Innovative insole that is proven to improve balance and
prevent falls is featured on Global News
Toronto Rehab scientists have developed a simple footwear insole called SoleSensor ™, which has proven to improve balance and prevent falls.
“Pressure sensation from the soles of the feet plays an important role in controlling several key aspects of balancing reactions,” says Stephen Perry, a Toronto Rehab adjunct scientist and associate professor of kinesiology and physical education at Wilfrid Laurier University.
Over time sensation in the soles of our feet is dulled as skin hardens, calluses develop, and tiny sensors in the skin decrease in number and sensitivity. In addition, nerve impulses to the central nervous system slow down with age.
SoleSensor has a raised ridge that surrounds the perimeter of the foot, stopping just short of the large toe. This ridge is designed to enhance the sole’s sensory perception by stimulating tiny sensors located in the outer edges of the sole. SoleSensor enhances balance by heightening foot-sole sensation.
“SoleSensor increases the sensory information your foot sends to your brain with every step you take,” explains Perry. “If you’re swaying back and forth, the raised edge will apply pressure to the side of your foot, telling you subconsciously that you’re falling. You can then adjust your body movements and hopefully prevent a fall.”“Roughly one in three people aged 65 or older falls at least once a year. Falls result in almost 95 per cent of hip fractures in older people and 20 per cent die within a year of the fracture,” says Geoff Fernie, Toronto Rehab’s vice president of research and co-inventor of the insole. “Fall-related injuries in Canada have been estimated to cost the economy $2.8 billion a year.”
“SoleSensor is a simple, cost-efficient way to help older people stay on their feet. The savings to the health care system are considerable if the device can reduce visits to emergency rooms, surgical procedures, and hospital stays,” says Fernie.
Many older people who survive a fall never fully recover. Even one bad fall can have long-term consequences, including chronic pain from the injury, a disability that reduces independence, or constant fear of another fall. All of these consequences discourage a healthy active lifestyle.
“Older people fear falling, so they stay indoors,” says Perry. “They don’t exercise, so they lose functionality. It’s a cycle of decline. Giving them more confidence – so they can go out more often for fresh air or to run errands – might be just enough to increase their quality of life.”
Perry and colleagues tested SoleSensor over a 12-week period in winter. Twenty healthy older adults who wore the sole had half the number of falls compared to 20 who wore only conventional or flat insoles. Their findings were reported in the June 2008 issue of the Journal of Gerontology: Medical Sciences.
Currently, SoleSensor is being tested on people with Parkinson’s disease. Parkinson’s is a progressive disease of the central nervous system that affects 100,000 Canadians and 6.3 million people worldwide. The disease generally affects people 60 and over. In Perry’s study, 40 people with Parkinson’s disease and 40 who do not have the disease, were tested walking 20 feet at a time while wearing, alternately, a ribbed insole (SoleSensor) and flat insole. As reported in the May 2009 issue of Parkinsonism and Related Disorders, Parkinson’s participants showed significant improvements in their walking stability and a normalizing of their walking patterns. Perry hopes that SoleSensor will ultimately reduce the likelihood of falling in people with Parkinson’s disease.
SoleSensor, funded by the Canadian Institutes of Health Research, is manufactured and distributed by Ontario-based AJ Hart Group, a division of AJ Hart Enterprises, and is currently being made available in select pharmacies and specialty home health-care stores across Canada. Go to www.ajhartgroup.com for more information on SoleSensor.
To watch Global TV’s story, go to http://www.globaltoronto.com/story.html?id=1820467
For more information on Wilfrid Laurier University, go to www.wlu.ca
Senior Toronto Rehab researcher publicly defends older drivers
Toronto Rehab geriatrician and scientist Dr. Gary Naglie refuted in an interview with the Toronto Star the notion that older drivers are unsafe drivers. The comment was made in response to the tragic death of a young mother who was struck and killed by an 83-year-old woman who allegedly ran a red light.. Dr. Naglie pointed to a few high profile car accidents involving older divers that have resulted in the unfair portrayal of older drivers in the media.
