Session Descriptions

Rehabilitation in Nepal: Reflections from NepalAbility Team 19

This presentation will review suggestions for getting involved with international rehabilitation projects. The common themes we will go over are the use of a needs assessment as a starting point for any project, and the importance of collaboration with local stakeholders. We will also discuss some of the challenges of providing rehabilitation care in the resource limited setting, particularly when coming from the background of providing care in Canada.

To illustrate these examples, we will talk about our experiences working with NepalAbility, a non-profit organization dedicated to improving rehabilitation care in Nepal. We had the opportunity to travel to Nepal in October-November 2017 on the 19th NepalAbility team. This session will be of value to any physiatrist, medical student or resident looking to partake in international rehabilitation opportunities.

Learning Objectives:

  1. To demonstrate how to undertake an international project and how to conduct a needs assessment in collaboration with local partners
  2. To discuss limitations and challenges involved with providing rehabilitation care in the developing world
  3. To outline past, current and future directions of NepalAbility – a non-profit organization dedicated to supporting rehabilitation in Nepal

 Updates to the ASIA Exam in SCI

Dr. C. Craven, Dr. C. O’Connell

The International Standards for the Neurological Classification of Spinal Cord Injury (ISNCSCI), often referred to as “the ASIA exam” is a standardized approach to the physical examination of a person with spinal cord injury, used to determine the level and severity of injury. The Standards have undergone numerous revisions since first published in 1982, the latest update in 2015. This session will review the key elements of the classification, its utility in research and clinical care, and the current recommendations for examination. A case will be used to highlight the scoring and grading.

This session is intended for all physicians, residents, students, and allied health professionals.


Accessing Medical Cannabis in Canada: ABC Essentials for the Physiatrist

This workshop will focus on practical discussions that physiatrists need to have with their patients who request or are going to be considered for accessing medical cannabis. Cases will be used to allow for discussions highlighting the main ingredients in medical cannabis, how to consider dosing, and what forms of medical cannabis to suggest.The cases will be primarily spasticity and neuropathic pain cases. The history as to how marijuana evolved to be used for medical purposes has previously been discussed and will not be a focus. Similarly, the evidence has previously been presented for use in spasticity and neurogenic pain, and will not be a main focus. This workshop will be of value to physiatrists, residents in physiatry, and medical students with a primary interest in physiatry.

Learning Objectives:

    1. Have an informed discussion with patients regarding the process of accessing medical cannabis in Canada
    2. Educate patients about the different routes available for medical cannabis
    3. Discuss with patients the main therapeutic ingredients in medical cannabis
    4. Explain to patients what the important differences are with medical cannabis as opposed to recreational cannabis

Critical Illness Rehabilitation

Recovery following a critical illness can be difficult. People often experience impairments in physical, cognitive, and mental health domains that can be long-lasting. Interestingly, these impairments are often not obviously directly attributable to the diagnosis that prompted their admission to an intensive care unit. As a result, the difficulties in restoring one’s health following a critical illness can often be under-appreciated. Very often, following discharge from hospital, patients are left to their own devices to plot out a path back to health.

This session will be of value to: Physiatrists, Medical Students, Residents.

Learning Objectives:

  1. Discuss common recovery experiences following a critical illness.
  2. Describe Calgary’s approach to critical care rehabilitation.
  3. Plant a seed. Consider addressing the rehabilitation needs of this important population in your home community.

International Initiatives in PM&R (09:45 – 10:30 am, Thursday, May 31, 2018)

Dr. C. O’Connell, Dr. S. Gulasingam

This presentation will impart insight into classification, conceptual framework and principles of current evidence based functional classification in para sports. It will also provide the basic information to seek opportunities to develop local, national and international classifiers in various para sports.

The session will be of value to Physiatrists, Residents, Medical Students and Physiatry related allied health who would be interested in para sports.

Learning Objectives:

  1. Identify International and Outreach potentials in Physiatry
  2. Discuss role of physiatry in relation to sports
  3. Explain classification process and principles of classification in para sports
  4. Discuss International opportunities through sports classification

Neuromuscular SIG

Dr. Kristine Chapman

This is a case based discussion of advances in our approach to a the treatment of neuropathy. Illustrative cases of a selection of common and rare neuropathies will be presented.

This Neuromuscular Special Interest Group presentation will be of value to: Medical Students, Residents and Physiatrists with an interest in Neuromuscular Disease.

