin’s research will use exercise testing and sensitive imaging modalities (cardiac MRI) to detect the prevalence and extent of early damage to the heart after various cancer treatments.

“One of the major problems associated with cancer treatment is that normal cells are often significantly damaged, along with the cancer cells. Improved knowledge of molecular biology has contributed to the development of ‘targeted’ therapies, so the new cancer drugs only treat the abnormalities seen in cancer cells,” she explains.

“Unfortunately, there are still troublesome side effects observed. A major side effect that can cause long-term disability is damage to the heart or circulatory system.”

Pituskin will be looking at the specific kinds of cardiac damage that occur and the approaches to prevent or minimize damage. She will be studying a medication used for people with kidney cancer to see how much treatmentassociated heart damage the medication may carry.

Pituskin’s supervisor is physical therapy professor Mark Haykowsky, PhD, who she says is an outstanding researcher. “Dr. Haykowsky contributes an excellent laboratory environment, world-class collaborations with multiple disciplines (cardiology, biomedical engineering) and an exceptional publication record.

I have found everyone here in administrative and teaching positions to be extremely helpful with any questions. They are responsive to issues identified by students,” she smiles. “I have also observed that the multiple disciplines within the Faculty offer various viewpoints and strengths to discussions and research approaches.”

FALL/WINTER 09

Before coming to the U of A, Rose studied at Texas A&M University, where he is considered one of the greatest swimmers in school history, holding records in the 100 yard freestyle and is second all-time in the 50m freestyle and 100m backstroke. The Faculty of Rehabilitation Medicine was highly recommended to Rose by physiotherapists he had worked with throughout his swimming career and U of A swim coach Bill Humby’s reputation helped bring Rose to Edmonton. But for now, Rose’s focus is on academics while swimming takes a back seat. He trains with Humby and acts as a mentor in the water to varsity swimmers, and competes for Canada as a member of the national team.

“Having a busy schedule helps me focus on what I need to do instead of getting caught up in too many distractions,” says Rose. “There is still quite a bit of juggling that goes on and you definitely have to prioritize your time but I enjoy it.

“I’m done my program in the fall of 2010 and then I start my life after swimming—my second career, I guess.

Swimming has been my job for years now so it will take some time to transition to a ‘regular job,’ but I think I’ve picked something that I’ll really enjoy in physical therapy.

I’m excited about the future and also very proud of my past accomplishments.”

award competition

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ALUMNI Feature

Client-centred

teaching

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ALUMNI FEATURE RHONDA KAJNER

FALL/WINTER 09

Rhonda Kajner (SLP ’02) cannot say enough about her job. Being able to combine two tasks she is committed to—engaging clients’ participation in the community and enhancing student clinical education—evokes praise from Kajner, who is in a new position to improve adult speech services.

“My work encompasses two things I am passionate about,” says Kajner. “I love seeing success stories after working with clients in their own environment and I love transferring that knowledge to students and seeing them learn.”

Kajner is spearheading a new program in Edmonton, a partnership between the University of Alberta Department of Speech Language Pathology and Alberta Health Services (AHS). Speech-Language Pathology in Integrated Community Living has been running for one year. Its focus is to provide services to clients in three streams: integrated home living; integrated supported living and integrated facility living.

“These were areas that had little or no SLP services in the past,” says Kajner. “We also looked at opportunities to increase clinical student placements since there was a shortage for spots. So far, everything is going really well.”

With a philosophy to improve opportunities for successful communication, Kajner observes how clients participate and communicate in their own environment and tries to increase that interaction. “It is all really client-centred,” she says. “I’ve seen clients in their home setting—whether at a private home or in a continuing care centre—and I take a good look at their environment to see what changes could be made. It might mean looking at someone’s supports so he can go home instead of stay at a facility. Or it might mean increasing participation in groups at a facility. The goals are individualized.”

By Phoebe Dey

On the teaching side of things, Kajner has adopted a collaborative education model established by the Faculty of Rehabilitation Medicine that assigns two students to one clinician educator. As much as the students are benefiting from the placements, Kajner and the clients are learning from the contact as well. “We get to learn from each other,” says Kajner. “It allows me to deliver services in different ways when there are three therapists providing the services.”

Kajner went into her U of A degree with an open mind about where her career would take her, but working with adults always seemed to be the constant. During her studies, she volunteered with Neighbourhood Chat, an adult speech language service, and right after graduation she worked at the Halvar Johnson Centre for Brain Injury in Ponoka. She spent three years there, working with adults with acquired brain injuries. She then moved to the inpatient stroke rehabilitation unit and the feeding and swallowing (dysphagia) team at the Glenrose Rehabilitation Hospital, where she spent another three years. “I loved both of those places,” says Kajner. “I started to gain a real interest in aphasia and team environments and saw some really interesting cases.”

The speech-language pathology position, created through a Health Workforce Action Plan grant and a collaboration between the U of A and Alberta Health Services, was a perfect fit for Kajner. Her supervisor agrees.

“Teaching occurs almost constantly in this role, and Rhonda quickly determines what her audience is ready to learn,” says Erane McManus, manager of communication disorders at Glenrose Rehabilitation Hospital. “She also conveys her messages respectfully and meaningfully, while still accomplishing her goals.

“Rhonda knows that relationship building is extremely important, and her engaging manner puts people from all backgrounds at ease. She effectively communicates the value that she contributes to clients, families and teams. She is an excellent ambassador for speech-language pathology, and I’m so pleased for her success.”

Kajner hopes to see the program develop into other regions. Currently, she and a second SLP who has been added to this project work in the Edmonton area in selected sites.

“A year from now things might look completely different since we’re just getting started,” says Kajner. “But it’s been great so far. I love this job.”

