Virtual Rehabilitation | Pi Day Speaker Series - March 2, 2021

Virtual Rehabilitation | Pi Day Speaker Series - March 2, 2021

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Jodi Cowan: Good afternoon, everybody and  welcome to our Pi day of giving virtual   speaker series event today's topic is virtual  rehabilitation of promising way forward. Jodi Cowan: Before we start, I’d like  to start with a land acknowledgement   of the traditional territory in  which we are gathering today. Jodi Cowan: Our university campus is situated on  the traditional territory of the Mississaugas,   a branch of the greater Anishinaabeg  nation, which includes Algonquin,   Ojibwe, Odawa, and Pottawatomi. Jodi Cowan: Because, everyone is turning  in with us remotely across a variety of   cities, I don't want to forget this  important element of reconciliation. Jodi Cowan: So, I’d like to ask everyone take a  moment to reflect on the traditional territory on   what you're on the Treaty that it's covered under  and your own personal relationship with the land. Jodi Cowan: As a university community we're  dedicated to increasing our awareness,   understanding and gratitude for  the lands in which we share.

Jodi Cowan: My name is Jody Cowan and I’m  the Community engagement coordinator here   at Ontario tech university, thank you  for joining with us for today's session. Jodi Cowan: Today is with Dr Pierre  Côté from our faculty of health sciences   it's a second 10 sessions, where we're  hosting with Ontario tech experts   to share the research and to spread  the word about our pi day of giving. Jodi Cowan: This will help raise funds for  our student relief fund which helps our   students who are experiencing  financial need to cover 19.

Jodi Cowan: Now, there will be time for  Q&A following the presentation so use   the Q&A function at the bottom of  your screen at any point during. Jodi Cowan: today's presentation and we'll  do our best to get to your questions. Jodi Cowan: This session is being recorded and  we will be posting it on our website so you   can watch it again or share with your friends  who are unable to make it with us to make it   work last life today I’d now like to introduce Dr  Peter coyote from the Faculty of health sciences. Jodi Cowan: Dr containers to Canada research  chair and disability prevention and rehabilitation   his research interests include the  study the management and prognosis   of musculoskeletal pain  mental health and disability. Jodi Cowan: His work aims to identify  modifiable risk factors and design   interventions that will reduce the burden of  chronic pain and disability and our population.

Jodi Cowan: He is also interested  in the translation of scientific   evidence into policy now I’d like  to turn it over to you, Dr. Côté,   for your presentation on virtual rehabilitation  a promising way forward take it away Pierre. Pierre Côté: Thank you very much Julie.

Pierre Côté: I will share my screen and good  afternoon everyone, and thank you so much for   sharing your lunch hour with us. Pierre Côté: I have to tell you that,  as someone who's been interacting with   students over the past year, I am  amazed every day by the resiliency. Pierre Côté: That the students  at our university have shown,   and I am truly impressed by  how they've adapted to this   challenging situation, so I thank you  very much for supporting our student body.

Pierre Côté: And for contributing  to their future success,   I’d like to talk to you today about  a topic that is very close to. Pierre Côté: My heart and that  I’m very passionate about which is   the world of rehabilitation and  I’d like to use the lens of an   epidemiologist I know most of you will I  heard that term a lot during the pandemic. Pierre Côté: To look at how we can actually  move the world or the field of rehabilitation   forward, given what we've experienced in the past   week, and how our university can really play  a role, nationally and globally in influencing   rehabilitation and people  helping people with disabilities. Pierre Côté: I think it's important  to first define rehabilitation   in in because there's been a lot of  misconception about what rehabilitation is.

Pierre Côté: rehabilitation is really a  set of interventions that are designed   to improve or optimize function and  disability with health conditions in   relationship and interaction with the environment. Pierre Côté: So, although rehabilitation  has been traditionally defined as caring   for individuals with severe  conditions or severe injuries. Pierre Côté: rehabilitation is much broader  than that, in fact, if some of you today   are wearing glasses hearing aids or you're wearing  some kind of support to help with your back pain.

Pierre Côté: These interventions  are all part of rehabilitation. Pierre Côté: So, rehabilitation is really part  of our daily life, whether we seek healthcare   or whether we interact with the environment  in, in fact, there are two main buckets. Pierre Côté: of interventions or  things that are done to ensure that our   public our patients have access  to appropriate rehabilitation. Pierre Côté: The first one is you  know is clinical rehabilitation,   which will consist of providing individuals  will need them with healthcare interventions. Pierre Côté: And this can range from seeing a  physical therapist a chiropractor in the Community   to having access to very significant in advance.

