Dr. Alfonso Fasano, (L), and fellow Dr. Wilson Fung consult with a patient remotely to adjust their neuromodulation device. (Photo: UHN)

Krembil Brain Institute first in Canada with remote adjustment to neuromodulation patients

UHN's Krembil Brain Institute (KBI) at Toronto Western Hospital (TWH) last month became the first site in Canada to provide remote neuromodulation patient-care technology for patients with chronic pain or movement disorders.

The availability of this technology will not only help increase access to treatment for conditions such as chronic pain, Parkinson's disease and essential tremor, but also improve the quality of life of patients currently receiving treatment who have difficult accessing their healthcare provider due to the distance between the hospital and the patient's residence, or other travel-related challenges.

The remote technology, supported by Abbott's Neurosphere Virtual Clinic, lets patients receive care anywhere by connecting with their healthcare provider via a secure in-app video chat. An integrated remote programming feature allows the provider to make changes to the patient's neuromodulation device – a device that alters nerve activity – adjusting the stimulation up or down as needed by the patient; all without them leaving their home.

As a world-renowned centre for the treatment of movement disorders and pain, KBI already has many patients from across the province and even across the country travelling to TWH for treatment, which can be both costly and tiring.

"Alternatives to in-person programming helps expand access to patients who may delay or forego care for pain or a movement disorder, particularly those who face a travel burden," says Dr. Alfonso Fasano, a neurologist with KBI. "Fortunately, innovative virtual healthcare options are changing the treatment landscape, essentially extending care beyond clinic walls.

“Remote programming is an important new option that allows patients to communicate with their physicians virtually to ensure proper device settings and functionality and, ultimately, giving patients the ability to manage their therapy in a way that fits their personal needs."

A team will also be researching the efficacy of combining consultations through the Ontario Telehealth Network (OTN) with remote programming, which were previously done separately. This builds on research done in 2017 that evaluated the benefits of using OTN for pre and post surgery followup care for patients seeking Deep Brain Stimulation (DBS).

The study confirmed the feasibility and usefulness of remote check-​​​​​ins with patients which significantly reduced the burden and costs of travelling and set the stage for an effective pivot to virtual care after the COVID-19 pandemic was declared.

Love is Blind – retired UHN physiotherapist shares her story, shows 'all things are possible'

Retired Toronto Rehab physiotherapist Ruth Vallis, who is blind, pictured here with her service dog, Ruby, in her graduation photo from the University of Greenwich, where she received a Master of Science in Continuing ​Professional Science (Health). Ruth has written a memoir, Love is Blind, about the obstacles she has faced – and overcome. (Photos: Courtesy Ruth Vallis)

By the time she was in Grade 8, Ruth Vallis's school teacher suggested she had already lived a life so interesting that it needed to be shared in a memoir.

Now a retired UHN physiotherapist (PT), Ruth, who has been blind since age three and recognized as a leader in the integration of the blind in Canada, has done just that.

In Love is Blind, Ruth weaves the story of the obstacles she has faced and overcome as she navigates a world was not built for her.

As a PT in Toronto Rehab's MSK Rehab Program for 30 years, Ruth supported patients receiving rehab for many issues, including multiple traumas and hip fractures. She believes her own lived experiences deepened her connection with patients, and motivated them in their recovery journey.

"My patients know I understand," she says. "They see that I take my disability home with me every day; that I never make excuses and that success is possible."

With Love is Blind, Ruth says hopes to touch many different audience groups.

"I hope mothers and daughters will be reminded of the very special and unique relationship that exists between them, and that together, women can conquer anything," she says.

"I hope healthcare professionals will be reminded of the unique and important role they play in the lives of every person they meet and treat.

"I hope teachers will be reminded of the significant role they play in the lives of children.

"And I hope those with disabilities and the individuals who work with them believe that all things are possible, if they are prepared to ignore the doubters and put in the effort."

Research shows unequal impact of COVID-19 on minority ethnic groups

Research from Toronto Western Hospital neurologists, Dr. Joseph Chu, (L), and Dr. Robert Chen, found Chinese and South Asian Ontarians who contracted COVID-19 were more likely to suffer complications or require acute care services. (Photos: UHN)

It has been well noted throughout the pandemic that, though the SARS-CoV-2 virus is a risk for everyone, it affects some populations more severely than others – particularly those from minority ethnic groups.

New research published in the Canadian Journal of Cardiology Open (CJCO) shows that, compared to the general population, Chinese and South Asian Ontarians who contracted COVID-19 were more likely to either suffer complications or require acute care services.

"These findings show that ethnicity continues to be an important determinant of mortality, cardiac and neurological outcomes, and healthcare use among patients with COVID-19," says Dr. Joseph Chu, an associate staff neurologist at Toronto Western Hospital (TWH) and the principal investigator of the study.

"Though more research is needed to better understand the factors contributing to these outcomes, this study informs how to better support these populations in future waves of the pandemic."  

Along with TWH staff neurologist Dr. Robert Chen, the research group conducted a statistical analysis of data collected between the first three waves of the pandemic – January 2020 to June 2021.

The analysis revealed that patients identified as being of Chinese background had a much higher mortality, and were 44 per cent more likely to die of COVID-19 within 30 days of having contracted it. These patients were also more likely to be hospitalized or need to visit an Emergency Department, and had a greater risk of suffering cardiac and neurological complications as a result of the virus. 

Though COVID-19 patients identified as being of South Asian background had slightly better outcomes for mortality and cardiac or neurological complications – possibly due to the overall younger age of the study group – these patients were also more likely to require hospitalization or need to visit an Emergency Department.

"Understanding how different populations are affected by the same virus is very important to overcoming this pandemic," says Dr. Chen. "As we continue to refine strategies for vaccination distribution, education, and allocation of health resources, it is helpful to know who can benefit most from these resources particularly as the virus continues to evolve itself."

The study was made possible with funding from the University of Toronto's Department of Medicine Research Fund and the Ontario Ministry of Health's Ontario Health Data Platform (OHDP).

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