Multiple Sclerosis Society of Canada

Dr. Michelle Ploughman

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Dr. Michelle Ploughman is a neuroscientist and physiotherapy researcher focusing on creating novel and potentially powerful rehabilitation interventions that not only restore function but that also promote brain plasticity. She is a Canada Research Chair (Tier II) in Rehabilitation, Neuroplasticity and Brain Recovery and Assistant Professor in Physical Medicine and Rehabilitation in the Faculty of Medicine, Memorial University. Dr. Ploughman’s interest has always been in determining the effects of rehabilitation intensity on recovery of function. She completed her postdoctoral fellowship with the endMS Regional Research and Training Centre at Dalhousie University. She also launched Newfoundland and Labrador’s first rehabilitation research program, opening her laboratory (the Recovery & Performance Laboratory) in the tertiary rehabilitation hospital in 2014. Funded by CFI, the laboratory is equipped with exercise testing and training suite (metabolic cart, treadmill with safety harness, recumbent trainer, heart rate monitors), brain excitability measurement station using Magstim BiStim and Brainsight Neuronavigation, an instrumented walkway to measure gait and balance (Protokinetics), private assessment area with hydraulic plinth and data collection and analysis hardware and software. Some of the recent projects in her lab include: exploring the synergistic effects of aerobic and cognitive training in chronic stroke (2013-17), defining optimal training parameters and outcomes for aerobic exercise in MS (2015-2017), altitude training to break through the recovery plateau after stroke (2017-2019), a pilot trial of intensive aerobic exercise to restore walking through remyelination and neuroplasticity in MS (2018-2019), fluoxetine to open the critical time window to improve leg motor recovery after stroke (2017-present), investigating the role of sensorimotor integration in upper extremity dysfunction in MS (2019-present).

Learn more about Dr. Ploughman

How did you become interested in MS Research? What inspires you to continue advancing research in this field?

When I was working as a physiotherapist in an MS clinic it became clear to me that patients were receiving mixed and sometimes conflicting information regarding exercise and rehabilitation. I discovered that, unlike other neurological conditions such as stroke, there was very weak evidence to support exercise and rehabilitation in MS at the time. I set about to change that. I learned that people with MS who had lived with the disease for decades, were a very important source of wisdom in order to learn how to live a long and healthy life with MS. These interactions spurred me on to undertake a national survey of health and aging with MS with 743 participants from coast-to-coast. Furthermore, I was determined to improve the care of people with MS, because several of my classmates and colleagues have MS and I wanted better options for them.

What do you enjoy most about doing research and what are some of the challenges you face?

I’ve always enjoyed being able to engage with our research participants and see the direct impact of my research on an individual level. Supervising my students and helping them develop the skills needed to become the next generation of researchers in MS is very rewarding. My greatest challenge, of course, is securing funding for research projects and for graduate students. Convincing granters that our research is valuable and impactful can certainly be challenging in this field.

Describe the importance and level of collaboration in your research?

To be successful in the type of research I do (clinical intervention trials), partnerships with other researchers and laboratories are critical. I collaborate with scientists in almost every province in Canada and internationally. Furthermore, I collaborate intensely with people with MS in order to make sure we target our efforts to address problems that are meaningful for patients. Research is a huge effort and collaboration helps ensure that the outputs are powerful and game-changing. For example, beginning in 2015, myself, Dr. Craig Moore, MS neurologist Dr. Mark Stefanelli and the MS community in Newfoundland and Labrador, created the Health Innovation Team in MS (HITMS) registry, a database of annual clinical, upper and lower limb performance, cognition, brain excitability, fitness, and neuroimmune profiles. The intent of this registry is to understand how health and lifestyle factors, such as fitness, interact with neuro-immune axis and epigenetics to impact MS progression. To date, we have enrolled 210+ MS patients (500+ individual patient visits). We hope that our discoveries will make meaningful impacts on the lives of people with MS for years to come.

How important is the support from the MS Society in enabling you to conduct research?

Between 2010 and 2011, the MS Society and its network of researchers helped me to build our cross-Canada study of health and aging with MS. We gained immense knowledge about successful aging with MS which I continue to talk about and publish. In 2015-2017, we received a grant from the MS Society for our pilot research to define optimal training parameters for aerobic exercise in MS. The two grants we received in 2019 build upon that solid foundation and are crucial for the continuation of my MS research aimed at restoring arm and leg function; without these grants we would be unable to proceed.

If you were describing your research to a member of your family using an analogy, what would you say?

We know that exercise has direct benefits on the brain. It increases blood flow, reduces inflammation, increases neurotransmitters, promotes healthy brain connections and preserves cognition. What other intervention can provide such profound benefits! People with MS face major challenges when undertaking exercise. For example, they have extreme fatigue, heat sensitivity and vision and coordination problems that create barriers to exercise. Our research involves crafting specialized training interventions, tailored for people with MS, which aim to restore movement and help to reorganize and heal the brain. We believe that we need to treat and prescribe intensive rehabilitation the same way as we would a drug.

If you could ask one question to a person living with MS that would help you design your study, what would it be?

People with MS work with us every day to design our studies. These are some of the questions I always ask: How does this test/treatment make you feel? How useful do you think it is? From your point of view, what are your top 3 priorities in terms of your experience with MS? If you were to advise another person just diagnosed with MS, what would you tell them?

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