Learning Objectives:

  1. Participants will discuss neuromuscular cases, including localization based on the nerve conduction studies.
  2. Learners will be able to list new developments in treating rare and common neuropathies.
  3. Participants will review the spectrum of treatable aquired demyelinating neuropathies

Updates in Spinal Cord Injury Classification

This session will be jointly conducted by Drs Craven and OConnell. At the end of this session, you will be familiar with the revised International Standards for Classification of Spinal Cord Injury and available tools to assist you and your medical learners to accurately assign the Neurological Level of Injury and American Spinal Injury Association Impairment Scale.

Learning Objectives:

  1. To review the International Standards for Neurological Classification of Spinal Cord Injury
  2. To highlight recent changes in the ISNCSCI standards
  3. To share available ISNCSCI calculators to ensure accurate charaacterization of Impairment

Resident Town Hall: Transition to Practice: A panel discussion

This session will be of value to residents of all levels. We will have a panel of 6 physiatrists from different regions and areas of practices. They will answer questions submitted ahead of time, as well as any questions that come up during the course of discussion. This will be an informal and interactive session.

Learning Objectives:

  1. How do you make yourself competitive for the job market during residency?
  2. Do I need a fellowship to work in Canada in the current PM&R job market?
  3. What unique jobs are available as a physiatrist (i.e. creative things we can do with our PM&R residency outside of typical institution based or typical community based?
  4. What should we look for in a contract and how do we know if the contract we are being offered is fair/reasonable?
  5. How do I build a balanced practice (Within my practice, between work and personal life)?
  6. Should I incorporate or not? And if so, when?

Competency by Design – Update on PM&R Residency Training in Canada

Dr. Jennifer Yao

This presentation will focus on the Competence by Design (CBD) initiative from the Royal College and how it will be applied to specialty training in Physical Medicine and Rehabilitation. Special emphasis will be on work currently being done and how the audience member can be involved with CBD in their own local programs. This presentation will be of value to all physiatrists involved with postgraduate training, residents and medical students.

Learning Objectives:

  1. Identify at least two reasons why we are moving to competency based education
  2. Explain the difference between milestones and entrustable professional activities (EPAs)
  3. Describe the stages of physician development
  4. Describe at least two ways that residents can be assessed in the CBD framework
  5. Identify at least two ways you can be involved with the implementation of CBD in your program

Artificial Intelligence in Rehabilitation

Dr. P. Pilarski

From primitive tools to advanced interventions, technology has been critical to the practice of medicine over the course of human history. With the advent of powerful modern computers, computation-based technologies from the fields of artificial intelligence (AI) and machine learning (ML) are being developed at an unprecedented rate and with the potential to transform how we pursue clinical care. However, AI and ML are often misrepresented or misunderstood outside their respective communities. As such, and with a clinical audience in mind, this talk will (1) introduce AI and ML in general terms, (2) present the defining characteristics of AI and ML in an accessible and interactive format, and (3) present examples of how AI and ML have already started to impact physical medicine and rehabilitation. This presentation will further suggest trends and research trajectories in AI that are likely to influence clinical practice within the next 5-10 years, and highlight longer-term changes that we might expect for both patients and practitioners with respect to clinical intervention, assessment, and planning. This session will therefore be of value to Physiatrists, Medical Students, Residents, and other practitioners who wish to better plan for the use of advanced technology in their current and future work.

Learning Objectives:

  1. be able to define artificial intelligence (AI), machine learning (ML), and related concepts from the field of intelligent systems.
  2. be able to describe and discuss the defining characteristics of AI and ML.
  3. be able to describe and discuss how AI has been applied in physical medicine and rehabilitation.
  4. be able to estimate the impact emerging intelligent systems technology will have on their own area of practice, study, or work within the next 5-10 years.
  5. be able to find and cite appropriate resources for future self-study on AI and its application within physical medicine and rehabilitation.

Stroke SIG: Pediatric Stroke

Dr. A. Kirton

The essentials of perinatal and childhood stroke will be reviewed with a focus on rehabilitation of motor and other morbidities.

The session will be of value to: Physiatrists, Medical Students, Residents.

