CURRICULUM VITAE - The Ottawa Hospital Research Institute

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Hillel M. Finestone 6 Stroke Rehabilitation RESEARCH I have concentrated on three key research areas that complement my clinical involvement as a physiatrist with a special interest in stroke rehabilitation: 1) nutrition and stroke, 2) driving and stroke, and 3) virtual reality exercise therapy in the stroke survivor. 1. Nutrition and stroke In 1990, I designed a prospective research project designed to study nutritional aspects of all stroke patients admitted to the London University Hospital Rehabilitation Unit. Internal funding support was received and a research assistant was hired. Over the years, several abstracts and a book chapter were published, culminating in the much-cited publications “Malnutrition in stroke patients on the rehabilitation service and at followup: prevalence and predictors” (1995) (148 citations) and “Prolonged length of stay and reduced functional rate improvement in malnourished rehabilitation stroke patients” (1996) (97 citations), both in the Archives of Physical Medicine and Rehabilitation. I authored a chapter on nutrition and diet in neurological rehabilitation in a reference textbook entitled Principles of Neurologic Rehabilitation (McGraw-Hill, New York, 1998). I received funding from the Heart and Stroke Foundation (HSF) ($99,704 over 2 years, starting in July 1996) for a project on the nutritional status and metabolic requirements of stroke survivors. An HSF grant was awarded to me for the project “Acute phase reactants and loss of muscle mass following stroke” ($68,022 over 2 years, starting July 1, 1999). As Principal Investigator, these grants enabled me to further my research on metabolic issues in stroke. Research was continued at the University of Ottawa and culminated in publication in 2003 of the original article “Measuring longitudinally the metabolic demands of stroke patients” in Stroke. I continue to be asked to review the topic of nutrition and dysphagia in stroke as a result of my research and clinical experience. A 2003 review article in CMAJ is highly cited. I coauthored a book chapter entitled “Malnutrition after stroke” for a major US textbook, Stroke Recovery and Rehabilitation, published in January 2009 by Demos Medical Publishing, New York; I am currently updating this chapter. 2. Driving and stroke On my arrival in Ottawa in 2000 I became intrigued with the innovative driving research that I was exposed to through faculty members such as colleague and physiatrist Dr. Shawn Marshall. I became a member of Candrive (Canadian Driving Research Initiative for Vehicular Safety in the Elderly), and after pilot work on a driving database at The Ottawa Hospital Rehabilitation Centre, it was clear that the area of driving and stroke required further study. I received summer student funding from the University of Ottawa Faculty of Medicine for 2 years (2004 and 2005). I was then awarded 3 years of funding from the HSF in 2005 and 2007 for the project “Driving post-stroke: a
Hillel M. Finestone 7 prospective study of community integration and driving habits.” As principal investigator I studied stroke survivors and how stroke affected their driving abilities. Two data-based retrospective and prospective studies have been published thus far in important physical medicine and rehabilitation journals. As a result of my driving and stroke initiatives I was asked to edit the chapter on stroke in the Canadian Medical Association guide Determining Medical Fitness to Operate Motor Vehicles (2006). Dr. Marshall and I recently updated this chapter. I have presented numerous abstracts and workshops on the effect of stroke on driving ability and the physician’s responsibilities concerning this issue. I coauthored a chapter on driving and stroke in a comprehensive stroke rehabilitation textbook (Stroke Recovery and Rehabilitation, January 2009). I am a coapplicant on a team grant entitled “Canadian Institutes of Health Research Team on Older Person Driving (Candrive II),” in which $5.58 million was granted to carry out a large prospective cohort study with other associated studies in areas such as stroke. 3. Virtual reality exercise training and stroke I collaborate with Dr. Heidi Sveistrup, neuroscientist with the School of Human Kinetics, Faculty of Health Sciences, University of Ottawa. Three publications concerning the use of this technology in brain-injured adults have been published. We completed a pilot project among inpatients and outpatients at the Élisabeth Bruyère Hospital Stroke Rehabilitation Unit and showed that virtual reality technology can potentially improve fitness and balance in this population. Two grants totalling $120,000 were awarded to me from the Bruyère Academic Medical Organization Incentive and Innovation funds to study the use of virtual reality to improve balance in rehabilitating stroke inpatients. A new collaboration has been set up with Dr. Martin Bilodeau, a neuroscientist at the Bruyère Research Institute and Associate Professor and Director of the School of Rehabilitation Sciences at the University of Ottawa. I will be cosupervising a PhD student (Dan McEwen) with Drs. Bilodeau and Sveistrup. A randomized prospective study was commenced in July 2010. In June 2010 I was named the inaugural recipient of the Dr. Tony Hakim Innovative Stroke Research Award ($100,000 unrestricted grant) from the Heart and Stroke Foundation Centre for Stroke Recovery for this virtual reality project. I hypothesize that virtual reality exercise therapy will become a mainstream stroke rehabilitation treatment that will enable stroke survivors to become more active in their communities. Also in June 2010, the Bruyère Foundation received a community donation to establish the Tony and Elizabeth Graham Virtual Reality Research and Training Centre at the Élisabeth Bruyère Hospital. Funds will be used to purchase state-of-the-art equipment and hire personnel to research the area of virtual reality in the rehabilitating stroke patient ($270,000). I am Medical Director of the centre.
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