Muscles: From Molecules to Mobility

Direction setting workshop on muscle and musculoskeletal rehabilitation research

June 11 - 13, 2006
Manoir St. Sauveur, St. Sauveur Quebec

Return to top

Preface/Introduction

The CIHR Institute of Musculoskeletal Health and Arthritis brought together seventy participants for the meeting entitled Muscles: From Molecules to Mobility - Direction setting workshop on muscle and musculoskeletal rehabilitation research at Manoir St. Sauveur, St. Sauveur, Quebec, from June 11 - 13, 2006. The purpose of this meeting was to identify common research objectives and to set integrated research directions in the focus areas of muscle research and musculoskeletal rehabilitation research. This was the first time that such a diverse group of stakeholders had an opportunity to meet and discuss these topics; participants included patient representatives, representatives from both government and non-governmental organizations, representatives from private companies and researchers from diverse backgrounds such as physical therapy, mechanical engineering, rehabilitation sciences, biochemistry, occupational therapy, molecular biology and kinesiology. The meeting succeeded in educating participants about other research areas, fostered communication and collaboration, and resulted in the creation of a list of defined outcomes and next steps.

CIHR Institute of Musculoskeletal Health and Arthritis - Meeting Host

Vision: To sustain health and enhance quality of life by eradicating pain, suffering and disability caused by arthritis, musculoskeletal, oral and skin conditions.

CIHR Institute of Aging - Meeting Sponsor

The Institute of Aging will champion health research on aging in Canada, and create innovative opportunities for research and researchers. All researchers working in the field of aging will want to be affiliated with the Institute. Policy makers will look to the Institute for information and advice, and use the knowledge we generate to develop more effective policies and services. Our work will enhance the health and lives of older Canadians.

Return to top

The Process

At the meeting, top researchers provided state of the art reviews of research priorities from two focus areas: muscle research and musculoskeletal (MSK) rehabilitation research. Breakout groups identified strengths, weaknesses, opportunities and threats as well as targets and plans for new research collaborations within the focus areas. The outcomes of the breakout groups were presented to all meeting participants. To inspire collaboration, participants were presented with examples of research integrating muscle and musculoskeletal rehabilitation; this presentation demonstrated research tools, experimental techniques and highlighted the various research areas included in the project. Participants were presented with a conceptual model for linking basic muscle and muscle rehabilitation research and inspired to think about partnerships and knowledge translation and exchange. Finally, after additional brainstorming sessions to identify research collaborations and opportunities, recommendations were made to the CIHR and IMHA on how to increase collaborative research in these areas.

Return to top

Breakout Group Summaries

The key strength identified for both muscle and MSK rehabilitation, is that research in Canada is very strong and includes a very broad range of disciplines and research areas. The interdisciplinary nature of MSK rehabilitation research encompasses all four CIHR pillars. Not only does muscle research have excellent basic research in Canada, this research uses funds efficiently and effectively. CIHR/IMHA is viewed as a strong asset to both of these research communities.

The key weakness identified for both groups is the lack of a platform or meeting place for Canadian researchers; there is no annual meeting, workshops or other opportunities for face to face interactions across the areas of expertise. Both focus areas lack a clear source of financial support for annual meetings on muscle research. As a consequence, poor integration of research efforts and the lack of networking have resulted in a low profile for some of the research and the isolation of researchers. Relatively low levels of collaboration between researchers and clinicians, has resulted in many research and treatment areas not being currently explored. Both focus areas could improve knowledge translation and exchange activities; muscle researchers are not always comfortable or knowledgeable about knowledge transfer and exchange despite a strong potential KT (Knowledge translation) component to their studies. MSK rehabilitation research has not resulted in a consensus on best practices for prevention and intervention.

The key opportunity identified by participants in both focus areas was for enhanced networking and collaboration between researchers and clinicians. It was suggested that the International Classification of Function (ICF) developed by the WHO could potentially be used as a conceptual model to integrate the two groups. Knowledge translation and outcomes were recognized as an opportunity, especially with regards to creating functional collaborations to apply the discoveries from basic research to the community and in approaches to deliver outcomes. In addition, there are opportunities for integrating muscle and MSK rehabilitation research into research of conditions and diseases such as aging, diabetes, alcohol abuse, and cancer. Mentoring was recognized as an opportunity, for students as well as junior researchers. Finally, defining and studying approaches to the delivery of interventions was seen as an opportunity, with the type of exercise, group versus individual delivery, defining the ideal setting and economic feasibility all being factors to consider.