Learning Objectives:

  1. Kids have strokes
  2. Outcomes are poor
  3. Perinatal stroke causes cerebral palsy
  4. New therapies may improve function

Noninvasive Neurostimulation Workshop

Dr. Adam Kirton, Dr. Joan Stilling

This workshop will include a short didactic session followed by two hands-on experiences using both TMS and tDCS. Dr. Adam Kirton will discuss the field of non-invasive neurostimulation and explain the principles of how both TMS and tDCS work. Clinical applications and recent research will be discussed. Afterwards, the group will split into two and spend 15 minutes at both the TMS and tDCS stations, to learn fundamentals related to operating the technologies. The session will be of value to: Physiatrists, Residents, Medical Students.

Learning Objectives:

  1. State the types of non-invasive neurostimulation available for clinical use.
  2. Describe the principles of how transcranial magnetic and direct current stimulation works.
  3. List the diagnostic and therapeutic applications for neurostimulation in rehab populations.
  4. Counsel about the risks, complications, and contraindications associated with neurostimulation.
  5. Explain the fundamental operation of TMS and tDCS systems.

Code Blue: the status of physician health in Canada in 2018

Physician dissatisfaction and burnout amongst Canadian doctors is highly prevalent. Physicians and medical learners are increasingly voicing distress and calling for strategies and support. Burnout has been linked to adverse physician, patient, and system outcomes. Physician health is increasingly recognized as a quality indicator of health care systems. Addressing physician ill health is a shared responsibility of individual physicians and the systems in which they work. This session will describe the status of physician health in Canada in 2018 and present individual and organizational strategies for managing distress and burnout.

Learning Objectives:

  1. Describe the status of physician health in Canada in 2018
  2. List the signs and symptoms of distress and burnout
  3. List individual and organizational strategies for managing distress and burnout

Stroke SIG: Stroke Education and Competence by Design

Dr. G. Leung

Competence by Design (CBD) is the Royal College’s version of competency based medical education (CBME). CBD organizes training into stages and clearly lays out markers for teaching and learning at each stage.

The specialty of Physical Medicine and Rehabilitation is currently in the planning stages with respect to CBD, with the goal of launching across the Canadian physiatry residency programs in the near future. This session will provide a basic overview of the key concepts around CBD, with a more interactive discussion on what CBD would look like practically when residents are rotating through a stroke rehabilitation rotation.

Learning Objectives:

  1. Describe the key concepts of Competence by Design (CBD).
  2. Compare and contrast CBD with the current time-based model of medical education.
  3. Apply CBD concepts to the training and supervision of learners during stroke rehabilitation clinical rotations.

EMR use and Email Communication with Patients: Medical-legal Pitfalls

During this session, participants will divide into smaller groups to discuss 5 commonly encountered pitfalls of EMR and email use in clinical practice. Each group will report back on the outcome of their discussions, with emphasis provided on the medical-legal lessons learned to promote safe medical care. This session will be of value to practitioners who use an EMR and who are using or considering using email to communicate with patients.

Learning Objectives:

  1. List 5 pitfalls commonly encounted in EMR use
  2. Describe 2 best practices for communicating with patinents via email

This is Such a Simple Procedure, it Doesn’t Require Consent…

During the session, a triad of participants (physician, patient, observer) will undertake a simulated consent discussion. Thereafter, participants will be asked to document their consent and using a brief checklist, the observer will lead a debrief of their learning. This session will be of value to anyone who orders treatments or performs procedures.

Learning Objectives:

  1. Explain the importance of informed consent in the physician-patient relationship
  2. Explain what is informed consent
  3. Describe a practical approach to the credible documentation of informed consent

To Prescribe or not to Prescribe? Is that the question?

Dr. S. Bellemare, CMPA

In this skills-building session, participants will for triads where an observer, a physician and a simulated patient will deal with the case of patient seeking an opioid prescription. Each group will summarize their interaction and explain why they chose their course of action. All participants will be asked to write a note documenting the encounter, as if they were the treating physician. Using the outcome of the role-play, the group will leverage the wisdom from the crowd to identify what elements of the interaction warrant documentation, linking those to the medico-legal issues encountered in CMPA cases of opioid prescribing. Participants will be asked to take a critical look at their notes to see whether they documented enough to help them demonstrate meeting the standard of care. This session will be of value to physicians who may be asked to prescribe opioid medications to their patients.

Learning Objectives:

  1. List 2 medico-legal issues encounted in opioid prescription cases
  2. Identify 2 good practices that can help support the provision of safe medical care for patients taking opioids

Leaving AMA? Make sure it’s a safe departure!