Pierre Côté: Intervention interventions  in tertiary care hospitals,   but the other bucket of interventions that   is really important rehabilitation is  what we call Community based we have. Pierre Côté: How do individuals with disability  with impairments can actually contribute and live   an active life in society, how do we adapt  our workplace, how do we adapt our sidewalk. Pierre Côté: These things, called Community  based rehabilitation are essential to ensure   that people with disabilities, a whole range  of disabilities can actually contribute. Pierre Côté: So today I’m going to navigate  between the fields of clinical rehabilitation   and community-based rehabilitation  and offer some thoughts about how we   and the university and can really  contribute to advance in this field. Pierre Côté: This very important study  published in The Lancet in at the end of 2020   in December of 2020 by the  World Health Organization. Pierre Côté: had a very strong  message for the global community,   what we've learned from this paper is  that today globally around the world.

Pierre Côté: There are 2.41 billion individuals  who are in need of rehabilitation services   and often cannot access them. Pierre Côté: Because of funding, because of  access, because they live in remote areas or   because they live in low-  and middle-income countries. Pierre Côté: And what does also  is also surprising for a lot of us   is that the main reason why people need. Pierre Côté: Rehabilitation services  is musculoskeletal disorders or   pain or disorders that affects your bones  your joints or muscles your ligaments. Pierre Côté: Such as your spine, in fact, low  back pain is the single most condition the similar   condition for which there is the highest need  of rehabilitation services throughout the world.

Pierre Côté: And that is the case for  134 of 204 countries in the world,   so low back pain is the main reason why  people experience disability in their life. Pierre Côté: what's so  surprising is that this problem   is not only an issue in the  low- and middle-income country,   but in fact low back pain is the main  reason for needing rehabilitation services. Pierre Côté: in Canada in our country in our  province and where we live and, as you can see,   this is also true in South America in Africa  in part of the Middle East and Southeast Asia.

Pierre Côté: So, disability related  to low back pain in the need   to provide rehabilitation  services for these individuals   is the main reason for lost productivity  or loss of functioning in our communities. Pierre Côté: No back and neck pain, in fact, are  the main cause of disability in Canada and try the   wall, as I just mentioned, and they are the most  common cause of medically certified six absence. Pierre Côté: sickness and certification   and they have led to the opioid epidemic that has  been plaguing our nation, for the past decade. Pierre Côté: In fact, people  with low back pain and neck pain,   or very likely to use healthcare services. Pierre Côté: Roughly about half of individuals who  experienced something in their back will consult   the healthcare providers and half of the  costs are related to direct patient visits. Pierre Côté: The costs are rising exponentially  in fact just completed an analysis of the cost   of low back pain, you know Ontario and  the cost annually or close to $1 billion.

Pierre Côté: depend them, it  did not help with the situation   last March, as you well know, and you're seeing me  my Home Office, we have to change our lifestyles. Pierre Côté: And our lifestyles change I’ve  led to the way different ways in which we live,   we had to take care of children  at home, we had to take care. Pierre Côté: of our elderly parents, we had  to adapt our workplaces, to be able, that   we function make times to actually deliver on our  work outputs while taking care of our loved ones. Pierre Côté: And these lifestyle changes have  led to an impact on our health, our cemetery   the prevalence of sedentary lifestyle  has greatly increase in our communities.

Pierre Côté: Our sleep as nothing prove  it has gone down in terms of quality,   a large segment of the population is now  experiencing stress anxiety and depression. Pierre Côté: Because we're less active and more  sedentary we have gained some weight and also,   we have suffered, or we are suffering from  social isolation, these are not new things   for you, I knew, you are well aware of  these changes that we had to adapt to. Pierre Côté: But what's also very important  to consider is that those individuals in our   Community will live with long term conditions,  these would be chronic diseases and disability.

Pierre Côté: reported to a  statistics Canada survey conducted   last summer that their health and  actually deteriorated more than 50%. Pierre Côté: Of these individuals reported  that their health is worse that has been   made worse by the pandemic 61% are now  reporting to have worse mental health. Pierre Côté: But what is also  very important, is that about 53%   of these individuals with chronic conditions  needed medical treatment, but could not access it. Pierre Côté: So there has been  a real challenge for individuals   with long term conditions and disability  to access their appropriate health care. Pierre Côté: And this is also through for  those who needed rehabilitation services   such as physical therapy chiropractic and massage   about 42% of those cannot access their treatments  and therefore help with their disabilities.

