Musculoskeletal Ultrasound – Pearls and Pitfalls of Common Cases. Dr. Linda Probyn – Radiologist, University of Toronto, Sunnybrook Health Sciences Centre

At the end of the session, participants will be able to:

  1. Describe anatomy, pathology and ultrasound appearances of common MSK cases outlining use of dynamic imaging and doppler
  2. Identify potential pitfalls
  3. Demonstrate how other imaging modalities are complimentary to MSK ultrasound.

The presentation will use a case-based approach to describe and review relevant anatomy and pathology of cases, outlining the ultrasound appearances of pathology, including the use of dynamic imaging and ultrasound. Pearls and pitfalls will be identified and reviewed. The use of other modalities and how these are complimentary to ultrasound will be demonstrated. The session will be of value to: Physiatrists, Medical students, Residents, Fellows


Post Traumatic Dizziness. Dr. John Rutka – Professor Department of Otolaryngology-Head and Neck Surgery, University of Toronto, University Health Network

At the end of the session, participants will be able to:

  1. Determine the important features necessary for the history and physical examination of the “dizzy” patient.
  2. List the necessary vestibular function tests for investigation of the dizzy patient.
  3. Compare and contrast different physical therapy manoeuvres for the treatment of BPPV.
  4. Compare the resilience of different professions with dizziness following head injury.
  5. Summarize the common causes for dizziness post head injury.
  6. Explain features that suggest a peripheral vestibular cause for an individual’s post head injury dizziness

Headaches, neuropsychological/neurocognitive complaints and dizziness are common findings post head injury. This presentation will concentrate on a tailored approach to the history, physical examination and then necessary laboratory inner ear investigations required for the management of the dizzy patient post head injury. Special attention will be focused on the clinical neurological provoking tests and management of benign position paroxysmal vertigo (BPPV) which is the most common organic peripheral vestibular disorder identified post head injury. Physical therapy manoeuvres for the management of BPPV are demonstrated. Surgical treatment for those with incapacitating BPPV recalcitrant to medical management and for canal dehiscent syndromes post trauma are demonstrated additionally Unique findings from a prospective series of > 4,000 head injured workers with “dizziness” referred from the Workplace Safety and Insurance Board (WSIB) since 1988 are presented. The mechanism of injury (fall, contusion, explosion etc.), class of injury (blunt, penetrating, accelerating/decelerating etc.), its severity (minor, closed, closed with skull # etc.), whether there was an associated loss of consciousness, imaging findings etc. have been studied. Overall approximately 20% were identified to have neurotological abnormalities in this series. The common diagnoses made in those with post head injury dizziness is noted. There were quite significant differences in the presence of organic pathology depending on the profession involved. Controversial areas such as the development of Meniere’s disease post trauma/differing resilience levels in certain professionals, assault in the workplace, the most dangerous jobs in Ontario etc. are discussed.


Concussions and their Consequences. Dr. Charles Tator – Director, Canadian Concussion Centre, Toronto Western Hospital

At the end of the session, participants will be able to:

  1. Identify the consequences of concussion
  2. Treat post concussion syndrome (PCS) patients
  3. Manage PCS headaches, vertigo, and mental health disorders
  4. Assist in primary, secondary and tertiary concussion prevention measures

It is now apparent that the consequences of concussion can be long lasting, and that many aspects of PCS are treatable. Management of PCS must be individualized with recognition and accommodation for thresholds of exacerbation due to mental and physical activity. This session will be valuable for practicing physiatrists and those in training in this specialty.


Polytrauma and Traumatic Brain Injury – Dr. David Cifu
Program description/Purpose statement.

The purpose of this presentation is educate health care providers, academicians, researchers and other professionals on the evidence-based, practical, clinical approach to the assessment, management and risk communication strategies for individuals who believe they may be at risk to develop or currently have Chronic Traumatic Encephalopathy as a result of traumatic brain injury exposures or injuries, including repetitive traumatic brain Injury (concussions), sports injury or combat-related blast injury. Topics will include; a critical review of the scientific literature of CTE, blast, sports injury and mild TBI, an update of ongoing VA, DoD, and academic multicenter, longitudinal studies of individuals, including athletes, Veterans and Servicemembers, with exposures to one or more concussions, sports injury and blasts, a rational approach to diagnostic testing, a comprehensive, clinical practice guideline-directed management strategy, and recommendations on risk communication techniques for patients, caregivers and clinicians. The presentation will include a critical literature review, a research update from the VA/DoD Chronic Effects of Neurotrauma Consortium (CENC) Longitudinal Study, clinical case studies, and a recommended clinician’s guide to diagnostic testing (imaging, biomarker, posturography, electrophysiology, neuropsychology), rehabilitation therapies, diet, exercise, vocational services, medications, and mental health care. Issues surrounding research trial and brain donation will also be discussed.