Triads of learners will engage in a skills-development activity, using the roles of patient, physician and observer, in a scenario involving a patient who wants to leave against medical advice. They will then undertake a debrief of the exercise to extract learnables with specific examples from the interaction. Participants will subsequently document the interaction, regardless of the role they played, as if they were the treating physician. Using a brief checklist of items found on a good clinical note, participants will be invited to review their notes for key pieces of information.

Learning Objectives:

  1. Identify what key information required to determine whether a patient can leave against medical advice
  2. List 5 key points to document in a note summarizing a departure AMA

Diagnosistic Error: Team-based Counter Measures

In this session, a case will be demonstrate how a rehab patient developed a PE and outline how different healthcare providers had pieces of information that, had they been shared, might have prevented the outcome. In teams, participants will be invited to discuss inteams how various practices can contribute to the development of situational awareness. Each team will present a summary of their findings to the group and discussion will ensue. The session will be of value to anyone who works as part of team in the delivery of health care.

Learning Objectives:

  1. Explain the concept of situational awareness and its relationship to misdiagnosis
  2. Name 4 team-based practices that increase situational awareness

Maximizing spasticity management. From early intervention to novel interventions for the upper extremity.

Sub-Session: Surgical intervention including motor neurectomy in the treatment of hemiplegic spasticity

Current approaches to the treatment of hemiplegic spasticity focus on the use of neurotoxin and chemical peripheral nerve injury to reduce muscle tone, spasiticity and contracture. Frequent limitations of these treatments include dose-limitations, toxic-associated antibodies, cost, and the poor motor selectivity of chemical neurectomy treatments such as phenol.

Surgery has long been a component of the treatment algorithm for spasticity including muscle and tendon release, lengthening, and transfer, and joint procedures. Surgical neurectomy can be a permanent effective intervention to reduce upper extremity spasticity. Current understanding of anatomy, including intra-fascicular nerve anatomy, improves the applicability and reliability of neurectomy to a broader variety of upper limb contractures including elbow flexion, pronation, and the clasped hand. Pre-operative ultrasound-guided nerve block can enhance clinical decision-making and patient education by temporarily mimicking the expected results of surgical neurectomy. Surgical selective motor neurectomy should be considered in the treatment algorithm of patients with spasticity who are poor candidates for non-surgical interventions.

Learning Objectives:

  1. Identify limitations of non-surgical treatment of hemiplegic spasticity
  2. Review surgical options for spasticity
  3. Discuss surgical indications for, and limitations of, neurectomy to assist in appropriate patient selection
  4. Discuss the role of ultrasound-guided nerve block in patient selection for surgery
  5. Discuss and critique a developing algorithm from non-surgical to surgical treatment of hemiplegic spasticity

Simulation in Rehab

Dr. S. Plamondon, Dr. C. Grant, Irina Charania, Michele Cowan

This workshop will provide an introduction to the anatomy of a simulation, and identify key assumptions and critical factors for success when beginning to use simulation training in the local healthcare setting. Discussion will also include specific ideas of how simulation may be used in Physiatry settings to uncover and address patient safety issues. The workshop will conclude with an opportunity for participants to begin to develop a new simulation scenario that could be applied to their local environment. This session will be of value to: Physiatrists, Medical Students, Residents, Nursing and Allied Health.

Learning Objectives:

  1. Discuss the key elements of a simulation session
  2. Select the appropriate simulation modality to address specific needs of learners to address patient safety standards
  3. Propose clinical events in PM&R that could be adapted into interprofessional simulation scenarios
  4. Construct a scaffold for potential simulation scenario for your local setting

Rehab challenges in rural and remote settings….Northern Canada, Africa and Nepal

Dr. S. Macdonald, Dr. B. Zimmerman

My spouse, Sally Macdonald, and I will present a brief overview of our work experience as physicians in remote rural settings. This includes Inuvik, Yukon, Zimbabwe, and Nepal. We will illustrate through case examples the challenges faced in provision of medical rehabilitation in these diverse environments.

Hopefully this will be of interest to all medical providers curious about health care provision in a variety of geographic settings.

The presentation will be informal and open to questions and discussion.

Learning Objectives:

  1. Increase my awareness of challenges in provision of rehab medicine in remote settings
  2. Evaluate present rehab methods in remote settings
  3. Recommend new approaches to rehab medicine in remote settings
  4. Question goals of rehab in remote settings

Accessing Medical Cannabis in Canada: ABC Essentials for the Physiatrist

Dr. Karen Ethans, Dr. Colleen O’Connell

This workshop will focus on practical discussions that physiatrists need to have with their patients who request or are going to be considered for accessing medical cannabis. Cases will be used to allow for discussions highlighting the main ingredients in medical cannabis, how to consider dosing, and what forms of medical cannabis to suggest.The cases will be primarily spasticity and neuropathic pain cases. The history as to how marijuana evolved to be used for medical purposes has previously bee n discussed and will not be a focus.

Similarly, the evidence has previously been presented for use in spasticity and neurogenic pain, and will not be a main focus. This workshop will be of value to physiatrists, residents in physiatry, and medical students with a primary interest in physiatry.

Learning Objectives:

  1. Have an informed discussion with patients regarding the process of accessing medical cannabis in Canada
  2. Educate patients about the different routes available for medical cannabis
  3. Discuss with patients the main therapeutic ingredients in medical cannabis
  4. Explain to patients what the important differences are with medical cannabis as opposed to recreational cannabis

Maximizing spasticity management. From early intervention to novel interventions for the upper extremity.

Dr. Jorg Wissel, Dr. P. Winston

The session will be of value for physiatrists, residents and medical students and team members of mutli-professional and interdisciplinary teams involved in the management of patients with spastic movement disordrs or sensorimotor disturbances following lesions of the Central Nervous System (CNS). The presentation will cover and discuss the modern definition of spasticity causing a spastic movement disorder (SMD) and evidence based treatment methods in the management of this disabeling condition following stroke and other etiologies causing a SMD. The talk will focus on definition of SMD and epidemiological data of post stroke spasticity (PSS) to discuss the time course of spastic movement disorder in PSS. As well this paper will discuss the value of clinical predictors and imaging information from MRI studies with respect to the probability to develope PSS following first ever stroke.

Early management strategies of PSS including focal botulinumtoxin injections in the upper and lower limb and managing strategies in patients on risk to develope PSS will also be presented and discussed.

Learning Objectives:

  1. definition of spastic movement disorder
  2. epidemiology of post stroke spasticity
  3. clinical predictors of post stroke spasticity
  4. imaging technics as predictors for post stroke spasticity
  5. early botulinumt toxin management of post stroke spasticity
  6. management of patients on risk for post stroke spasticity

US Guided Injection Techniques for the Management of Common Joint Injections & Spasticity Chemodenervation

This interactive full-day US course will offer 7 stations for US learners in small groups of approximately 7 people at each station. The format will be a didactic demonstration by a skilled injector, followed by small group practice session on volunteer patients. There will also be observed techniques for patients with spasticity. The course will focus on both upper and lower limb spasticity and common upper and lower joints and surrounding tendons.

This session will be of value to all Physiatrists and learners that participate in the management of spasticity and joint and tendonous injections.

Learning Objectives:

  1. To demonstrate proper technique for US guided injections
  2. To integrate US into common PMR procedures
  3. To demonstrate approaches to specific muscles for chemodenervation
  4. To demonstrate common approaches to key joints
  5. To participate on hands on interactive injection techniques with live patients

Cultural Competency in Practice

Dr. C. Barnabe

The session will introduce historical legacies that shape health and health care delivery to Indigenous populations in Canada. Using an example of rheumatoid arthritis management, we will explore how outcomes are practically influenced by inequalities of social determinants of health. Participants will then explore, using physical medicine and rehabilitation cases, how to best approach care management.

Learning Objectives:

  1. Introduce the history of Indigenous peoples in Canada.
  2. Generate examples of how existing inequities in determinants of health influence management of health conditions.
  3. Explore solutions to existing care gaps using case presentations.

Creating Sustainable Models of Arthritis Care in Indigenous Communities

Dr. C. Barnabe

This keynote presentation will provide an overview of identified care gaps for Indigenous populations in Canada with arthritis conditions. These care gaps have informed the creation of models of care and cultural competency initiatives that will be described. The session will be of value to Physiatrists, Medical Students and Residents.

Learning Objectives:

  1. Develop an approach to identifying Indigenous community health service needs.
  2. Acquire knowledge on models of care development, implementation and evaluation in collaboration with Indigenous communities.
  3. Discuss practical issues to resolve in the implementation of models of care in Indigenous communities.