Rhonda Kajner (standing) with two SLP students helping a client. >>

Rhonda Kajner

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ALUMNI FEATURE RHONDA KAJNER

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UPDATE ON ERIC PARENT

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UPDATE On

Scholarly sleuth

Eric Parent

By Caitlin Crawshaw

Eric Parent seeks answers to lingering questions surrounding lower back pain and scoliosis After Eric Parent, PhD, finished his physical therapy undergraduate degree at the Université Laval in Quebec City in the mid-1990s, he secured a position at a private outpatient clinic with the intention of working as a practitioner.

For three years he treated patients with

After earning his PhD in 2005, he completed a postdoctoral fellowship at the University of Utah before returning to Edmonton in January 2008. Now he maintains dual posts as an assistant professor at the U of A Department of Physical Therapy and a clinical scientist at the Glenrose Rehabilitation Hospital. At both institutions, Parent conducts clinical research.

At the moment, Parent has a number of research projects on the go. In one study, Parent is trying to identify the factors that predict how well patients with back pain respond to certain treatments. “We know patients with back pain complain about the same thing, but they’re very different in terms of how they respond to treatment,” he explains.

various musculoskeletal conditions, but while he enjoyed the work, he was struck reasons, physiotherapy treatments didn’t always alleviate back pain for sufferers.

UPDATE ON ERIC PARENT www.rehabmed.ualberta.ca

“I got frustrated with the unanswered questions,” says Parent.

“I wanted to get better at treating back pain and I was frustrated with the research out there.”

So, Parent registered in a master’s program in experimental medicine at Université Laval, in hopes of learning how to gather some answers. However, as a graduate student studying the biomechanics behind the movement of patients with knee replacements, Parent discovered a strong interest and aptitude for research. Rather than work as a clinician, he realized research was a better fit. The experience and his interest for back problems propelled him to the University of Alberta, where he completed a PhD under Michele Crites Battié, PhD, a professor and Canada Research Chair in common spinal disorders.

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by the limitations of the job. For unclear

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UPDATE ON ERIC PARENT

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UPDATE On

While some patients find relief from flexion exercises (those that require bending forward), others respond best to extension (which involves bending backward). The prescription is often based on trial-and-error, but offering incorrect treatment can actually make a patient worse. Parent is in search of key variables that can predict how well a patient will respond to a particular treatment to better care for pain sufferers and help therapists make informed decisions. He is isolating these prediction rules from patients’ medical histories, responses to different exercises, and a number of clinical tests.

So far, Parent has developed a prediction rule to identify patients with a good response to extension exercises. He has found that patients who exhibit four or more of the six identified predictors have an 80 per cent chance of success with extension exercises. The next step will be conducting randomized control trials to see how well the method works.

Iain Muir, a colleague collaborating with Parent on the project, explains that the team is breaking ground. “This is a fairly new area, so it’s not well-established. There are a few groups doing this, but not many.”

As a member of the Edmonton Scoliosis Research Group based out of the Glenrose Rehabilitation Hospital, Parent is also conducting extensive scoliosis research. At the moment, he’s developing a non-invasive way to study changes in the spinal curvature of patients. The method involves projecting laser light on the surface of the skin in order to create a digital surface topography of the patient’s back. “The benefit is that it doesn’t expose patients to x-ray radiation,” Parent explains. This is critical as the patients he sees are between 10 and18 years old and susceptible to damage from x-rays.

Parent’s scoliosis work also involves assessing the functionality of the Scoliosis Research Society-22 and the Scoliosis Quality of Life Index—two tools used to assess the

Eric Parent

health and well-being of people with scoliosis. He’s also about to start a study examining the link between spinal stiffness and the different parts of the scoliosis curve.

Doug Hill, a clinical engineer with the Glenrose Rehabilitation Hospital and assistant professor at the U of A Department of Surgery, has worked with Parent for about three years. Recently, he’s collaborated with Parent on projects assessing the validity of quality of life questionnaires for scoliosis patients.

“He’s very good at developing strong methodology in research studies and critically thinking about what we’re doing and what others have done,” says Hill.

Parent is also very dedicated to the well-being of the people he treats, which is the mandate of the Edmonton Scoliosis Research Group. “We really want to take our research findings into the clinic and make life better for the children.

It’s really applied research. Our focus is on the children at the clinic,” says Hill. “Someone like Eric Parent is very conscious of that.”

So far, Parent has developed a prediction rule to identify patients with a good response to extension exercises. He has found that patients who exhibit four or more of the six identified predictors have an 80 per cent chance of success with extension exercises.

ALUMNI Feature

Linda Miller

Self-made specialist

By Mifi Purvis

Linda Miller recognized early that unique worksite problems call for tailored solutions. So she customized a role for herself.

FALL/WINTER 09

“All our interventions are customized,” she says.

“We design solutions and training programs that help people avoid or address injury in specific circumstances.”

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It accounted for various hazards, such as musculoskeletal injuries suffered by staff moving and treating patients.

“We needed to find out specifically what tasks different staff members, such as nurses and nursing aids, were performing,” Holloway says. “We started with the place with the highest rate of injury: inpatient units.”

ALUMNI FEATURE LINDA MILLER

Occupational therapist Linda Miller graduated from the University of Alberta in 1989, sharing her classmates’ commitment to rehabilitation medicine. “It’s a highly creative field, but it’s still medicine,” Miller says of her profession. “We keep people functioning in their environment.” But, even in the late 1980s, she knew her path would differ from that of her colleagues.

An early professional goal was to start a business. “I always knew I wanted to,” she says. “My family owned a construction company for 42 years.

Being an entrepreneur is normal for me.” In 1991 she launched the company that evolved into EWI Works International Inc. It’s not just the family bent for small business; it’s the family expertise in building that captured Miller. “I definitely played off the construction aspect,” she says. Despite her interest in building— she earned a Master Home Builder’s certificate in 2005 –it has always been practice over product.

