Mohamad Fakhereddin (PhD student) presented a poster abstract on a project that he worked on with supervisor Dr. Dave Walton about the Traumatic Injuries Distress Scale (TIDS). Mohamad presented his poster at the International Association for the Study of Pain 2018 World Congress on Pain, in Boston. The TIDS is a self-report questionnaire comprised of 12 items intended to measure the experience of post-traumatic distress and predict recovery. The TIDS has three subscales: negative affect, uncontrolled pain, and intrusion/hyperarousal. The main objectives of the study were to identify trajectories of recovery in a longitudinal cohort of people with non-catastrophic injuries affecting the musculoskeletal system, and to identify cut scores of the TIDS that best predict recovery trajectories. Mohamad and Dr. Walton’s findings showed that the TIDS can predict whether a patient will experience rapid or prolonged recovery from disability with 97% accuracy. Furthermore, the scale showed potential in predicting similar recovery trajectories in pain, post-traumatic stress disorder and depression (≥85%). Mohamad, along with Dr. Walton, were interviewed by Pain Medicine News to explain their findings and highlight the importance of this revolutionary prognostic tool. Click here to watch the video! You can also read the full article here for more information.
PIRL MSc student Sadia Siraj, who just successfully defended her thesis on August 17th, has opened new ways of exploring the link between musculoskeletal trauma and distress. Sadia used data from the SYMBIOME longitudinal databanking project to find associations between pain, psychological distress, and key biomarkers when all were captured within hours to days of a traumatic injury. Using a sample of 80 participants drawn from the local urgent care centre, Sadia focused on 3 key biomarkers of distress: cortisol, brain-derived neurotrophic factor (BDNF), and transforming growth factor beta-1 (TGF-B1). These were chosen as they've previously shown differences in people with and without chronic pain and Sadia wanted to know if similar associations could be found between those experiencing heightened psychological distress and those with little distress following a mixed group of injuries affecting any body part from the neck to the ankle. Of the 3 biomarkers, cortisol was most frequently associated with the amount of pain and distress patients said they were experiencing, thought BDNF also showed potentially important effects. Then Sadia chose to look deeper and explored the possibility that those who have experienced significant traumas as a child would react differently, both physiologically and psychologically, to trauma in adulthood. Using responses to the Adverse Childhood Experiences (ACE) questionnaire, she found a number of potentially important interaction effects, suggesting that indeed the response to trauma such as a car crash, sports or work injury may be different for those who have experienced childhood traumas (e.g. abuse, neglect, dysfunctional homes) and those who have not experienced such traumas. As with much research, these findings lead to more questions than answers and of course require replication before any of the the results can be endorsed with confidence, but it certainly fits with the ongoing views that trauma does not occur in a vacuum but rather is affected by prior life experiences.
The publication is currently under preparation.
The clinical sites have been set, 26 sites in all across Canada with at least 1 in every province and in the Yukon. Travel arrangements are finalized, recording equipment is at the ready, research ethics approval has been obtained and packing for 49 straight days on the road is underway. The next step is FOCUS GROUPS! Yes, we want to hear from YOU. We will be stopping at several major centres across the country and running 1.5 – 2 hr focus sessions to capture your views on the threats facing physiotherapy in Canada in the next 5-15 years, the opportunities we should be expecting to present themselves, the primary research questions we need to be asking NOW to make sure we’re ready for the future, and how you think physiotherapy training programs should be reformed all to ensure that the profession continues to thrive into the digital and information age.
The cities in which we’re holding focus groups are:
· Newfoundland: Steady Brook and St. John’s
· Nova Scotia: Halifax
· New Brunswick: Fredericton
· Quebec: Montreal and Quebec City
· Ontario: Ottawa, Thunder Bay, Toronto, London, Hamilton
· Manitoba: Winnipeg
· Saskatchewan: Saskatoon
· Alberta: Edmonton and Calgary
· British Columbia: Prince George and Vancouver
· Yukon Territory: Whitehorse
CLICK HERE to register for one of these sessions (space is limited!). Dates and locations are being updated all the time as we confirmations roll in. Great big extra special thanks to those clinicians and friends who have provided space for the focus sessions in each of these cities.
