Patty Wellborn

Email: patty-wellborn@news.ok.ubc.ca


 

an elderly person holding up a piece of wearable tech

UBCO researchers are using wearable technology to help track the involuntary movements of Parkinson’s patients.

Wearable health technologies are vastly popular with people wanting to improve their physical and mental health. Everything from exercise, sleep patterns, calories consumed and heart rhythms can be tracked by a wearable device. But timely and accurate data is also especially valuable for doctors treating patients with complicated health conditions using virtual care. A new study from the Southern Medical Program (SMP), based at UBC Okanagan, has examined the use of wearable health technology and telehealth to treat patients with Parkinson’s disease. Dr. Daryl Wile, a movement disorder specialist and SMP clinical assistant professor, routinely uses telehealth to connect with Parkinson’s patients across the vast and rugged landscape of BC’s Interior. “Even prior to the pandemic, telehealth helped deliver specialized care to patients living in remote and rural settings,” says Wile, a clinical investigator with the Centre for Chronic Disease Prevention and Management. “But with the complex nature of Parkinson’s, we wanted to enhance these appointments to better understand how movements vary throughout a patient’s entire day.” To add a new layer of health information, Wile and the research team added wearable technology to the equation. “We recruited Parkinson’s patients with either tremors or involuntary movements,” says Joshua Yoneda, SMP student and co-author of the study. “We then divided them into two groups — some using telehealth and device-based health tracking and others attending traditional face-to-face appointments.” The telehealth group wore wearable devices to track their movements, involuntary or not, throughout waking hours. The reported data was then reviewed during telehealth appointments to identify peak times patients experienced Parkinson’s symptoms. “With the integration of accurate and reliable data from wearable devices, we were able to tailor a patient’s medication to better manage their symptoms throughout the day,” adds Wile. As part of the study, patients were asked a series of questions from the standardized Parkinson Disease Quality of Life Index. Both study groups were assessed at intervals of six weeks, three months and six months. Overall, the patients using the wearable devices reported positive experiences and health outcomes in combination with telehealth appointments to access specialized care. “There’s definitely a strong case to leverage multiple technologies to improve a patient’s quality of life and limit the added stress and cost associated with travel,” says Yoneda. The study was recently published in Parkinsonism & Related Disorders.
The COVID-19 Disability Survey captured perspectives from Canadians with different types of disabilities and their family members.

The COVID-19 Disability Survey captured perspectives from Canadians with different types of disabilities and their family members.

Nearly 30 per cent of those polled are hesitant to get vaccinated

A new study led by UBC researchers and the Ontario-based Abilities Centre is sounding the alarm over the damaging effects of COVID-19 for Canadians with disabilities.

Dr. Kathleen Martin Ginis, director of the Centre for Chronic Disease Prevention and Management, points to public health restrictions and lack of community resources as key contributors to heightened challenges facing those living with disabilities.

“Limited social support, reduced access to recreational space and financial uncertainties have exacerbated the current situation,” says Martin Ginis, a professor at UBC Okanagan. “As the pandemic continues to draw on, we need to prevent more individuals from slipping further through the cracks.”

The COVID-19 Disability Survey targeted Canadians who identify as having a disability — such as a physical, cognitive or sensory disability — or having a child or family member living with a disability in their household. The survey collected responses from across Canada and with representation from most provinces and territories.

Of those surveyed, 82 per cent reported that the pandemic is negatively impacting their mental health. Individuals reported unmet needs for emotional counselling, recreation and leisure programs, income support, specialized health care, accessible housing and transportation.

A majority of people reported decreased physical activity, less healthy lifestyles and significant social isolation. For children with disabilities, more than half of parents reported their child experiencing decreased physical activities as a result of public health restrictions.

“Another key finding was that only 72 per cent of Canadians with disabilities planned to get a COVID-19 vaccine,” says Stuart McReynolds, president and chief executive officer with the Abilities Centre. “We need to help boost vaccine confidence for all individuals, so we can collectively put this public health crisis behind us.”

The COVID-19 Disability Survey data has already contributed to positive policy changes such as the Ontario Government’s amendment for people with disabilities to have access to physical therapy programs and by providing guidance around how to ensure that vaccination sites are fully accessible.