EWI Works focuses on programs of prevention, on how to get people back to work, and how to keep individuals or groups working injury-free and productively. If she had started making products to address these challenges, it could have put her in a conflict of interest against the goals of her own company.

Instead, she makes it her business to know about the best rehab med products on the market and to identify how they might benefit her clients in their specific circumstances.

“All our interventions are customized,” she says.

“We design solutions and training programs that help people avoid or address injury in specific circumstances.” For example, she recently worked with a client group, led by Barbara Holloway, occupational health and safety manager of cancer care at Alberta Health Services, to come up with a framework that would include safeguarding the health of employees caring for cancer patients.

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Miller and her team from EWI Works spent time observing the work underway at cancer care in-patient units. The team watched and made notes, and the staff answered anonymous questionnaires about their work. EWI Works built a rapport with the staff and performed an audit of existing equipment, describing how staff used it. Then Miller made her suggestions. “Linda came in with the right background and supporting documents,” says Holloway, “and put forward a concise proposal.” Included in her paperwork were options for costs and recommendations that the organization initiate two committees, one made of an administrative group and one made of frontline workers.

It’s that willingness to go the extra mile that’s getting Miller noticed. Her work is broad-based and cuts

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ALUMNI FEATURE LINDA MILLER

FALL/WINTER 09

across many industries.

Despite the comprehensive nature of Miller’s work, “she didn’t come in like a bull in a China shop,” Holloway says.

“Her report was detailed, offering realistic timelines and components to implementing the package. She went above and beyond our expectations.”

It’s that willingness to go the extra mile that’s getting Miller noticed. Her work is broad-based and cuts across many industries. Another project included redesigning a front counter in a provincial court building that accounted for height of the counter, distance from employees, placement of computer and static front counter space. Each job brings different challenges—hence her focus on customized plans for each client. “Last month, I was in a factory that makes chips.

And recently, I worked in a power plant,” Miller says. “It keeps you on your toes.”

Miller initially received her Master’s Home Builder certificate because she was moving into a specialized field of building with her parents’ company, which constructed seniors’ housing. She felt marrying OT with building would produce better outcomes for seniors to age in place. Her father died suddenly, thwarting those plans, but she says the training is still valuable. Despite not becoming a builder, the certificate demonstrates that she has learned construction fundamentals, building codes and estimating.

Plus, “OTs can sometimes be fanciful when ordering up modifications to existing structures,” says Miller. Her MHB certification gives her an eye to what is practical and not out-of-reach in terms of modification and installation costs.

“And having Master Builder status has really opened my eyes to the possibilities of how we can keep people active in the workplace. Now I have a clear idea of what can be accomplished, from a construction standpoint, and how to do it in a cost-effective manner.”

Linda Miller

It can be tough to juggle the demands of running a business while still actively growing in her field (and raising a couple of kids). Choosing her staff carefully has ensured that each adds complementary expertise to the business mix.

EWI Works has a staff of five—two in Calgary—that includes experts in ergonomics, physical therapy, environmental design and kinesiology. And Miller, who has also earned a Master of Environmental Design, makes sure she stays current. “I’m constantly watching industry and reviewing reports,” she says.

She travels frequently for coursework and industry jobs.

The company is busy, despite the economic downturn.

While she loves her role a business owner, it satisfies only part of her professional life. She is deliberate about growing the company slowly. “To aggressively grow the business, I’d need to drop my personal client load.”

And ramping up the business side wouldn’t leave her enough time to teach principles of ergonomics to fourthyear students at the U of A, or to take on residents from the Occupational Med program. Miller doesn’t want to distance herself from the OT end of work or sacrifice her work with long-term clients.

The one-of-a-kind role she has made for herself, says client Barbara Holloway, “allows her to work from bedside care to management.” Miller wouldn’t have it any other way.

Find Out More Occupational therapist Linda Miller’s company, EWI Works International Inc., works with clients to find a customized ergonomic intervention program to address their particular challenges.

The company strives to help its clients reduce workplace injury and related costs, increase productivity and improve product quality.

Web

ewiworks.com

Tel

780.436.0024

E-mail

info@ewiworks.com

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ALUMNI FEATURE LINDA MILLAR

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THE LEADING Edge

Jana Rieger

Research that never runs dry

By Laurie Wang

Speaking, swallowing and chewing are actions we often take for granted, but

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THE LEADING EDGE JANA RIEGER

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Jana Rieger sure doesn’t.

“I work with many mouth cancer patients through my research and I can see what a difference it makes in quality of life when these functions are restored,” says the associate professor in speech pathology at the University of Alberta Faculty of Rehabilitation Medicine.

“There are social repercussions if you can’t speak properly, you could even lose your job. And if you can’t eat properly, it impacts your health and social interactions with friends and family,” says Rieger, PhD. “So much of what we do today centres around eating.

“When patients have head and neck cancer, they often go through radiation therapy. The radiation destroys salivary glands and patients have to live with dry mouth for the rest of their lives,” Rieger explains. “They have to deal with it every day, and many say it’s the hardest thing. It affects eating—food doesn’t form normally—and it’s uncomfortable even when you’re just sitting there.”

The Alberta Heritage Foundation for Medical Research (AHFMR) researcher and Edmonton radiation oncologist Dr. Naresh Jha and head and neck cancer surgeon Dr. Hadi Seikaly just wrapped up a project studying dry mouth in patients with mouth cancer. The study looked at the benefits of a specific surgery developed at the U of A Hospital compared to a pharmaceutical treatment. By taking the salivary gland and transferring it under the chin, the surgeons can shield the gland when the patient goes through radiation therapy.

“The cells don’t die and the gland is still able to produce saliva,” says Rieger, who will be taking the project further by studying bigger groups in the future.

