IME Plus SUPPORTS TRILLIUM HEALTH CENTRE

IME Plus was pleased to once again attend the Trillium Health Centre Foundation’s 3^rd annual Ride of Hearts on October 6, 2012. Numerous riders attended this year’s fundraiser and the commitment of all participants was outstanding.

We are proud to contribute to this remarkable community event and as always take great pleasure in participating and supporting such a tremendous cause! 

Photos from this remarkable event are shown below:

UNDERSTANDING FUNCTIONAL CAPACITY EVALUATIONS

 

 By Dr. Philip Conway BPE DC FCCPOR(C)

There are numerous Functional Capacity Evaluation (FCE) protocols and systems, some of the more popular systems are Arcon, Matheson and Issernhagen to name a few.  An FCE is a short-term intensive evaluation that examines or evaluates major physical tolerance abilities that are related to musculoskeletal strength, endurance, speed and flexibility.

There are 3 common applications for FCEs:

• Baseline Evaluation – This usually lasts 3 to 4 hours and addresses the full range of physical tolerances

• Job Specific – This averages 5 to 6 hours and focuses on the physical tolerances in comparison to the task demands of the target job.

• Medical-Legal –  This on average lasts 5 to 6 hours and can be spread over two days.  The Medial-legal FCE addresses the residue physical tolerances, loss of ability and potential for rehabilitation in preparation of determining loss of earning capacity  and future cost of care.

Interestingly, these 3 common FCEs have been modified and have evolved over time.  For example the Job Specific FCE which averages 5 to 6 hours has evolved into much shorter and more specific tests, designed to address very specific questions and abilities of the job in question.  The employer has 5 to 10 critical components of a job that are evaluated and the client usually has a pass/fail result.  Where as the Medical-Legal FCE has evolved to include a full physical examination, addresses several questions that are forward by third parties and will address physical tolerances, deficits, abilities, pain, motivation, effort, non-organic signs, placebo test and reports vs. observations.  Another evolution is the addition of a clinical examination. The end result is a Clinical Functional Capacity Evaluation.  This enables the examiner to make clinical correlations to client presentation, to understand the underlying diagnosis and determine how the clinical presentation will affect the functional capacity and physical tolerances of the client.

The key to a good FCE is documentation.  As evidence based methodologies are the gold standard these days, subjective reporting does not meet standards.  Objective measurements and accurate testing are extremely important. For example,  Arcon testing very accurate and there is very little that is subjective.  Effort, heart rate, strength, range of motion for example are all electronically measured and immediately compared to normalized data and can then be determined as deficits or poor efforts.

 Another major component of an FCE is the importance of the  forwarded questions by the third party.  By providing accurate and specific questions, the FCE evaluator can then direct the testing specifically and can answer each question. It is also very important that the FCE evaluator be fully trained and be trained in diagnosis and clinical examination.  This will ensure that the FCE was completed by fully trained evaluator and not just a technician.

Dr. Philip Conway is A Functional Capacity (FCE/FAE) evaluator at IME Plus Evaluations Ltd. He is Matheson trained and incorporates Arcon FCE testing. He is a Board Certified Specialist in Physical and Occupational Rehabilitation, certified in Low Speed Collision and Injury Analysis, and Biomechanical Injury Analysis.  He graduated from the Canadian Memorial Chiropractic College in 1986 and is a member of Chiropractic College of Rehabilitation Sciences Canada since September 2006, the Canadian Chiropractic Association , the College of Chiropractors of Alberta and Canadian Chiropractic Protective Association since June 1986. He is the Founding Member, Radiological and Technological Society CMCC Toronto and has been the President of the Calgary Chiropractic Society: 1987 – 1989. He was a Certified Member of the 1988 Winter Olympics Chiropractic Health Team and also a Member of the Foundation for Chiropractic Education and Research:  1991 – 1995. He has been on the Alberta Civil Trial Lawyers Association Expert Witness Pool: Chiropractic since 1994

Spring Training Tips

By Jason McLachlan,
B.Sc. Kinesiology, C.K.


 

Now that the weather has taken a turn for the better, many Canadians are headed outside to shed pounds they picked up during winter hibernation. If you are planning to start a running or walking program, here are 10 tips for a smart and healthy beginning to your spring training:

1. Medical. Check with your doctor if you are starting a new exercise routine. This is especially important if you have not exercised in more than two years, or have any underlying medical conditions.

2. Start slowly! (Doing about half of what you think you should do is probably a good way to start!) If you are starting a running program, run no more than three times per week. If you are walking, four to five times per week is OK. You can cross-train a couple other days if desired - combine biking, elliptical, swimming, weight training, etc. It is helpful to use a training diary to track your time or distances and make sure you do not do too much too soon.  Your body requires approximately three weeks to adapt to new exercise and loading on your tissues, and approximately six weeks to develop the tissue tolerance for longer and more
aggressive activity. So, take the first three weeks easy, the next three weeks do a little more, and then from week six through twelve you can really start to get into it. A general rule of thumb is to increase your total weekly running volume by no more than 10 percent per week for running, or 20 percent per week for
walking.

3. Get the right shoes. It is important to get the correct shoes for running or walking. Generally, a running shoe will work best for either activity. There are also many more options for running shoes with regard to specific needs for your foot type and biomechanics. Shoes will last for roughly 500 miles. This could turn out to be one or two pair per year for many people.  Comparing the price difference of two pairs of department store shoes verses running specialty store shoes, there is approximately a $5 per month difference over the year. If you are exercising regularly, it is well worth the cost difference to help prevent injuries and keep you moving. Also, wear these shoes only for your running or walking. Wearing them all day compresses the mid-sole material and makes the shoes less shock absorbing for your exercise when you need it most.