“The majority of older drivers are safe drivers and they represent the most experienced drivers on the road,” says Dr. Naglie. “The issue is not age, but disease and functional disabilities that often come with age.”
“Unfortunately, many family doctors do not feel confident in their ability to evaluate their patients’ driving fitness,” adds Dr. Naglie.
In previous research conducted by Dr. Naglie, it was found that half of surveyed family doctors do not feel equipped to assess whether an older patient is safe to continue driving or should hang up their keys.
Giving physicians a simple, fair and objective screening tool that front-line health-care professionals can use to identify older drivers who are safe and unsafe to drive is the goal of a current, long-term, international study by the Canadian Driving Research Initiative for Vehicular Safety in the Elderly (Candrive).
Dr. Naglie, one of the investigators in this international study, hopes it will lead to a better understanding of diseases and medications that impair older peoples’ ability to drive and the many other factors associated with diving competency.
The study, funded by the Canadian Institutes of Health Research, will follow 1,000 older drivers – who are 70 and older and drive at least four times a week – for five years. The study is taking place in seven Canadian cities, including Toronto, where it is headquartered at Toronto Rehab. Sunnybrook Health Sciences Centre’s Dr. Mark Rapoport is also partnering on the study.
Volunteers are still needed for Candrive studies, particularly in the Toronto, Thunder Bay, Victoria, Hamilton and Montreal areas.
How to participate in the study: For information about how to participate in the driving study in Toronto, please call Novlette Fraser at 416-597-3422, ext. 7851.
If you live outside the Toronto area, please call the Candrive Research Office toll-free at 1-866-233-1133 or visit www.candrive.ca.
For more information on keeping older drivers safely behind the wheel, check out Toronto Rehab’s Living With-Living Well Educational Series: Navigating the Road to Safe Driving: Knowing when it’s Time to Hang up the Keys.
Paul Wheaton (middle) on graduation day, surrounded by his rehab care team Penny Pashby, Social Worker; Ana Ferreira, Physiotherapist; Katie Churchill, Occupational Therapist; and Phillip Lam, Rehab Therapist (Left to Right)
Gander is located in the north eastern part of Newfoundland Island. It’s a three-hour drive from St. John’s, the provincial capital. Fewer than 10,000 people live there.Some would say that it is a pretty isolated community. But 46-year-old Paul Wheaton is just happy to be home – home in time for Christmas.
Paul has called Gander home for most of his life – except when he’s working on a cargo ship traversing the Atlantic Ocean and other commercial shipping lines. After sustaining a serious brain injury in September 2007 in an onboard accident, Paul returned home and really began to feel the isolation many people with brain injury experience.
“I got into a certain pattern of not leaving the house and spending too much time alone. I found social situations too stimulating and when I did venture out, I was easily overwhelmed by crowds,” remembers Paul.
Two years later, Paul is back in Gander after completing 12 weeks of intensive neuro rehabilitation therapy in Toronto Rehab’s Complex Injury Outpatient Rehab Service. The service, offered on an outpatient basis, treats people with complex brain impairments as a result of brain injury and stroke.
Paul says he doesn’t remember being hit by the one-inch steel wire mooring line that snapped and ricocheted off the ship hitting him in the side of the head.
“We were docking the ship in the Welland Canal. I was standing by the mooring winches and heard a bang. The next thing I remember is picking myself off the deck,” recalls Paul.
Paul was rushed to hospital in nearby St. Catharines, Ontario, and given an emergency CT scan which found six internal bleeds in his brain. Paul spent six days in hospital and returned home to Gander. After a while, Paul felt better and thought he would return to work soon after the accident – but he didn’t.
“Every time I went to see my family doctor I brought up returning to work and every time she would say that I wasn’t ready because I was still experiencing some serious symptoms,” says Paul.
The Workplace Safety Insurance Board (WSIB) sent Paul to Toronto Rehab last spring for a specialized neurological assessment in its Neurology Service. Toronto Rehab specialists determined that his injuries were severe enough to require comprehensive therapy. He started treatment in the Complex Injury Outpatient Rehab Service in October 2009.
