Muscles: From Molecules to Mobility

CIHR Institute of Aging - Meeting Sponsor

The Institute of Aging will champion health research on aging in Canada, and create innovative opportunities for research and researchers. All researchers working in the field of aging will want to be affiliated with the Institute. Policy makers will look to the Institute for information and advice, and use the knowledge we generate to develop more effective policies and services. Our work will enhance the health and lives of older Canadians.

The Process

At the meeting, top researchers provided state of the art reviews of research priorities from two focus areas: muscle research and musculoskeletal (MSK) rehabilitation research. Breakout groups identified strengths, weaknesses, opportunities and threats as well as targets and plans for new research collaborations within the focus areas. The outcomes of the breakout groups were presented to all meeting participants. To inspire collaboration, participants were presented with examples of research integrating muscle and musculoskeletal rehabilitation; this presentation demonstrated research tools, experimental techniques and highlighted the various research areas included in the project. Participants were presented with a conceptual model for linking basic muscle and muscle rehabilitation research and inspired to think about partnerships and knowledge translation and exchange. Finally, after additional brainstorming sessions to identify research collaborations and opportunities, recommendations were made to the CIHR and IMHA on how to increase collaborative research in these areas.

Breakout Group Summaries

The key strength identified for both muscle and MSK rehabilitation, is that research in Canada is very strong and includes a very broad range of disciplines and research areas. The interdisciplinary nature of MSK rehabilitation research encompasses all four CIHR pillars. Not only does muscle research have excellent basic research in Canada, this research uses funds efficiently and effectively. CIHR/IMHA is viewed as a strong asset to both of these research communities.

The key weakness identified for both groups is the lack of a platform or meeting place for Canadian researchers; there is no annual meeting, workshops or other opportunities for face to face interactions across the areas of expertise. Both focus areas lack a clear source of financial support for annual meetings on muscle research. As a consequence, poor integration of research efforts and the lack of networking have resulted in a low profile for some of the research and the isolation of researchers. Relatively low levels of collaboration between researchers and clinicians, has resulted in many research and treatment areas not being currently explored. Both focus areas could improve knowledge translation and exchange activities; muscle researchers are not always comfortable or knowledgeable about knowledge transfer and exchange despite a strong potential KT (Knowledge translation) component to their studies. MSK rehabilitation research has not resulted in a consensus on best practices for prevention and intervention.

The key opportunity identified by participants in both focus areas was for enhanced networking and collaboration between researchers and clinicians. It was suggested that the International Classification of Function (ICF) developed by the WHO could potentially be used as a conceptual model to integrate the two groups. Knowledge translation and outcomes were recognized as an opportunity, especially with regards to creating functional collaborations to apply the discoveries from basic research to the community and in approaches to deliver outcomes. In addition, there are opportunities for integrating muscle and MSK rehabilitation research into research of conditions and diseases such as aging, diabetes, alcohol abuse, and cancer. Mentoring was recognized as an opportunity, for students as well as junior researchers. Finally, defining and studying approaches to the delivery of interventions was seen as an opportunity, with the type of exercise, group versus individual delivery, defining the ideal setting and economic feasibility all being factors to consider.

The key threat to muscle and MSK rehabilitation research identified was a lack of funding for these research areas, which leads to "brain drain" as researchers leave for other research or geographical areas where funding is perceived to be more readily available. There is not a clear framework for clinicians to conduct research and communicate with researchers. There is a lack of collaboration due to geographical isolation and research isolation, referred to as "siloing". In addition, the lack of core facilities and technical multi-user platforms for muscle researchers to use and to assist with collaborations between groups was also identified as a threat to these research areas.

Meeting Outcome - Collaborative Research Priorities

• Muscle atrophy - collaborations on activity and atrophy, with reference to aging, dystrophy, prevention versus reversal of atrophy, disease progress and interventions, muscle maintenance, frailty, and metabolic impact. This area spans the spectrum, from basic research through to providing patient interventions
• Muscle function and dysfunction - in primary muscle diseases (dystrophies), secondary muscle dysfunction (osteoarthritis, inflammatory arthritis, diabetes, obesity, osteoporosis, hip fractures), muscle injury (prevention, overuse, chronic, reversible/irreversible), impact of joint replacements on muscle and pre- and post surgical intervention and overuse.
• Movement and Exercise - physical activity guidelines and the impact on various medical conditions, with emphasis on individual variation, dose/responses, different age-groups and genders, and medication. This includes the identification of the factors and tools to promote activity/exercise adherence/compliance and healthy behaviors as well as monitoring outcomes to determine safe exercise progression and maximizing the impact of rehabilitation interventions and strategies.
• Animal models for therapy and rehabilitation research - correlation/integration of techniques used on animal models transferable to humans, outcomes measurements, interactions between physical activities and medications, electronic advances and robotics.
• Muscle responses to non neuromuscular diseases/conditions - including cancer, diabetes, chronic obstructive pulmonary disease (COPD), spinal cord injuries, alcohol abuse.

Recommendations to IMHA and CIHR to Increase Collaborative Research Between The Two Focus Areas of Muscle and Musculoskeletal Rehabilitation

The three changes/goals to increase collaboration between the two focus areas are:

1. Increased interaction of kinesiology researchers, rehabilitation researchers, basic, and clinical researchers, both intra-and inter-institution.
2. Address and attempt to reduce the impact of barriers to increased cooperation: geography, competition for funding, mutual respect issues, communication barriers.
3. Develop creative tools, such as workshops, websites, cross-disciplinary training and mentoring vehicles.

Recommendations for achieving these three goals:

• Create a national platform - to encourage continued collaboration, networking, interdisciplinary cross-fertilization and to raise the profile of muscle and musculoskeletal research in Canada. This could be either through the creation of a muscle network, either formal or informal, or by an annual muscle meeting/workshop with content progressing from molecule to muscle to function. Either initiative would have cross pillar involvement, would encourage cross-focus researcher interaction and would need to involve the broad range of disciplines reflected in the focus areas.
• Establish more funding for muscle and MSK rehabilitation research in the form of collaborative RFAs - to raise the profile of this research and to build multidisciplinary teams.
• Agree upon and adopt a common conceptual framework (similar to the ICF one), use common language, identify key problems and define outcome measures.
• Implement speaker exchanges, mentoring, student funding, muscle research days.
• Create a Website or expand the IMHA website to include an expert match list (between disciplines for team research or RFAs), national database with the workshop participants, listing their backgrounds, tools and techniques they use, interests and expertise.
• Commission a review specifically for the synthesis of basic and rehabilitation research.
• Incorporate a stronger KT component to raise the profile of this research by demonstrating how this work contributes to other conditions/diseases/research areas or with muscle research days. Need to promote muscle and MSK rehabilitation research in order to make a significant improvement of the quality of life, positive economic benefits, and psychosocial and health-related quality of life outcomes.

Next Steps

• The IMHA will launch a request for applications mid July, 2007.

Participants and Planning Committee

Participants

Program

Day 1 - June 11 2007

Day 2 - June 12 2007

Day 3 - June 13 2007