“This survey provides a snapshot of the negative impact of the pandemic and COVID-19 restrictions on the well-being of Canadians with disabilities,” adds Martin Ginis. “We strongly urge governments and community agencies to work quickly to address service gaps and mitigate further negative mental and physical health impacts.”

The full report can be viewed at: abilitiescentre.org/Abilities/media/Documents/Covid-survey-report

About UBC's Okanagan campus

UBC’s Okanagan campus is an innovative hub for research and learning founded in 2005 in partnership with local Indigenous peoples, the Syilx Okanagan Nation, in whose territory the campus resides. As part of UBC—ranked among the world’s top 20 public universities—the Okanagan campus combines a globally recognized UBC education with a tight-knit and entrepreneurial community that welcomes students and faculty from around the world in British Columbia’s stunning Okanagan Valley.

To find out more, visit: ok.ubc.ca

About the Centre for Chronic Disease Prevention and Management

Based at UBC Okanagan, the Centre for Chronic Disease Prevention and Management (CCDPM) serves as a leader for research, knowledge translation and exchange in the urgent research field of chronic disease prevention. The CCDPM is the UBC Faculty of Medicine’s first research centre located outside of the Lower Mainland. To learn more, visit: ccdpm.med.ubc.ca

About the Abilities Centre

Abilities Centre strives to make communities more accessible and inclusive to increase quality of life for every individual and enable them to participate fully in community and economic life. As a community hub, living lab and inclusion incubator, Abilities Centre engages individuals and communities in inclusive and accessible programs, leads research and advocacy on inclusion issues, and develops innovative frameworks for programs that are replicable, scalable and customizable to the needs of local communities in Durham Region and across Ontario and Canada. Learn more at: abilitiescentre.org

A UBC professor says the WHO exercise guidelines for people with disabilities miss the mark because they are not based on people who exercise mainly with their arms.

A UBC professor says the WHO exercise guidelines for people with disabilities miss the mark because they are not based on people who exercise mainly with their arms.

Physical activity guidelines for people living with disabilities miss the mark

A UBC researcher is calling out the World Health Organization’s newly introduced activity and sedentary guidelines for people living with disabilities.

Kathleen Martin Ginis is director of the Centre for Chronic Disease Prevention and Management and a professor with UBC’s Department of Medicine and UBC Okanagan’s School of Health and Exercise Sciences. She holds the Reichwald Family Chair in Preventive Medicine, is a researcher with the International Collaboration on Repair Discoveries and works to help people living with spinal cord injury maintain a physically active lifestyle.

Martin Ginis discusses the WHO’s recently-announced global guidelines and how they missed the mark.

Much of your research focuses on physical activity guidelines for people living with disabilities. Can you explain why getting exercise is so important for this population?

People with disabilities are at just as much risk for inactivity-related chronic diseases (heart disease, Type 2 diabetes) as the general population, if not more so. We also know that physical activity is important for mental health. However, people with disabilities do far less activity than the general population because of the countless barriers to activity that they face in their daily lives.

You have recently written an article for the Human Kinetics Journal, questioning the World Health Organization’s new physical activity and sedentary behaviour guidelines for people living with disabilities. What did they get wrong?

I’ve got several concerns with these guidelines. My biggest is that the guidelines are based on scientific evidence derived from studies of people without disabilities. Admittedly, there are still relatively few good studies that have measured the role of physical activity in preventing chronic diseases and improving the health of people with diseases. But in the absence of those types of studies, the WHO decided to simply extrapolate the research evidence for the general population and apply it to people with disabilities.

The upshot is that the guidelines for people with disabilities are now exactly the same as for the general population—150 to 300 minutes each week of moderate to vigorous aerobic activity and strength-training twice per week. One problem with this is that people with certain types of physical impairments do not have the same physiological response to exercise as the general population. We don’t know if they will get the same benefits from the recommended guidelines as the general population.