The research project looked specifically at pilocarpine, a drug given to patients going through radiation therapy. The drug has been thought to have a protective effect on the salivary glands, keeping them from being destroyed.

“After we compared the surgery group with the drug treatment group, we found a large difference in salivary flow.

The salivary flow outcomes showed that surgery worked better than the pharmaceutical choice.”

The study took place over four and a half years. Rieger will be examining and assessing more patients and collecting outcomes while collaborating with fellow researchers in New York, Germany and Finland.

“You just see such a huge impact in the patients. They can eat easier and faster, and food is appetizing again. They are better off nutritionally and socially,” says Rieger.

Without saliva, a person’s teeth may decay and fall out because there is no buffering and cleansing action from that protects the teeth. People with severe dry mouth are constantly thirsty, have difficulty speaking and swallowing, and are unable to eat or enjoy food properly.

“Most people don’t realize the emotional and social impact of mouth cancer surgery. Yes, the patient survives the cancer, but there is a huge change in their life,” she says. “They may speak differently and don’t interact the same way anymore.

People may perceive them differently or don’t think they’re as intelligent, when really, nothing has changed about them as a person.”

Rieger continues to be a strong advocate for restoring function and quality of life for cancer patients. “It’s the reason for my passion in this area. If we can figure out what surgery or drug is working better, we can help people have a better quality of life. It makes the research continually exciting and worthwhile.”

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THE LEADING EDGE JANA RIEGER

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SPECIAL Feature

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SPECIAL FEATURE SUSAN ARMIJO OLIVO, CHRISTINE DAUM, CARRIE GOTZKE

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Endowed success The first round of endowed PhD scholarships was awarded to three worthy students in each of the Faculty’s departments. Physical therapy student Susan Armijo Olivo, Christine Daum in occupational therapy and Carrie Gotzke in speech, each received $5000 to go toward their doctorate studies.

“Knowledge regarding the effectiveness of PT interventions in TMD will ultimately contribute to reduce the cost of overall health and personal care as well as improve the quality of life of individuals with TMD,” says Armijo Olivo. She was honoured to receive the first round of scholarships.

“It is very motivating to receive this recognition from your peers,” says Armijo Olivo. “In this case to receive this award from the Physical Therapy College means that my research was important for my profession and colleagues.

This encourages you to contribute to the knowledge and enhancement of your profession. It’s a great feeling.”

Last year, all three professional colleges in the province, the College of Physical Therapists of Alberta, Alberta College of Speech Language Pathologists and Audiologists, and Alberta College of Occupational Therapists, donated $100,000 each to the Faculty toward an endowed PhD fund.

Susan Armijo Olivo is a clinical researcher who studies craniomandibular and temporomandibular disorders (TMD, jaw pain) and their connection with the cervical spine. Most of the time people with jaw pain complain about problems in their neck as well.

Physical therapists treat the neck with exercises in order to improve symptoms in the jaw. “However, it is not clear which kind of exercises are more beneficial for treating this condition and if neck muscles function property in people with jaw pain,” says Armijo Olivo.

“In addition, the connection between jaw and neck has not strongly been supported by the research.”

Armijo Olivo is investigating the connection between the jaw and neck to determine if neck muscles have an appropriate function in people with jaw pain. The results of her project will help create a physical therapy treatment using neck muscle training to help improve pain and function of the jaw. It will also help guide clinicians in prescribing effective interventions for individuals with muscular TMD.

People with jaw pain often complain about neck pain.

Susan Armijo Olivo, Christine Daum, Carrie Gotzke

Elderly adults sometimes attribute their wellbeing to the neighbourhood they live in.

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Daum first became interested in what would become her PhD project while working overseas as an occupational therapist. In speaking with her clients and their families, she noticed that some older adults attributed their well-being to their neighbourhoods. “These observations led me on my journey to explore the experiences of older women—80 and older—living in low income neighbourhood environments, particularly as it relates to occupational engagement and quality of life,” says Daum. “It is crucial to understand how urban neighbourhood contexts impact occupational engagement and quality of life due to the increasing proportion of older adults aged 80 and older and the health-promoting effect of occupational engagement.”

To ensure that her findings have practical relevance, she will partner with community and government agencies.

Findings can also inform service providers’ practices, urban planning, and local programming for older adults.

SPECIAL FEATURE SUSAN ARMIJO OLIVO, CHRISTINE DAUM, CARRIE GOTZKE

Christine Daum agrees. “I am honoured to have been selected for the inaugural Alberta College of Occupational Therapists Centennial PhD Scholarship,” says Daum. “Receiving this award has allowed me to concentrate on my doctoral studies on a fulltime basis and work toward my ultimate goal of an academic career in occupational therapy and gerontology research.

I have been able to devote my time toward completing coursework, preparing my research proposal, developing partnerships with researchers in my areas of interest as well as with local service providers and policy influencers, and writing manuscripts. This scholarship and other travel awards permitted me to present my work at the World Congress of Gerontology and Geriatrics in Paris, France.”

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Carrie Gotzke is developing a measure of speech intelligibility for young English speaking children with cleft palate in order to get a better understanding of the speech errors contributing to their intelligibility deficit.

Cleft palates are often repaired surgically during the first year, yet children may still produce distorted or unrecognizable speech sounds, limiting social, academic and vocational opportunities. Speech intelligibility, or how understandable one’s speech is to others, is an important measure of disorder severity and intervention success.

“So far, it has not been measured in a standardized way for children with cleft palate,” says Gotzke. “This makes it difficult to compare the outcomes of various surgical approaches and speech therapy programs. If we do not know how successful surgery or speech therapy is at increasing a child’s speech intelligibility, we are not in a position to improve these interventions to lead to better speech outcomes for these children.” Gotzke’s research is focused on developing a standardized measure of intelligibility for young Englishspeaking children with cleft palate. Her project should increase understanding of communication impairments in children with cleft palate.

