The Effects Of A Two Year Randomised Exercise Intervention On Markers Of Bone Turnover In Postmenopausal Women
Funder
National Health and Medical Research Council
Funding Amount
$43,573.00
Summary
Osteoporosis is a condition where the bones become more fragile and can break more easily. In Australia after age 60, three out of every five women and three out of every ten men will fracture a bone. When people fracture a hip they lose their independence and become much less mobile. Exercise is one lifestyle approach which may help in preventing osteoporosis by slowing bone loss and keeping the muscles strong. Previous research has not been able to clearly demonstrate the usefulness of exercis ....Osteoporosis is a condition where the bones become more fragile and can break more easily. In Australia after age 60, three out of every five women and three out of every ten men will fracture a bone. When people fracture a hip they lose their independence and become much less mobile. Exercise is one lifestyle approach which may help in preventing osteoporosis by slowing bone loss and keeping the muscles strong. Previous research has not been able to clearly demonstrate the usefulness of exercise due partly to the difficulty in getting people to exercise for a least one year, which is how long bone studies must be carried out for. We have conducted two large research studies in women past the menopause where they have done weight training exercises. In the previous study we showed the greatest increase in bone mass occurred in those women lifting the heaviest weights. In a recently completed two year study in 126 woman, which forms the basis of this proposal, we found a weight training program was effective at increasing the bone mass at the hip, a common fracture site. The fitness group did not show any increase. So although we have been able to show this type of exercise helps increase bone mass we don't know how the bone is able to respond to this. The question we wish to address with this proposal is does exercise slow the breakdown of bone or does it help form new bone? The best way to be able to answer this question is by measuring certain products in blood, known as bone markers. Bone is continually turning overthese markers are released from bone into the blood. By studying these bone markers in blood samples taken from the subjects over two years it will helps us determine how exercise is affecting bone. From our previous studies we know that weight training can help slow bone loss. By measuring the bone markers we will then be able to make recommendations to people on how exercise will help prevent bone loss.Read moreRead less
A Behavioural Intervention For The Adoption & Maintenance Of Physical Activity In Type 2 Diabetes
Funder
National Health and Medical Research Council
Funding Amount
$334,955.00
Summary
For people with type 2 diabetes (T2DM) it is essential that blood glucose levels are managed well to reduce the risk of developing complications. Physical activity is essential for maintaining glucose levels because it helps make the muscles use glucose more effectively. In particular, being active through strength training not only improves blood glucose levels, but can be very effective for maintaining good physical functioning, which is known to be reduced by having T2DM. This study builds on ....For people with type 2 diabetes (T2DM) it is essential that blood glucose levels are managed well to reduce the risk of developing complications. Physical activity is essential for maintaining glucose levels because it helps make the muscles use glucose more effectively. In particular, being active through strength training not only improves blood glucose levels, but can be very effective for maintaining good physical functioning, which is known to be reduced by having T2DM. This study builds on our earlier research which demonstrated significantly improved blood glucose levels from a strength training program for older adults with T2DM. The strength training program is to be administered nationally in a research to practice trial (Lift for Life); however, the original research found that those who did not complete the program as it was intended (ie, poor adherence) did not show significant improvements in blood glucose levels. Furthermore, maintenance of strength training exercises after completion of the program was poor and resulted in return of blood glucose levels back to pre-starting levels. In people without diabetes, we have collected pilot data that shows that the use of behavioural strategies based on behavioural theories whereby each person's motivations and barriers are taken into consideration is more effective than the traditional one-treatment-fits-all approach. This study will evaluate the effectiveness of using behavioural strategies for improving adherence and maintenance to the Lift for Life strength training program (Enhanced L4L) for older adults with T2DM compared with the Standard L4L program. It will also follow-up participants 6 months later to determine the extent to which the changes in behaviour can be maintained. The study will provide information that will assist in the design, delivery and uptake of programs to improve treatment strategies in older adults with T2DM through the maintenance of healthier behaviours and lifestyles.Read moreRead less
Combined Dry-needling, Advice And Graded Exercise: A Randomized Controlled Trial In Chronic Whiplash
Funder
National Health and Medical Research Council
Funding Amount
$309,339.00
Summary
Central hyperexcitability is a feature of chronic whiplash and may be one reason for the poor response of this condition to standard treatment approaches such as exercise. Complementary and Alternative Medicine (CAM) treatment of dry-needling has shown potential to decrease this hypersensitivity in other musculoskeletal conditions. This study will investigate the effects of dry-needling combined with an orthodox treatment of advice and graded exercise on pain and disability in chronic whiplash.
