Physical Therapy

Newly minted graduates of rehabilitation sciences programs at the 91�Թ� will walk across the stage at Convocation Hall on Tuesday to receive their degrees. The Faculty of Medicine’s Ciara Parsons asked soon-to-be alumni of occupational therapy, physical therapy, speech-language pathology and the Rehabilitation Sciences Institute to share why they are passionate about their fields and what drives their professional and academic work.

Here are their responses:

Thi-Ut Nguyen
Master of Science in Physical Therapy

I worked as a personal support worker with a 54-year-old patient who was involved in a horrific car accident. When I started working with him, he was at five months post-injury. He had a tracheostomy and a gastrotomy tube. He was fully dependent for bed mobility and transferred via a lift. I worked with him for a period of one year. By the time he was discharged, he was walking and moving about independently with a walker.

Witnessing his extraordinary recovery journey sparked my interest in physical therapy. I was impressed by the impact early intensive physical therapy has on neuro-motor rehabilitation and I was fascinated by the concept of movement as medicine. Determined to pursue a career as a physiotherapist, I went from being a working mother with no high school degree, to being accepted into the transitional year program at the 91�Թ� and I never looked back.

I think it’s important to continue to set goals that are almost dreams for my own personal growth.

Mary Boulos
Master of Science, Rehabilitation Sciences Institute

One of the most memorable moments of my program was working with the Fred Victor agency in Toronto. Our lab’s clinical arm, the Telerehab Centre for Acquired Brain Injury, strived to provide neuropsychology services to individuals in the justice system experiencing brain injury and mental illness. There is an incredibly high prevalence of brain injury in the justice system; however, access to neuropsychology services is almost non-existent.

By collaborating with Fred Victor, we were able to begin addressing this gap by connecting clients with neuropsychology services and raising awareness of the need for services and support during the justice process. Having the opportunity to advocate for increased awareness and support of brain injury through presentations to clinicians, judges and lawyers has inspired me to continue advocacy work throughout my career.

Now, as a first-year medical student at McMaster University, I hope to bring forward the lessons I learned from the individuals I worked with during my [master of science] training at the 91�Թ� and continue advocating for increased access to mental health care, home care and assisted living supports for patients across Canada.

Sanjana Shellikeri
Doctor of Philosophy, Rehabilitation Sciences Institute – speech-language pathology stream program

My mother was diagnosed with amyotrophic lateral aclerosis (ALS) in 2010 and passed away in March 2019. I met Yana Yunusova through my mother in 2012, as she was a research participant in one of her speech studies. I was a recent undergraduate in neuroscience at the time and was very interested in contributing to the medical field. Although I didn’t have much knowledge in speech-language pathology, I was drawn to the idea of research in a disease that was so close to my heart. After meeting Yunusova and learning about her work, I knew this line of research would be a great fit for me.

I hope to follow the academic path as an independent investigator and contribute research to the study of neurodegenerative diseases, such as ALS, Parkinson’s disease, Alzheimer’s disease and other dementias. I am currently pursuing a postdoctoral research fellowship at the University of Pennsylvania’s Frontotemporal Degeneration Center and aspire to improve the lives of people with neurodegenerative conditions and work towards a real-world impact.

Daniela Chok
Master of Health Science in Speech-Language Pathology

As social beings, a person’s quality of life can be drastically affected by their ability to effectively express themselves and understand others’ messages. I was attracted to the speech-language pathology program because I wanted to work with people with communication disorders to enhance their quality of life. This is a rewarding field where I can work with others to establish and maintain meaningful relationships.

Through completing this program, I have learned that every situation and person is unique. As speech-language pathologists, we need to keep in mind both the diagnoses we are working to address and the patients themselves. Two people with the same diagnosis may have very different clinical presentations. The ability to integrate my classroom knowledge while recognizing the person’s unique situation is the beauty of balancing the art and science that exists within this field.

Janany Jeyasundaram
Master of Science in Occupational Therapy

As the daughter of refugees, I have a strong sense of being between two worlds – the world of my parents in their homeland, which I have imbibed and internalized, and the world I was born into, where I do not fully belong. I have witnessed legacies of trauma both in my personal circles and in my role as an occupational therapy student. Throughout my occupational therapy education, I actively sought opportunities to further my understanding of equity and move the profession towards greater inclusion of vulnerable populations.

As a contextually situated practice, occupational therapy can advance healing work that benefits both individuals and communities. For many culturally diverse populations, individual healing is contingent upon the healing of families and communities. My occupational therapy education challenged me to reflect on client values by developing a greater appreciation for interdependence and interconnectedness. I feel better equipped to disrupt the notion of self-care in the traditional sense and expand our understanding of what it means for vulnerable populations to collectively heal from histories of trauma.