Also, none of the guideline evidence is based on people who do their exercise with their arms (e.g., to push a wheelchair or use an arm-cycle). No studies have looked at the long-term effects of 150 to 300 minutes a week of arm exercise so we don’t know the benefits or the risks. Even for people with disabilities who would be expected to have the same physiological response to exercise as the general population (e.g., people with visual or cognitive impairments), we cannot simply assume that that amount of physical activity will mitigate the many other risks to well-being that people with disabilities constantly face, such as poverty, lack of access to health care and social isolation.

Your paper talks about the tremendous societal barriers to participation. Can you explain what some of these barriers might be?

There are so many! People with disabilities are often turned away from fitness centres and recreation facilities not just because those spaces are physically inaccessible, but because the people who work there have misconceptions or a complete lack of knowledge about how to support a person with a disability in a physical activity setting.

A lack of transportation is also a huge barrier—one of the most common. People with disabilities are mostly excluded from public health campaigns and advertisements promoting physical activity. There’s the old adage ‘’if you can see it, you can be it.” Unfortunately, people with disabilities don’t see themselves represented in physical activity settings as often as they should.

If people living with disabilities decide these guidelines are unrealistic and unachievable, do you think they will simply stop trying to be active?

Yes. That’s my concern. The studies that we do have on physical activity for people with disabilities suggest that they can achieve significant health and fitness benefits by doing much less than 150 minutes a week. For instance, people living with spinal cord injury can improve their cardiometabolic health by doing 90 minutes of moderate- to vigorous-intensity exercise each week.

Given the plethora of barriers to physical activity experienced by people with disabilities, and evidence of significant benefits from lower doses of physical activity, it does not make sense for the WHO to promote the general population’s guideline as being an appropriate guideline for people with disabilities. I understand the WHO had good intentions to be inclusive with this guideline, but my concern is that the guideline will actually put people off, and further exclude people with disabilities from physical activity.

About UBC's Okanagan campus

UBC’s Okanagan campus is an innovative hub for research and learning founded in 2005 in partnership with local Indigenous peoples, the Syilx Okanagan Nation, in whose territory the campus resides. As part of UBC—ranked among the world’s top 20 public universities—the Okanagan campus combines a globally recognized UBC education with a tight-knit and entrepreneurial community that welcomes students and faculty from around the world in British Columbia’s stunning Okanagan Valley.

To find out more, visit: ok.ubc.ca

The Stronger Together project connects patients with expert resources, online counselling, daily health trackers and opportunities to build social connections with Canadians experiencing similar health circumstances.

The Stronger Together project connects patients with expert resources, online counselling, daily health trackers and opportunities to build social connections with Canadians experiencing similar health circumstances.

Free online health resources, coaching and peer-to-peer support

Researchers with the UBC Centre for Chronic Disease Prevention and Management (CCDPM) have teamed up with digital health company Curatio to provide Canadians with virtual health support during the COVID-19 pandemic. The Stronger Together project harnesses Curatio’s social networking health app to connect patients with expert resources, online counselling, daily health trackers and opportunities to build social connections with Canadians experiencing similar health circumstances. “Patients are facing unique challenges accessing health care resources during the COVID-19 pandemic,” says Kathleen Martin Ginis, director with the UBC Okanagan-based CCDPM. “We need to bridge these gaps and help patients build social connections that can improve their health and well-being.” In addition to contributing expert content, CCDPM researchers will assist with program evaluation for the platform’s nine different public communities—which are cardiovascular health and well-being, disability and physical activity, stroke recovery, keeping mentally strong with multiple myeloma, respiratory health and well-being, prostate cancer, 4+2 diabetes reversal, plan to move your kids and parenting during COVID-19. Curatio CEO Lynda Brown-Ganzert stresses the importance of helping patients stay healthy from their own home while also reducing the burden on an already-strained health care system. “By providing daily virtual support to patients, we can help improve the lives of Canadians and support the important work of our dedicated health care professionals,” says Brown-Ganzert. “Current participants have already seen improvements in their health literacy and outcomes by using our private and secure platform, not to mention the enjoyment of making social connections with people going through the same thing.” Individuals can register for free access at www.curatio.me/strongertogether. By joining the platform, participants will assist researchers in learning how to best offer virtual health support and contribute to Curatio’s program development. “We are thrilled to offer this new online resource that will contribute to the health of Canadians and the health care system as a whole,” adds Martin Ginis. The Stronger Together project is supported by an investment from the Digital Technology Supercluster which brings together private and public sector organizations of all sizes to address challenges facing Canada’s economic sectors including health care, natural resources, manufacturing and transportation.