At the end of the session, participants will be able to:

  1. Critically discuss the scientific literature and ongoing mTBI, sports injury, blast, and CTE research studies
  2. Formulate an assessment and management care plan for individuals who believe they are at risk for or have CTE due to one or more TBI exposures
  3. Recommend an evidence-based diagnostic approach for individuals who believe they are at risk for or have CTE due to one or more TBI exposures
  4. Prescribe a practical, CPG-guided, comprehensive intervention plan for individuals who believe they are at risk for or have CTE due to one or more TBI exposures
  5. Utilize appropriate and effective risk communication strategies concerning blast exposure, repetitive concussion, and CTE for individuals, Caregivers and Clinicians

Lecture Outline

  1. Chronology of disorders with unexplained symptoms and war
  2. Critical review of CTE, blast and mild TBI
  3. Update on ongoing VA, DoD and Academic Multi-Center, Longitudinal Studies of repetitive mild TBI, sports injury and blast exposure, including the CENC Longitudinal Study
  4. Evidence-Based Diagnostic Testing for individuals with combat-related exposure to blast, sports injury and/or repetitive mild TBI who believe they are at risk for or have CTE
  5. Clinical Practice Guideline-directed, comprehensive approach to the clinical management for individuals with combat-related exposure to blast, sports injury and/or repetitive mild TBI who believe they are at risk for or have CTE
  6. Recommendations on risk communication techniques for individuals with combat-related exposure to blast, sports injury and/or repetitive mild TBI who believe they are at risk for or have CTE, and their caregivers and clinicians

Vision Therapy for Traumatic Brain Injury: An evidence-based method of rehabilitation – Dr. Angela Peddle

At the end of the session, participants will be able to:

  1. Identify the signs and symptoms of post-trauma vision syndrome
  2. Describe the anatomy and physiology of the visual system and how it can be impacted during a brain injury
  3. Review evidence-based research on vision therapy

This presentation will review how the visual system can be impacted during a traumatic brain injury, with a review of system pathways and anatomy. Evidence-based research on vision therapy will be discussed, and how vision therapy can be a successful part of the rehabilitation team. Clinical pearls on identifying post-trauma vision syndromes and those in need of vision therapy will be emphasized. The session will be of value to physiatrists, family physicians, medical students, residents, and rehabilitation teams (physiotherapy, occupational therapy).


Regenerative Therapies, PRP and Stem Cells in Musculoskeletal PainDr. Jihad Abouali

At the end of the session, the participants will be able to:

  1. Describe the physiology of PRP and stem cells
  2. List techniques of harvesting and preparing PRP and stem cells
  3. Describe and appreciate the current and future roles of regenerative medicine

Regenerative medicine represents the next wave of MSK medicine and surgery. This presentation will review some of the basic physiology behind platelet-rich plasma and stem cell therapy in the setting of MSK pain and injuries. Techniques of harvesting, preparation, and injections will be reviewed to allow learners to appreciate how these procedures are performed. A critical appraisal of the literature will be summarized to help determine when these treatments have the best clinical outcomes.


Integrating Cannabis into Patient CareDr. Carolina Landolt

At the end of the session, the participants will be able to:

  1. Describe the endocannabinoid system and endo- and exogenous cannabinoids
  2. Review the clinical indications for the use medical cannabis
  3. Apply a clinical framework for the initiation and monitoring of medical cannabis

Opioid and Cannabis – A 20 min Update for the Busy PMR Specialist.Dr. John Flannery

At the end of the session, the participants will be able to:

  1. Recall the 10 updated 2017 opioid guidelines
  2. Participate in compassionate conversations for chronic pain patients
  3. Apply a clinical framework for the initiation and monitoring of medical cannabis

This 20-minute presentation will provide pragmatic updates and how to steps for chronic pain management in a PM&R specialist in community practice and academic rehab. The target audience will be active practitioners. Chronic pain care will find you in your practice no matter how far you run or how much try to hide so best to have a pragmatic approach!


Imaging Traumatic Brain Injury.Dr. Sean Symons

At the end of the session, the participants will be able to:

  1. List the options to image the traumatic brain
  2. Define the strengths and weaknesses of the different imaging modalities
  3. Describe the typical appearances of traumatic injuries on imaging

Options for imaging the traumatic brain will be reviewed. The strengths and weaknesses of the various imaging modalities will be discussed. Numerous examples will be provided showing typical appearances of traumatic brain injuries using different modalities. The appropriateness of selecting an imaging modality in the acute, subacute and chronic traumatic brain injury patient will be discussed. The session will be of value to: Physiatrists and residents.


Helping Our Clients by Building CommunityDianne Henderson & Bernard L. Gluckstein

Our law firm represents some of the most vulnerable people in our society, at a time in their lives when they are likely especially stressed, strained, and scared. Our clients must put their energy towards therapy, medical tests and procedures to aid in their recovery and improve their quality of life; while also contemplating and participating in a lawsuit to obtain the funds and resources that they will need for their long-term care and well-being.
As advocates for our clients’ best interests, we must think of what we can do to ensure they have access to the resources that they will need in the future.

Knowing that many of our past clients may be facing difficult circumstances in the future, is our responsibility to our client over when the case concludes?

Can we continue to help our clients after litigation, if we support the organizations that support them?


Personalized & Evidence-Based Medical Cannabis CareTanny Raz

At the end of the session, the participants will be able to:

  1. Describe the benefits of referring patients to a medical cannabis clinic for personalized treatment support, care and ongoing monitoring
  2. Review Apollo’s latest medical cannabis research & how it informs treatment plans
  3.  Describe & appreciate the future of medical cannabis as a treatment option