Physical Activity Coaching For Adults With Physical Disabilities: A Pragmatic Randomised Controlled Trial.
Funder
National Health and Medical Research Council
Funding Amount
$1,371,185.00
Summary
People with impaired mobility can achieve substantial benefits from appropriate physical activities but face many barriers to being active so require targeted interventions and health professional support. This trial (n=600) will test the effectiveness and cost-effectiveness of an enhanced physical activity coaching intervention (home-visit from a physiotherapist, phone coaching, technology) with phone coaching alone and with no intervention.
ASPREE is the largest clinical trial ever conducted in Australia and will determine whether daily low dose aspirin prevents disease in healthy older people. The study was well-funded initially but will require additional support to complete the vital final stage of data collection and analysis. This will enable the study to answer important questions about the benefits and risks of aspirin in this age group and its effect on disability free survival.
Tai Chi For Independent Living: RCT Of Efficacy Of Tai Chi In Delaying Disability Among Older People.
Funder
National Health and Medical Research Council
Funding Amount
$1,157,574.00
Summary
This study addresses the issue of disability among our ageing population. Preservation of function among our older citizens, and their capacity to live independently, is of significant social, public health and economic benefit. The aims of this study are to (1) test the efficacy of Tai Chi in delaying disability among older people, prior to its onset, (2) investigate the mechanisms by which Tai Chi intervenes in the disability pathway, (3) determine the cost-benefits of Tai Chi for older people ....This study addresses the issue of disability among our ageing population. Preservation of function among our older citizens, and their capacity to live independently, is of significant social, public health and economic benefit. The aims of this study are to (1) test the efficacy of Tai Chi in delaying disability among older people, prior to its onset, (2) investigate the mechanisms by which Tai Chi intervenes in the disability pathway, (3) determine the cost-benefits of Tai Chi for older people. The study will recruit 670 people over 70 years of age and randomly assign them to receive either Tai Chi, or a stretching and relaxation program, for a period of 48 weeks. The groups will then be compared to determine if there is any difference in the development of disability as well as a range of functional outcomes such as strength, balance, depression, arthritic symptoms, life satisfaction, and falls. This will be the first study world-wide to test the impact of any exercise program on delaying the manifestation of disability among older people. Robust evidence that Tai Chi can in fact delay disability will have immediate and significant implications for the maintenance of independence among older people at a critical time for our ageing population. Translation of these research results to practice will decrease demand for support services for community dwelling older people, and for places in supported accommodation facilities. Older people will have improved quality of life, and government and non-government agencies will experience reduced demand for limited resources. This internationally significant study will also contribute to understanding the mechanisms by which disability develops, and create the valuable opportunity for continuing research on attrition of effect and long term adherence to exercise programs.Read moreRead less
Neurorestorative Rehabilitation In Children With Cerebral Palsy
Funder
National Health and Medical Research Council
Funding Amount
$451,716.00
Summary
Cerebral palsy (CP) is the most common physical disability (1 in 500) with life-long impact. The economic burden is AUS$1.47 billion/yr. Children have limitations in function which impacts daily activities and participation. Deficits in visual perception and learning have an impact on vocational aspirations. This program will test novel interventions (Action Observation training, constraint induced movement therapy, multi-modal web training) measuring broad outcomes and mechanisms with Advanced ....Cerebral palsy (CP) is the most common physical disability (1 in 500) with life-long impact. The economic burden is AUS$1.47 billion/yr. Children have limitations in function which impacts daily activities and participation. Deficits in visual perception and learning have an impact on vocational aspirations. This program will test novel interventions (Action Observation training, constraint induced movement therapy, multi-modal web training) measuring broad outcomes and mechanisms with Advanced Brain Imaging.Read moreRead less
The Transition From Hospital To Home: A Longitudinal Study Of Indigenous Traumatic Brain Injury (TBI)
Funder
National Health and Medical Research Council
Funding Amount
$888,851.00
Summary
The six-month transition period following discharge from hospital after a traumatic brain injury (TBI) is critical. During the transition period, key sentinel events may influence health and wellbeing. The research will investigate key sentinel events during the transition period following TBI in the first longitudinal study with Indigenous Australians. This study will provide the first systematic evidence regarding the support Indigenous Australians need to successfully transition back into the
Understanding Fear Of Falling And Risk Taking In Older People
Funder
National Health and Medical Research Council
Funding Amount
$355,877.00
Summary
Fear of falling is a very significant issue for many older people. Estimates of the prevalence of fear of falling in older community-dwelling people range from 29 to 92% in those who have suffered previous falls, and 12 to 65% in those have not. Fear of falling can lead to restriction and curtailment of activity, reduced quality of life, anxiety, depression and social isolation. To date, all studies addressing fear of falling have simply considered no fear to be good and presence of fear to be b ....Fear of falling is a very significant issue for many older people. Estimates of the prevalence of fear of falling in older community-dwelling people range from 29 to 92% in those who have suffered previous falls, and 12 to 65% in those have not. Fear of falling can lead to restriction and curtailment of activity, reduced quality of life, anxiety, depression and social isolation. To date, all studies addressing fear of falling have simply considered no fear to be good and presence of fear to be bad, and have not attempted to assess whether this fear is rational or irrational in relation to actual balance abilities or physical functioning. In this study, we aim to find out which psychological, physical, health and lifestyle factors distinguish between older people with and without an irrational fear of falling based on their actual physical falling risk. We also wish to understand the role that fear of falling and other psychological factors (anxiety, depression and avoidance) play in causing older people to fall; and to measure how falls can lead to increased fear of falling, anxiety and depression and reduced physical functioning. The complex nature of psychological risk factors of falling and the limited background information on this subject, hampers its integration in falls prevention programs. Although there is growing awareness of this problem among health care providers, additional research is needed about why older people develop a fear of falling in order to fully understand fear of falling and to tailor specific intervention and prevention strategies.Read moreRead less
