The indoor or outdoor game incorporates elements of tennis, badminton, table tennis and racquetball. It’s played with paddles and a perforated plastic ball on a badminton-sized court.

Invented in the 1960s, pickleball has long been regarded as an activity for retirees. But its popularity with all ages has taken off, and it’s now one of the fastest-growing sports in North America.

When Webber, professor of physical therapy at the College of Rehabilitation Sciences, took up the game, she became curious about how much exercise it provides.

“When I started playing pickleball, I wouldn’t say that I had any preconceived ideas about it not being demanding, but I was very impressed with the intensity of play and thought it was worth measuring,” says the professor, who is also a research affiliate with the UM Centre on Aging.

She went on to conduct a study, published in September 2022 in the Journal of Aging and Physical Activity, on the physical activity intensity of singles and doubles pickleball in older adults. She and her team tracked heart rates and steps in 53 recreational players with an average age of 62 while they played for one to two hours.

“I do a lot of research with gadgets like accelerometers and smart watches, which we had the players wear in this study,” Webber says. “There hadn’t been much written about the physical activity associated with pickleball.”

The study found that those who played singles averaged 3,222 steps per hour of play, while those playing doubles averaged 2,790 steps.

The average heart rates during both singles and doubles play were 111 beats per minute. Accelerometer counts were higher in singles play because of the greater movement required. Heart rates were in a moderate intensity zone for more than 70 per cent of play time in both singles and doubles.

The researchers concluded that the sport can provide a moderate workout for middle-aged or older adults. If an older adult played pickleball for four and a half hours each week, Webber says, they would meet the standard recommendation to engage in at least 150 minutes of moderate-intensity activity per week.

“Interestingly, many people involved in the sport easily play for six to 10 hours per week,” she says.

(Photo: Brook Jones, River City Photography)

The pickleball study made a good-sized media splash. Webber was interviewed by outlets ranging from the Winnipeg Free Press and the Washington Post to the website Pickle Madness.

“I have never experienced so much interest in research I’ve conducted. I think many pickleball players were pleased that our data busted the myth that it’s a low-effort sport, at least for intermediate-level players like those we assessed.

“If our findings encourage participation in pickleball, that’s great because it’s a game that can be enjoyed by people with a large range of skill levels. Compared to many other sports, most people can achieve a satisfying level of success within a short period of time.”

Webber grew up in Pinawa, Man., as a sports lover who particularly succeeded at tennis. “I was fortunate to play on the provincial team when I was a teenager,” she says.

“It was my connection to sports and health that got me interested in physiotherapy. But once I got into it, I realized that there was so much more to it than treating people with sports injuries.”

While completing her bachelor’s in physical therapy at UM, Webber gained an interest in research through assisting Brenda Loveridge [Dip.P.T./68, BPT/71, M.Sc./80, PhD/83], former director of what was then the School of Medical Rehabilitation, who was studying wheelchair training in people with spinal cord injuries.

“That was my first exposure to research, and I saw it as kind of like a puzzle,” she says. “The first part of the puzzle is trying to figure out what you want to study and how you’ll do that, and then you have to figure out what the message is in all the data you collect.”

After working for several years as a physiotherapist in Winnipeg and Ottawa, Webber joined the College of Rehabilitation Sciences as a lecturer in 1997.

Her research, published in journals such as Physical Therapy and Rehabilitation (Physical Therapy), Physiotherapy Canada and Medicine & Science in Sports & Exercise, largely focuses on physical capacity and activity in older adults, or in people with chronic diseases such as arthritis and fibromyalgia.

She has published a number of studies of physical activity among people with knee osteoarthritis, including those who are waiting for knee-replacement surgery.

Webber says she is still examining data from the pickleball study and hopes to further investigate the sport’s health benefits, particularly in relation to muscle strength and bone density.

“I think there could be some really good benefits for bones and avoiding things like hip fractures as people get older,” she says.

“Participating in the sport may help to maintain bone density beyond what is achieved by going for a brisk walk every day.”

Long COVID is a condition that affects people beyond their initial COVID-19 infection. The most common symptoms of long COVID are fatigue, shortness of breath, muscle pain and difficulty concentrating. Emerging evidence suggests that 10 to 30 per cent of individuals who have had a COVID infection experience long-COVID symptoms. 

“Given the number of confirmed COVID-19 cases, it is likely that thousands of Manitobans are affected by long COVID,” said Dr. Patty Thille, administrative lead for the project.

“Emerging international guidance recommends that policy-makers address long COVID through a multidisciplinary approach, including interprofessional rehabilitation services.”

Rehabilitation interventions like supervised conditioning programs, respiratory training, developing strategies for living with cognitive symptoms, and mindfulness and cognitive behavioural therapy for mental health concerns are among the important components of long COVID recovery, Thille said.

The group includes nine faculty members from the College of Rehabilitation Sciences, joined by one from community health sciences in the Max Rady College of Medicine and a PhD student in the Applied Health Sciences program.

PhD student Brenda Tittlemier works part time as a best practice coordinator at the Health Sciences Centre and was asked to take part to provide a health-care worker perspective.

“It is very exciting that some early research is showing that rehabilitation can help people with long COVID improve their function, and as such, rehabilitation for long COVID should be available to all Manitobans within our health-care system,” Tittlemier said.

Two group members, Dr. Sandra Webber and Dr. Diana Sanchez-Ramirez, have published papers on long COVID over the last few months. The group is also supported by two research staff, one of whom is also a master’s trainee.

Thille, an assistant professor of physical therapy, said long-COVID patients may be referred to rehabilitation programs that are not designed to meet their needs, as there are few existing programs for long COVID.

“To meet the demand of long-COVID clients, there was a big influx of referrals to the WRHA (Winnipeg Regional Health Authority) pulmonary rehabilitation program. While that may help people in the Winnipeg region with lung and breathing problems, it can’t help with the extreme fatigue some experience after exertion,” she said. “Many people with long COVID are not eligible for this and other existing rehabilitation programs, leaving them without any rehabilitation services at all.”

From July to October 2021, the group conducted an environmental scan to learn about long-COVID management across Manitoba, Canada and other countries with similar health systems. They found that Alberta, and Saskatchewan are the only provinces to currently have long-COVID frameworks in place, and only BC has an interdisciplinary care network for long COVID care.

They noted several provinces plan to manage long-COVID patients through existing systems, but that Manitoba lacks the capacity to do so due to consistently high demand of publicly-financed rehabilitation programs for people with non-COVID rehabilitation needs.

They also identified major gaps in Manitoba, including accessible community-based interprofessional care and services for youth and children.

“Rehabilitation programs specifically for people with long-COVID are being developed but are not yet funded,” Thille said.

The group is now meeting with Manitoba provincial health system leaders to facilitate efforts to support people living with long-COVID in Manitoba.  Among their recommendations are for decision-makers to ensure dedicated resources and funding specific to long-COVID patients, and that provincial health authorities coordinate to improve access to rehabilitation specialists with proper referrals.

Read the full report.

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.