The key threat to muscle and MSK rehabilitation research identified was a lack of funding for these research areas, which leads to "brain drain" as researchers leave for other research or geographical areas where funding is perceived to be more readily available. There is not a clear framework for clinicians to conduct research and communicate with researchers. There is a lack of collaboration due to geographical isolation and research isolation, referred to as "siloing". In addition, the lack of core facilities and technical multi-user platforms for muscle researchers to use and to assist with collaborations between groups was also identified as a threat to these research areas.

Return to top

Meeting Outcome - Collaborative Research Priorities

  • Muscle atrophy - collaborations on activity and atrophy, with reference to aging, dystrophy, prevention versus reversal of atrophy, disease progress and interventions, muscle maintenance, frailty, and metabolic impact. This area spans the spectrum, from basic research through to providing patient interventions
  • Muscle function and dysfunction - in primary muscle diseases (dystrophies), secondary muscle dysfunction (osteoarthritis, inflammatory arthritis, diabetes, obesity, osteoporosis, hip fractures), muscle injury (prevention, overuse, chronic, reversible/irreversible), impact of joint replacements on muscle and pre- and post surgical intervention and overuse.
  • Movement and Exercise - physical activity guidelines and the impact on various medical conditions, with emphasis on individual variation, dose/responses, different age-groups and genders, and medication. This includes the identification of the factors and tools to promote activity/exercise adherence/compliance and healthy behaviors as well as monitoring outcomes to determine safe exercise progression and maximizing the impact of rehabilitation interventions and strategies.
  • Animal models for therapy and rehabilitation research - correlation/integration of techniques used on animal models transferable to humans, outcomes measurements, interactions between physical activities and medications, electronic advances and robotics.
  • Muscle responses to non neuromuscular diseases/conditions - including cancer, diabetes, chronic obstructive pulmonary disease (COPD), spinal cord injuries, alcohol abuse.

Return to top

Recommendations to IMHA and CIHR to Increase Collaborative Research Between The Two Focus Areas of Muscle and Musculoskeletal Rehabilitation

The three changes/goals to increase collaboration between the two focus areas are:

  1. Increased interaction of kinesiology researchers, rehabilitation researchers, basic, and clinical researchers, both intra-and inter-institution.
  2. Address and attempt to reduce the impact of barriers to increased cooperation: geography, competition for funding, mutual respect issues, communication barriers.
  3. Develop creative tools, such as workshops, websites, cross-disciplinary training and mentoring vehicles.

Recommendations for achieving these three goals:

  • Create a national platform - to encourage continued collaboration, networking, interdisciplinary cross-fertilization and to raise the profile of muscle and musculoskeletal research in Canada. This could be either through the creation of a muscle network, either formal or informal, or by an annual muscle meeting/workshop with content progressing from molecule to muscle to function. Either initiative would have cross pillar involvement, would encourage cross-focus researcher interaction and would need to involve the broad range of disciplines reflected in the focus areas.
  • Establish more funding for muscle and MSK rehabilitation research in the form of collaborative RFAs - to raise the profile of this research and to build multidisciplinary teams.
  • Agree upon and adopt a common conceptual framework (similar to the ICF one), use common language, identify key problems and define outcome measures.
  • Implement speaker exchanges, mentoring, student funding, muscle research days.
  • Create a Website or expand the IMHA website to include an expert match list (between disciplines for team research or RFAs), national database with the workshop participants, listing their backgrounds, tools and techniques they use, interests and expertise.
  • Commission a review specifically for the synthesis of basic and rehabilitation research.
  • Incorporate a stronger KT component to raise the profile of this research by demonstrating how this work contributes to other conditions/diseases/research areas or with muscle research days. Need to promote muscle and MSK rehabilitation research in order to make a significant improvement of the quality of life, positive economic benefits, and psychosocial and health-related quality of life outcomes.

Return to top

Next Steps

  • The IMHA will launch a request for applications mid July, 2007.

Return to top

Participants and Planning Committee

Planning Committee  
Aileen Davis Health Care and Outcomes Research, Toronto Western Research Institute
Louise Desjardins CIHR Institute of Musculoskeletal Health and Arthritis
Phillip Gardiner Kinesiology / Physiology, University of Manitoba
John McDermot Faculty of Pure and Applied Science, York University
Linda Mealing CIHR Institute of Aging
Ilona Skerjanc Department of Biochemistry and Microbiology and Immunology, University of Ottawa
Archie Cooper Emeritus School of Medical Rehabilitation, University of Manitoba
Ms.Sharon Nadeau Institute of Musculoskeletal Health and Arthritis

