Orthostatic Tolerance During FES-evoked Stepping In Paraplegia: A Safety And Viability Study
Funder
National Health and Medical Research Council
Funding Amount
$244,900.00
Summary
In the past 30 years, there has been growing interest in the potential benefits of functional electrical stimulation (FES) of the paralysed leg muscles as a means of restoring movement in the lower limbs. FES uses electrical impulses generated by a stimulator to elicit purposeful muscle contractions via skin-surface electrodes placed over the muscles. Although traditionally limited to health-related activities such as stationary cycling exercise, recent bioengineering advances in the area of FES ....In the past 30 years, there has been growing interest in the potential benefits of functional electrical stimulation (FES) of the paralysed leg muscles as a means of restoring movement in the lower limbs. FES uses electrical impulses generated by a stimulator to elicit purposeful muscle contractions via skin-surface electrodes placed over the muscles. Although traditionally limited to health-related activities such as stationary cycling exercise, recent bioengineering advances in the area of FES present the SCI person with a means of restoring upright mobility and reinstating functional tasks. Yet, while this technological innovation remains promising for optimising functional outcomes after SCI, there remains a distinct lack of knowledge of the physiological stresses placed upon the individual. In this preliminary safety and viability study, the physiological implications central to enhanced upright mobility will be investigated during FES-evoked prolonged stepping. The responses during FES-stepping will be contrasted with the responses observed during stepping performed without FES. The study will investigate the blood pressure responses during FES-gait, but also address possible physiological mechanisms underlying those blood pressure responses. The findings from this study will identify whether there is a phsiological limitation to the performance of FES-evoked functional mobility. Current physiotherapy practice recognises blood pressure control and orthostatic hypotension as a significant barrier to functional standing and stepping, yet little is known about the physiology underpinning the condition. If FES does present a limitation to the performance of upright functional activities, this study will also assist in devising alternative physiotherapy gait training regimens.Read moreRead less
Lifestyle (LIFE) Versus Structured Balance And Strength Training To Reduce Falls In The Elderly: A Randomized Trial
Funder
National Health and Medical Research Council
Funding Amount
$650,968.00
Summary
Thirty to thirty five percent of persons who are 70 or older fall each year. The magnitude of problems as a result of falling is reflected by the fact that the costs of fall injuries of the elderly to the health system is already more than double that of road injury. It is estimated that these costs will rise substantially and alarmingly in the next 30 to 50 years if we cannot find effective and sustainable ways to make an impact on the incidence of falls in older people. The aim of this project ....Thirty to thirty five percent of persons who are 70 or older fall each year. The magnitude of problems as a result of falling is reflected by the fact that the costs of fall injuries of the elderly to the health system is already more than double that of road injury. It is estimated that these costs will rise substantially and alarmingly in the next 30 to 50 years if we cannot find effective and sustainable ways to make an impact on the incidence of falls in older people. The aim of this project is to improve the capacity of people living at home to avoid falls. The project will evaluate the effectiveness of an integrated lifestyle approach to balance and strength exercise (LIFE) and a structured balance and strength exercise program to reducing falls in people who are at high risk . The control group will comprise a gentle flexibility exercise program as this is known to have no effect on reducing falls. In the lifestyle approach (LIFE), older people will be taught how to do balance and strength training and integrate it into their lifestyle so that it is embedded within their daily activity and weekly routines. It is expected that this integrated lifestyle approach to balance and strength training will be effective in reducing falls and will be sustainable over a a one-year period. This study will also determine for which groups of people LIFE is most effective . The research is a three-arm randomized trial that will be conducted with 381 people who are 70 years or over, who have experienced at least two falls in the past year or had an injurious fall. The notion of balance training is not well understood by allied health professionals or older people - a product of this project will be an alternative balance and strength intervention (LIFE) that offers, in a user friendly and simplified manner, a way of operationalizing the principles of balance and strength training for use by older people within their daily lives.Read moreRead less
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