William McIlroy

The complex science of keeping people upright

Ever thought about how you keep your balance? You probably don’t need to. But for the elderly and people who have experienced brain injuries and diseases, staying upright – and avoiding falls – can be a big challenge.

William McIlroy, a Senior Scientist at Toronto Rehab, is trying to better understand how people get around so that new treatments can be developed to improve mobility and reduce the risk of falling.

Dr. McIlroy’s interest in balance control was sparked by a personal experience. “My grandmother had a nasty fall and broke her hip. Her fear and anxiety about falling again was profound. She never really recovered from that hip fracture.”

A student of physiology at the time, Dr. McIlroy decided to pursue research in balance control. He has emerged as an international expert in neurological rehabilitation.

In one of his most illuminating discoveries, he and his colleagues showed that there is more to staying upright than just muscle strength and reaction time. It turns out the brain can play a key role.

Specifically, the researchers found that people create an internal “map” of their immediate surrounds – a map that is crucial to getting around.        

 “Our work has led to an understanding of how important it is for people to create internal maps of the world around them so that if they get out of balance they are able to capture their balance by taking advantage of obstacles nearby, and to grasp and step.”

Dr. McIlroy is now investigating whether this internal map changes as we get older. He is also trying to pinpoint which specific regions of the brain are involved in balance control.

“As we learn more about how balance is controlled, it will allow us to better diagnose people’s balance problems and to better target treatment,” he explains.     

Mobility is tied to so much of what we do. “All of us are extremely dependent on our ability to move about for our quality of life. And if you start to have limitations in that control, that change in mobility has a profound impact on your life overall.”

Dr. McIlroy and his colleagues are busy developing innovative devices to measure and enhance mobility. For example, they are working on a “smart” walker that will help users better navigate the real world, including tight turns and slippery, uneven surfaces. The walker will eventually include cueing systems which can alert the user to danger zones and even prompt them with instructions.

The device will also measure a person’s balance and mobility outside the lab or hospital. This will provide therapists with vital information.               

In another project, Dr. McIlroy is probing new rehabilitation approaches that may help people recovering from stroke. One study focuses on the relationship between physical fitness levels and recovery.

“One of the things that limits the recovery of people who have had a stroke is not just their ability to move their limbs but the fact that their fitness levels are so low they have difficulty in maintaining activity for extended periods of time,” says McIlroy.

In a study taking place at Toronto Rehab, stroke patients are undergoing aerobic training to see whether this brings cardiovascular health benefits and improves their walking ability.

Early results suggest “people’s fitness levels do improve if you train them. Within one to two weeks after a stroke, it seems feasible to train people in the way that we are training them.”

Another study by Dr. McIlroy looks at whether certain pharmacologic agents, such as amphetamine, can help promote self-repair of the brain after a stroke.    

Dr. McIlroy thrives on the combination of lab work and interaction with patients. “These days, that’s what really gets me excited – the chance to make a difference in an individual’s life or speed up their rate of recovery.”

Dr. McIlroy's Sunnybrook Research Institute profile page

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