“It is an honour to receive an award from my provincial association that recognizes the value of research, and researchers, in the field of speech-language pathology,” says Gotzke. “The funding allows me to dedicate my time to research and removes some of the financial stresses associated with pursuing full-time education. Receiving this scholarship was a surprise and an honour.”

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ALUMNI Feature

Military medic

Keith Ross

By Phoebe Dey

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ALUMNI FEATURE KEITH ROSS

FALL/WINTER 09

Physio alum helps repair soldiers on Canadian Forces base As a physiotherapist, Keith Ross expects to see a range of injuries.

Yet, sometimes nothing can prepare him for what comes through his door at Edmonton Garrison. Three years ago, for instance, he met a 29-yearold whose arm was shredded during a suicide bombing in Kandahar, Afghanistan. He has treated military members who have faced years of whiplash pain from a vehicle rollover.

Other soldiers in Afghanistan have lost limbs from improvised explosive devices or IEDs. For Ross, it’s a typical day on the military base. He starts his morning at “sick parade,” at the medical clinic. Military personnel are able to see a physiotherapist without first reporting to a doctor for a referral. Working along physicians, nurse practitioners, physician’s assistants and medical technicians, Ross is part of a site that was the first to implement such a practice in Canada. The Canadian Forces Health Services model of care ensures a co-ordinated multidiscipline approach to patient care that is similar to civilian primary care delivery.

Canadian Forces physiotherapist Kelly Deboute (L) and Keith Ross (R)

This inter-disciplinary team of civilian and military primary care providers work with each other in a collaborative practice to provide the services that traditionally have been provided by physicians. Ross might assess someone for a sprained ankle in the morning and request she come back in a week.

Another patient might be discharged after the initial visit or report to the physiotherapy clinic in the afternoon, where Ross also works.

With 4,400 Canadian Forces members at the base, Ross’ every hour is accounted for. “That’s the draw of working at a clinic like this,” he says. “We see a very specialized sports medicine and occupational medicine workload. In two years we would see a wide enough caseload that might take a regular physiotherapist five years to see.”

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ALUMNI FEATURE KEITH ROSS

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ALUMNI Feature

Aside from the physical injuries, volatile peacekeeping missions can add a whole new dimension to treating a patient. Teams made up of mental health professionals, nursing teams, doctors and social workers assess and treat people returning from Afghanistan. When a soldier is severely injured overseas, the base surgeon at Edmonton Garrison will be notified and the medical team at the Garrison will develop a plan for treatment.

When Ross receives an e-mail alerting him to be prepared, it brings mixed feelings. “We are then on a priority basis to drop what we are doing to meet with the medical team and initiate not only medical care but the start of rehabilitative care. While we never, ever want to see anyone hurt, from the medical point-of-view we are exposed to some interesting cases,” says Ross.

“The psychology of an injury is very important,” says Ross. “It’s extraordinarily difficult to treat someone who has been injured because of someone else’s decision. When you spin out on ice and crash, it is one thing. It’s not an accident when people try to kill you.”

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ALUMNI FEATURE KEITH ROSS

FALL/WINTER 09

“The psychology of an injury is very important,” says Ross.

“It’s extraordinarily difficult to treat someone who has been injured because of someone else’s decision. When you spin out on ice and crash, it is one thing. It’s not an accident when people try to kill you.”

Keith Ross

When Ross graduated from the Faculty of Rehabilitation Medicine in 1994, he didn’t see this career path coming.

Right after graduation, he filled a six-month maternity leave pediatrics position at the Glenrose Hospital before going to work at a multidisciplinary pain clinic, where he spent six years. “In some ways, pediatrics was the most rewarding job, but the most exhausting as well,” he says. “Once I started in orthopedic and chronic pain, I found it really challenging and stepped away from pediatrics.”

Along the way, Ross took graduate orthopedics training, started lecturing at the pain centre and established himself as a multi-faceted physiotherapist. “In private practice orthopedics, everyone gets a chronic pain following that makes up the hardest percentage of the orthopedic populations—patients that have been to other clinics and are still in pain,” he says. “The challenge is to try to make a difference in their lives. It gave me a lot of professional satisfaction helping those patients, especially early in my career. I tried to take the time to work with these patients and get better results.”

During his time in private practice, Ross treated military members and in 2001 he was recruited to work with military personnel because of his extensive orthopedic training. He joined the PCRI team and has been there ever since. With so many troops in Afghanistan and the pressure to rehabilitate the soldiers to send them back, his workload has increased significantly over the last few years. “The military term is ‘operational tempo,’” says Ross. “It’s very busy and we’re treating more seriously injured members than we were four or five years ago.”

Ross’s Fellowship in Physiotherapy allows him to teach post graduate orthopedic courses and to act as a mentor for younger physiotherapists taking exams. He has also participated in federal government meetings on the pilot program launched in Edmonton in order to get other military bases across the country on a similar plan.

In addition, Ross is certified in Intramuscular Stimulation or IMS needling and incorporates that practice regularly into his workload.

“Nineteen years ago when I started PT as a young guy, I immediately thought I’d be doing sports injuries and then I thought, no, it’s pediatrics I want,” says Ross. “And then one thing started opening doors for another and here I am.

“There are unique elements in this job you wouldn’t get anywhere else. It’s a good place to be.”

RESEARCH News

Cary Brown

Uncovering pain Pain in older adults with dementia such as Alzheimer’s is often undetected and undiagnosed. University of Alberta Faculty of Rehabilitation Medicine occupational therapy researcher Cary Brown, PhD, has developed an online workshop and toolkit for caregivers, health-care providers, family members and friends of persons with dementia to help.

