Page 11

L - Skeletal Integrity

Spotlight Best Practice Organization Brain and Spinal Cord Rehab Program – Toronto Rehabilitation Institute (TRI), University Health Network, Toronto The clinical and research expertise of the clinicians and scientists, at this site, are recognized internationally. Members of the bone health team include two physiatrists, outpatient nurses, physical and occupational therapists, a dietitian, orthotist and two DXA technologists. Knee region bone density testing is routinely assessed using a standard protocol, for individuals with sub-acute or chronic SCI, through yearly assessments of bone health and fracture risk. The knee region bone density-testing protocols, developed here, have been shared with other sites and are routinely used in Hamilton, Québec City, Calgary and Toronto. Physiatrists routinely review patients’ health status, nutrition status, lifestyle factors, fracture risk factors and BMD results, when diagnosing SLOP, identifying fracture risk and selecting appropriate therapies. Pharmacological therapy, including oral or intravenous bisphosphonates and injectable medications (including monoclonal antibodies like danosamub and recombinant PTH), are routinely prescribed, in the outpatient setting. individuals have access to non-pharmacological SLOP therapies, including FES biking and passive standing. Individuals with fractures are supported and followed by the bone health team. Post-fracture clinical services include provision or rental of elevating leg rests, medications to prevent bone loss and to augment fracture healing, interventions to assist with delayed union or nonunion fractures, and monitoring of skin, during and after application of fracture immobilizers; liaison with local orthopedic surgeons, and reconditioning after fracture healing or operative intervention. Bone health research, at this site, spans from long-term, observational cohort studies, to clinical drug trials, and therapeutic device studies investigating novel treatment options. Research subjects have assisted Scientists in the determination of the efficacy of whole body vibration, FES therapy and oral bisphosphonate therapy, for treatment of SLOP. Local scientists are collaborating to prospectively evaluate the feasibility and diagnostic yield of knee region DXA versus pQCT, of the tibia. 124 CAPTURING CAPACITY IN CANADIAN SCI REHABILITATION


L - Skeletal Integrity
To see the actual publication please follow the link above