Inter-rater Reliability And Predictive Validity Of A New Functional Capacity Evaluation For Chronic Back Pain
Funder
National Health and Medical Research Council
Funding Amount
$105,794.00
Summary
Back pain costs the Australian community tens of billions of dollars. Back pain is one of the main causes of work injury and lost time from work. The longer a person is off work, the harder it is to get them back to work. Workers' compensation systems around Australia aim at getting the injured worker with back pain back to work as soon as possible. One of the difficulties in this process is determining what the person with back pain can physically do in the workplace. An evaluation technique, c ....Back pain costs the Australian community tens of billions of dollars. Back pain is one of the main causes of work injury and lost time from work. The longer a person is off work, the harder it is to get them back to work. Workers' compensation systems around Australia aim at getting the injured worker with back pain back to work as soon as possible. One of the difficulties in this process is determining what the person with back pain can physically do in the workplace. An evaluation technique, called functional capacity evaluation (known as FCE), is one method used to find out what the person with back pain physically can and cannot do. In a FCE, a trained health professional such as an occupational therapist, observes the person performing a range of physical activities like the ones he or she may have to perform in a job. The therapist closely observes the person performing activities such as lifting, carrying, kneeling, crouching, balancing, and walking and notes any limitations in the person's ability to complete the activities. The therapist makes comments about what difficulties the person may have on the job and recommendations about how these could be reduced or eliminated. The information gained from these evaluations can be valuable for the treating doctor in deciding whether the person is ready to go back to work and what duties the person can and cannot do on the job. Because of such value they provide, FCE is commonly used in rehabilitation programs endorsed by workers' compensation systems around Australia. This widespread use and endorsement of FCE occurs despite limited research on the soundness of the ratings made from these evaluations. There is a need to see whether recommendations made from FCEs are consistent between therapists (i.e. reliable) and to see if the FCE accurately predicts the person's physical capacity for work. This research will examine these issues with injured workers with back pain.Read moreRead less
Clinical Efficacy And Physiological Mechanisms Of Nerve And Tendon Gliding Exercises For Carpal Tunnel Syndrome
Funder
National Health and Medical Research Council
Funding Amount
$370,068.00
Summary
Compression of one of the major nerves at the wrist (carpal tunnel syndrome) is a very common condition that significantly impacts on the well-being of the patient. To date, there is no good evidence that traditionally advocated interventions are effective in the long term. This project will evaluate the effects of a novel, active treatment strategy and will investigate the underlying mechanisms that may be associated with exercises that aim to mobilise the nerve and tendons at the wrist.
The Impact Of Electronic Medication Administration Records (e-MAR) On Medication Administration Safety And Nurses' Work
Funder
National Health and Medical Research Council
Funding Amount
$735,675.00
Summary
The demands on health systems, both nationally and internationally, are growing, exacerbated by an ageing population and health workforce shortages. The incorporation of information technology into new health care delivery models promises both improvements in the safety and efficiency of care delivery. Medication errors are one of the most significant safety issues for health care systems. Medication management occupies a significant amount of nurses' time, and is also fraught with error potenti ....The demands on health systems, both nationally and internationally, are growing, exacerbated by an ageing population and health workforce shortages. The incorporation of information technology into new health care delivery models promises both improvements in the safety and efficiency of care delivery. Medication errors are one of the most significant safety issues for health care systems. Medication management occupies a significant amount of nurses' time, and is also fraught with error potential. One-third of all medication errors that cause patient harm arise from medication administration errors (MAEs). Electronic medication administration records (e-MARs) provide the potential to make the administration of medications safer for patients by reducing error rates, and also by allowing nurses to more efficiently manage medication tasks. However there is very limited research from Australia or overseas which has examined whether they computerised system work and in fact reduce error rates or save nurses time. In this project we will conduct prospective, controlled observational studies to determine the effectiveness of an electronic medication administration record (e-MAR) to reduce MAEs and the amount of time nurses spend in the medication administration process. The project will apply innovative data collection tools using PDA software purpose-built for these studies which have undergone extensive pilot testing in clinical settings. The results will have important implications for hospitals across Australia and internationally as they consider the implementation of e-MARs. This research will provide the first comprehensive data of medication administration errors in Australia against which future preventative error strategies can be evaluated. The results will provide the evidence needed to develop recommendations about how to reduce MAEs and improve the design of e-MARs.Read moreRead less
Effectiveness Of Training Somatosensation In The Hand After Stroke: A Randomized Controlled Trial.