Sahar Panju
Master of Health Science in Speech-Language Pathology

Through the speech-language pathology program, I’ve learned a lot about what it takes to be a good clinical therapist, but, more importantly, what it takes to be a good partner in care, as there is so much more to rehabilitation than just therapy. Being present for what is happening in a person’s life, beyond their impairment, has been an incredibly valuable lesson, both personally and professionally.

As a graduate of the program, I hope to continue to add to the foundation I’ve built and grow as a clinician. I recognized that one of the most important aspects of being a clinical therapist is to remain flexible and make yourself available to understanding new and sometimes challenging ideas. With the profession changing on a daily basis, continuing education is especially important. The program may have finished, but my education certainly hasn’t.

'Chronic pain really challenges the medical model of health care': 91�Թ� experts talk about the opioid crisis

noreen.rasbach — Mon, 06 May 2019 19:21:16 +0000

'Chronic pain really challenges the medical model of health care': 91�Թ� experts talk about the opioid crisis

noreen.rasbach Mon, 05/06/2019 - 15:21

Cutline

Moderator André Picard with panellists from 91�Թ�, Tania Di Renna, Judith Hunter, Andrea Furlan and Abhimanyu Sud

Topic

Tania Di Renna is dressed as a firefighter to drive home the analogy she is making about chronic pain.

“There’s no more fire, but her alarm bell is still ringing,” said the 91�Թ� assistant professor of anesthesia in describing a breast cancer patient whose pain after a mastectomy has turned chronic. While the patient’s tissue seems to have healed after surgery, her “stove” is no longer on fire and her body’s nervous system is still sounding the alarm.

“Three months and five opioid prescriptions later, she still has pain,” said Di Renna. “She can’t hug her husband or kids, she is irritable, anxious and short. She’s not using her stove and everyone is going hungry.”

Di Renna was part of a recent Faculty of Medicine event called UofTMedTalks, moderated by Globe and Mail public health reporter André Picard, that explored what happens when pain is no longer a symptom but becomes the disease. With an estimated 20 per cent of Canadians suffering from chronic pain – and with more than 10,300 Canadians lost to opioid overdoses since 2016 – it’s a weighty question.

At the event, 91�Թ� pain experts from a number of specialties delved into the complexities of pain medicine, the opioid crisis and crucial advances in research, education and clinical care.

Di Renna described how the Toronto Academic Pain Medicine Institute (TAPMI), where she serves as medical director, is now the hub for chronic pain care in Toronto. “We try to get people to move again…to love their stove,” she said.

With the risk of acute pain during surgery developing into chronic pain, she stressed the key role of anesthesiologists in preventing its onset, through interventions before and during surgery.

Assistant Professor Judith Hunter of 91�Թ�'s department of physical therapy spoke of changing the curriculum to focus on cognitively targeted exercise as a way to retrain the brain and change pain. Family physician Abhimanyu Sud reflected on the importance of educating practitioners about safer opioid prescribing. Associate Professor Andrea Furlan of the department of medicine explained chronic pain as an invisible disability, and highlighted her work equipping health-care providers across Ontario to treat patients appropriately.

“What’s going on out there? Is it a war on drugs? An overdose crisis? A pain crisis? A war on pain patients?” asked Picard. “It’s one of the worst public health crises we’ve had in this country in modern times. It’s everywhere but it’s invisible at the same time.”

This invisibility struck Sud when reflecting on his time as a trainee on an emergency medicine rotation in 2008. He had been in the middle of an opioid crisis, but hadn’t realized it. It contrasted with the widespread awareness of the SARS outbreak. Now, as course director of the 91�Թ� Continuing Professional Development safer opioid prescribing program, Sud is helping increase education around opioids with medical practitioners.

“Chronic pain really challenges the medical model of health care. Chronic pain is subjective, and it’s not always obvious using the tools that we typically use in medical care, like MRIs and blood tests,” said Sud. “We’ve moved so far away from a holistic approach in medicine. My hope is that we can learn from the opioid crisis to reform and improve our care.”

This is the type of change Hunter has led in physical therapy education, informed by her PhD in pain neuroscience. “As physical therapists, we learned that pain reflects what’s going on in the tissues, and we use that to find the tissue at fault and fix it,” she said. “That works well in acute pain, but not in chronic pain.”

With physical activity recognized as the most effective treatment for a range of chronic pain conditions, the new curriculum teaches students to use physical exercises – not just to strengthen tissues, but to actually change processing in the nervous system. “And that’s not easy because it hurts for these people to move, and most fear that moving will cause further harm,” said Hunter.

Of course, this interdisciplinary care takes much more time and resources than prescribing a pill – in the short term at least. But not only have opioids led to addiction and our current health crisis, Furlan pointed out that they can also make the pain worse.

