Laser Acupuncture In Patients With Chronic Knee Pain: A Randomised Placebo-controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$701,120.00
Summary
Chronic knee pain is a common and disabling musculoskeletal condition that causes a loss of functional independence and results in significant health care costs. In the majority of patients the most common cause is osteoarthritis. Acupuncture is a form of non-surgical treatment commonly sought by patients and often recommended by GP's. The main outcomes from our project are to establish the role, clinical effectiveness and cost benefit of laser and needle acupuncture in knee pain patients.
Although chronic pain is a serious clinical problem, treatments for its alleviation have largely failed, in part because they have not been tailored to the specific origin of the pain. This proposal focuses on rheumatoid arthritis, a common and incurrable source of chronic pain. This study will investigate how specific changes in spinal cord nerve cells contribute to chronic arthritic pain. The outcomes will help identify new targets to treat chronic pain in rheumatoid arthritis.
Disruption And Restoration Of Motor Control In Musculoskeletal Pathology: Implications For Physiotherapy Management
Funder
National Health and Medical Research Council
Funding Amount
$210,990.00
Summary
The way in which the nervous system controls muscles and movement may play a role in the development and progression of common musculoskeletal conditions. One of these conditions is patellofemoral pain syndrome which is associated with pain around the knee cap. This condition may result from an imbalance in the activity of the thigh muscles that control movement of the knee cap as the knee bends and straightens. This imbalance is due in part to problems with the control of the muscles by the ner ....The way in which the nervous system controls muscles and movement may play a role in the development and progression of common musculoskeletal conditions. One of these conditions is patellofemoral pain syndrome which is associated with pain around the knee cap. This condition may result from an imbalance in the activity of the thigh muscles that control movement of the knee cap as the knee bends and straightens. This imbalance is due in part to problems with the control of the muscles by the nervous system. Our previous studies have shown that physiotherapy treatment aimed at restoration of the control of the knee muscles results in clinical improvement of the condition. The first part of this project will investigate possible reasons for this muscle imbalance including the effects of pain, swelling and muscle fatigue. Understanding the reasons for the imbalance in muscle activity will help direct and refine more appropriate treatment strategies for this and other musculoskeletal conditions. The second part will assess whether a specific physiotherapy muscle training program for the thigh muscles is more effective in correcting the muscle imbalance than a more generalised thigh strengthening exercise program. The results will help us to better understand why the condition occurs and how we can best assess and treat the problem.Read moreRead less
Are Large Joint Osteoarthritis And Low Back Pain Metabolic Disorders?
Funder
National Health and Medical Research Council
Funding Amount
$381,972.00
Summary
While osteoarthritis (OA) is considered a “wear and tear” disease, there is evidence that OA may be related to a cluster of metabolic abnormalities including obesity, diabetes mellitus, hypertension and high cholesterol. Similarly, low back pain main be linked to a sedentary lifestyle and metabolic changes. This project will examine the relationship between metabolic derangements and back pain and large joint OA in an attempt to better understand these diseases and develop effective treatments.
In Vivo Patellofemoral Joint Measurement Using Kinematic Radiostereometric Analysis (RSA)
Funder
National Health and Medical Research Council
Funding Amount
$141,000.00
Summary
Complications following total knee joint replacement continue to be a major cause for revision surgery and leads to a significant financial burden in terms of health care expenditure. Recent studies suggest that many of these complications are associated with post-surgical pain from the patella knee cap joint, commonly termed anterior knee pain (AKP). Post-surgery AKP may be influenced by the motion of the patella. Recent prospective, randomised trials have compared clinical outcomes between peo ....Complications following total knee joint replacement continue to be a major cause for revision surgery and leads to a significant financial burden in terms of health care expenditure. Recent studies suggest that many of these complications are associated with post-surgical pain from the patella knee cap joint, commonly termed anterior knee pain (AKP). Post-surgery AKP may be influenced by the motion of the patella. Recent prospective, randomised trials have compared clinical outcomes between people with TKA in which the patellar surface is replaced (patellar resurfacing) or retained, but have been unable to accurately account for differences in patellar movement in those people with post-surgery complications. To date, studies of patellar motion after total knee replacement have been limited to two-dimensional analyses. This study addresses the technological limitations of previous trials by utilising accurate techniques for directly measuring skeletal motion using kinematic radiostereometric analysis (RSA). These data will measure patellar kinematics in three-dimensions for the first time. This information will allow optimisation of the design of TKA and the surgical techniques required for their implantation. Furthermore, the results will assist in the identification of surgical indications for patellar resurfacing, and the kinematic factors associated with anterior knee pain following total knee replacement surgery.Read moreRead less
Molecular Mechanisms Of Joint Degeneration In Osteoarthritis
Funder
National Health and Medical Research Council
Funding Amount
$718,273.00
Summary
Arthritis is a major clinical and socio-economic problem. Arthritis involves the destruction of cartilage in joints. However, the mechanisms of initiation and progression of cartilage destruction remain poorly understood. Our studies will for explore the role of a new regulator of gene expression, microRNA, in the initation and progression of osteoarthritis. This will provide important new information on disease mechanisms for the development of diagnostic biomarkers and therapies
Control Of Mastication By Periodontal Mechanoreceptors In Man
Funder
National Health and Medical Research Council
Funding Amount
$169,990.00
Summary