About UBC's Okanagan campus

UBC’s Okanagan campus is an innovative hub for research and learning founded in 2005 in partnership with local Indigenous peoples, the Syilx Okanagan Nation, in whose territory the campus resides. As part of UBC—ranked among the world’s top 20 public universities—the Okanagan campus combines a globally recognized UBC education with a tight-knit and entrepreneurial community that welcomes students and faculty from around the world in British Columbia’s stunning Okanagan Valley. To find out more, visit: ok.ubc.ca
With gyms, recreation centres and sports programs closed due to COVID-19, people living with disabilities are looking for creative ways to stay active at home.

With gyms, recreation centres and sports programs closed due to COVID-19, people living with disabilities are looking for creative ways to stay active at home.

UBCO, Queen’s University, offer virtual, at-home physical activity program

For many people, staying active during COVID-19 isolation can be a struggle. More so for people living with disabilities, says UBC Okanagan’s Kathleen Martin Ginis. Martin Ginis is a professor in UBCO’s School of Health and Exercise Sciences and director of the UBC Faculty of Medicine Centre for Chronic Disease Prevention and Management. She’s also the director of the Canadian Disability Participation Project (CDPP)—a group that has revived a service called Get in Motion to support people with disabilities get regular physical activity. Get in Motion was a phone-in coaching service led by Martin Ginis’s lab, but put on hold a few years ago. Now, with people self-isolating, there is a push from public health authorities for people to get a daily dose of physical activity. However, Martin Ginis and her colleagues from Queen’s University, Amy Latimer-Cheung and Jennifer Tomasone, say Canadians with disabilities have fewer options than others to get exercise. “People with a disability are at increased risk for social isolation under ‘usual’ circumstances, but especially so during the COVID outbreak,” says Martin Ginis. “They also face unique barriers and challenges to physical activity. With the closure of adapted physical activity and recreation programs, we are very concerned about the health and well-being of Canadians with disabilities. We are offering the Get in Motion service as a way to manage some of the psychosocial and physical health risks of being inactive at home.” Martin Ginis explains that adapted sport and exercise programs were closed across the country because of COVID-19. “We had been talking to our community partners who were closing their programs and we were all feeling upset about the impact these closures will have on community members with disabilities,” she says. “We were all thinking ‘I wish we still had Get in Motion’ and then Amy Latimer-Cheung started the ball rolling—and got the service back up and running.” Based virtually out of Latimer-Cheung and Tomasone’s lab at Queen’s, Get in Motion is available for all Canadians with physical disabilities, as well as for Special Olympics athletes. Participants can connect with a volunteer physical activity coach via phone or online conferencing. The volunteer then guides that person through an at-home physical activity program. The CDPP is based out of UBC Okanagan and Martin Ginis has several students actively counselling Get in Motion participants while others are being trained. Get in Motion volunteer Sarah Lawrason is a second-year doctoral student who studies physical activity participation among people with spinal cord injuries who walk. She was matched with someone who fits into her research population. “My client lost access to her regular physiotherapy when COVID-19 happened. We talk once a week about her exercise goals,” says Lawrason. “She appreciates the accountability of checking in and setting a goal each week and she's enjoyed the resources I've sent her that have similar exercises to her normal routine.” Lawrason notes, however, this is definitely a two-way relationship where both the coach and the client are benefitting. “Initially, I was really excited to start coaching as it aligns with my own research,” she says. “But I also really look forward to my calls each week because it's a new friendly person to talk to when I'm feeling isolated.” The CDPP has documented data about the benefits of sport and exercise participation for Canadians with disabilities including improved health, well-being and overall life satisfaction. “Our research has shown that a sense of belonging is key to people with disabilities experiencing ‘full and effective participation’ in sport and exercise,” says Martin Ginis. “With Get in Motion, we are striving to provide that sense of belonging through phone calls with trained volunteers who have experience with adapted sport and exercise. Because the belongingness piece is removed if you are doing this all alone.” For more information about the Get in Motion, or to enrol in the program, visit: cdpp.ca/get-involved