Rehab Update – Concussion

Dr. C. Debert

Annually, concussion affects at least 250,000 Canadians and more than 40 million people worldwide. A concussion can occur at any point, but more at risk populations include children and older adults. Up to 30% of individuals with concussion may suffer persistent post-concussion symptoms that include headache, dizziness, memory difficulties, poor sleep and mental health distress which can drastically effect their every day life. This session will address the new return activity, school and work guidelines and literature. As well, we will discuss recent research on preventative measures for concussion. Further discussion will include an evaluation of persistent post-concussion symptoms and potential treatments. Finally, there will be a brief discussion of emerging research on diagnostic and prognostic biomarkers in concussion.

The session will be valuable to: Physiatrists, Medical Students, Residents and Family Physicians.

Learning Objectives:

  1. demonstrate appropriate return to activity protocol following concussion
  2. Cite an appropriate return to learn and work protocol
  3. Review the preventative measures for concussion
  4. Acknowledge the many different sequale of concussion and persistent symptoms
  5. Consider the variety of treatments following concussion
  6. Consider the new tools for diagnosing and prognosticating outcomes following concussion

Rehab Update – ICU Rehabilitation

Dr. C. Grant

This presentation outlines current knowledge around critical care outcomes and critical care rehabilitation strategies. It summarizes current efforts in Calgary to address the needs of the post-ICU population. It will hopefully bring together like-minded care providers who have an interest in critical care rehabilitation.

This session will be of value to: Physiatrists, Medical Students, Residents.

Learning Objectives:

  1. Identify common difficulties patients experience post-critical illness
  2. Question current rehabilitation practices for patients who experience a critical illness
  3. Stimulate interest in collaborating nationally to address the rehabilitation needs of this population

Brain-Computer Interfaces in Rehabilitation: Real world applications

Dr. A. Kirton

Brain computer interfaces (BCI) have the potential to revolutionize the lives of the most severely disabled individuals. BCI systems can extract messages from the brain and translate them to control effector devices such as computers, wheelchairs, and communication devices. Original concepts required invasive brain implants connected to cumbersome analytical and effector systems with only partial efficacy. However, rapid technological advances are creating increasingly effective simple, wearable, wireless systems usable by real patients in the real world. Formerly “locked-in” people with cerebral palsy, brainstem stroke, spinal cord injury and other disorders are realizing new pathways through which they can interact independently with their world. Clinician awareness of BCI is poor and active engagement from the experts in physical medicine and rehabilitation targeted in this session is essential to advance progress.

Learning Objectives:

  1. Explain the fundamentals of how brain computer interfaces (BCI) work.
  2. Identify the clinical characteristics of ideal BCI candidates.
  3. List 5 practical activities of daily living that might be performed by an immobile person using BCI.
  4. Learn how BCI can augment communication in nonverbal individuals.
  5. Discuss the role of clinicians, patients and families in advancing BCI research and clinical applications.

Using electrodiagnosis to estimate prognosis after nerve injury

Dr. Larry Robinson

In this talk we will review key electrodiagnostic attributes and how they allow us to estimate prognosis after peripheral nerve injury. This session will be of value to physiatrists as well as neurologists, medical students, residents and peripheral nerve surgeons.

Learning Objectives:

  1. Classify nerve injuries
  2. Describe key attributes of prognosis
  3. Estimate prognosis for nerve injuries

Community SIG – “Research in the Community”

Dr. T. Lapp

This SIG will be a collective discussion of community physiatrists’ research experiences, and/or research aspirations. To date there has not been a forum for this conversation.

The breadth of community research remains unknown. By sharing our experiences perhaps we can find collaborative partners, better understand the community research method (funding, ethics review, publishing, etc), and encourage others to participate. This session is suitable for community physiatrists, or those considering a community position including residents.

Learning Objectives:

  1. Share community research experiences
  2. Compare nation wide funding opportunities
  3. Establish whether there are opportunities to combine research

Medical Legal/Traumatic Brain Injury Special Interest Group

Using a debate format, the two presenters will take opposing views towards the post concussion syndrome. The audience will be invited to actively participate in the debate about whether post concussion syndrome really exists. This will be followed by a discussion of the role of the physiatrist as an expert witness in cases of post concussion syndrome.
Learning Objectives:

  1. Name at least four reasons why post concussion syndrome is controversial.
  2. Discuss the overlap between post concussion syndrome and other post traumatic conditions.
  3. Name the pros and cons of treatment based on which position one takes on the post concussion syndrome.
  4. Discuss the role of the physiatrist as an expert witness in cases of post concussion syndrome.

