Treatment Of Invasively Ventilated Adults With Early Activity And Mobilisation
Funder
National Health and Medical Research Council
Funding Amount
$1,467,137.00
Summary
The sickest patients in intensive care units (ICUs) receive prolonged, invasive support for their breathing. This is currently managed with complete bed rest, and results in severe muscle weakness, increased duration of hospital stay and poor recovery. We have found that early activity and mobilisation during invasive breathing support is safe and may improve survival and recovery. We will test early activity and mobilisation in a large randomised controlled trial of 750 ICU patients.
Randomised Controlled Trial Of Stretching For Contracture After Ankle Fracture
Funder
National Health and Medical Research Council
Funding Amount
$55,220.00
Summary
Restricted ankle motion (contracture) commonly occurs after cast immobilisation following ankle fracture. The prevalence of contracture could be as high as 77% immediately following cast removal. This interferes with tasks such as walking and stair climbing, and can result in significant disability. While physiotherapists regularly treat contracture after ankle fracture, the efficacy of specific treatment programs has not been established. This project aims to determine the effectiveness of two ....Restricted ankle motion (contracture) commonly occurs after cast immobilisation following ankle fracture. The prevalence of contracture could be as high as 77% immediately following cast removal. This interferes with tasks such as walking and stair climbing, and can result in significant disability. While physiotherapists regularly treat contracture after ankle fracture, the efficacy of specific treatment programs has not been established. This project aims to determine the effectiveness of two commonly used stretching programs for contracture after ankle fracture initially treated with cast immobilisation. Stretches of short and long duration will be compared to a no stretch condition. The study will determine the effects of these interventions on ankle flexibility, ability to perform everyday tasks (eg, walking), self-ratings of disability and pain.Read moreRead less
Efficacy And Cost-effectiveness Of Physiotherapy For Chronic Rotator Cuff Pathology
Funder
National Health and Medical Research Council
Funding Amount
$384,675.00
Summary
Shoulder disorders are common, being third only to back and neck complaints as musculoskeletal reasons for medical consultation and accounting for 10% of all physiotherapy referrals. The painful shoulder affects up to 2-5% of the general population, being more common in middle to older age. One of the most common shoulder disorders is chronic rotator cuff pathology. This causes significant pain and disability that restricts activities of daily living as well as work, sleep and leisure. Forty per ....Shoulder disorders are common, being third only to back and neck complaints as musculoskeletal reasons for medical consultation and accounting for 10% of all physiotherapy referrals. The painful shoulder affects up to 2-5% of the general population, being more common in middle to older age. One of the most common shoulder disorders is chronic rotator cuff pathology. This causes significant pain and disability that restricts activities of daily living as well as work, sleep and leisure. Forty percent of sufferers will continue to have symptoms beyond 3 years and 15% will have persistent disability which may require surgical intervention. Because this disorder is prevalent, it imposes a considerable burden on the Australian health care system. Physiotherapy is a common conservative treatment option but its efficacy has not been well established. A recent Cochrane review of the literature revealed several problems with many of the existing studies: (i) the populations have included a mix of shoulder diagnostic categories; (ii) the research designs have major flaws and (iii) a single physiotherapy modality has been evaluated rather than a combined program as is current clinical practice. Thus, this novel research project involving 200 participants will answer important questions about the efficacy of a physiotherapy program for chronic rotator cuff pathology and whether benefits can be maintained. In addition it will determine whether the costs of physiotherapy represent good value for money which is important in today's economic climate. The results of this project can be easily and immediately translated into clinical practice as recommendations can be made about the usefulness of physiotherapy for this patient population. The results will be of major benefit not just to the physiotherapy profession but to the medical profession who must justify patient referral to physiotherapy and to funding and compensable bodies.Read moreRead less
Efficacy Of Physiotherapy After Hydrodilatation For The Painful Stiff Shoulder: A Randomised Placebo-controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$269,020.00
Summary
Shoulder disorders are common, being third only to back and neck complaints as musculoskeletal reasons for medical consultation and they account for 10% of all physiotherapy referrals. The stiff painful shoulder affects up to 2-5% of the general population, being more common in middle age and diabetes. It causes significant pain and disability that restricts activities of daily living as well as work and leisure. Forty percent of sufferers will continue to have symptoms and restricted movements ....Shoulder disorders are common, being third only to back and neck complaints as musculoskeletal reasons for medical consultation and they account for 10% of all physiotherapy referrals. The stiff painful shoulder affects up to 2-5% of the general population, being more common in middle age and diabetes. It causes significant pain and disability that restricts activities of daily living as well as work and leisure. Forty percent of sufferers will continue to have symptoms and restricted movements beyond 3 years and 15% will have persistent disability. Because this disease is prevalent, it imposes a considerable burden on the Australian health care system. Shoulder hydrodilatation is a common conservative treatment option that has been shown by our research group to have short-term but not long-term benefits. Physiotherapy may be prescribed following hydrodilatation on the basis that it may maintain the initial benefits seen with hydrodilatation. However, there are no studies to either support or refute this hypothesis. Thus, this novel research project will answer important questions about the efficacy of a physiotherapy program in addition to hydrodilatation for the stiff painful shoulder. We will determine whether physiotherapy offers a benefit over hydrodilatation alone and if so, whether this benefit is sustained. In addition we will determine whether the additional costs of physiotherapy represent good value for money. The results of this project can then be easily and immediately translated into clinical practice as recommendations can be made about the usefulness of physiotherapy for this patient population. The results will be of major benefit not just to the physiotherapy profession but to the medical profession who must justify patient referral to physiotherapy.Read moreRead less
My primary research interest is in the effectiveness of physiotherapy interventions. A second research interest is in the mechanical and architectural properties of human muscles and tendons.