Funder
National Health and Medical Research Council
Funding Amount
$180,660.00
Summary
Stroke is a leading cause of death and disability, requiring provision of rehabilitation services to help minimize impairment and its impact on the ability to resume daily activities. The ability to feel textures and objects through touch and to know where one s limbs are in space are impaired in up to 85% of people who have suffered a stroke. People with this loss are handicapped by difficulties in exploring objects through touch and in performing everyday tasks that require grasp and manipulat ....Stroke is a leading cause of death and disability, requiring provision of rehabilitation services to help minimize impairment and its impact on the ability to resume daily activities. The ability to feel textures and objects through touch and to know where one s limbs are in space are impaired in up to 85% of people who have suffered a stroke. People with this loss are handicapped by difficulties in exploring objects through touch and in performing everyday tasks that require grasp and manipulation of objects. Yet clinicians are either not treating the problem or are using methods without a sound theoretical basis and controlled evidence to support their application. We have systematically investigated optimal methods of sensory training across different sensory abilities using a series of single-subject experiments. Marked improvement in the ability to discriminate trained and related untrained texture stimuli and limb positions was achieved and maintained in most participants. These findings have provided the foundation for development a scientifically based and clinically focused sensory retraining program that has apparently excellent therapeutic potential. The purpose of the proposed study is to test the effectiveness of this scientifically based, clinical sensory retraining program in a broad group of stroke clients using the internationally recommended randomized controlled group design. The program will train a range of functionally important sensory discrimination tasks, i.e. texture discrimination, limb position sense and tactual object recognition, in clinical and home environments. Demonstration of clinically important and statistically significant training effects will provide the evidence necessary to recommend the introduction of the program into routine health service delivery. Investigation of patient characteristics that may impact on the ability to benefit from training will assist in the targeting of services to appropriate individuals.Read moreRead less
Neuromuscular Exercise : A Novel Treatment To Reduce Symptoms And Joint Load In Medial Knee Osteoarthritis
Funder
National Health and Medical Research Council
Funding Amount
$719,199.00
Summary
There is currently no cure for knee osteoarthritis (OA). Thus treatments are needed that not only reduce symptoms but also slow disease progression. Exercise is recommended for knee OA but traditional thigh muscle strengthening exercises do not appear to be effective in all cases and may not slow the disease. This project will compare novel 'neuromuscular exercise' and compare it to traditional strengthening exercise. The results have the potential to alter current exercise prescription
Neurophysiological Basis For Sensorimotor Interventions In Rehabilitation After Stroke
Funder
National Health and Medical Research Council
Funding Amount
$332,036.00
Summary
Stroke is estimated to cost the Australian government almost $2 billion annually, and is the most common cause of death after heart disease and cancer and one of the largest single causes of long-term disability. Of people who survive a stroke, a large number have some degree of residual motor dysfunction on one side of the body. Motor rehabilitation programmes are generally considered to enhance the recovery of motor function and to reduce the degree of long-term disability. However the rationa ....Stroke is estimated to cost the Australian government almost $2 billion annually, and is the most common cause of death after heart disease and cancer and one of the largest single causes of long-term disability. Of people who survive a stroke, a large number have some degree of residual motor dysfunction on one side of the body. Motor rehabilitation programmes are generally considered to enhance the recovery of motor function and to reduce the degree of long-term disability. However the rationale for the design of effective rehabilitation programmes is largely empirical, and there is uncertainty regarding the efficacy and cost-effectiveness of currently used therapies. The empirical nature of stroke rehabilitation has resulted in a diversity of techniques, many of which were pioneered 30-40 years ago, and which are generally aimed at enhancing brain plasticity as a means to facilitate motor recovery. However, despite the belief that brain plasticity is a key to recovery, it is still not known how best to develop this potential for reorganisation into practical interventions that could be introduced in stroke rehabilitation. The aim of the present study is to investigate the physiological bases for the action of commonly used sensorimotor rehabilitation strategies and identify those strategies which are most effective in bringing about corticomotor reorganisation, in the belief that such reorganisation is fundamental to motor recovery. Specifically we will investigate the changes in the organisation of the cortical projection to muscles of the upper limb as a result of passive movement, resisted and non-resisted movement, increased functional motor use and visuomotor training programmes. It is anticipated that the study will lead to a better understanding of the physiological basis for therapeutic interventions after stroke and will allow a more rational approach to the design of effective rehabilitation programmes for stroke patients.Read moreRead less
The Efficacy Of Novel, Non-robotic Devices To Train Reaching Post Stroke
Funder
National Health and Medical Research Council
Funding Amount
$491,605.00
Summary
Up to 50% of stroke survivors are left with upper limb disability that limits their daily activities and their paralysis is so severe that it excludes them from training with the most effective methods. This study is a clinical trial of innovative new techniques to assist people with severe upper limb paralysis to reach following stroke. Positive results are likely to reduce disability in a large number of stroke survivors and has the potential to be used by other patients with paralysis.
Effects Of Circadian Disruption And Sleep Deprivation In Respiratory Disorders
Funder
National Health and Medical Research Council
Funding Amount
$408,000.00
Summary
This project aims to determine the impact of reduced sleep hours and jet lag-sleep time shift in two very common breathing disorders; sleep apnea (snoring sickness) and asthma. We will also make measurements in healthy normal people as well. Reduced sleep hours are common in many sections of society due to a number of factors, including increased work hours, overtime, shiftwork, medical conditions (sleep and other medical disorders), caring for a new baby, and other family and social demands. In ....This project aims to determine the impact of reduced sleep hours and jet lag-sleep time shift in two very common breathing disorders; sleep apnea (snoring sickness) and asthma. We will also make measurements in healthy normal people as well. Reduced sleep hours are common in many sections of society due to a number of factors, including increased work hours, overtime, shiftwork, medical conditions (sleep and other medical disorders), caring for a new baby, and other family and social demands. In addition, body clock disruption due to shiftwork, transmeridien travel, circadian based sleep disorders and other factors that shift the timing of normal sleep-wake behaviour is also very prevalent in today's society. The effects of reduced sleep hours and jet lag-sleep time shift effect a number of body systems but have only been studied to a limited extent in the breathing system. Jet lag-sleep time shift changes are result of changes to the body clock rhythms - these rhythms effect coordinate activities of essentially all bodily functions, vigilance and thinking, heart, breathing, hormones, bowel function and the immune system that fights off infection and cancer. Together, this body clock system and sleep coordinate the majority of systems of the body and brain. This project will address a number of questions including whether reduced sleep hours worsen brain function in sleep apnea or whether shifting sleep (jet lag effect) can worsen airway function and increase risk of asthma. We will use two types of study - simulated jet lag and reduced sleep hours under complete laboratory supervision to test our theoriesRead moreRead less