PM&R Musculoskeletal and Chronic Pain Programs

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Program Lead: Dr. Noorshina Virani

MUSCULOSKELETAL (MSK) PROGRAM

Community MSK

MSK Physiatry continues to expand with novel initiatives:

  • Dr. Robert Burnham, a well-known Central AB MSK Physiatrist/Researcher, has opened the Vivo Cura clinic in Calgary; providing image guided interventional pain management in a multi-disciplinary model. The clinic creates new learning opportunities for our residents and much needed evidenced-based MSK care for the community. He is joined by fellow Physiatrists, Drs. George Deng, Stephen Hung, Zain Rajabali, Josh Kutcher and Brett Wegenast.
  • Opening of the Benson Concussion Institute in March 2022, at the Winsport Markin MacPhail Centre. This is an active hub for concussion research.
  • Dr. Janet Tapper is working with underserved populations through her involvement at the Alex Community Health Centre and at the Elbow River Healing Lodge with the Indigenous Health Program, providing care to Indigenous children and adults throughout the province. 

Education

Teaching to Course 2 (MSK/Rheum/Ortho) Cumming School of Medicine students is provided by many Physiatrists including Drs. Ken Lam, Gentson Leung, Vincent Gabriel, Ranita Manocha, Vithya Gnanukumar (Course 2 Chair) and Noorshina Virani. Drs. Gabriel and Manocha are also instructors in the Health Sciences Health Research Methods and Research Practicum course. Dr. Manocha is an Examination Quality Reviewer with the RCPS Canada, Physical Medicine & Rehabilitation Examination Board.

Dr. Ranita Manocha

Trainee Achievements

Trainee

Kirinpreet Dhillon

Program

Kinesiology

Awards/Recognition

• 2nd Place, Poster Presentations - Session 1 ($200), 2021 McCaig Summer Student Symposium, University of Calgary

• 2021 SUPERWork Award ($1000), University of Calgary

• 2021 Program for Undergraduate Research Experience (PURE) Award ($6000), University of Calgary

Kate Bartel

Life Sciences

• News article: Abel A. Embracing the pivot, scholarship winner shifts from medicine to law. Available at: https://news.ucalgary.ca/news/embracing-pivot-scholarship-winner-shifts-medicine-law

• 1st Place, Poster Presentations - Session 1 ($300), 2021 McCaig Summer Student Symposium, University of Calgary

Adesua Egbase

Kinesiology

• 2nd Place, Oral Presentations - Session 3 ($200), 2021 McCaig Summer Student Symposium, University of Calgary

Christopher Roberts

Kinesiology

• 2021 SUPERWork Award ($1000), University of Calgary

• 2021 R. R. Singleton Summer Studentship Award ($5000), McCaig Institute for Bone and Joint Health

RESEARCH

George Deng

Deng G, Gofeld M, Reid JN, Welk B, Agur AM, Loh E. A Retrospective Cohort Study of Healthcare Utilization Associated with Paravertebral Blocks for Chronic Pain Management in Ontario. Can J Pain. 2021 Jun 30;5(1):130-138.

Brian Benson, Chantel Debert, Sean Dukelow

PEER-REVIEWED PUBLICATIONS

  1. Pinky NN, Debert CT, Dukelow SP, Benson BW, Harris AD, Yeates KO, Emery CA, Goodyear BG.  Multimodal magnetic resonance imaging of youth sport-related concussion reveals acute changes in the cerebellum, basal ganglia, and corpus callosum that resolve with recovery.  Front. Hum. Neurosci. 2022
  2. Wanner ZR, Southam CG, Sanghavi P, Boora NS, Paxman EJ, Dukelow S, Benson BW, Montina T, Metz GAS, Debert CT. Alterations in Urine Metabolomics following Sport-related Concussion: A 1H NMR-Based Analysis. Frontiers in Neurology, Neurotrauma 2021

Honours, Awards, Scholarships

  • Philanthropic Donation ($21,694.06). Benson Concussion Institute, Canadian Sport Institute Calgary, Calgary, Alberta. 2021.

