Canadian MSK Rehab Research Network Bone and Joint Institute

Vision

Network LogoThe main goal of the Network is to advance innovative rehab solutions that will:

Together, this multi-sector cross-jurisdictional collaborative group will leverage strengths within various research communities to:

  1. Address key priorities in MSK Rehab
  2. Lead to successful external funding applications
  3. Foster sustainability of the network.

Scope & Vision

  • foster innovative high-quality, national, collaborative, transdisciplinary research, and capacity building for Musculoskeletal (MSK) Rehabilitation (Rehab) research initiatives
  • advance innovative rehab solutions that will improve MSK health outcomes, support positive changes in the patient experience, and contribute to the Canadian economy
  • focus on key MSK impairments (i.e. mobility and pain) and participation restrictions (e.g. work disability) where the greatest need and impact are expected
  • be inclusive to all those affected by MSK conditions (children, adolescents, adults, elderly, genders, cultural and socioeconomic groups) to address equity issues through research and KT
  • pool resources and conduct activities that are aligned to network objectives and overarching guiding principles (i.e. engagement and equity, knowledge translation (KT), and advancing discovery and technology)
  • enhance partnerships to mobilize multi-sector and cross-jurisdictional patients/caregivers, healthcare professionals, trainees, new and experienced investigators, decision-makers, professional bodies, and community agencies
  • actively engage in the setting of priority research questions, co-create knowledge, and KT plans
  • improve early uptake and implementation of best-practices that will produce better services and health outcomes to improve people’s ability to actively participate in society across their lifespan
  • leverage strengths within various research communities to create innovative and impactful research proposals that will: 1) address key strategic priorities in MSK Rehab; 2) lead to successful external funding applications; and 3) foster sustainability of the network 

Strategic Priorities

  • Mobility
  • Work
  • Pain

Guiding Principles

  • Engagement & Equity
  • Discovery & Technology
  • Knowledge Translation

Objectives

The overall objectives are to: A) form a virtual and interactive structure that facilitates collaboration, interaction, and best use of cross-jurisdictional expertise and resources; and B) set specific research priorities and action plans through widespread consultation. Three main sub-objectives have been identified and will be fulfilled through the development of:

  1. National Platforms and Outcome Measures: a) establish core biomechanical, clinical and cost measures through consensus to advance research efficiency and impact; b) create a technology/expertise registry to enhance resource sharing and cross-centre collaboration; and c) develop and launch national platforms to collect/share data and improve research quality and efficiency through shared web-based patient data collection/aggregation systems and a KT tools repository.
  2. Scale-up of Innovations (Clinical trials and Cohorts Studies) that will reduce pain, improve mobility, and enhance work function throughout the lifespan: a) implement a clinical trials network that would leverage network platforms to address research priorities (e.g. multi-centered RCTs evaluating cost-effectiveness of web-based or wearable technologies for rehab, expanding the Quebec acute low back pain platform nationally, creating a patient-driven arthritis cohort) to enhance understanding of longitudinal changes in pain and disability; and b) facilitate future impacts through network pilot studies on new approaches (e.g. personal virtual reality devices) or adaptations of current innovations (e.g. online exercise and self-management with built-in virtual social networking) to overcome implementation barriers (e.g. cost, time constraints, low socioeconomic status, and rurality).
  3. Collaborative Mentorship and Training Opportunities: a) build capacity for MSK research by fostering the success of trainees/new investigators through transdisciplinary training (e.g., trainee-led workshop, leadership and career advancement workshops, KT training,  scholarships,  peer review, travelling awards for internships in labs across the network); b) create virtual or cross-network exchange opportunities to maximize learning and skill development related to key technologies and research methodologies; and c) enhance multi-institutional mentorship via supervisor-trainee/new investigator-mentor matching.

Rationale

The increasing burden of a wide range of MSK disorders (MSKD) such as arthritis, osteoporosis and other muscle, tendon, joint, and bone conditions, including work and activity-related injuries, creates an urgent need for innovative and collaborative MSK rehab research. Strategic investments from CIHR, and the emergence of advanced and accessible technologies (wearable sensors, e-health, robotics, etc.) can facilitate this innovation.

With commitment to scientific excellence, it is an ideal and critical time to establish an inclusive national MSK Rehab Research Network that incorporates, facilitates, and supports the multidisciplinary and multi-thematic work of research groups, partners, knowledge users, and stakeholders (not-for-profit organizations, associations, industry, provinces, patients, caregivers, clinicians, decision-makers, etc.) from across the country. It will be critical to focus on priority research themes where the evidence to date points to the greatest need and potential for impact. Bringing together innovators across a breadth of different disciplines focused on MSK Rehab has the potential of accelerating innovation and translation of technology solutions into clinical applications. Patients define two primary issues in MSK disorders as loss of mobility and pain. Research that focuses on mitigating these is of vital importance.

Given recent CIHR (Chronic Pain SPOR), SSHRC (Productive Work) and CFI investments (Biomechanics and imaging labs; Data Management and Methods Centre) and institutional commitments, this network will leverage existing infrastructure, efforts, and partnerships to facilitate success. As the majority of the economic burden of MSK disorders relates to loss of work role function, there is a need for research to focus on ways to maintain MSK health and work roles. Network investigators and partners will engage in a priority setting exercises to establish the key MSK rehab research questions and activities that will move research forward for these key priorities.

Potential Impact

The network is expected to have, and will monitor, impacts across the CIHR performance measurement regime. The specific indicators selected from over 100 included in the measurement regime will be determined based on the strategic priorities set out by the network in the first year. Building capacity is an important foundation for future excellence and the network will accomplish this goal through support of highly qualified personnel and shared infrastructure.

We are committed to patient engagement in priority setting and as lay researchers on pilot projects. We have identified consumers who are highly experienced in research and we have relationships with multiple patient groups that will facilitate engagement (e.g. PaCER, Pain SPOR, Canadian Pain Coalition). Training workshops and tools designed specifically for lay researchers will accelerate their effectiveness and engagement. We will facilitate effective engagement of consumers in all network activities (e.g. network mentors, key roles in network, involvement in pilot projects, trainee awards, etc.). We will develop an MSK mentorship program for trainee and young investigators to access a cross-network mentorship approach. Engagement of multiple research chairs and research leaders will provide a rich knowledge resource for trainees and junior researchers.

The network is expected to increase the volume, quality, and impact of research that advances knowledge and informs decision-making. Network key research priorities will serve as guideposts to fund pilot studies that move the field forward (advancing knowledge and improving health outcomes). Too many MSK rehab research studies are inconclusive due to small samples and weak designs. Pilot studies supported by the network will need to show how they plan to utilize national platforms created by the network and how they can scale-up into multi-centre trials to advance the future success of MSK rehab research. Overall the network will support 41 cross-disciplinary, pilot studies ($10,000 each) addressing the network research priorities in an attempt to leverage network investigators to attract larger funding. The development of a clinical trials network and supporting infrastructure will allow investigators to conduct the pilot studies and subsequent larger RCTs/cohorts more efficiently and at greatly reduced costs (see Empowers Letter of Support).  The network will provide intellectual, infrastructure and funding for emerging innovations to accelerate their translation into the highest quality studies that will have positive health impacts on Canadians.