And finally, a HUGE thanks to those provincial associations that have provided support for this project: the Canadian Physiotherapy Association, PTAlberta Association + College, The Manitoba Physiotherapy Association, the Ontario Physiotherapy Association, l’Association Quebecoise du Physiotherapie, the Nova Scotia Physiotherapy Association, the New Brunswick Physiotherapy Association, and the Newfoundland and Labrador Physiotherapy Association.
The Pain and Quality of Life Integrative Research Lab is excited and proud to congratulate the following lab members in their recent successes:
Josh Lee (PhD candidate) was recently awarded an Earl Russell Trainee Grant ($10k for one year) for his project exploring gut microbiotic changes over the first 6 months in people following acute musculoskeletal trauma and pain.
Ryan Power (Research Assistant) has recently been offered a research administration and coordination position with the Musculoskeletal Rehabilitation Research Network (PI Joy MacDermid) that will see him move to full time on campus. We're pleased that he'll be able to continue working with the PIRL as well.
Dave Walton (Director) was the successful applicant from the Faculty of Health Sciences for the Western Teaching Fellows program. This title comes with $10k/year for 3 years and additional money for protected time for conduct of research on education. Dave will be exploring and evaluating the development and delivery of a competency (mastery)-based interprofessional non-thesis Master's program in Interprofessional Pain Management at Western.
Dave was also awarded a grant from the Bone and Joint Institute at Western ($15k for 1 year) along with co-investigator Jim Dickey (biomechanics) to further development of a VR-based immersive road traffic collision simulator to allow highly sensitive exploration of startle and other reactions to 'virtual' trauma without actually damaging any tissues. Dave was also co-investigator on another pilot grant (Aaron Price PI, Ana Luisa Trejos co-I) to allow development of smart wearable fabrics for evaluating neck impairments and behaviours.
Stacey Guy (PhD candidate) also recently successfully defended her comprehensive/candidacy examination for which she argued in support of inclusion of individual clinician heuristics and team dynamics into implementation science frameworks for translating new clinical practice guidelines in pain and other conditions into actual change in clinical behaviour.
Congrats to all members of the lab for their accomplishments and ongoing successes!
PIRL PhD student Swati Mehta (co-supervised by Drs. Dave Walton and Eldon Loh) successfully defended her thesis entitled "Predicting Response to Medial Branch Blocks: A Clinical Decision Making Tool". Swati presented 3 studies in her thesis: 1. An exploration of the contribution of patient demographics and clinical signs to neck-related disability, 2. An exploration of the ability of cognitive and psychosocial factors to explain chronic neck disability, 3. A clinical decision tool to predict response to medial branch blocks for neck pain. Dr. Mehta made her supervisors and lab-mates proud with an outstanding defense and we're excited to see the results of her next academic steps. Starting later this year she will be off to University of Saskatchewan to begin her post-doctoral work exploring the effectiveness of cognitive behavioural therapy for pain delivered through an online platform.
Congratulations Dr. Mehta!
Three groups of Master's of Physical Therapy students that were supervised by Dr. Dave Walton during their final year project presented the results of their research during the School's research poster day in July. The projects included a pilot evaluation of some key metrics to be used in a whiplash simulation project currently being developed, a survey of health valuations across different symptom frequencies and intensities, and the first stage of the 'Good Physio' project in which the group captured the views of academics when asked the question 'what makes a good physio?'
Dr. Theo Versteegh has recently made news for his new TopSpin360 device, a new neck training invention that he believes may have application in neck and concussion rehab. He has recently been profiled in the London Free Press and on CBC Radio One's Ontario Morning with Wei Chen. Continuing this string, Dr. Versteegh also recently won the London TechAlliance's 'Techcellence Award for Innovation' for his invention. Congrats Theo and here's to continued success!
