KITE, Toronto Rehab-University Health Network, Toronto, Canada
My passions for applied physiology, care of the “whole person” with spinal cord injury (SCI), and belief in the value and effectiveness of interprofessional care have influenced my career directions and choice of research activities. My initial career focus was on describing changes in lower extremity bone mass and bone quality after SCI. My subsequent efforts and publications have aimed to help the field identify individuals with SCI, low bone mass, and high fracture risk who require therapy. This led to systematic reviews describing, and intervention studies determining, which therapeutic interventions are effective for the treatment of sublesional osteoporosis. Concurrent advances in bone physiology, the muscle-bone unit, and Wnt signaling, led to my conduct as Primary Investigator intervention studies evaluating the efficacy of medical therapy (RCT - oral risedronate), and rehabilitation therapies (proof of principle - standing and whole-body vibration) for augmenting lower extremity bone mass and reducing fracture risk.
I have become increasingly fascinated by the related fates of bone, muscle, and adipose tissue after SCI, and their roles in precipitating secondary health conditions. These tissue changes include: declines in hip and knee region bone quality; reductions in muscle density and increases in Type IIx fibers; and, increases in abdominal, visceral, and intramuscular fat. These physiological events combine to precipitate distal femur fracture, pressure sores, a pro-inflammatory state, and cardiometabolic disease. My most recent research has focused on the preservation of tissue, and optimization of residual tissue function through the application of medical and neurorehabilitation strategies to prevent or ameliorate fractures, heart disease, and pressure sores. I am the Primary Investigator for a Craig H. Neilsen funded clinical trial The Efficacy and Safety of Rosuvastatin for Modifying Bone Mass and Cardiometabolic Disease Outcomes (NCT03113994). I am the panel Chair for the PVA 2020 Bone Health and Osteoporosis Management in Adults with Spinal Cord Injury Guideline. These prior clinical research endeavors and administrative experience and the support of a high caliber team qualify me to present at the 2020 PVA Summit.