Pelvic organ prolapse in women is associated with poor quality of life. The standard treatment currently available for prolapse is surgery. The evidence for conservative management with physiotherapy is not clear. This randomised controlled trial will examine the effect of physiotherapy treatment, including pelvic floor muscle training, on prolapse symptoms and severity, compared with lifestyle advice only. Appropriate conservative management may reduce the need for surgery and associated costs.
Pelvic Floor Muscle Training For The Management Of Urinary Incontinence In Elderly Women: A Randomized Controlled Trial.
Funder
National Health and Medical Research Council
Funding Amount
$321,240.00
Summary
Urinary incontinence is associated with significant personal shame and social stigma and affects around 10% of Australians. one-third of women over 60 years of age. Incontinence limits physical activity and this in turn can lead to loss of independence and poorer general health. Fewer than one-third of those with regular incontinence seek assistance. Pelvic floor muscle re-education by physiotherapists is the most commonly recommended method of conservative management for urinary incontinence. P ....Urinary incontinence is associated with significant personal shame and social stigma and affects around 10% of Australians. one-third of women over 60 years of age. Incontinence limits physical activity and this in turn can lead to loss of independence and poorer general health. Fewer than one-third of those with regular incontinence seek assistance. Pelvic floor muscle re-education by physiotherapists is the most commonly recommended method of conservative management for urinary incontinence. Pelvic floor muscle training is safe and effective and should thus be offered as the first choice of treatment for stress urinary incontinence. However there is still no strong evidence for the effectiveness of this intervention in the elderly and because of a perception by medical practitioners that pelvic floor muscle re-education is only effective in younger women, relatively few elderly women are referred to physiotherapy for management of incontinence. Although in clinical practice it is customary to complement pelvic floor muscle training with other forms of conservative management of incontinence such as bladder training, a recent influential study suggested that pelvic floor muscle training and bladder training were equally effective in patients with stress urinary incontinence. It is important to distinguish the relative effectiveness of these interventions used in isolation in order to ensure that urinary incontinence is managed in the most effective and efficient way. This project will therefore investigate the effectiveness of two conservative interventions, pelvic floor muscle training and bladder-behavioural training in women with stress urinary incontinence over 70 years of age. Moreover, strong evidence that conservative intervention is effective for urinary incontinence in the elderly will result in appropriate intervention being offered routinely as the first choice of treatment in older women.Read moreRead less
MECHANISMS OF TRANSMITTER SECRETION AT SYMPATHETIC NERVE VARICOSITIES
Funder
National Health and Medical Research Council
Funding Amount
$438,707.00
Summary
The mechanism by which quantal packets of transmitter are secreted from release sites called varicosities on sympathetic nerve terminals can now be taken to the molecular level, given the new techniques which we have introduced to solve this problem. There are two main facets to the problem. The first of these involves the question of how proteins involved in controlling the regulated secretion or exocytosis of the quantal packets of transmitter carry out this function. These proteins (syntaxin, ....The mechanism by which quantal packets of transmitter are secreted from release sites called varicosities on sympathetic nerve terminals can now be taken to the molecular level, given the new techniques which we have introduced to solve this problem. There are two main facets to the problem. The first of these involves the question of how proteins involved in controlling the regulated secretion or exocytosis of the quantal packets of transmitter carry out this function. These proteins (syntaxin, synaptobrevin, SNAP25 and synaptotagmin) together with a calcium channel are complexed with a docked synaptic vesicle containing a quantum of transmitter in a module of secretion appropriately called a secretosome. The leading questions here are to determine if only a single secretosome participates in transmitter release on the arrival of a nerve impulse, whether the number of these secretosomes in a varicosity determines its probability for secretion of a quantum, and fundamentally, how do the proteins within the secretosome cooperate to trigger exocytosis when there is sufficient calcium influx through the secretosome-associated calcium channel following the impulse. The other problem concerns the mechanism of removal of calcium from the varicosity once it has entered through the channels, This calcium can have considerable affects on the extent to which secretosomes participate in secretion with subsequent impulses. Furthermore, this influx of calcium can be modulated for subsequent impulses by transmitter released by the first impulse. The present research will solve these problems, providing a molecular description of secretion from single sympathetic varicosities.Read moreRead less
The Influence Of A-actinin-3 On Muscle Structure, Metabolism, Performance And Response To Diet And Disease
Funder
National Health and Medical Research Council
Funding Amount
$624,355.00
Summary
We have identified a common genetic variant that results in absence of the fast muscle fibre protein a-actinin-3 in more than one billion humans worldwide. Loss of a-actinin-3 influences elite athletic performance, muscle bulk and strength in the general population, response to diet and exercise, and susceptibility to developing type 2 diabetes. We will now study mice and humans to determine how this gene influences variations in human performance, metabolism and severity of muscle disease.
Understanding The Human Hand In Grasping And How This Changes After Stroke
Funder
National Health and Medical Research Council
Funding Amount
$227,855.00
Summary
The hand allows remarkable feats of dexterity. But, paralysis of the hand severely limits daily activities and is common after stroke. We will determine key mechanisms that control the hand at the level of the brain and spinal cord. We will assess some limits that develop in the muscle itself. Stroke patients will be tested so that we can better understand the brain�s control of the hand and use this to enhance recovery of hand performance in those with impaired function.
Modulating Heat Shock Protein Expression In Skeletal Muscle To Improve The Pathophysiology Of Muscular Dystrophy
Funder
National Health and Medical Research Council
Funding Amount
$502,361.00
Summary
Duchenne muscular dystrophy (DMD) is the most common and severe form of muscular dystrophy. Dystrophic muscles are fragile, prone to injury, and regenerate poorly after damage. Defective calcium handling has been implicated in these processes. We have revealed that upregulating levels of stress proteins called _heat shock proteins� (HSPs) can improve calcium regulation in muscular dystrophy. Modulating the HSP response has significant potential to delay the onset or slow the progression of DMD.
Pain changes movement. Although undisputed, there is a surprising lack of agreement regarding the underlying mechanisms. This project involves an innovative mix of neurophysiological methods to investigate the drive to muscle cells from the nervous system and changes in the mechanics of contraction. These studies will resolve the perplexing problem of how pain changes our ability to activate muscle. Clear understanding of the underlying mechanisms can guide rehabilitation.