PhD Candidate Swati Mehta has recently been announced one of the co-winners of the Lawson Health Research Institute's Leadership Award 2016. Established in 2002, the Leadership Award recognizes motivation, integrity, critical reasoning and scholarly aptitude in trainees. Swati will be presented the award at the Lawson Impact Awards Dinner and Gala in April. Congratulations Swati!
PIRL Director Dr. David Walton was one of nearly 40 co-applicants on a successful Strategy for Patient Oriented Research (SPOR) grant in Chronic Pain offered through CIHR, totaling $12.5 million to be shared across a network of researchers from the east coast to the west. Dave also recently received word of a successful grant that will provide some funding for select graduate students and research support personnel through 2021.
And speaking of support personnel, the PIRL is pleased to announce the hiring of its first Research Assistant. Mr. Paul Phares will serves as the RA focused on the SYMBIOME longitudinal databanking project for at least 6 months (we're hoping to keep him longer, wink wink).
Onward and upward!
It is with great pleasure and considerable pride that the Pain and Quality of Life Integrative Research Lab announces the successful thesis defense and degree completion of our first PhD student Dr. Theodore (Theo) Versteegh. Dr. Versteegh did himself, his lab, and his supervisory committee proud as he presented and defended his thesis entitled "Development and Initial Validation of a Novel Neck Strength Assessment and Neuromuscular Training Protocol". His projects included the development and testing of a portable handheld method of assessing neck strength including reliability and validity, and a pilot study of the effects of training football players on a new neuromuscular training apparatus on strength, coordination, and concussion risk. Despite it being still early days, it seems Dr. Versteegh has a promising area of research to develop as he matures into an independent researcher.
Congratulations Dr. Versteegh!
A bit late off the mark on this post, but need to recognize the phenomenal job that students from Western's Master's of Physical Therapy (MPT) and Master's of Clinical Science (MClSc) programs did during their poster presentation day July 17th, 2015. This is a great opportunity to showcase the work that's going on in the PIRL and more broadly in the School of PT at Western.
An innovative 2-day invite-only workshop was recently held at Western University, hosted by Dave Walton with support from a strong organizing committee, March 25th and 26th 2015. The workshop brought together 30 participants representing leaders in the field of post-traumatic MSK pain, leaders in other fields that already exist here at Western, and key representatives from consumer stakeholders. The event was modeled as a hybrid of short TED-type talks interspersed with periods of active participation and idea generation. The goal of this event was to identify new directions for research into questions such as 'why do some people develop chronic pain and disability after an acute injury while others recover well?' and 'what is the relationship between pain and disability, and where to biology, psychology and the environment overlap?'. The event was organized by a committee led by Dr. Walton and included Drs. Joy MacDermid, Jeff Dixon, David Holdsworth, and Trevor Birmingham with special assistance from Shannon Woodhouse of the Joint Motion Program at Western. Professional facilitator Bill Aal from www.unconference.net kept the event on track and ensured a successful outcome.
The event was sponsored by The Canadian Institutes of Health Research, the Faculty of Health Sciences at Western, the Schulich School of Medicine and Dentistry, the two Clusters of Research Excellence at Western: Cognitive Neuroscience and MSK Health, the London Orthopedic Unit of the Ontario Physiotherapy Association, the Orthopedic Division of the Canadian Physiotherapy Association, and Gordon Good Law Office. Participants from Western included those in fields as diverse as Physical Therapy, Physiatry, Psychiatry, Endocrinology, Microbiology, Dental Science, Epidemiology, Imaging Physics, and Biomechanics among others. Experts from other institutions were present, representing McMaster University, McGill University, University of Maryland, the University of British Columbia, Northwestern University, the University of Western Sydney and the University of North Carolina. Consumer groups included the Canadian Physical Therapy Association, the Ontario Chiropractic Association, the Canadian Pain Coalition, the Canadian Medical Association, and the Ontario Trial Lawyers Association.
