Dr. Ruth Barclay, professor of physical therapy, College of Rehabilitation Sciences, was appointed the centre’s inaugural Research Chair in Telerehabilitation for a five-year term starting September 2024. She will provide leadership in the creation of a rehabilitation research program with a strong emphasis on new technologies. 

Barclay’s research is focused on stroke rehabilitation and community ambulation. She has been involved in several research projects with Riverview since 2009. Current projects include two telerehabilitation studies with Riverview as one of multiple Canadian sites in the CanStroke Recovery Trials platform, which supports multi-centre trials in stroke recovery across Canada.   

The studies include a virtual physical activity seated exercise program and an examination of the effectiveness of virtual exercise to improve lower extremity recovery for individuals with stroke.  

Barclay said telerehabilitation is becoming more common and has been continuing to grow since the COVID pandemic. 

“A lot of clinics and research studies turned to telerehab during COVID and afterwards, focusing on how important that is for inclusion of people living in a variety of different locations or those who maybe aren’t comfortable coming to an in-person setting.” 

Barclay will also serve as a liaison to engage faculty, Riverview staff and the community in research. She said that past research she’s done at Riverview has involved both rehabilitation staff and patients. 

“I think it’s really important as a clinician to be aware of current research and to have the opportunity to play an active part in research,” she said.  

Dr. Reg Urbanowski, dean of the College of Rehabilitation Sciences, called the creation of the chair a logical step in fostering the relationship between the college and Riverview.  

“Dr. Barclay’s research focus on health-related quality of life, community ambulation and participation after stroke – and her long history of working with the Riverview Health Centre – makes her well-suited to be a research chair,” he said.  “She will work closely over the next five years with other Riverview staff and the college to ensure that advances in telerehabilitation meet the needs of Manitobans in rural, remote areas and urban centres across the province.”  

Barclay is the second Rady Faculty of Health Sciences faculty member to become a research chair at Riverview. In 2023, Dr. Genevieve Thompson, professor with the College of Nursing, was announced as Research Chair in Person-Directed Living. 

Kathleen Klaasen, Riverview CEO, said Barclay’s new position strengthens the relationship between the centre and the College of Rehabilitation Sciences – including an interprofessional student-run clinic that has been operating there since 2022.  

“Dr. Barclay’s relationship with Riverview and her understanding of who we are and where our strategic plan is moving make her a perfect fit for this role,” she said.  

Klaasen added that the research chair will also help grow other partnerships the centre has, including one with the Interlake-Eastern Regional Health Authority that brings physiotherapy and rehabilitation access to residents of Lake Manitoba First Nation and Pinaymootang First Nation via telepresence robots and videoconferencing. 

“This role will help us evaluate as we grow and find innovative ways to deliver that program. Telerehabilitation and the use of new technology improves access to care in rural and remote communities, but we need the research and evidence to support that,” Klaasen said. 

In 2020, Dr. Ruth Barclay, associate professor of physical therapy in the College of Rehabilitation Sciences, Rady Faculty of Health Sciences and Nancy Salbach, professor of physical therapy at the University of Toronto, were near the end of a two-year study that looked at ways to improve outdoor walking among older adults when the pandemic hit Canada.

Participants in the study, funded by the Canadian Institutes of Health Research, were randomly assigned to a walking workshop plus a 10-week outdoor walking program or the walking workshop plus 10 weekly phone call reminders. Follow-up assessments occurred at three, six and 12 months. Between the six- and 12-month assessments with the second group of participants, many had their walking routines interrupted by the pandemic.

This led to an unexpected sub-study, Barclay said. “We were able to amend the project and additionally ask people about their walking and physical activity experience during COVID. We wanted to know how they experienced physical activity during and after lockdown relative to prior to the pandemic.” 

Without being able to continue with walking or other physical activities, some participants noted negative consequences, like weight gain, shortness of breath or weakness.

“It was a real sense of loss for people,” Barclay said.

The last assessments for the study were done in July 2020 and at that time, many participants were taking small steps to increase their physical activity, whether through online exercise videos or walking outside, either with a mask or at times of day when there was less foot traffic outside.

“Some participants said they’d still walk with a friend, but at a distance and with masks on,” she said. “With the weather getting nice again, I imagine it may be similar this year, depending on changes to restrictions.”

Barclay and Salbach’s study took place over two years at four universities – UM, the University of Toronto, McGill University and the University of Alberta – with 191 participants, all of whom were aged 65 and older and described themselves as having difficulties walking due to individual or environmental barriers. Some individual barriers included impaired balance or decreased motivation, while environmental barriers included the distance needed to walk to a desired location or time and speed required to walk across an intersection.

The walking workshops were led by a team of faculty, graduate students, physiotherapists and research assistants at each of the sites. In small groups, the participants took part in eight activity sessions in the five-hour workshops. The stations were both practical and informative and included topics like monitoring exercise intensity, walking with Nordic walking poles and correctly using a pedometer.

The project included five other sub-studies by faculty and graduate students at each of the participating universities. One of the key sub-studies, according to Barclay, was a look at cadence thresholds – or steps per minute – that was led by Dr. Sandra Webber, associate professor of physical therapy at the College of Rehabilitation Sciences.

The sub-study used accelerometry and GPS systems to determine when people were engaged in relatively sustained or purposeful walking.

“It can be difficult to make sense of step data when most episodes of walking in adults last less than 30-60 seconds and involve fewer than 40 continuous steps,” Webber said. “We were then able to use the technique to identify sustained purposeful walking that occurred during everyday life in our participants.”

“Hopefully in future, other researchers will be able to use that kind of analysis,” added Barclay.