Pierre Côté: So, what did people do and what how  did our society in our healthcare system react   to this to this side effect of the pandemic. Pierre Côté: Well, we saw an increase  in the use of telehealth and virtual   health services internationally, in  fact, the World Health Organization. Pierre Côté: reported that 63% of countries  that are Members States of the who   reported disruption in this  in rehabilitation services. Pierre Côté: And 58% of these  countries had to replace   in person consultation with  Tele health during the pandemic. Pierre Côté: Now telehealth is not new,  it was its origin date back to the 1960s,   but there has been a slow evolution of telehealth  and virtual health and virtual rehabilitation   really until the pandemic, which  has led to a really rapid evolution   of services in the United States, compared to. Pierre Côté: 50 but there has been a 50% increase  in synchronous Tele health visits in 2020.

Pierre Côté: This is basically you need to consult  your general practitioner your doctor, you cannot   go to the office, so therefore you're likely to  pick up the phone or engage with your physician. Pierre Côté: To a zoom conferences,  this is what synchronous Tele health is,   and this has increased by 50% compared  to last year in the United States. Pierre Côté: And what was really noticeable is  that in the early phases of the pandemic there was   154% increase in telehealth utilize a synchronous  Tele health utilization in the United States,   and I would assume that we are, we have faced  a similar type of issue here in the country. Pierre Côté: Fortunately, most Canadians did  not get infected with the coronavirus but   one of the side effects of the pandemic again was  the reduced access to health care and, in fact.

Pierre Côté: telehealth was used not primarily to  treat covert patients, but it was used to treat   the people's heart disease arthritis depression,  diabetes and other chronic health disorders. Pierre Côté: So, what is tilly rehabilitation  and what is virtual rehabilitation well tilly   rehabilitation is really the delivery  of professional rehabilitation services   at a distance using technology  like we are doing right now. Pierre Côté: And this has rapidly evolved more  so recently, but over the past 1015 years into   virtual reality rehabilitation and  this is what I’m really excited about. Pierre Côté: And where I think our university  can play a great role in the future.

Pierre Côté: virtual reality  rehabilitation is really using   technology to allow users to interact with  a multi-sensory simulated environment. Pierre Côté: and receive real time   feedback on performance and I’ll give  you an example of that in a minute   so it's really about changing behaviors adapting  lifestyle using virtual reality visitation. Pierre Côté: gaming is a key  component of these technologies,   now I do the work to people benefit from using  20 rehabilitation and virtual we have station. Pierre Côté: So, some of the work that  we've engaged with in starting with. Pierre Côté: In last spring   at the Center for disability prevention and  rehabilitation, where I am the director.

Pierre Côté: The stretching looked at the overall  body of knowledge, the overall body of science   to understand whether or not patients, we use  these technologies these services actually   benefit from them from a health perspective. Pierre Côté: And the evidence is quite clear,   and this is very, very important  that synchronicity rehabilitation. Pierre Côté: Being in contact with your  physical therapist during his session   for whatever health problem you  have such as non-acute headaches   neurological disorders low back pain, are  still are try this of the knee and the hip.

Pierre Côté: is actually similar in benefits  to seeing a healthcare provider in person. Pierre Côté: So, the idea that timmy   rehabilitation is not as good as  being with a clinician in their office   is actually not supported by the evidence  people benefit from these interventions. Pierre Côté: Now,   what about 3D virtual rehabilitation,  we are virtual reality rehabilitation. Pierre Côté: Well, again looking  at the seven that's, it is clear   that there was this is a promising and viable  options for rehabilitation of musculoskeletal   disorders neurological disorders and even  mental health and cardiovascular disease. Pierre Côté: And this is  really where I think the future   of rehabilitation is going to be  evolving in the next 10 to 20 years.

Pierre Côté: It was an example of the  delivery of virtual rehabilitation   intervention, which was just recently tested  for people with chronic low back pain. Pierre Côté: Now, chronic low  back pain is a really challenging   disorder condition to treat because once  you've had pain for more than six months. Pierre Côté: The course is really challenging for  individuals that pain tends to become chronic,   and it has lasting consequences on the ability of  individuals to engage in their daily activities. Pierre Côté: So, I was really excited  when I saw this new intervention,   which is basically using virtual reality. Pierre Côté: With the goggles that individuals  put on their face for a period of eight weeks,   and they were shown little videos and.

