15
"...[vehicle] injuries cause many different problems, including sudden onset intense pain, occupational and domestic disability, sleep disruption, day time exhaustion, family stress, and psychological and emotional distress."
problems, including sudden onset intense pain, occupational and domestic disability, sleep disruption, daytime exhaustion, family stress, and psychological and emotional distress. In 2011, Côté and his colleagues at the UOIT were awarded a grant by the Ministry of Finance and the Financial Services Commission of Ontario (FSCO) to develop the first-ever evidence-based clinical practice guidelines for managing traffic injuries in Ontario. The objective was twofold: create a new protocol for insurers and healthcare providers to use when treating common traffic injuries arising from automobile collisions; and develop a clinical prediction rule to screen for patients who may be at a higher risk for developing chronic pain and disability. Over a two-year period, Côté and his team of experts conducted a comprehensive review of the scientific literature, and interviewed patients receiving health care for auto collision-related injuries. They also gathered input from experts such as clinicians, academics, scientists and auto industry executives and a retired judge. Their effort resulted in an almost 300page report detailing 22 different care pathways designed to improve the recovery of individuals with auto collision-related injuries and
facilitate their return to healthy, productive lives. Their report, which is currently under review by the FSCO, also proposed a new approach to classifying car crash injuries that better reflects the degree of disability patients experience. “We identified the best research and most relevant insights on this subject so that clinicians who treat people injured in traffic accidents can be most effective,” Côté says. The International Classification of Functioning, Disability and Health a collaboration between SDU, UOIT and CMCC What will also enable chiropractors and other healthcare professionals providing manual therapy to be more effective is a CDPR research initiative focusing on more holistically addressing disability and promoting functioning in individuals with back pain. Post-doctoral fellow Ellen Aartun is investigating how these practitioners can follow the International Classification of Functioning, Disability and Health (ICF), a functioning classification system developed by the World Health Organization that takes a bio-psycho-social approach to measuring health and disability. “In manual medicine, the focus tends to be on assessing pain, and there is less emphasis on
factors such as the patient’s social activities, family support and work environment. The ICF takes these factors into account, so it is a useful tool to manual medicine clinicians,” says Aartun, who completed her PhD at the University of Southern Denmark (SDU), with which CMCC has a memorandum of understanding to explore collaboration in education and research. Introduced in 2001, the ICF offers thousands of options for classifying every conceivable aspect of physical, mental and emotional functioning. Yet, its vastness and complexity can make it daunting for healthcare providers to use, Aartun says. To figure out how to make it more accessible to manual medicine practitioners worldwide, she is collaborating with international researchers to create a new functioning assessment schedule for musculoskeletal disorders. The first research stage, which is still under way, involves reviewing existing scientific literature to identify the clinical tests and instruments health professionals use to assess functioning in patients with MSK conditions. Next is conducting a qualitative study of chiropractic patients in Canada, Norway – Aartun’s native country, where she worked as a chiropractor in private practice for nine years –
SPRING 2017