 


The gloves are off: Does post concussion syndrome really exist?
What is the role of the physiatrist as an expert witness in cases of post concussion syndrome?

Dr. C. Vaidyanath

Using a debate format, the two presenters will take opposing views towards the post concussion syndrome. The audience will be invited to actively participate in the debate about whether post concussion syndrome really exists. This will be followed by a discussion of the role of the physiatrist as an expert witness in cases of post concussion syndrome.

The session will be of value to: Physiatrists, Residents and Medical Students.

Learning Objectives:

  1. Name at least four reasons why post concussion syndrome is controversial
  2. Discuss the overlap between post concussion syndrome and other post traumatic conditions.
  3. Name the pros and cons of treatment based on which position one takes on the post concussion syndrome
  4. Discuss the role of the physiatrist as an expert witness in cases of post concussion syndrome

SCI SIG: Theraputic Application of Intermittent Hypoxia

Dr. G. Mitchell

In this presentation, I will discuss developments with significant promise to improve rehabilitation in those suffering from impaired movement due to chronic, incomplete spinal cord injury and other clinical disorders that compromise movement. I will present this material as a story of clinical translation. The story begins by summarizing decades of basic science research concerning mechanisms through which modest exposure to brief episodes of low oxygen (intermittent hypoxia) triggers spinal motor plasticity. Although this concept is not intuitive to most clinicians or biomedical researchers, it has already inspired 7 publications and multiple ongoing studies concerning the ability of intermittent hypoxia to improve breathing, walking and arm/hand function in humans with chronic incomplete spinal cord injuries. Next steps towards clinical utilization will be discussed.

Learning Objectives:

  1. tell story of basic science translation to clinical application
  2. demonstrate that low oxygen can be good or bad–the difference is dose
  3. describe how low dose intermittent hypoxia triggers spinal cord plasticity
  4. explain how it was realized that this understanding could be “harnessed” to restore function after spinal cord injury
  5. update current human trials of low dose intermittent hypoxia
  6. reveal the next steps necessary for routine clinical practice

 


Issues in Diagnosis/Management of Chronic Pain in Community and Academic Centers

Dr. J. Flannery, Dr. D. Khumbhare

Our presentation will consist of an interactive goal focused presentation that provides the attendee with practical information that will enhance their approach to the chronic pain patient that finds their way into our collective practices. the session will expand upon the learning objectives through the use of:

  1. didactic information
  2. practical physical assessment
  3. video analyses regarding crucial conversations
  4. interactive exploration of the concepts that underlie the complexities of the chronic pain patient and practical methods of office management

This SIG on chronic pain assessment will be of value to community Physiatrists (within their general office based practice as well as their medical legal assessments), Residents and Fellows.
Learning Objectives:

  1. Able to perform a categorization within the biopsychosocial model for chronic pain
  2. Recall the pertinant features of history taking for chronic pain
  3. Perform a focussed physical examination for the chronic pain patient
  4. Utilize standardized questionnaires

 


Roundtable Workshop – Using self-reflection for practice asssessment

As part of the CanMEDS Scholar role, physicians are expected to engage in “the continuous enhancement of their professional activities through ongoing learning.” (CanMEDS, 2015) One of the enabling competencies to facilitate this is to “identify opportunities for learning and improvement by regularly reflecting on and assessing their performance using various internal and external data sources.” (CanMEDS, 2015)

This year, we have chosen to provide a forum for dedicated reflection and feedback for conference participants, with a guided reflection worksheet and an opportunity to provide peer feedback to a colleague on a difficult or memorable event. The goal is to provide a chance to practice critical reflection and consider how this technique can be useful as a form of practice assessment.

Learning Objectives:

  1. Discuss the components required to critically reflect on a recent memorable incident, highlighting one’s own performance in a specified role (e.g. clinician, educator, researcher, etc.);
  2. Demonstrate an organized approach to critical reflection, using this memorable incident as a focal point for discussion;
  3. Evaluate one’s own response to peer feedback and determine actions for future behaviour change.