Michelle Ploughman

What brought me to MUN? What keeps me at MUN?

I was born in Labrador, grew up in Newfoundland and after attending university in Nova Scotia, returned to St. John’s to begin my career. When I decided to begin graduate studies I found Memorial University’s, Faculty of Medicine offered me the environment and opportunities I needed to be successful. Memorial University genuinely strives to meet its mission: to serve the people of Newfoundland & Labrador. You can see that every day in how it supports its faculty and students.



Education

Post-doctoral fellow (CIHR): “Health, lifestyle and aging with multiple sclerosis”
Atlantic endMS Regional Research and Training Network (supervisors Dr. JD Fisk, Dalhousie University and Dr. M Godwin, Memorial University) 2008-2012

PhD Neuroscience (with distinction): “The effects of exercise on neurotrophins, neuroplasticity and functional recovery in a rat model of focal ischemia” BioMedical Science, Faculty of Medicine, Memorial University (supervisor Dr. D. Corbett) 2003-07

MSc Neuroscience: “An examination of constraint-induced therapy as a method to intensify intervention and improve functional outcome during the rehabilitation phase of stroke” BioMedical Science, Faculty of Medicine, Memorial University (supervisor Dr. D Corbett) 2000-03

BSc Physiotherapy: Dalhousie University 1984-88


Training

Physiotherapy Clinical Practice Leader in Neuroscience, Eastern Health, St. John`s NL (1991-2003 & 2007-08). Most senior physiotherapist specializing in the rehabilitative management of neurological disorders including stroke, Parkinson’s disease, MS, and traumatic brain and spinal cord injury; Member of the MS and Movement Disorders Provincial Clinics within Eastern Health.


Research/Teaching Summary

Dr. Ploughman is a physiotherapist and neuroscientist; a recognized expert in neuroplasticity and neurorehabilitation in stroke and multiple sclerosis. Her research focuses on the effects of aerobic exercise, intensive training paradigms and lifestyle habits on the brain challenged by injury, disease and aging. Dr. Ploughman is a Canada Research Chair in Neuroplasticity, Neurorehabilitation and Brain Recovery. Her work is published in journals such as Stroke, Neuroscience, Brain Research and Archives of Physical Medicine and Rehabilitation. She is the Principal Investigator for the Canadian Survey of Health, Lifestyle and Aging with Multiple Sclerosis, the largest study of aging with MS in Canada with over 740 participants from 10 study sites. Dr. Ploughman continues to practice as a neurological physiotherapist in St John’s and her Recovery and Performance Laboratory is located in the Rehabilitation Research Unit (RRUNL), L.A. Miller Centre, St. John’s NL.


Research Interests

Stroke recovery research

• Our laboratory is located in a large rehabilitation hospital, the Miller Centre, in St. John’s, Newfoundland & Labrador, Canada. We are part of a network of Canadian centres that work together to conduct clinical trials in stroke rehabilitation.
• We tested whether virtual reality using the Nintendo Wii would promote arm recovery.
• We combined aerobic and cognitive training to restore memory and thinking.
• We are now testing drugs combined with physiotherapy to drive leg recovery.

Preventing Decline and Restoring Function in Multiple Sclerosis
When you practice a skill, the circuits in the brain responsible for that skill are strengthened. We create and test new methods to increase training intensity and thereby help repair and restore these brain connections. One such method is to cool the room to 16°C and increase amount of training using a special treadmill with a safety harness:

• https://www.youtube.com/watch?v=m-EbNIz43fk
• https://www.youtube.com/watch?v=hQvne952izA&t=12s

Deciphering Ways to Drive Neuroplasticity
Our research shows that participating in exercise increases brain activity-the key to recovery after injury. Our laboratory, funded by the Canada Foundation for Innovation and the Province of Newfoundland & Labrador uses state of the art functional brain imaging equipment, movement analysis and robotics to assess the brain-body connection.

• Dr. Ploughman and Dr. Yong discuss how exercise can activate repair mechanisms in the brain in MS.
• Drs. Michelle Ploughman and Arthur Chaves discuss how they used Transcranial Magnetic Stimulation to detect exercise-induced changes in the brain in people with progressive MS.