But they need to learn how. With the support of the Alberta Centre on Aging, The Canadian Council on Learning, The Canadian Dementia Knowledge Translation Network and The Alzheimer’s Society Alberta and Northwest Territories, Brown was able to create an evidence-based website with: a narrated presentation on pain and dementia; a downloadable resource pack for family members; a downloadable pain log (including the PAINAD assessment tool developed by other researchers in the field); and a facilitator’s toolkit with background material, a planning guide, promotional material and supplemental information for organizations who wish to put on a workshop. Agnes Mitchell, Grant MacEwan College School of Nursing, helped put the narrated presentations together. The project took more than a year and a half to get to this stage, undergoing about six months of field testing.

“Arthritis, diabetic neuropathy, fractures, muscular contractures, bruises, abdominal pain and mouth ulcers are among the list of common ailments that go undetected,” Brown says. “It is important for those who live or work with persons with dementia to be informed—detecting pain and getting treatment sooner rather than later. Dementia shouldn’t mean you have to suffer needlessly in pain.”

The online workshop and toolkit are available at: www.painanddementia.ualberta.ca

FALL/WINTER 09 RESEARCH NEWS CARY BROWN www.rehabmed.ualberta.ca

“The elderly who suffer from dementia aren’t able to say when something hurts or is sore.

They may demonstrate their pain through behaviours like rocking or striking out, and we often dismiss these actions for the dementia instead of treating the pain which is usually from a different problem,” says Brown, associate professor, Department of Occupational Therapy.

Pain is the most frequently reported symptom of older persons living the community. More than 80 per cent of people living in residential care experience enduring pain.

For older persons with dementia, the problem is even greater because they cannot always reliably self-report or ask for medical attention. It takes time to observe and understand that a person with dementia is in pain.

“Sometimes you hear the story about how Mom starts lashing out and fighting when people are helping her get dressed—people think it’s the dementia. It turns out that Mom actually has a fractured elbow but nobody knows because she was alone when she fell and hurt herself,” Brown says. “Health-care providers have a hard time detecting pain because they are not with the person often enough or long enough to notice changes in behaviour. Frequently family members are the best people to make these types of meaningful observations.”

By Laurie Wang

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CLINICAL EDUCATION REESE VLIENGENTHART, SIMONE REID, ELLY PARK

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CLINICAL Education

Students without borders

Reese Vliegenthart

By Caitlin Crawshaw

At first glance, occupational therapy and travel might not seem to have much in common—but at the heart of it, both are about broadening understanding.

OT broadens a person’s engagement with their environment; travel broadens cultural literacy. Combining the two can create powerful learning experiences, as several University of Alberta students recently discovered.

A photo of pingos, huge ice-covered hills formed by a combination of frost and abundant water, taken by Reese Vliegenthart right before landing in Tuktoyaktuk. >>

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<< Reese Vliegenthart spends time volunteering at a greenhouse in Inuvik, one of the largest greenhouses of its kind in Canada.

CLINICAL EDUCATION REESE VLIENGENTHART, SIMONE REID, ELLY PARK

While Vliegenthart learnt about Canada’s first peoples in grade school, as many children do, it was very abstract before seeing the lifestyle up close. “Honestly, I didn’t know people in Canada still live like that,” she says. “It was really neat to see.”

Though her placement typically involved working at the Inuvik Regional Hospital, she was sent on several community visits, including a trip to the small hamlet of Tuktoyaktuk. There she met an elderly woman who wasn’t very interested in what Vliegenthart had to say. “She said she didn’t want our ‘whiteman medicine.’ ” It struck her that Inuit peoples had been surviving—and thriving—in Canada’s North for countless generations and, naturally, had their own medicine and ways of doing things.

The experience taught Vliegenthart to focus more on creating culturally sensitive solutions for clients and creating rapport from the start. “Their way of life and culture is everything to them. It’s so important. You can’t ignore it.

Your therapy won’t work for them if you do.”

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This summer, OT student Reese Vliegenthart completed her third work placement—her first in Canada’s North.

Stationed in Inuvik, she was part of a team that served the Beaufort-Delta Health and Social Services Authority, which encompasses eight remote regions in the Northwest Territories. It’s a region where many people still live huntergatherer lifestyles, fishing and hunting half of the year, and living in town for the other six months.

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CLINICAL Education

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CLINICAL EDUCATION REESE VLIENGENTHART, SIMONE REID, ELLY PARK

FALL/WINTER 09

Like Vliegenthart, Simone Reid chose to expand her cultural knowledge when she organized her final work placement this summer.

Simone Reid

Reid, whose grandfather was from Scotland, celebrates her roots by playing tenor drum in a Vancouver pipe band. The band often travels to Scotland to play in championships, as it did this summer. While there, Reid approached Caledonia University about doing an OT placement and managed to secure a position at Marie Curie Hospice, just outside of Glasgow—a rare opportunity for an international OT student.

Most of Reid’s placement involved palliative care, something she’d never done before. “Some of the patients were at the point where they were dying and there wasn’t much to do,” she says. Those who had a little more time benefited from OT strategies to conserve their energy and manage their breathlessness and fatigue. Reid adds: “It was just about making things easier for them so they could enjoy their last few months or last couple of years of life.”

Having done four placements already, she was struck at how different Scotland’s OTs approached the intersection between theory and practice. “They were really evidence-based practitioners,” says Reid, whose Scottish preceptors would often press her to provide the theoretical basis for her decisions.

Simone Reid plays tenor drum for the Inveraray and District Pipe Band.

She was also surprised by the difference in the health-care systems. In Scotland, equipment can be delivered to a patient— at no cost—within days of requesting it through an online system. In Alberta, equipment is also requested online with reasonable ease, but it can cost a patient up to $500. Reid has also done a practicum in BC, where OTs spend a lot of their time applying for government grants in order to secure equipment for clients.