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
Efficacy Of Exercise Physiologist Counselling In Primary Care Patients: A RCT Of Two Pragmatic Approaches
Funder
National Health and Medical Research Council
Funding Amount
$940,925.00
Summary
Physical activity is one of the most powerful contributors to health, but population levels of activity are low. General practitioners (GPs) are well placed to provide physical activity counselling, but many are too busy. This project examines the effectiveness of referral of insufficiently active adults to an exercise physiologist (EP), using step counts from a pedometer as the outcome. We compare usual care from the GP with: (1) 5 EP visits, and (2) a single visit and telephone follow up.
Healthy Lifestyle Intervention For Cardiovascular Disease Risk Reduction Among People With Psychotic Disorders
Funder
National Health and Medical Research Council
Funding Amount
$800,806.00
Summary
This study proposes a multi-site randomised controlled trial of treatment to enhance healthy living among people with psychotic disorders, specifically targeting smoking, diet, and physical activity. These issues are highly prevalent, associated with premature death and reduced quality of life among this group. The results will better inform the treatment choices of clinicians, and will potentially improve the match between treatment and client, improving health and wellbeing of this group.
Efficacy And Mechanisms Of Exercise Training In Diastolic Heart Failure
Funder
National Health and Medical Research Council
Funding Amount
$385,250.00
Summary
Heart failure is modern epidemic which presents a significant public health burden, due to a high mortality, frequent hospital admissions and impaired functional capacity. Although the typical heart failure patient presents with a reduced contractile function, many patients have typical heart failure symptoms but with normal contraction. The problem in these patients seems to relate to the heart's ability to fill with blood, and this entity is known as diastolic heart failure (DHF). This syndrom ....Heart failure is modern epidemic which presents a significant public health burden, due to a high mortality, frequent hospital admissions and impaired functional capacity. Although the typical heart failure patient presents with a reduced contractile function, many patients have typical heart failure symptoms but with normal contraction. The problem in these patients seems to relate to the heart's ability to fill with blood, and this entity is known as diastolic heart failure (DHF). This syndrome is most frequently due to ischemic or hypertensive heart disease, and most commonly occurs in the elderly. The optimal management of DHF is not well defined, although some drug trials are currently in progress. A number of studies have shown exercise training to improve functional capacity by 15-20% in typical heart failure. However, training has not so far been trialled in DHF. In this multicenter, multi-disciplinary study, we will study a training and control group to determine whether exercise capacity and DHF symptoms are responsive to exercise training. This work will teach us about the optimum exercise prescription, in terms of the duration and nature of training, as well as the safety and effectiveness of exercise training. By using a number of sensitive measurements of heart and vessel function (in which our group has special expertise), we will identify whether exercise training exerts its effect through improvement in vascular function and myocardial properties. If successful, the clinical implications of this study are that; 1. Exercise training will be adopted to improve functional capacity and symptoms of DHF 2. The merits of aerobic and strength training will be identified in DHF 3. Abnormal blood vessel function will be identified as a major and reversible contributor to DHFRead moreRead less
Improving Muscle Function After Injury: Novel Tissue Engineering Strategies For Exercise, Surgery And Sports Medicine
Funder
National Health and Medical Research Council
Funding Amount
$288,210.00
Summary