Participants left the 2-day event with a sense of excitement over what true interdisciplinary, inter-institutional and international collaboration could accomplish and how we may someday identify the true nature of pain, disability and recovery after traumas such as whiplash, low back injuries, sports injuries or post-surgical pain. A paper will be published that outlines the results of the event and serves as a white paper for those looking for rigorously-developed research priorities in the field.
Three student groups, two from the entry-level Master's of Physical Therapy (MPT) and one from the post-graduate Master's of Clinical Science (MClSc), Manipulative Therapy fields, presented their posters during the annual PT school Poster Day at Elborn College on Friday June 18th. As expected, all did very well and made their supervisor(s) and the lab proud. Well done to the following students:
Quantitative Physiological Responses to an External Perturbation Mimicking a Small Whiplash Moment under Emotionally Neutral Conditions
aka: The Whippy Kids
A Pilot Evaluation of a Novel Clinical Tet for Cold Hyper-reactivity in Healthy and Neuropathic Pain States
Diagnosing Anterior Cruciate Ligament Tears: An Updated Systematic Review and Meta-Analysis of Common Clinical Tests
Congrats to all of our student groups on a job well done!
Dave Walton will be offering a first-of-its-kind opportunity for clinicians interested in improving their skills and knowledge in the area of comprehensive pain assessment. This intensive 1-day workshop will take participants through a deeper exploration of pain intensity scales, quantitative sensory testing, evaluations of cognitions and perceptions, and pain-related disability. A full description of the workshop can be accessed from the course registration page. A 1-page flyer for posting can be downloaded here.
We are excited to welcome four new students into the PIRL family. Below you will find a quick introduction about each one of them.
- a Ph.D student from Calgary
- background in Basic Science will help him pursue new research directions in the biology of chronic pain
- a work study student currently in her fourth year of completing a Bsc degree at Western
- interested in pursueing further schooling in an area of the health sciences including physiotherapy
- a high school co-op student working three hours a day with Dave untill the end of January
- an avid hockey and volleyball player (look for him in the NHL in about 5 years)
- a fourth year student in health science
- conducting an independent study under Dave's supervision in which she will review common theories behind health behaviour changes and how they have been applied to type II diabetes management
We are excited to be welcoming Northwestern University's Dr. Jim Elliott for a one-day visit to the PIRL lab and the campus of Western University. As part of his visit, Dr. Elliott will be offering a 1-hour special lecture to faculty, students, and interested members of the community. A flyer can be downloaded here.
The Clinical Whiplash Intervention and Prognosis research group has undergone a name change, and is now the Pain and Quality of Life Integrational Research Lab, or the PIRL for short. We've revised the website to provide cleaner interface and will be doing our best to keep the information updated and active. Please check back frequently for ongoing updates.
On Friday July 19th, 2013, 4 groups of students in the Master's of Physical Therapy or Master's of Clinical Science programs at Western presented the culminations of their year-long PIRL-related research projects during the annual Poster Day at Western. Congratulations go to the following students (with titles of their projects):
Matthew Pulickal, Amber Rollack, Jennifer Veitch: Psychometric testing of a Health-related satisfaction tool: The Satisfaction, Interference and Recovery Index (SIRI)
Uday Emani, Katrina Sovio, Nathalie Desmarais: Evaluating the psychometric properties of the Trauma Anxiety and Distress Scale (TADS) for acute musculoskeletal trauma
Jessi Doucette, Leah Higginbottom, Melissa Seifreid, Kristen Wanless: Evaluating a new tool for testing cold reactivity in a healthy sample
Danielle Beaudet, Marla Greenbaum, Leah Hellyer, Amanda Tritton: Evaluating the reliability of a neck strength asssessment protocol using self-generated resistance with a handheld dynamometer
All of the groups did a great job on their presentations. Congratulations to all on a job well done!