The Complex Injury Outpatient Rehab Service offers each patient a goal-oriented, customized treatment plan designed to support reintegration into his/her community. The program offers patients a chance to practice community living skills in real world environments under the guidance of an interdisciplinary rehab team.Paul’s therapy involved working with a speech language pathologist, physiotherapist, occupational therapist, neuropsychologist, rehabilitation therapist, and a physiatrist – a doctor of physical medicine and rehabilitation.
For many people who suffer a brain injury, social isolation is a problem as a result of being away from work and losing contact with friends. Paul is grateful that he had the opportunity to participate in Toronto Rehab’s program where he met other people who share the same day-to-day challenges of living with a brain injury and who hold the same hopes of returning to meaningful work and continuing to make meaningful contributions to their communities.
Toronto Rehab’s Complex Injury Outpatient Rehab Service helped bring Paul a little closer to achieving his recovery goals. Paul is confident that he’ll be able to work again soon.
“The last 12 weeks have been really good for me and I know I’m going to carry on with all the skills I learned in the program so that I can continue to get better,” says Paul. “I’ve accepted that I can’t return to the water and that was hard but I know there are lots of things that I can do that will get me out of the house and back into the world.”
For now, Paul is just glad to be home for Christmas…and his wedding anniversary.
Global TV Toronto turns to Toronto Rehab’s leading experts for their advice in two recently broadcast stories. One is about innovative technologies that help people with disabilities and the other explains how the body’s internal clock reacts to seasonal time changes.
A belt worn around a person’s waist that gently vibrates to indicate directions when walking; a house that can call for help if you fall ill or fall down; expert advice on how the transition out of daylight savings time affects our internal clock.
These are two stories Global TV Toronto has recently aired which profile the innovative research being conducted by Toronto Rehab scientists and which tap into the expertise of Toronto Rehab medical staff.
The technology story is one segment in a series called “Smart Shift”, which is being presented by IBM in partnership with Financial Post Magazine. The story aired nationally with all of Global TV’s affiliate stations picking it up. The story reached an estimated 1.8 million TV viewers.
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A rare disease and four months in a coma: Louis Benitez has a lot to be thankful for this Thanksgiving.
Less than 18 months ago, Louis Benitez, 62, lay in a hospital intensive care unit on life support—comatose for almost four months. An investigation determined that salami Louis had eaten contained a bacteria, which led to botulism—a rare disease that causes paralysis and can be deadly.
Thanks to intensive surveillance and safe food-production methods, cases of botulism are so rare in Canada — 18 cases were reported in 1997 — that we tend to forget that the spores of C. botulinum are ubiquitous and that its neurotoxin is the most potent lethal substance known.
After seven months in an acute care hospital, he was transferred to E.W. Bickle Centre for Complex Continuing Care, where he was admitted into the low tolerance, long duration rehab service.
“When I arrived, I could hardly move. I could not speak and I could hardly see people—my vision wasn’t clear,” he recalls.
Louis put his “mind and heart to work” to achieve the goals he had set with his rehab team of physicians, therapists and nurses.
Today, Louis has a message for his rehabilitation team: “Please look at me. I am the result of all your hard work. It’s paying off big time.”
In March 2009, he was discharged and left the hospital with the aid of a walker. Now he is walking with a cane, talking, driving and he even hopes to return to work part-time in industrial flooring design.
His rehab continues three days a week as an outpatient in the Musculoskeletal Rehabilitation Program at Hillcrest Centre. “I’ve been given a second chance in life,” Louis beams as Elvia, his wife of 42 years, looks on. “I’m a very happy customer.
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Stint in cardiac rehab slashes risk of dying
Research results featured
on Toronto StarMichael Irving constantly cares for his heart. The 59-year-old psychotherapist and avid sculptor eats his vegetables, exercises seven days a week, manages his stress, and does almost everything else he can to keep his heart healthy.
This wasn't always the case. Less than three years ago, at midnight on June 11, 2006, Irving was overweight, underexercised and having a heart attack on his couch.