Participants

Judy Anderson Academic, Faculty of Medicine, University of Manitoba
Cathy Arnold School of Physical Therapy, University of Saskatchewan
Bertrand Arsenault École de Réadaptation, Université de Montréal
Dorcas Beaton Mobility Program Clinical Research Unit, St Michael's Hospital, University of Toronto
Ed Biden School of Graduate Studies, University of New Brunswick
Nicola Birchall Canadian Paraplegic Association (Alberta)
Dina Brooks Department of Physical Therapy, University of Toronto
Lucie Brosseau Physiotherapy Program School of Rehabilitation Sciences, University of Ottawa
Brenda Brouwer School of Rehabilitation Therapy, Queen's University
Juliette (Archie) Cooper Emeritus School of Medical Rehabilitation, University of Manitoba
Claude Côté Département de Réadaptation, Faculté de Médecine, Université Laval
Aileen Davis Health Care and Outcomes Research, Toronto Western Research Institute
Louise Desjardins CIHR Institute of Musculoskeletal Health and Arthritis
Reggie Edgerton Neuromuscular Research Laboratory within the Department of Physiological Science and the Brain Research Institute, University of California, Los Angeles
Carla Fellows CIHR Institute of Musculoskeletal Health and Arthritis
Cyril Frank CIHR Institute of Musculoskeletal Health and Arthritis
Jérôme Frenette Centre de Recherche du CHUL, Université Laval
Jayne Garland Department of Physical Therapy, Faculty of Health Sciences, University of Western Ontario
Bud Gage School of Kinesiology and Health Science, York University and Toronto Rehabilitation Institute
Phillip Gardiner Kinesiology / Physiology, University of Manitoba
Stephen Gee Department of Cellular and Molecular Medicine, University of Ottawa
Tessa Gordon Centre for Neuroscience, University of Alberta
Kenneth Hastings Montreal Neurological Institute, McGill University
Russ Heppel Faculty of Kinesiology and Faculty of Medicine, University of Calgary
Walter Herzog Faculty of Kinesiology, University of Calgary
Audrey Hicks Department of Kinesiology, McMaster University
Kristin Houghton Pediatric Rheumatology and Sports Medicine, British Columbia's Children's Hospital and Allan McGavin Sports Medicine Centre
Susan Jaglal Department of Physical Therapy, University of Toronto
Jennifer Jakobi Faculty of Human Kinetics, Department of Kinesiology, University of Windsor
Leslie Johnson School of Medical Rehabilitation, University of Manitoba
Allyson Jones Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta
Gareth Jones School of Occupational Therapy, Faculty of Health Sciences, University of Western Ontario
Joanne Kay Sport Canada
Diane Ladouceur Patient Representative
Christian Larivière Occupational Health and Safety Research Institute Robert-Sauvé
Leslie Leinwand Colorado Initiative in Molecular Biotechnology Molecular, Cellular and Developmental Biology, University of Colorado at Boulder
Douglas Mahoney Children's Hospital of Eastern Ontario Research Institute
Brian Macintosh Faculty of Kinesiology, University of Calgary
Joy McDermid School of Rehabilitation Science, McMaster University
John McDermott Faculty of Pure and Applied Science, York University
Bill McIlroy Graduate Department of Rehabilitation Science, Department of Physical Therapy, University of Toronto
Linda Mealing CIHR Institute of Aging
Brenda Merritt School of Occupational Therapy, Dalhousie University
Bill Miller The School of Rehabilitation Sciences, Division of Occupational Therapy, University of British Columbia
Helene Moffett CIRRIS Research Center, Laval University
Anne Mündermann Department of Mechanical Engineering, Stanford University
Sharon Nadeau CIHR Institute of Musculoskeletal Health and Arthritis
Earl Noble School of Kinesiology, University of Western Ontario
Fergal O'Hagan Kinesiology Wellness Works Professionals Inc.
Wade Parkhouse Research Faculty of Applied Sciences, Simon Fraser University
Ted Putman Faculty of Physical Education and Recreation and The Centre for Neuroscience, Faculty of Medicine & Dentistry, University of Alberta
Dilson Rassier Faculty of Education, Kinesiology and Physical Education, McGill University
Darlene Reid Muscle Biophysics Lab, Vancouver Coastal Health Research Institute
Jean-Marc Renaud Department of Cellular and Molecular Medicine, Neuromuscular Research Centre, University of Ottawa
Carol Richards Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Rehabilitation Institute of Quebec
Jean-Sebastien Roy Institut de Réadaptation en Déficience Physique de Québec
Ilona Skerjanc Department of Biochemistry and Microbiology and Immunology, University of Ottawa
Samantha Stephens The Hospital for Sick Children
Nancy St-Onge School of Physical and Occupational Therapy, McGill University
Scott Thomas Faculty of Physical Education and Health, University of Toronto
Bill Tillier Patient Representative
Jacques Tremblay Unité de Génétique Humaine, CRCHUL, Université Laval
Sophia Tsouros CIHR Institute of Musculoskeletal Health and Arthritis
Russ Tupling Department of Kinesiology, University of Waterloo
Veronica Wadey Faculté de medicine, Université Laval
Hannelore Walther CIHR Institute of Musculoskeletal Health and Arthritis
Leah Weinberg Department of Physical Therapy, School of Medical Rehabilitation
Richard Wells Department of Kinesiology and Centre of Research Expertise or the Prevention of Musculoskeletal Disorders, University of Waterloo
Linda Woodhouse Rehabilitation Science, McMaster University
Klaus Wrogemann Biochemistry and Medical Genetics, University of Manitoba