About UBC's Okanagan campus

UBC’s Okanagan campus is an innovative hub for research and learning founded in 2005 in partnership with local Indigenous peoples, the Syilx Okanagan Nation, in whose territory the campus resides. As part of UBC—ranked among the world’s top 20 public universities—the Okanagan campus combines a globally recognized UBC education with a tight-knit and entrepreneurial community that welcomes students and faculty from around the world in British Columbia’s stunning Okanagan Valley. To find out more, visit: ok.ubc.ca
Vernon’s Josh Dueck is one of many people who have given the physical activity guidelines a test drive. Photo by: OI Canada

Vernon’s Josh Dueck is one of many people who have given the physical activity guidelines a test drive. Photo by: OI Canada

Researchers take the guesswork out of exercising effectively

A team of researchers has developed an online platform of tried and true resources to help people living with spinal cord injury (SCI) lead a more active life.

Professor Kathleen Martin Ginis is the director of the Centre for Chronic Disease Prevention and Management based at UBC Okanagan. She says a major barrier to physical activity for people with a spinal cord injury is a lack of knowledge or resources about the amount and type of activity needed to achieve health and fitness benefits.

“It’s really hard for people to be active, let alone people living with a spinal cord injury,” she says.

To complicate matters, an international consortium of experts created two international guidelines for people with SCI. One provides recommendations for using exercise to increase cardiorespiratory fitness and muscle strength while the other is a recommendation for using exercise to improve cardiometabolic health.

Both guidelines stipulate the minimum amount of aerobic exercise and strengthening exercises needed weekly.

“These are scientific guidelines, that are great for scientists,” says Martin Ginis, who led the international consortium of experts. “But for Canadians with an SCI, we didn’t provide a really clear path and clear information on how to implement those guidelines into a daily routine.”

Martin Ginis’s team, including staff from Spinal Cord Injury BC and researchers with the International Collaboration on Repair Discoveries, spent the past two years reviewing, analyzing and testing the guidelines. More than a hundred people from the SCI community provided feedback.

“We sat down with experts, scientists, clinicians, people living with spinal cord injury, and key organizations and asked how we can take this scientific information and put it into something that people with spinal cord injury can use,” she explains.

The end result is a concise combination of the two scientific exercise guidelines into one clear and understandable online physical activity guideline.

“After two years of research, we’ve provided an online tool that people with a spinal cord injury can use with confidence to become more physically active.

Along with suggested amounts of cardio required each week, the research also provides strength training ideas and tips. Users will find links to community resources, suggestions on how to get started with a physical activity program and advice from people living with an SCI.

One such end-user is Vernon’s Josh Dueck, retired Paralympic athlete and current executive director for Freestyle BC. Injured in a skiing accident in 2004, Dueck has continued with an active lifestyle winning numerous accolades in the sport of para-alpine ski racing. He has worked with UBCO’s research team providing insight to the activity guidelines, which he says are easy to follow and should help promote an active lifestyle for the SCI community.

“There is a beauty in simplicity and the simple approach is often the most attainable,” Dueck adds. “The SCI physical activity guidelines take the mystery out of what is needed to keep your body and mind thriving. It brings great joy to know the base parameters to maintain a healthy life are accessible and achievable.”

Users will find beginner and advanced levels along with additional tips and suggestions to avoid chronic ailments like Type 2 diabetes and heart disease.

This research, partially funded by the Praxis Spinal Cord Institute and the Social Sciences and Humanities Research Council of Canada, is published in Nature’s Spinal Cord journal.

About UBC's Okanagan campus

UBC’s Okanagan campus is an innovative hub for research and learning founded in 2005 in partnership with local Indigenous peoples, the Syilx Okanagan Nation, in whose territory the campus resides. As part of UBC—ranked among the world’s top 20 public universities—the Okanagan campus combines a globally recognized UBC education with a tight-knit and entrepreneurial community that welcomes students and faculty from around the world in British Columbia’s stunning Okanagan Valley.

To find out more, visit: ok.ubc.ca