Current Projects

The Health Innovation Team in MS project 2015-2025

The HITMS project tracks the health of about 200 people with MS in NL annually for 10 years. The project is supported by the Canadian Institutes of Health Research and the Canadian Foundation for Innovation. Using sophisticated measures of brain activity, performance on cognitive and physical tests, as well as detection of immune cells in the blood, we aim to understand whether fitness and exercise impacts disease progression. Dr. Ploughman collaborates with neuroimmulogist Dr. Craig Moore, biostatistician Dr. Zhiwei Gao and neurologists Drs. Mark Stefanelli and Fraser Clift on this project.

We are recruiting people with MS in NL who are willing to come to our lab each year for testing. The testing takes about 3 hours and we provide you with a detailed ‘report card’ each year.


The CanStroke Recovery Trials Network and the FLOW Study 2019-2022

We are working together with eight major stroke rehabilitation research sites in Canada to test innovative treatments to drive stroke recovery. Our first trial (the FLOW study) involves studying whether combining physiotherapy with a drug known to promote neuroplasticity (fluoxetine) will result in greater recovery compared to placebo. This study is sponsored by BrainCanada and the Canadian Partnership for Stroke Recovery. We are currently recruiting people who had a stroke in the previous 12 months and have weakness in their leg.


Dosage and Timing of Aerobic Exercise to ‘prime’ the brain for stroke recovery (partnership with Dr. Lara Boyd in UBC) 2020-2022

We are working in partnership with Dr. Lara Boyd at University of British Columbia to find out when is the best time to implement a complex intervention aimed at promoting recovery of the arm after stroke. The intervention involves a bout of intensive aerobic exercise followed by training in a virtual reality environment ( Kinarm). We are measuring brain recovery using Transcranial Magnetic Stimulation and functional near infrared spectroscopy. This study is expected to begin recruiting people in Spring 2021 who have stroke-related arm and hand problems.


Developing and testing new treatments for Manual dexterity (arm and hand) problems in MS 2019-2022

We are collaborating with people with MS to find the source of manual dexterity problems (sensory, motor or both) in order to find better ways to restore lost ability. This involves looking at the structure (MRI) and function of the brain and how that relates to the experiences of people with MS. We are also testing new ideas that have the potential to make brain-body connections stronger. This project is funded by the MS Society of Canada, the Health Care Foundation (Eastern Health), NLSUPPORT and the Memorial University Seed and Interdisciplinary Research Fund. We are recruiting people with MS who experience problems with their hand or hands in everyday life.
The study involves about 5 visits to our lab in St. John’s.


The BIGMS Study: Comparing two treadmill walking training methods to restore walking and promote neuroplasticity in MS 2019-2023

We are testing two different approaches of restoring walking in people with MS who have walking problems. Some people may argue that intensity of training is important while others point out that relearning the quality of the movement is key to recovery. We actually do not know the answer to that debate. We will be comparing the two approaches in our laboratory at the Miller Centre in St. John’s. Participants enroll in a 12 week training program three times per week using a special body weight harness on a treadmill. We use a cool room to prevent fatigue. We intend to see whether the treatments restore walking and promote neuroplasticity measured using TMS. We hope to begin recruiting in Fall 2021 depending on COVID.


Developing new tests to detect subtle sensorimotor problems early in MS: Hopping and dual - tasking

What if we could detect subtle changes in nervous system function before they become apparent to the neurologist or even to the person with MS themselves? We think that pre-habilitation is important. Pre-habilitation is an approach whereby we detect a problem early and work on the problem extensively in order to help the brain heal and modify itself. We are creating a suite of new tests that we hope can detect problems early so we can develop a plan for treatment. This study uses a special instrumented walkway that maps foot pressures as a person walks, hops or balances in on it. We are using the data from the walkway during a HITMS participant visit (See #1 above) to make new movement tests.


Research funding

• https://www.canadianstroke.ca/en/research/funding
• https://mssociety.ca/about-ms-research/about-our-research-program/research-we-fund/69/its-like-a-disconnect-investigating-the-role-of-sensorimotor-integration-in-upper-extremity-dysfunction-in-ms
• https://mssociety.ca/about-ms-research/about-our-research-program/research-we-fund/66/training-to-restore-walking-and-promote-nervous-system-repair-in-multiple-sclerosis-a-randomized-controlled-trial-to-determine-the-importance-of-intensity