In September, Reid completed her placement and returned to her hometown of Vancouver. Now she’s looking for work opportunities both in Canada and Scotland while she prepares to write her Canadian Association of Occupational Therapists’ exams to get her professional designation.

Inveraray, Scotland

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Elly Park and her preceptor (one of the local OTs) working with a four year old client who has delayed development issues. >>

Now that Park has returned from Canada—along with her husband and two young children who travelled with her—she plans to carry the spirit of the experience with her in future roles.

“My hope is that in Canada, I will be able to foster the same collaborative and encouraging atmosphere wherever I may work, and to provide occupational therapy with as much passion and dedication as I have seen at Yonsei Rehabilitation Hospital.”

CLINICAL EDUCATION REESE VLIENGENTHART, SIMONE REID, ELLY PARK

In the last few months, Park has discovered many differences between the practices of OTs in Korea and Canada. At her hospital in Korea, patients are very passively involved in treatment, and home visits aren’t done. “I noticed that the medical model is still the predominant foundation of rehabilitative medicine in this hospital,” says Park.

She’s also noticed that Korean OTs are involved in all areas of treatment, including assessment, parent/ caregiver interactions, administrative work, and daily therapy. Park was also struck by the level of caring, towards both patients and one another. “The OTs all had an innate ability to care for their clients in a nurturing and loving manner—a genuine gift that is hard to imitate,” says Park, who figures it stems from Korean culture. “The difference in a collectivist and individualistic society was apparent. The therapists saw one another as an extension of themselves and, as such, would support one another in a way that I have never seen before.”

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The first U of A student to do an OT placement in Korea, Elly Park has been living and working in Seoul for the last three months.

She combined her last two practica into one and brought her husband and two toddlers (aged three and one) with her.

Her physical medicine placement at Yonsei Rehabilitation Hospital has involved pediatric and adult in-patient and out-patient departments, and the use of Neuro-Developmental Therapy (NDT), which is used to help patients with central nervous system impairments.

Elly Park

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ALUMNI FEATURE MARGRETA SPENCER

FALL/WINTER 09

ALUMNI Feature

Finding home Margreta Spencer is frank about how her career path took her to Israel.

“I studied physical therapy because I wanted to. I went to Israel because I wanted to,” says Spencer. “I didn’t do anything in that country that someone who lived there couldn’t have done and I wasn’t there to teach them anything—in fact, I learned so much from them.”

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the battle between Barak and the army of Jabin, commanded by Sisera.

After high school, she went to Saskatoon to look after her brother’s three older children while his wife was about to have their fourth child. She ended up working full time at the tuberculosis (TB) sanatorium as a nurse’s aide. At the time, a polio epidemic was raging through the prairies and the physiotherapist hired to work at the sanatorium spent part time there and the rest treating polio patients. That left Spencer to learn exercises and teach them to the TB patients, piquing her interest in the field.

In 1956, after a mission for her church, Spencer wound up in Edmonton at the newly formed School of Rehabilitation Medicine. Dean Richard Fowler squeezed her in the program at the time and set her up with a Canadian Legion Bursary, since her father had fought in both world wars.

Spencer arranged to do her last placement at McKellar Hospital in Ft. William, Ontario, because of a job posting she saw in a PT journal. “I’m not even sure I had $30 in my pocket then, so I needed that position,” says Spencer, who returned to her alma mater for reunion weekend along with 18 out of 23 classmates this October, the highest percentage of any other class on campus. “I applied for a loan from the university while I was studying but was refused. They said I couldn’t possibly live on the amount I was requesting. Well, I showed them and lived on even less.”

ALUMNI FEATURE MARGRETA SPENCER

<< Mount Tabor is located in Lower Galilee, at the eastern end of the Jezreel Valley.

It is believed by many to be the site of the Transfiguration of Christ and for

By Phoebe Dey

FALL/WINTER 09

Perhaps all true, but Spencer’s tale of going from smalltown Alberta to establishing and running a physiotherapy department—and working through several wars—in Galilee still bears repeating. Spencer was born in Magrath, Alberta, to a Mormon family and had always imagined she would follow in her midwife grandmother’s footsteps.

Margreta Spencer

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ALUMNI Feature

Margreta Spencer

room to move and did many of the back classes on the hospital lawn. She continued her Hebrew studies as a means to communicate with her patients and picked up bits of Russian, Romanian and Arabic along the way.

She worked through the Yom Kippur War in 1973 which was a “bloody, bitter agony,” she says. “That was effort. I was up with people who needed chest work done and then mending crutches for the next day. There is no such thing as beyond the call of duty in a time of war—you do whatever is asked of you.”

Spencer’s postgraduate courses included an electrotherapy course in Holland, a spinal manipulation certificate in Israel and a respiratory treatment class in Utah.

She also made homecare calls as the only mobile PT in the region. Other physiotherapists were kibbutz women who had a communal vehicle, so Spencer got to know the farmers and rural people in the area. “I enjoyed home care,” she says. “You have no equipment except your own imagination.”

“Israel is home for me—I took out citizenship in

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ALUMNI FEATURE MARGRETA SPENCER

FALL/WINTER 09

Margreta Spence catching up with friends during Reunion Weekend.

After Ft. William, where she had begun taking Hebrew lessons to understand the scriptures better, Spencer went to Stoke Mandeville Hospital in London, the first spinal injuries hospital to exist. She then went to Belfast, Ireland, for thoracic training followed by London for a course in treating people with cerebral palsy. Spencer had always been drawn to Israel so once she secured a job (“I’m not a backpacking hippie— I always had to have a job first,” she says) she went to work at Beersheba Hospital in1966.

She was there for a year before the Six-Day War began at 7 a.m. on June 5, 1967. Casualties started arriving to her hospital by 4 that afternoon. “You don’t go to your manager when he needs you the most and say ‘good bye’ I can’t stay to help,” says Spencer. So for six days, she washed soldiers, turned the wounded in her beds and then once the war ended, she got to work rebuilding bodies.