He remembers the moment well.
"I was watching the Edmonton Oilers lose the last game of the Stanley Cup playoffs, and bloody Carolina was winning," he recalls. "I was so excited and eating Chinese food. But then I started getting chest pains, up close to my throat ... as it got worse, my wife took me to the hospital."
Irving had three clogged arteries – one was 95 per cent blocked – and needed to have stents inserted to prop them back open. While the surgery saved his life, Irving says it was the rehabilitation program he attended in the months after his heart attack that has ultimately kept his ticker ticking.
"I would not be alive today if I hadn't had cardiac rehab," he says.
A Toronto study, published this month, backs up Irving's claim. It shows that people who participate in a cardiac rehab program after having a major heart attack can cut their risk of dying from another heart episode by 50 per cent. A cardiac rehab program offers medically supervised courses that help people modify exercise, diet and lifestyle habits to improve heart health. Experts call the study results compelling and say more people need to have access to cardiac rehab programs. Heart disease is the Number 1 killer of men and women in Canada and, according to the Heart and Stroke Foundation, there are more than 2 million Canadians living with heart disease.
"The results show that it is vital that one participates in a program of rehabilitation if you experience a heart event," says Dr. Paul Oh, study co-author and medical director of the cardiac rehabilitation and secondary prevention program at the Toronto Rehab Institute.
The largest of its kind, the study compared the long-term survival of 2,042 patients enrolled in a cardiac rehab program with an equal number of matched individuals who did not participate in a program. All study participants had been hospitalized with a severe cardiac event, such as a heart attack, between 1999 and 2003, and all were followed for roughly five years.
The study, published in the European Journal of Cardiovascular Prevention and Rehabilitation, found those who participated in cardiac rehab had a 50 per cent lower mortality rate than those who did not.
"It also highlights how the power of basic lifestyle measures – walking regularly, eating well, dealing positively with stresses in life – can have a profound impact on health down the road," says Oh.
In Ontario, only 30 to 40 per cent of eligible people are referred to cardiac rehab, and only a small fraction of those will stay for the full program, says study co-author Dr. David Alter, a cardiologist at St. Michael's Hospital and senior scientist with the Institute for Clinical Evaluative Sciences. There needs to be a co-ordinated effort across the province to get more people into cardiac rehab, and fund more spots – and even more centres, he says.
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Groundbreaking research results from Toronto Rehab’s Sleep Research Laboratory
Research results featured
on Global NewsWatch the video which aired our research: Click the above image, then click the title "FH Sleep Apnea" on the right hand column. Researchers at Toronto Rehab recently discovered a link between obstructive sleep apnea and the amount of time spent sitting during the day.
They observed 23 non-obese men who were suspected of having the breathing disorder and found that fluid, which accumulates in the legs throughout the day, shifts from the legs to the neck during sleep. This causes compression of the upper airway, a key characteristic of obstructive sleep apnea. The findings also demonstrated a connection between the volume of leg fluid and the amount of time spent sitting the previous day. In other words, people who are largely inactive or who have jobs that cause them to sit for most of the day may be predisposed to obstructive sleep apnea.
The study results have major implications for people with desk jobs. “Gravity forces fluid down to the bottom of the body when you are sitting and your legs are inactive,” says Dr. Douglas Bradley, director of Toronto Rehab’s Sleep Research Laboratory. “Standing and walking cause the calf muscles to contract, pumping fluid from the legs up through the veins toward the heart. The message is: try to be active throughout the day – get up and walk around periodically.”
Obstructive sleep apnea, a common disorder that affects approximately nine per cent of men and four per cent of women, causes people to stop breathing for brief periods of time while asleep. The disorder has been linked to an increased risk of sleepiness, which affects people’s ability to drive, work and perform everyday tasks. Obstructive sleep apnea has also been connected to other serious conditions, such as high blood pressure, heart attack and stroke.
The study, which was published in the February 1st issue of the American Journal of Respiratory and Critical Care Medicine, may lead to new methods of preventing or treating obstructive sleep apnea.