Resolve: A New Treatment - Sensorimotor Retaining With Explaining Pain - For Chronic Low Back Pain.
Funder
National Health and Medical Research Council
Funding Amount
$1,005,534.00
Summary
Most treatments for low back pain that are provided by a GP, physiotherapist or chiropractor are only moderately effective. A new approach is needed. We have developed a new treatment, sensorimotor retraining, based on principles from neuroscience, education, psychology and physiotherapy that we are testing in a randomized controlled trial. If successful this new treatment will provide relief for the millions of Australians who suffer from this debilitating condition.
Clinical Trial Of Rehabilitation After Ankle Fracture
Funder
National Health and Medical Research Council
Funding Amount
$443,348.00
Summary
Over 20,500 Australians fracture their ankle each year. Initially the fracture is managed with cast immobilisation, sometimes after surgery. Pain, stiffness, weakness and swelling are disabling consequences of fracture and cast immobilisation, and can prevent return to work and sport. This trial will determine the effects and cost of rehabilitation (a physiotherapy exercise program) implemented after cast removal, and enable provision of evidence-based treatment for this very common problem.
Effects Of Laterally Wedged Insoles On Symptoms And Disease Progression In Knee Osteoarthritis
Funder
National Health and Medical Research Council
Funding Amount
$480,850.00
Summary
Knee arthritis is a painful, disabling, costly condition particularly affecting the elderly. As there is presently no cure for knee arthritis, strategies that slow progression of the disease will reduce the personal and societal burden of arthritis. Most research has focussed on drug therapies, which are effective in reducing pain and disability but have side effects and are expensive. Insoles worn inside the shoes are a simple, cheap, self-administered intervention with the potential to slow di ....Knee arthritis is a painful, disabling, costly condition particularly affecting the elderly. As there is presently no cure for knee arthritis, strategies that slow progression of the disease will reduce the personal and societal burden of arthritis. Most research has focussed on drug therapies, which are effective in reducing pain and disability but have side effects and are expensive. Insoles worn inside the shoes are a simple, cheap, self-administered intervention with the potential to slow disease progression in certain patients, in addition to managing symptoms. However, to date there has been little quality research investigating the effectiveness of insoles in knee arthritis. This study aims to see whether 12 months of wearing insoles can lead to improvements in knee pain and function and slow disease progression in 200 people with knee arthritis. It will use state-of-the-art technology, magnetic resonance imaging, to measure changes in the amount of knee cartilage. This research is timely and the findings will be of major significance as there is increasing world-wide attention on slowing progression of knee arthritis. Insoles are one of the few non-drug therapies with the potential to influence both symptoms and disease progression. If the results show that insoles are beneficial, then this research will: 1. Better inform clinical guidelines to firmly recommend insoles to manage knee arthritis 2. Provide the basis for developing education strategies for health care practitioners and patients about the benefits of insoles 3. Provide the impetus to make insoles more readily available directly to patients 4. Ultimately lead to better patient outcomesRead moreRead less
Patellofemoral Arthritis: Efficacy Of Physiotherapy And Understanding The Role Of Joint Stress
Funder
National Health and Medical Research Council
Funding Amount
$616,430.00
Summary
Arthritis of the kneecap leads to considerable pain and difficulty with daily activities. This project is testing whether a physiotherapy treatment (8 sessions over 12 weeks) designed specifically for people with kneecap arthritis is effective. In order to understand more about kneecap arthritis, this project will calculate the force on the kneecap and its relationship to pain and other factors, including thigh and hip muscle strength, knee alignments and knee movements.