Despite the importance in chewing and speech, very little is known regarding the fine control of jaw muscles. A thorough understanding of the control of the jaw muscles is at the base of improved diagnosis and treatment of many chewing disorders. For example: We still do not understand the causes of the jaw muscle-joint pain disorder (temporomandibular dysfunction) which accounts for about 5 % of total dental patients. The current treatments, including pain killers, night plates and massage cure ....Despite the importance in chewing and speech, very little is known regarding the fine control of jaw muscles. A thorough understanding of the control of the jaw muscles is at the base of improved diagnosis and treatment of many chewing disorders. For example: We still do not understand the causes of the jaw muscle-joint pain disorder (temporomandibular dysfunction) which accounts for about 5 % of total dental patients. The current treatments, including pain killers, night plates and massage cure only about half of all patients. Improved diagnosis and treatment techniques require more precise elaboration of the neural and muscular mechanisms of chewing. Why do the chewing forces in toothless individuals, despite well fitting dentures, fall to about 20 % of the value in teethed individuals? Do jaw muscles in these subjects weaken because they get less feedback from the receptors around the teeth? How does the chewing force automatically adjust to overcome sudden or gradual changes in the characteristics of foodstuff? Although bite to bite changes in the chewing force is observed in subjects with natural teeth, no such changes occur in toothless subjects or subjects chewing with implanted bridges. How do the receptors adjust the activation of jaw muscles so that bite force is applied in the right direction and right amount at each bite? The aim of this study is to define the importance of the periodontal mechanoreceptors (tiny nerve cells that are situated between the roots of the teeth and the jaw bone that signal bite force to the brain) in the control of jaw muscles. This study will, therefore, illustrate the importance of keeping the teeth and gums healthy for the development of strong, smooth and well-controlled chewing forces, and potentially create opportunities to improve chewing (and thereby quality of life) in toothless individuals or those experiencing other difficulties in chewing.Read moreRead less
The Design, Development And Clinical Assessment Of A New Metacarpophalangeal Joint Prosthesis
Funder
National Health and Medical Research Council
Funding Amount
$188,450.00
Summary
Rheumatoid arthritis is a crippling form of arthritis that affects many people in the community. It commonly involves the finger joints in the hands resulting in deformity, pain and subsequent loss of function. There have been implants designed for finger joint replacement, but unfortunately these implants have had only moderate benefits and can break and lead to further joint destruction resulting in the worsening of deformity and pain. A new implant for finger joint replacement has been develo ....Rheumatoid arthritis is a crippling form of arthritis that affects many people in the community. It commonly involves the finger joints in the hands resulting in deformity, pain and subsequent loss of function. There have been implants designed for finger joint replacement, but unfortunately these implants have had only moderate benefits and can break and lead to further joint destruction resulting in the worsening of deformity and pain. A new implant for finger joint replacement has been developed. This implant has several potential advantages. Firstly the unique design acts to prevent recurring deformity in the fingers with rheumatoid disease while allowing functional motion. Secondly, it is thought that patients will return to function earlier and avoid the need for further finger surgery as this implant design relies less on the tissues around it for stability. The purpose of this study is to investigate the biomechanical and clinical benefits of this new implant for finger joint replacement. The new design will undergo specific laboratory tests and be used in a clinical trial to quantify the therapeutic benefits it provides to patients with rheumatoid arthritis.Read moreRead less
The Effect Of Glucosamine Sulphate On Structural Disease Progression In Knee Osteoarthritis
Funder
National Health and Medical Research Council
Funding Amount
$1,250,214.00
Summary
Osteoarthritis (OA) is a joint disease characterized by a progressive loss of cartilage and joint space resulting in increasing pain and difficulty performing usual daily activities. OA is the leading health problem amongst older Australians and a National Health Priority area. There is no known cure for OA and no intervention demonstrated to slow disease progression or delay time to joint replacement surgery. Currently patients are managed symptomatically with all clinical guidelines recommendi ....Osteoarthritis (OA) is a joint disease characterized by a progressive loss of cartilage and joint space resulting in increasing pain and difficulty performing usual daily activities. OA is the leading health problem amongst older Australians and a National Health Priority area. There is no known cure for OA and no intervention demonstrated to slow disease progression or delay time to joint replacement surgery. Currently patients are managed symptomatically with all clinical guidelines recommending paracetamol as 'the preferred long term oral analgesic'. This recommendation is based on the increased risk of serious gastrointestinal, cardiovascular and renal diseases with long-term NSAIDs use in older people. However, NSAIDs appear to provide better pain relief for patients with more than mild joint pain. Amongst patients with OA, there is much demand for the dietary supplement glucosamine sulphate. Product marketing has led to the belief that glucosamine is able to slow the rate of joint destruction and cartilage loss and help ease joint pain with, in contrast to NSAIDs, little risk of side effects. However, the few trials conducted to date have been inconclusive. If the marketing claims are unjustified, many older people are wasting limited financial resources and due to unrealistic expectations of the benefit of glucosamine, placing a lower priority on lifestyle changes of proven effectiveness, such as regular exercise and weight loss. A total of 900 patients with knee OA will be randomly allocated to glucosamine sulphate or matching placebo capsules for two years. The main outcomes will be the rate of joint space narrowing, use of NSAIDs and physical disability. If glucosamine results in slowing disease progression or in reducing NSAIDs consumption, the widespread use of this product would effectively decrease pain, disability and NSAIDs-related illnesses amongst the increasing number of people with OA.Read moreRead less