Pierre Côté: and music that emphasize the  concepts of cognitive based rehabilitation. Pierre Côté: And provided   messages about education relaxation mindfulness  escaping the stress of the daily lives. Pierre Côté: pain distraction gains and dynamic  breathing so individuals that were randomly   assigned to receive the ease Dr X device  received these virtual reality interventions. Pierre Côté: And it was compared to a sham  interventions people got the same goggle,   but they were just provided  with low key videos and random   music in their in their device,  and the results were very exciting. Pierre Côté:   The use of the virtual reality virtual reality  rehabilitation really had an impact on pain and   disability and as individuals, so this graph  shows the course the progression of pain overtime.

Pierre Côté: Since the beginning of the trial   for a period of about a year  following the intervention. Pierre Côté: In what you can see is  that there has been a constant decline   in the pain reported by the individuals  that was much more improved. Pierre Côté: In those who received the virtual  reality intervention compared to those who receive   the Shan intervention in this was also true for  a range of other outcomes, such as mental health   outcomes and also the activity their ability of  individuals to engage in their daily activities. Pierre Côté: So, the future is there for us, and  this is an area of research that we will be that   we are engaged in at the Center for disability  prevention and rehabilitation at the university. Pierre Côté: And there are some important  unanswered questions that I hope I’ll be able   to tackle with my colleagues and graduate  students over the next in the near future. Pierre Côté: And these questions are not  necessarily related to the medical interventions   related to the patients but they're also in  related issues related to equity and access.

Pierre Côté: Is this technology,   easily accessible by all by individuals in  all socio-economic status in the population. Pierre Côté: What about individuals  will live in remote areas   where the technology may be harder  to get this is an important area of. Pierre Côté: Research that we need to involve them   what do we do with the rapid  evolution of technology, how do   we adapt current technology with current  with very quickly evolving advancement.

Pierre Côté: The concept of patient  centered care and shared decision making,   which is now part of evidence-based  practice will need to be adapted. Pierre Côté: To the delivery of  virtual reality rehabilitation   simply often because we cannot  touch patients, we cannot establish   the necessary contact to engage with  patients in in a in a shared decision making. Pierre Côté: Well, we find ways to  deliver these services and a cost   effectiveness way so that can provide  value-based care to our population. Pierre Côté: And finally, is it going to be  safe for patients will increase the rate of miss   diagnosis or promote over medicalization by that  I mean will it be a technology that will be used.

Pierre Côté: For people to actually access  services when they may not necessarily   need them, so I think that Ontario tech. Pierre Côté: is very well positioned  to tackle these issues because   six of our faculties can actually join  forces, this is a challenging issue. Pierre Côté: That needs more than healthcare  intervention, it needs collaborations with our   colleagues and the Faculty of education  issues obviously related to equity. Pierre Côté: Human rights need to be tackled  with our colleagues and social medicine   sciences and humanities computer  engineering technology with science. Pierre Côté: And in business its  artificial intelligence and robotics,   so I think it's our challenge. Pierre Côté: to your rehabilitation virtual  rehabilitation is not going anywhere,   and I think that we can make a difference, so  thank you so much for sharing a few minutes of   your time with me today, and I hope we can engage  in a Q&A Thank you very much, God back to you.

Jodi Cowan: Thank you so much, Pierre I’m sure  I speak for all of us today when I say that we   all learned a lot, and we will keep these tips  in mind, especially when working from home and. Jodi Cowan: You mindful of our ergonomic setup so   we can eliminate that lower back  problem that you talked about so much,   I do have a couple great questions from the  audience today and the first one would be. Jodi Cowan: Do you think that VR  rehabilitation will help expand   the range of in-home services that can be offered. Pierre Côté: Yes, I think that this is one  of the goals of virtual rehabilitation. Pierre Côté: Especially in populations that are  either live in remote areas in rural areas or in   individuals that have issues such as mobility  problems they cannot easily get to a clinic. Pierre Côté: or even busy parents nowadays that  have to double tasks with their work, the children   Educating the children, so if they can take a few  minutes in their home use VR rehabilitation, then   I think that this is a promising avenue to  improve their chronic health conditions.