When her work permit expired in September of that year, Spencer went to Finland, which she loved. “But I got so homesick for Israel, which is utterly unreasonable,” says Spencer. “I went into a supermarket in Finland one day and picked up a tin of orange juice that had the smiling face of an Israeli farmer on it and I burst into tears. It was inexplicable.

I have no idea why I wanted to be there but I was drawn to Israel.”

Then Spencer saw an ad asking for a physiotherapist to open and establish a department in Safed Hospital in Israel.

She successfully applied for the position where she remained head of the department for 27 years. Her clinic started in a room that was five metres x three and a half metres. She measured every piece of equipment so she would still have

Israel in 1974,” she says. “I feel that I as a citizen should do something for her country and I am not doing anything for Canada right now. And as for work, as long as I can stand on my feet, I will keep working.

Retirement is a dirty word and I love being a physiotherapist. I’ll keep at it as long as I can.”

Right before Spencer was to retire at the age of 63 (“I could have worked until I was 65 but when the other jobs were available I thought it would be a good idea to retire at 63, which was allowable, and grab the jobs while I could, for fear that if I waited, they wouldn’t be there two years later”), she was headhunted for three jobs and took all of them. Now, at 76, her calendar is still jam packed. She leads exercise classes at a senior’s centre and a centre for the blind. She also works at a geriatrics daycare centre and examines and arranges people’s homes to prevent falls. With her church, she provides respite for women in Galilee, making quilts for battered women. She rides horses and travels when she can but always comes back to Israel.

“Israel is home for me—I took out citizenship in Israel in 1974,” she says. “I feel that I as a citizen should do something for her country and I am not doing anything for Canada right now. And as for work, as long as I can stand on my feet, I will keep working. Retirement is a dirty word and I love being a physiotherapist. I’ll keep at it as long as I can.”

Sunset view from Galilee Mountains to Galilee Sea, Kinneret. >>

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ALUMNI FEATURE MARGRETA SPENCER

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SPECIAL FEATURE MASAKO MIYAZAKI

FALL/WINTER 09

SPECIAL Feature

Masako Miyazaki

Going wireless Soon people with diabetes may have a wireless monitoring system that connects them with a clinician through Bluetooth technology. University of Alberta Faculty of Rehabilitation Medicine professor Masako Miyazaki, PhD, is the principal investigator who helped launch the spin-off company, Kanata Health Solutions Inc., which developed the Wireless Wearable Physiological Monitor (WWPM) as part of the new monitoring solution.

SPECIAL FEATURE MASAKO MIYAZAKI www.rehabmed.ualberta.ca

Diabetes patients are able to better manage the disease while being connected to a health professional that is able to advise them with the most current patient data available.

The WWPM initiative helps people with chronic diseases, such as diabetes, keep better track of their exercise, pulse rate, blood glucose levels, weight and more. It is worn as a piece of jewelry and replaces the paper chart patients usually fill out.

Nurses, caregivers or physicians can set their patients up with the device. Because the data is readily available, clinicians know what a patient needs ahead of time and can intervene to help the patient if needed.

“The WWPM is an excellent example of how innovative remote monitoring technology can support patients and enhance the treatment and health maintenance process,” says Doug Horner, Minister of Alberta Advanced Education and Technology. “This project reflects the kind of collaboration across government, industry and academia that our government is enhancing in Alberta’s new innovation system.”

In 2002, Western Economic Diversification and Alberta Advanced Education and Technology funded the WWPM team to start a collaborative development of homecare technologies.

In 2004, the first prototype was created. Through 2006 and 2007, clinical trials of more than 100 patients were conducted using the latest WWPM prototype. TEC Edmonton played an integral role in the commercialization of the WWPM technology.

“Our government is committed to building a more innovative and competitive Canada,” says the Honourable Rona Ambrose, Minister of Labour. “Together, through the Science and Technology Strategy in 2007 and through Canada’s Economic Action Plan, we are assisting our researchers to move ideas from the laboratory to the marketplace and creating new opportunities in this growing sector.”

Kanata Health Solutions Inc. launches into a global market of remote patient monitoring focused on providing home health services using telehealth technologies. “Our company’s goal is to deliver improved quality of care to patients, while reducing costs associated with avoidable emergency room visits and the management of chronic diseases by providing timely intervention and care,” says Tom Ogaranko, president, Kanata Health.

In 2003, the US remote patient monitoring devices market was estimated at $54.5 million. By 2010, total revenue for the remote patient monitoring devices market is forecast to reach $260 million at a compound annual growth rate of 25 per cent from 2004 to 2010. Market analyst Datamonitor is projecting that the homecare telehealth market, otherwise known as remote patient monitoring, will grow at a five-year compound annual growth rate of 56 per cent. That far surpasses the 9.9 per cent growth projected for the clinical telehealth market. Datamonitor expects to see the global telehealth market hit $8 billion or more by 2012.

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“This is an exciting event, transforming seven years of research into a commercial reality,” says Miyazaki.

“This is an important milestone in the history of our faculty,” adds Martin Ferguson-Pell, PhD, dean, Faculty of Rehabilitation Medicine. “It is the first spin-off company from Rehabilitation Medicine and an important indicator of the contribution our faculty can make to the future of health care in Alberta and globally.”

Kanata Health Solutions’ monitoring solution consists of a wrist-watch as a physiological monitor collecting pulse data, other sensor systems such as a glucose monitor for blood sugar levels, and a wireless base station that receives Bluetooth data transmissions and also has connection ports for other physiological monitoring equipment. Data is communicated through the central server software to technical and clinical staff while managing device inventory and patient schedules.

By Laurie Wang

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