HULC Clinical Lab


HULC Clinical Outcomes Research Laboratory


The HULC Clinical Research Laboratory is under the direction of Dr. Joy MacDermid. The lab produces high quality research on measuring, predicting and reducing upper extremity disability with a focus on surgery and rehabilitation. The lab accepts students at the MSc and PhD level. Supervision is through the Depts. of Medical Biophysics and Epidemiology and Biostatistics, and the Faculties of Physical Therapy and Health Sciences.

The research program is based on a strong foundation of clinical measurement studies that define optimal methods of measuring upper extremity impairment, pain and disability. Cohort studies address longitudinal outcomes and associated predictors. Clinical trials are conducted on specific important clinical issues in upper extremity surgery and rehabilitation and uses the following tools:

1. Outcome Measures
FIT-HaNSA protocol
Pain and Disability Scales and User Manuals:
Patient-Rated Wrist Evaluation (PRWE)
Patient-Rated Wrist/Hand Evaluation (PRWHE) 
Patient-Rated Elbow Evaluation (PREE)
Patient-Rated Tennis Elbow Evaluation (PRTEE)
Patient Specific Participation Scale

2. Knowledge Translation Tools
Readiness to Change Practice
Chart Stimulated Recall Form and Guide (Outcome Measures)

3. Critical Appraisal Tools
Diagnostic Studies
Effectiveness Studies
Psychometric Properties of Outcome Measures

Current projects include:
1.0 Injured Workers
1.1 Knowledge exchange with injured workers
1.2 Management of complex, work-related disorders
1.3 Gender issues in work disability
1.4 Defining the health services impacts of specialty clinics
1.5 Validation of work disability measures
1.6 Understanding the diagnostic process in complex upper extremity disorders 1.7 Prognostic profiles to predict optimal management and outcomes

2.0 Shoulder Disorders
2.1 delineation of clinical methods to assess strength and functional endurance 2.2 validation of outcome measures
2.3 clinical trials in shoulder surgery (rotator cuff)
2.4 cohort studies (shoulder arthroplasty, humeral fractures)
2.5 impact of waiting for surgery
2.6 prognosis
2.7 systematic reviews ( management of proximal humeral fractures)
2.8 evaluation of diagnostic tests

3.0 Elbow
3.1 delineation of clinical methods of pain and disability in tennis elbow, cubital tunnel and fractures
3.2 relationships between impairment and function
3.3 clinical trials (biceps repair, ulnar nerve transposition)
3.4 cohort studies (radial head arthroplasty)
3.4 prognosis for chronic pain and work loss
3.5 systematic reviews
3.6 rehabilitation practice survey (fracture)
3.7 Classification of ulnar nerve outcome ICF framework

4.0 Wrist/hand (fracture, nerve injury, carpal tunnel syndrome)
4.1 validation of outcome measures ( self-report and impairment measures)
4.2 modeling physical, social, environmental contributors to post-fracture disability
4.3 Sensory evaluation (current perception, touch and vibration thresholds; cold intolerance)
4.4 clinical trials (scaphoid surgery)
4.5 Cohort studies ( wrist fracture, scaphoid fracture, CMC arthroplasty)
4.6 systematic reviews (diagnostic tests for wrist instability, scaphoid fracture treatment)
4.7 hand function in RA and OA
4.8 prevention of post-fracture risks of loss of independence
4.9 Scaphoid healing

5.0 Evidence-based Practice and Knowledge Translation
5.1 Transferring outcome measures into practice
5.2 Push-out of research evidence
5.3 Clinical Practice Guidelines