Ranita Manocha

GRANTS AWARDED

Development of a wearable tool for prosthetic gait analysis

Funding Source: McCaig Institute for Bone & Joint Health, University of Calgary
Principal Investigator: Dr. Ranita Harpreet Manocha
Role: Principal Investigator
Total Amount: $2,500.00
Support Period: 02/22 to 01/24
Co-Investigators: Drs. Michael Poscente, Kenneth Lam 

Implementation of an app-based crutch skills training program following sport-related injury

Funding Source: Canadian Academy of Sport and Exercise Medicine
Program Name: Research Grant
Principal Investigator: Dr. Ranita Harpreet Manocha
Role: Principal Investigator
Total Amount: $15,000.00
Support Period: 02/22 to 12/22
Co-Investigators: Drs. Krista L. Best, Larry Katz, Victor Lun, Steven Macaluso, William C. Miller, François Routhier, Better Mobility Lab Patient Engagement Group

How do muscles and tendons influence metabolic cost and exercise tolerance in hypermobile Ehlers-Danlos Syndrome?

Funding Source: The Ehlers Danlos Society
Program Name: Clinical Research Grant
Principal Investigator: Dr. Jared R. Fletcher
Role: Co-Applicant
Total Amount: $148,348.10
Support Period: 11/20 to 10/22
Co-Investigators: Drs. Michael Asmussen, Ranita H. K. Manocha

Crutch type influences on assisted gait following knee surgery

Funding Source: Cumming School of Medicine and Alberta Health Services
Program Name: Clinical Research Fund – Seed Grant
Principal Investigator: Dr. Ranita Harpreet Manocha
Role: Principal Investigator
Total Amount: $25,000.00
Support Period: 01/21 to 12/23
Co-Investigators: Drs. Kelly Johnston, Gregor Kuntze, Artur Luczak, Gerlinde Metz, Nicholas Mohtadi, Janet L. Ronsky, Jason Werle 

 Conference Poster Presentations (presenter is bolded, trainees are starred)

  1. Madden RF, Lalonde-Bester S, Flueck JL, Hertig-Godeschalk A, Manocha RHK, Thatcher C, Martin JM, Shearer J, Parnell JA. Assessment of Sports Nutrition Knowledge Among Coaches of Athletes with a Spinal Cord Injury. International Paralympic Committee VISTA Conference (Virtual), December 16, 2021.
  2. Bartel K*, Shank J*, Scholz N*, Ismaguilova A*, Sigfusson M*, Egbase A*, Manocha RHK. Peripheral nerve injuries related to walking aid use: a systematic review. Hotchkiss Brain Institute Summer Student Symposium, Calgary, Alberta, August 26, 2021.
  3. Egbase A*, Graham R*, Fischer A, Manocha RHK. Is there a relationship between severity of generalized anxiety and severity of joint hypermobility? Hotchkiss Brain Institute Summer Student Symposium, Calgary, Alberta, August 26, 2021.
  4. Roberts C*, Kuntze G, Ronsky JL, Manocha RHK. The effect of forearm crutch length on triceps activation during swing-through gait. Hotchkiss Brain Institute Summer Student Symposium, Calgary, Alberta, August 26, 2021.
  5. Bartel K*, Shank J*, Scholz N*, Ismaguilova A*, Sigfusson M*, Egbase A*, Manocha RHK. Peripheral nerve injuries related to walking aid use: a systematic review. McCaig Institute Summer Student Symposium (Virtual), Calgary, Alberta, August 19, 2021.
  6. Dhillon K*, Quinn N, Woodward E, Mills S, Manocha RHK. Abilities in focus: How do healthcare providers influence physical activity among people with mobility impairments? McCaig Institute Summer Student Symposium, Calgary, Alberta, August 19, 2021.
  7. Wang E*, Shank J*, Manocha RHK. Development of a walking aid skills training app. Alberta Innovates High School Youth Research Poster Symposium, Calgary, Alberta, August 12, 2021.

Publications

  1. Kuntze G, Russell M*, Jivan S*, Ronsky JL, Manocha RHK. The effect of axillary crutch length on upper limb kinematics during swing-through gait. PM&R 2022.
  2. Manocha RHK, MacGillivray MK, Eshraghi M, Sawatzky BJ. Injuries associated with crutch use: a narrative review. PM&R 2021;13(10):1176-1192.
  3. Murani R*, Manocha RHK.  Avoiding anchoring bias in unexplained chronic pain: an unexpected diagnosis of synovial osteochondromatosis. BMJ Case Rep 2021;14:e240462.

Published Abstracts

  1. Febrer-Nafría M, Manocha RHK, Kuntze G, Font-Llagunes JM, Ronsky JL. Evaluation of optimal control formulations for predicting swing-through axillary crutch-assisted gait. Proceedings of the 18th International Symposium on Computer Simulation in Biomechanics 2021.

Media Interviews

  1. Interactive app helps prevent injury from incorrect use of walking aids. Research in Motion 2021-2022. McCaig Institute for Bone and Joint Health. January 2022, Calgary, Alberta, Canada.
  2. Impact Now: Smartphone App Provides Proper Use Training for Walking Aids. Now Innovating [Podcast]. January 8, 2022, Calgary, Alberta, Canada. Available at: https://directory.libsyn.com/episode/index/show/now-innovating/id/21471530
  3. Interactive app helps prevent injury from incorrect use of walking aids. UCalgary News. January 4, 2022, Calgary, Alberta, Canada.

 

CHRONIC PAIN PROGRAM

There are three streams of patient delivery at the AHS Chronic Pain Centre (AHS CPC) in Calgary, including the neuromusculoskeletal (NMSK), pelvic and headache teams. During the reporting period, the number of new assessments for NMSK, Pelvic and Headache teams were 498, 96 and 61 respectively. Average wait time until the first patient-physician visit to the NMSK team, is 405 days. Wait times for the headache team has reduced to 71 days and increased to the pelvic team to 369 days. This does not include visits to lectures, groups or other Allied Health providers, which may occur prior to the first physician visit. Despite lengthy waitlists for in person patient visits, teleconsultation has increased and facilitates timely access to chronic pain consultation services. The number of MD to MD teleconsults provided by CPC NMSK physicians was 675, by pelvic physicians was 45 and 27 MD to MD teleconsults were provided by headache physicians. We had a total of 30 learners attending clinics during this time period.

New initiatives include the development of new central triage referral forms, refining of our neuromodulation program under the guidance of Dr. Fady Girgis and we have initiated MAID consultation. We successfully completed our launch of the ECHO® program for chronic pain teaching to primary care physicians; a collaborative initiative with the AB College of Family Physicians (ACFP). (See “Chronic Pain Gains in Alberta: An ECHO Series”). There are currently 3 primary care networks (PCNs) who provide such care and 30% of PCN referrals are now referred to PCNs with a pain program. Lastly, the FibroFOCUS™ program was launched as a multidisciplinary virtual program for adults with Fibromyalgia, under the leadership of Dr. John Pereira. 

Members

AHS Chronic Pain Centre (AHS CPC): Dr. Nwamara Dike, Dr. Noorshina Virani

Community and Inpatient Practitioners: Dr. Maryana Apel, Dr. Brian Benson, Dr. Darren Chiu, Dr. Sean Dukelow, Dr. David Flaschner, Dr. George Francis, Dr. Tony Giantomaso, Dr. Arun Gupta, Dr. Chris Huang, Dr. Rebecca Iwanicki, Dr. Les LaPlante, Dr. Daniel LeBlond, Dr. Jennifer Litzenberger, Dr. Serge Mrkobrada, Dr. David Nabeta, Dr. Daniela Porter, Dr. Paul Reglin, Dr. Jordan Raugust, Dr. Vishal Tulsi, Dr. Andrew Malawski, Dr. Gentson Leung, Dr. Ranita Manocha, Dr. Nancy Scholz, Dr. Robert Burnham, Dr. George Deng, Dr. Stephen Hung, Dr. Brett Wegenast, Dr. Zain Rajabali, Dr. Josh Kutcher