“If you give opioids when the alarm system is broken, you can make the alarm system even worse,” said Furlan, who is also a clinician and senior scientist at the University Health Network’s Toronto Rehabilitation Institute. As a physiatrist – a medical specialist focused on rehabilitation – she led the development of Canada’s opioid guidelines, and educates health providers across Ontario through Project ECHO, a virtual knowledge-sharing network.

She pointed out how hard it is to treat chronic pain effectively: “It takes five minutes to give an opioid prescription and the patient leaves happy. But it takes 30 minutes to say ‘no’ to a prescription. And then you have to find alternatives, including self-management, exercises, retraining the pain system.”

“It is in complex areas like this where research and education become so critically important, said Darina Landa, the Faculty of Medicine's executive director of Advancement. She described 91�Թ�’s strengths as Toronto’s only Faculty of Medicine within a leading network of affiliated hospitals and health care sites.

“We’re uniquely positioned at 91�Թ� to tackle some of health care’s most complex questions and challenges, such as pain medicine,” she said.

Bao creator makes mom proud with Oscar win

geoff.vendeville — Mon, 25 Feb 2019 18:51:36 +0000

Bao creator makes mom proud with Oscar win

geoff.vendeville Mon, 02/25/2019 - 13:51

Cutline

Ningsha Zhong, a 91�Թ� employee, makes dumplings at Pixar with her daughter Domee Shi, the creator of the Oscar-winning short Bao (photo by Deborah Coleman / Pixar)

Topic

Ningsha Zhong, who has worked at the 91�Թ� for two decades, was so nervous before the Academy Awards on Sunday that she could hardly focus on anything else.

She could finally breathe a sigh of relief when her 29-year-old daughter, Domee Shi, and producer Becky Neiman-Cobb received the Oscar for best animated short for Pixar’s Bao, which opened ahead of Incredibles 2.

It tells the story of a Chinese-Canadian mom who nurtures a dumpling that magically comes to life, then smothers it with love – an allegory for parents dealing with their kids growing up and leaving the nest.

Holding her gold statuette, Domee thanked her mom and dad. In interviews leading up to the Oscars, she explained that she drew inspiration from her family. “I'm an only child,” she said, “so I've always been that overprotected little dumpling for my whole life.”

One has only to look around Zhong’s office to see how much Domee means to her. She has no less than four framed pictures of her daughter decorating her desk, spanning the ages of kindergarten to college graduation. There's also a cartoon of a smiling mushroom taped to a cabinet, a birthday present from her daughter.

“She is the joy of my life,” Zhong says.

Domee, Zhong and her husband Le Shi moved to Toronto from Chongqing, China in 1991, when Domee was two. “Domee” was one of many nicknames Zhong had for her daughter before it became her legal name. In Mandarin, it means the sprout of a pea plant.

Zhong is a professional education administrative co-ordinator in 91�Թ�'s department of physical therapy, while Le Shi is a freelance artist and art educator who teaches here and in China.

While Domee has loved drawing since she was a girl, Zhong says she and Le chose not to enrol her in art lessons at a young age to give free range to her creativity. They decorated the living room with her work, Zhong says. In her Oscar acceptance speech, Domee gave a shout-out to “all the nerdy girls out there who hide behind their sketchbooks.”

As in Bao, food is important in their household. Domee’s favourite dish, her mother says, are Chinese dumplings with chives, pork and Chinese cabbage. Zhong and her husband take turns in the kitchen, but they both want to cook whenever Domee visits.

Domee pitched the story that became Bao in a 2015 in-house competition at Pixar. Her mother ended up having a hand in the production, literally. She was invited to the Pixar studio where she made dumplings for the crew. The close-up shot in Bao of the mom rolling and cutting dough and filling it with pork and vegetables was a challenge, Domee told the Associated Pres s. “That took two effects artists over two months to create that shot,” she said.

In an interview with the New York Times, Domee said she wanted Bao to inspire audiences. “If they are Asian I hope they enjoy a bit seeing themselves on screen,” she said. “If not, I hope they learn about Chinese culture and community and are more curious about Chinese food, Chinatown. I hope they call their moms and take them out to lunch.”

Zhong says she was touched when she saw the storyboard for Bao. “Lots of scenes were very familiar,” she says. She admits it was difficult seeing her daughter grow up and move away.

Domee landed an internship at Pixar only a month after graduating from Sheridan College. “It’s hard. Sometimes I don’t want to let go,” Zhong says.

Zhong couldn’t get a ticket to attend the Oscars on Sunday, but her daughter called to say thank you. On Monday, Zhong received a surprise at work: Her colleagues decorated her door with streamers, pictures of Domee and Bao.

Although they live on opposite sides of the continent, mother and daughter are still close. Zhong insists Domee call her once a week. “Even if you have nothing to say,’ she instructed.

2016 Paralympics: 91�Թ� physical therapist looking forward to supporting role at #Rio2016

lavende4 — Fri, 26 Aug 2016 14:28:59 +0000

2016 Paralympics: 91�Թ� physical therapist looking forward to supporting role at #Rio2016

lavende4 Fri, 08/26/2016 - 10:28

Alyson Musial

Author legacy

Alyson Musial

Topic

Women's College Hospital

The 2016 Paralympic Games will be taking place September 7 to 18, and Mireille Landry, a physical therapy lecturer and exercise coordinator for the Women’s Cardiovascular Health Initiative at Women’s College Hospital, will be in Rio de Janeiro with the Canadian athletes. The Faculty of Medicine’s Alyson Musial talked to Landry about her role.

Tell us about your role on the Health Sciences Team for Team Canada. How will you be helping our Canadian Paralympic athletes?

I will be assigned specific teams or athletes that are part of the Canadian Paralympic Team, and accompany these athletes/teams to their training sessions and events. I’ll be on hand for any sporting event preparation, as well as emergency first aid. My “office” is the change room, the playing field, and the Team Canada clinic in our residence at the athlete’s village.

My role will involve providing treatment and rehabilitation of injuries, as well as support for performance through injury prevention, maintenance and recovery interventions. I mainly use manual and exercise therapy, soft tissue and taping techniques. Athletes are very in touch with their needs and often require less aggressive treatments than what you might provide in a clinic. They are fine-tuned, high-performance individuals, and gentle approaches are generally more successful. A high-stakes competition isn’t where you “show off” your skills in a new treatment or interfere with the athlete’s preparation!

What is the greatest challenge you face as a member of this team?

A typical day working a multisport event can be long and not very glamorous. I can expect to work from early in the morning to late at night depending on training and event schedules. In an environment where you are consulting and treating athletes in change rooms, on sidelines or the field, you never really know what to expect!

Parasport can be played by athletes with a visual impairment, a spinal cord injury, amputations, cerebral palsy, an intellectual difference, spinal bifida, multiple sclerosis and other different abilities. Treating musculoskeletal injuries in this context can be more complex than in other athletes. I have to take into consideration how their physical difference aids their function and performance, and interacts with equipment they may need. As an example, an athlete may use increased muscle tension to their advantage, so trying to “relax” the muscles would interfere with their performance. I also miss my kids being away for two weeks!

What is the most rewarding aspect of being on the Health Sciences Team?

I love being a “small cog on the big wheel” and helping the Paralympic Games, as well as our Canadian athletes, to thrive. It feels great contributing my knowledge, experience and skills; I call the Games my “happy place”. I also get to connect with other therapists, sports medicine physicians, athletes and the whole team, which is a fantastic learning experience. I’m very much looking forward to the comradery, and expect we’ll have a few adventures along the way.

Rehabilitation Sciences Sector

sgupta — Thu, 07 Jan 2016 20:47:18 +0000

Rehabilitation Sciences Sector sgupta Thu, 01/07/2016 - 15:47

URL

https://www.rehab.utoronto.ca

Remembering the veterans of Sunnybrook: a Convocation 2015 story

sgupta — Wed, 11 Nov 2015 09:47:28 +0000

Remembering the veterans of Sunnybrook: a Convocation 2015 story sgupta Wed, 11/11/2015 - 04:47

Cutline

Canadian flags on grounds of Sunnybrook Hospital (all images courtesy Sunnybrook Hospital)

Heidi Singer

Author legacy

Heidi Singer

Physical Therapy

#UofTGrad19: Meet rehabilitation science's newest graduates

Thi-Ut Nguyen Master of Science in Physical Therapy

Mary Boulos Master of Science, Rehabilitation Sciences Institute

Sanjana Shellikeri Doctor of Philosophy, Rehabilitation Sciences Institute – speech-language pathology stream program

Daniela Chok Master of Health Science in Speech-Language Pathology

Janany Jeyasundaram Master of Science in Occupational Therapy

Sahar Panju Master of Health Science in Speech-Language Pathology

'Chronic pain really challenges the medical model of health care': 91�Թ� experts talk about the opioid crisis

Bao creator makes mom proud with Oscar win

2016 Paralympics: 91�Թ� physical therapist looking forward to supporting role at #Rio2016

Rehabilitation Sciences Sector

Tags

Remembering the veterans of Sunnybrook: a Convocation 2015 story

Thi-Ut Nguyen
Master of Science in Physical Therapy

Mary Boulos
Master of Science, Rehabilitation Sciences Institute

Sanjana Shellikeri
Doctor of Philosophy, Rehabilitation Sciences Institute – speech-language pathology stream program

Daniela Chok
Master of Health Science in Speech-Language Pathology

Janany Jeyasundaram
Master of Science in Occupational Therapy

Sahar Panju
Master of Health Science in Speech-Language Pathology