The overall aim of this project is to address gaping holes in how musculoskeletal pain is served in BC emergency departments. We will develop and pilot the Musculoskeletal Comprehensive and Response in Emergency (MSK CARE) clinic in emergency departments in the Fraser Health Authority. This type of clinic diverts patients to a MSK practitioner for triage and management. Similar clinics are running successfully in Australia and Canada (Montréal, Quebec City, Kingston, Calgary, Sherbrooke). In BC, there are no similar clinics like the MSK CARE clinic, despite these types of clinics delivering “shorter wait times, happier patients and expert care.” We will measure whether the MSK CARE clinic can (1) reduce the amount of time patients spend waiting in emergency departments, 2) successfully re-direct (‘divert’) patients from the emergency departments, and (3) is an acceptable and feasible model of care. The findings will be shared through research publications, webinars, café scientifique, and infographics. The findings from this project can provide one solution to assist in tackling overcrowding in the Fraser Health emergency departments and improve access to primary care for all people with musculoskeletal pain in this region.
Research Location: Centre for Hip Health and Mobility (CHHM)
Effect of Lateral Meniscus Posterior Root Tears and Repairs on the Mechanics of the Loaded Knee
We will study how a lateral meniscus root tear, a common knee injury, impacts joint mechanics and whether a root repair can restore mechanics to normal. This is important because joint mechanics must be normal to protect the knee from osteoarthritis (OA) later in life. Menisci are crescent-shaped structures that attach to the top of the shin bone at the tips of their crescent shape, called the roots. There is an inner (medial) and outer (lateral) meniscus in each knee. They spread out load to reduce knee stress. Tears to the roots of lateral menisci are a common sport injury. A torn lateral meniscus cannot spread out as much load. This can lead to future knee OA. Lateral root tears can be repaired by stitching the torn root to the bone. This has helped the lateral meniscus spread out load again in cadavers and computer models, but whether it helps in a living person’s knee remains unknown. We will use a special MRI scanner that can image people standing up with their knee loaded. We will measure joint mechanics in patients before and after lateral root repair. This will inform us on how lateral root tears and repairs alter the mechanics of loaded knees, giving insight into mechanisms that can lead to or prevent future knee OA.
Making moves towards active living after hip and knee replacement surgery: A consensus meeting of healthcare providers, fitness leaders and people with lived experience
More than 18,000 people in BC will have a hip or knee replacement this year to treat severe pain and reduced mobility from arthritis. After surgery, most patients will have a short course of physiotherapy and be encouraged to engage in regular physical activity such as walking and cycling. However, our research shows that patients receive inconsistent advice and few supports to help them become more active. In fact, they are less active than guidelines recommend to promote health and less active than their healthy peers. There are community-based programs available to help people be active after surgery but we do not know where they are located or how well they are designed and delivered. Most importantly, we want to learn if these programs are safe and help people to become active after joint replacement surgery. To answer these questions, we propose to search websites and query providers to find programs available in BC and describe program features. We will then bring together researchers, healthcare providers, fitness leaders, and patients for a 1½-day meeting to decide what makes a community-based exercise program safe, easy to access, open to everyone, and helpful for people with a hip or knee replacement.
SuPA Mobility: Supporting Physical Activity for Mobility in Older Adults with Mobility Limitations
Problem
As individuals age, they have a greater risk of limited mobility, or difficulty in getting around safely in one’s environment. Limited mobility is linked to illness, disease, and decreased quality of life.
Recent research show increasing physical activity by 6-minutes per day can improve mobility and prevent future disability. Despite the positive impacts on health, many older Canadians do not perform sufficient physical activity. Health coaching, a person-centered process to change behaviors with goal-setting, action planning, and feedback, is effective at improving physical activity participation in older adults. However, none of the previous health coaching studies included older adults with limited mobility.
Research
This study aims to address this knowledge gap to evaluate if health coaching can improve mobility and increase physical activity in older adults with limited mobility. We will conduct a 6-month study comparing health coaching to health education on improving mobility in older adults aged with limited mobility.
Potential Impact
Increasing physical activity through the use of health coaching has the potential to improve mobility and decrease the negative health impacts of limited mobility in older adults.
Exercise for Healthy Aging: Mobilizing Knowledge with Users and Clinicians in BC
The number of adults over the age of 65 is expected to double in the next 20 years. Maintaining both cognitive function (i.e., thinking abilities) and mobility (i.e., the ability to move) are vital to functional independence and quality of life. Exercise can improve cognitive function and mobility in older adults.
However, many older adults are inactive. Key barriers to exercise include: 1) lack of motivation; 2) medical conditions, such as arthritis; and 3) lack of knowledge on how to exercise safely and effectively. To address these barriers, we will: i) disseminate the latest evidence on the benefits of exercise for cognitive function and mobility via a public forum; ii) deliver interactive workshops during which older adults (and caregivers) will learn how to exercise safely, how to individualize exercises, how to progress exercises, how to use popular wearables (e.g., Fitbit), and strategies to achieve a balanced 24-hour activity cycle for overall health; and iii) develop online resources capturing the content of the interactive workshops.
The intent of the public forum, workshops, and online resources is to motivate and enable older adults to uptake exercise, and thereby contribute to the global agenda of healthy aging.