Return to top

Program


Day 1 - June 11 2007

Time Event
6:00-8:30 pm Registration
6:30-8:30 pm Buffet supper

Day 2 - June 12 2007

Time Event
7:00-8:00 am Continental Breakfast
8:00-8:35 am Opening & Welcoming Remarks
Dr. Cy Frank
Scientific Director, CIHR Institute of Musculoskeletal Health and Arthritis
  Background to the Meeting
Dr. Archie Cooper
Emertus School of Medical Rehabilitation, University of Manitoba
  Review of Agenda and Objectives of the Meeting
Dr. Archie Cooper
  Welcome from Sponsoring Institutes
Institute of Aging
Dr. Linda Mealing
8:35-10:00 am Muscle Research - State of the Art Review - Where are we today? What are the gaps in research?
Dr. Leslie Leinwand*
Colorado Initiative in Molecular Biotechnology Molecular, Cellular and Developmental Biology, University of Colorado at Boulder
  Musculoskeletal Rehabilitation Research - State of the Art Review - Where are we today? What are the gaps in research? - Dr. Carol Richards*
Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Rehabilitation Institute of Quebec
Each presenter will have 30 minutes, with the remaining time for interactive discussion with participants.
10:00-10:20 am Break
10:20-noon Strengths and Weaknesses of Research in Each Focus Area
Four breakout groups in total: two breakout groups for the Muscle Research focus area, and two breakout groups for MSK rehabilitation research focus area . All groups have same task.
12:00-1:00 pm Lunch
1:00-2:30 pm Opportunities for and Threats to Research in Each Focus Area
Four breakout groups in total: two breakout groups for the Muscle Research focus area, and two breakout groups for MSK rehabilitation research focus area . All groups have same task.
2:30-2:45 pm Break
2:45-3:45 pm Targets - Opportunities and Plans for New Research Collaborations within the Focus Areas
Four breakout groups in total: two breakout groups for the Muscle Research focus area, and two breakout groups for MSK rehabilitation research focus area . All groups have same task.
3:45-5:15 pm Report Back to Plenary on Outcome of SWOTT Analysis (emphasis on targets, priority areas, actions, strategies)
Muscle MSK Rehabilitation Each group has a reporter who will summarize the discussion and outcomes of the SWOTT
5:15-5:30 pm Summary and wrap-up of Day 2 Dr. Archie Cooper
5:30 pm Break
7:00 pm - Reception and Dinner Assigned seating.

Day 3 - June 13 2007

Time Event
7:00-8:00 am Continental Breakfast
8:00-8:05 Review of Day 3 Agenda and Objectives Dr. Archie Cooper
8:05-8:35 am Integration of Muscle and Musculoskeletal Rehabilitation Research - From Molecules to Mobility Dr. Reggie Edgerton Neuromuscular Research Laboratory within the Department of Physiological Science and the Brain Research Institute, University of California, Los Angeles
8:35-9:05 am International Classification of Functioning, Disability and Health Dr. Aileen Davis Outcomes and Population Health, Toronto Western Research Institute
9:05-9:35 am Priming the Pump - IMHA's Opportunities Dr. Louise Desjardins Assistant Director, CIHR Institute of Musculoskeletal Health and Arthritis
9:35-9:45 am Question Period
9:45-10:00am Break
10:00-11:15 Opportunities and Plans for Research Collaboration Activity: Brainstorming Define one potential research collaboration Four breakout groups - each group has a reporter who will summarize the discussion and outcomes of the SWOTT
11:15-11:45 am Report Back to Plenary on Outcome of Research Collaboration Discussion Recommendations to CIHR and IMHA Each group has a reporter who will summarize the discussion and outcomes of the SWOTT
11:45am-12:00 pm Wrap Up and Next Steps - Dr. Archie Cooper
12:00 pm Workshop Adjourns
Date modified: