Innovative rehab research program improves patient care

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After a total knee replacement, Sebastiano Sarracini never imagined he would be swinging virtual golf clubs, lunging for virtual tennis balls or walking virtual tightropes as part of his rehabilitation at St. John’s Rehab Hospital. “I never expected rehab could be so much fun,” he admits.

Mr. Sarracini’s rehabilitation program has consisted of complex, interdisciplinary therapy complemented by the use of a new rehabilitation tool – the Nintendo Wii™. The Nintendo Wii™ is a video gaming system with a wireless controller that directs the actions of animated athletes on the screen. Using the controller, patients follow natural body movements associated with various sports and activities.

As Mr. Sarracini, 63, lunges, hops, steps, and sways along with the game, his excellent progress is carefully documented by Vera Fung, physiotherapist and member of the St. John’s Rehab research team.

“Preliminary results show that the video games introduce a ‘fun factor’ that increases the patients’ motivation, stimulation and enthusiasm to successfully continue their therapy,” explains Fung. The gaming system’s relationship to rehabilitation care is one of several innovative research projects currently underway at the hospital.

St. John’s Rehab Hospital’s research program aims to discover new and improved treatments and techniques in the area of rehabilitation science. By combining patient care with innovative research, the hospital is rebuilding people’s lives. “Rehabilitation is the new medical frontier, and research in this area is absolutely vital,” explains Dr. Manuel Gomez, Director of Research at St. John’s Rehab Hospital.

Over the next three years, the research program will focus on five of the hospital’s rehabilitation specialties: cancer, organ transplants, orthopaedics, neurology and severe burn injuries.

St. John’s Rehab offers Canada’s only organ transplant rehabilitation program, and the only rehab program in Ontario for severe burns. Study results in these areas could vastly improve the lives of patients from across Canada and the world.

Another major role of the research program is to raise awareness of how people can achieve improved health and quality of life with specialized rehabilitation for misunderstood injuries and illnesses.

For example, electrical injuries are quite common (in 2007, there were 384 electrical accidents in Ontario). Electrical injury symptoms are often invisible. They may arise unpredictably and often do not show up on traditional tests. The lack of awareness may cause a mistaken belief that people’s pain is solely a psychological issue. As a result, few electrical injury patients are referred to specialists where they can be assessed, treated and studied.

St. John’s Rehab is the only rehab facility in Canada working clinically and publishing research about the effects of electrical injuries. The research currently underway investigates these misunderstood injuries and highlights the challenges of making a correct diagnosis.

This research is essential. Health issues associated with electrical injuries must be dealt with quickly, or confusion, depression and sometimes permanent disability can occur. Through an increased understanding of symptoms and impairments, researchers hope to demonstrate how these injuries can be effectively treated, enabling patients to successfully return to work, their community and their lives.

The hospital is also investigating innovative ways to improve the health-care system. Recently, it expanded rehab services to seven days per week for inpatient therapy, admissions and discharges. In addition, outpatient service hours have been extended to increase patient capacity.

This led to exploring patients’ outcomes after seven-day-per-week rehabilitation therapy for total hip or knee replacements. Traditionally, these patients would be in hospital on the weekends without active therapy. Researchers are looking at whether these patients can now achieve the same outcomes within a shorter length of stay.

The study represents a major opportunity to improve health-care system efficiency. “[This] could facilitate the patient’s earlier return to the community, reduce waiting times for inpatient care, and help acute care hospital partners to free up space in their inpatient units and emergency rooms,” explains Marie Disotto-Monastero, Occupational Therapist, St. John’s Rehab’s Manager of Clinical Informatics and the principal researcher for the project.

The research program at St. John’s Rehab Hospital continues to develop new therapeutic approaches and programs to enhance patients’ lives. By studying and applying new initiatives, St. John’s Rehab is advancing its vision of being at the forefront of specialized rehabilitation care.