4. Clothing. The other equipment you should consider is proper clothing. Technical fabrics for running gear are extremely comfortable and do not hold moisture like cotton. This prevents friction and is much lighter and dryer even when you are sweating, as these garments keep the moisture away from your body where it can evaporate.

5. Don't sweat the scale. If you are focusing your exercise for weight loss benefits, do not get on a scale until your exercise habit is well established -- at least three weeks. Also, the real weight loss benefits may not be realized for two to three months, so don't be discouraged and stay consistent.

6. Work out with a friend, or find a running / walking group.  Working out with a partner can help you stay motivated. There are various running and walking groups throughout Ontario that have weekly workouts. Or, you can start a weekly workout group on your own with friends or co-workers.

7. Set a goal. Training for a specific event can be highly motivating. Pick a run, a walk or a bike event and prepare for it. Be sure to track your progress. Both the journey to the event and the event itself are very rewarding and beneficial to your health.

8. Don't push through pain. If you have pain, it is recommended that you stop activity for at least two to three days. Icing over the painful area for 15-20 minutes, two to three
times per day, can be helpful. If it resolves, start up again at half
distance and see if it recurs. If it does, ask for advice. Pain that
persists for more than a week should be evaluated. See a physical
therapist or your doctor. Make sure they are motivated to help you
return to your training.

9. Stretch! Flexibility and strengthening exercises can help prevent imbalances that occur with the repetitive 

and limited motion activity of running and walking. Stretches for your calves, hamstrings, thighs and hips are the most important ones to start with. Or, try a yoga class. This will incorporate flexibility and strengthening activity together to benefit your training.

10. Have Fun. Stick with your routine. As you get fit, it will become easier and more fun. This will help you continue for the long run (or long walk).

Jason McLachlan, B.Sc. Kinesiology, C.K. is a kinesiologist with IME
Plus Evaluations Ltd. with an undergraduate degree from University
of Waterloo (1993). He is a certified ARCON, ERGOS, FOCUS and
Matheson functional abilities assessor and a current member of the
Ontario Kinesiology Association. He is also a personal trainer.

Kusnierz vs. Economical Mutual Insurance Company - Appeal

Legal Decision

Kusnierz v. The Economical Mutual Insurance - Appeal  23 Dec 2011

BENEFITS OF CALCIUM AND MAGNESIUM

          By Dr. Michael Caterer, B. Kin, DC      

One of the most popular minerals in the news today is calcium, needed for strong bones and teeth. We are told to take increased amounts in our diet as a supplement to prevent osteoporosis and eliminate muscle cramping during menstruation or from over-exercising. Yet, calcium alone is often not enough given the importance of another mineral, magnesium, crucial in the absorption of calcium.  Without magnesium, calcium may be not fully utilized, and under absorption problems may occur leading to arthritis, osteoporosis, menstrual cramps, and some premenstrual symptoms.

Perhaps the single most significant reason calcium malabsorption is so common today is due to a discrepancy between what we eat and how we digest  and absorb the  nutrients  in our food.  When  we   look back at our ancestors diets, our ancestors ate foods high in magnesium and low in calcium.   Because calcium supplies were scarce and the need for this vital mineral was great, it was effectively stored by the body. Magnesium, on the other hand, was abundant and readily available, in the form of nuts, seeds, grains, and vegetables, and did not need to be stored internally.

Our bodies still retain calcium and not magnesium although we tend to eat much more dairy than our ancestors. In addition, our sugar and alcohol consumption is higher than theirs, and both sugar and alcohol increase magnesium excretion through the urine. Our grains, originally high in magnesium, have been refined, which means that the nutrient is lost in the refining process. The quality of our soil has deteriorated as well, due to the use of fertilizers that contain large amounts of potassium a magnesium antagonist. This results in foods lower in magnesium than ever before.

The current RDA for calcium is 1000 mg. The RDA for magnesium is 300 mg. Clients are generally recommended to take up to 1000 mg of calcium and 400-500 mg of magnesium twice a day for leg cramps. It may take up to 12 weeks to get optimum results. If you have problems with kidney stones, consult with your doctor before taking any calcium supplements.

The best form of calcium is calcium citrate- it is much better absorbed than other forms of calcium. The best form of magnesium is magnesium aspartate; magnesium malate or citrate are also good choices. Calcium and magnesium supplements should be taken between meals for best absorption. Taking 250-500 mg of vitamin C along with the minerals will increase absorption as well.  

Include lots of foods that are high in calcium and magnesium in your diet. Calcium rich foods include kelp, dairy products, leafy green vegetables and nuts and seeds. Magnesium rich foods include kelp, wheat germ, nuts, molasses and tofu.

Be sure to avoid alcohol, caffeine, soft drinks, and excess protein, sugar and sodium, as these all increase calcium excretion from the body. Medications like aluminum containing antacids and diuretics can also deplete calcium and magnesium in the body.

Dr. Michael Caterer, DC is an evaluator at IME Plus Evaluations Ltd. He  is a licensed chiropractor certified with the College of Chiropractors of Ontario, associate member  of the Canadian Society of Chiropractic Evaluators and certified by the American Board of Forensic Professionals in Impairment and Disability Rating. In addition, he is a certified FCE and In-Home evaluator.  Dr. Caterer is currently completing the residency program in Rehabilitation Sciences at the Canadian Memorial Chiropractic College.