Muscles can be injured by excessive strains when playing sports, in road and workplace accidents, and during plastic and reconstructive surgery. Some surgeries require an unavoidable interruption to the muscle's normal blood supply (called 'ischaemia'). Subsequent return of the muscle's blood supply (reperfusion) is problematic in that a severe secondary muscle injury can ensue mediated by the influx of damaging free radicals when blood flow is restored. Tissue-engineering provides a novel thera ....Muscles can be injured by excessive strains when playing sports, in road and workplace accidents, and during plastic and reconstructive surgery. Some surgeries require an unavoidable interruption to the muscle's normal blood supply (called 'ischaemia'). Subsequent return of the muscle's blood supply (reperfusion) is problematic in that a severe secondary muscle injury can ensue mediated by the influx of damaging free radicals when blood flow is restored. Tissue-engineering provides a novel therapeutic approach to restore muscle structure and function to damaged muscles after injury or disease. Our recent research using controlled release of growth factors from biodegradable hydrogels has exciting application for muscle repairafter injury. We will utilize these cutting edge tissue engineering strategies to deliver to damaged muscles a hydrogel containing controlled delivery (slow release) microcapsules loaded with an anabolic agent (the beta-agonist, formoterol) and-or a growth factor (IL-15) designed to enhance functional muscle repair after three distinct but clinically relevant models of muscle injury: a) crush injury: A model for muscle injuries on the sports field, in the workplace, and those associated with road trauma; b) ischaemia-reperfusion injury: a model for muscle damage associated with surgical interventions, muscle transfers for functional restoration, and other injuries associated with plastic and reconstructive surgery; and c) contraction-induced injury: a model for strain injuries such as hamstring muscle tears that can occur on the sports field. After injury we will assess functional muscle repair using a comprehensive series of histological, biochemical, molecular, immunochistochemical, and physiological techniques. The research has broad application to exercise and clinical medicine; including sports, emergency and rehabilitation medicine, and plastic, reconstructive, and orthopaedic surgery.Read moreRead less
Targeted Strength Training To Improve Functional Walking Capacity Of Adolescents And Young Adults With Cerebral Palsy
Funder
National Health and Medical Research Council
Funding Amount
$263,449.00
Summary
Cerebral palsy is the most common cause of disability in children. Caused by damage to the brain in early childhood cerebral palsy leads to muscle weakness and difficulties in walking. There is no cure for cerebral palsy, but we can help the weak muscles . The purpose of this trial is to establish that exercises to strengthen the weakest muscles will help the walking ability of teenagers and young adults with cerebral palsy, as they make the transition to independence and adulthood.
Exertional Dyspnoea With Increased Filling Pressure - Mechanisms And Treatment Strategies
Funder
National Health and Medical Research Council
Funding Amount
$387,793.00
Summary
Patients with early heart disease often present with shortness of breath with exercise, as myocardial reserve at that stage is usually sufficient to maintain normal function at rest . Indeed, much myocardial dysfunction may originate from the modern lifestyle, including inactivity, obesity, the metabolic syndrome and type II diabetes. The potential benefits of making a definitive early diagnosis are large, because it seems more likely that an impact can be made on the disease process (and theref ....Patients with early heart disease often present with shortness of breath with exercise, as myocardial reserve at that stage is usually sufficient to maintain normal function at rest . Indeed, much myocardial dysfunction may originate from the modern lifestyle, including inactivity, obesity, the metabolic syndrome and type II diabetes. The potential benefits of making a definitive early diagnosis are large, because it seems more likely that an impact can be made on the disease process (and therefore, outcome) than with late stage disease. Current treatment strategies are expensive and because they are directed at end-organ damage (heart failure, heart attacks etc), rather ineffective. This multispecialty, multidisciplinary group will undertake a series of unique studies aimed at identifying early cardiovascular disease. The strategy will involve detection of abnormal filling behaviour at stress echocardiography, with randomization into longterm and short-term trials to examine various therapeutic strategies. Sensitive new cardiovascular imaging techniques will be used to detect preclinical abnormalities in the structure and function of the heart and vasculature, facilitating a mechanistic understanding of the process of increasing filling pressure with exercise.Read moreRead less