Jodi Cowan: And as a really awesome follow up  question Dr Côté, we were wondering what the   VR rehabilitation will help  sorry, what kind of access, do   you need for bandwidth for those in remote  areas to offer these kind of services as. Jodi Cowan: Virtual rehabilitation okay. Pierre Côté: I must admit,  God that this is beyond my   knowledge, expertise I’m not well versed in the  technology requirements for this, but I know. Pierre Côté: having discussions  with my colleagues and the Faculty   of business and information  technology at the university   that's really, they are focusing on making sure  that these are accessible, so therefore using   cell phone or other devices could be an avenue  that is used to deliver these interventions.

Jodi Cowan: awesome now we both can agree that  the mental and physical health of our students   is of paramount importance to all of us, so  what would you like to see the university adopt   a virtual rehabilitation to best enhance  our services that we provide here. Pierre Côté: I think that I would  start by focusing obviously on the   mental health of our students now, and  I know that the University has done. Pierre Côté: tremendously tremendous  efforts and it's very conscious of these,   and I think that developing virtual  rehabilitation or virtual reality interventions. Pierre Côté: With the students understanding  their needs is really the way to move forward,   so I would focus on mental health in them on  promoting exercises and physical activity,   because that is really the key. Pierre Côté: To help with a lot of the  issues that I've mentioned about today. Pierre Côté: From pain to  sleep to sedentary lifestyle.

Jodi Cowan: This is very exciting now  can this be offered in in care settings   ltc age by the staff there do they need  specialized training, how do you see this   working in conjunction with primary healthcare,  such as chiropractors and physiotherapist. Pierre Côté: yeah, so obviously it would  have to be a bit of a learning curve,   with the staff but I’m sure that that  can be managed well and, in fact,   some of these interventions  have been delivered or used. Pierre Côté: In clinical setting on long  term care homes to compliment the services   that are provided to elderly populations  or individuals who need rehabilitation for.

Pierre Côté: Their musculoskeletal  neurological deficit, so this is also another,   this is a very good question and there another  avenue for these technologies is that they can   complement what is currently  provided in clinics and hospitals. Jodi Cowan: Great well, I must admit we're  so lucky to have someone with your expertise   as part of our Ontario tech family and the  support that you give for our students is   amazing, so thank you again so  much PR for joining us today. Jodi Cowan: This is our fourth annual pi  day of giving her we're celebrating the   infinite possibilities for our  students here at Ontario tech.

Jodi Cowan: it's been a difficult year  for everyone, as we all can imagine and   I’m glad that we're able to switch to  virtual learning within one day we're   really looking forward to being  back on campus with our students. Jodi Cowan: However, our students need help, more  than ever, so I really hope that everyone joining   us today will make a gift and supportive  our student really fun to help students. Jodi Cowan: who are experiencing their  financial need that were unexpected do to   reduce their last part time jobs and  all donations to the student Relief   Fund are going to be matched dollar for dollar. Jodi Cowan: For those of you who didn't make a  gift when registering today we do, thank you. Jodi Cowan: I’m pleased to share that we've  already given out nearly $400,000 to students   in addition to our regular scholarship  and bursary program which is just amazing. Jodi Cowan: And I in saying that I  would really like to also thank camp   travel group for their generous  sponsorship today for our pi day of giving.

Jodi Cowan: I hope those of you joining us  today will spend your lunch hour with us   for the remaining of our speaker series sessions. Jodi Cowan: You can find more details on  the topics and speakers on our website   on Ontario tech you dot slash  Ontario tech backslash pi day. Jodi Cowan: Thank you for joining us  again thank you so much to our Ontario   tech expert Dr Peter conte before we say  goodbye today, I’d like to share a short   message with you from our students here  in Ontario tech, thank you, thank you. Jodi Cowan:   On March 14 you can help support my dreams  knowledge is infectious and my dream is to teach. Jodi Cowan: My dream is to educate  young students about the benefits   of physical activity, so they can adopt  these practices into their daily lives. Jodi Cowan: And also contribute to  innovative technologies that leave   a lasting impact on society on pi day join  our circle and support students like me.

Jodi Cowan: I want to help save  people from natural disasters;   I want to be part of engineering projects  that to help make tech be your best friend. Jodi Cowan: I want to develop  technology to aid in space exploration   I aspired to design aerodynamic race cars  to shape the future Formula one racing,   just like the value of pie opportunities,  like me, are endless to join us.

2021-03-12 21:53

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