Intellectual disability, victimisation, challenging behaviour and offending. The expected national benefits that will arise from this research will include significant advances to policy and practice in the field, which will impact on service users and service providers at both individual and community levels. At the same time, this unique collaboration will foster research excellence, further develop interagency collaborations and thus advance Australia's research and clinical leadership in the ....Intellectual disability, victimisation, challenging behaviour and offending. The expected national benefits that will arise from this research will include significant advances to policy and practice in the field, which will impact on service users and service providers at both individual and community levels. At the same time, this unique collaboration will foster research excellence, further develop interagency collaborations and thus advance Australia's research and clinical leadership in the field of intellectual disability and community safety. Taken altogether, this research has a strong potential to lead to further collaborations focussing on research priorities of national and international significance. Read moreRead less
Improving Decision Making On Health Interventions: Factoring In The Long Term Economic Impacts Of Informal (unpaid) Care
Funder
National Health and Medical Research Council
Funding Amount
$628,963.00
Summary
This project looks at the future health of the Australian population that will keep more informal carers out of employment and diminish their own livings standards, thereby reducing funds available to government and the impact of interventions that could improve the health of the population and increase employment of carers.
A Randomised Controlled Falls Prevention Trial Of Long Distance Glasses In Elderly Multifocal Wearers
Funder
National Health and Medical Research Council
Funding Amount
$493,000.00
Summary
Each year, one-third to a half of people over 65 years old will fall at least once. The consequences of falls are immense in terms of suffering, loss of independence, fear of future falls, carer burden, mortality, residential care admissions and other health care resource usage. Clearly, effective and affordable falls prevention strategies are needed to address this major health care problem. Over 50% of people over 65 years old use bi-, tri- or multi-focal glasses. The lower part of these glass ....Each year, one-third to a half of people over 65 years old will fall at least once. The consequences of falls are immense in terms of suffering, loss of independence, fear of future falls, carer burden, mortality, residential care admissions and other health care resource usage. Clearly, effective and affordable falls prevention strategies are needed to address this major health care problem. Over 50% of people over 65 years old use bi-, tri- or multi-focal glasses. The lower part of these glasses are useful for reading and seeing at close range only and there is now evidence that the use of these glasses is associated with an increased risk of falls due to the blurring of vision when looking through the lower lenses at ground level obstacles. This is particularly relevant in unfamiliar outdoor situations. This study will determine whether providing plain distance glasses (with extensive counselling and recommendations for use in standing and walking activities) will prevent falls and their consequences over a one year period in older persons who wear bi-, tri- or multi-focal glasses. Pilot studies suggest that most elderly bi-, tri-, or multi-focal wearers at risk for falls are willing to purchase and use a second pair of glasses if the benefit of new plain distance glasses for their vision is demonstrated. We expect that the results of the study will be incorporated into all relevant areas of clinical practice and public health strategies.Read moreRead less
Confirming The Burden Of Disease Associated With Dementia Using New Empirically Driven Australian Based Disability Rati
Funder
National Health and Medical Research Council
Funding Amount
$138,084.00
Summary
The amount of burden the population experiences as a result of individual diseases influences health policy. The Australian Burden of Disease project quantifies the relative burden associated with each disease. New estimates are to be released this year will outline the magnitude of burden associated with dementia now and estimate that for the year 2023. Although the projections use the best data available, three improvements to the methodology would improve the accuracy of the dementia burden e ....The amount of burden the population experiences as a result of individual diseases influences health policy. The Australian Burden of Disease project quantifies the relative burden associated with each disease. New estimates are to be released this year will outline the magnitude of burden associated with dementia now and estimate that for the year 2023. Although the projections use the best data available, three improvements to the methodology would improve the accuracy of the dementia burden estimates. First, the dementia calculations currently use a “disability weight” metric derived from a Dutch study. This is problematic in that the weights do not reflect an Australian experience of dementia, nor do they reflect the preferences of people closely affected by the disease (e.g. carers). Second, the dementia estimates do not include cases of mild cognitive impairment (considered a precursor state of dementia). Hence the dementia estimates may not estimate the full impact of dementia in Australia. Finally, there is no evidence that the method used by the Burden of Disease study to account for the impact of disease comorbidity adequately deals with the comorbidity associated with dementia. Consequently, there is need to develop a new and comprehensive set of disability weights for dementia that are Australian-based, include all stages of dementia severity and account for comorbidity. The proposed project aims to develop a new set of empirically derived Australian-based disability weights for dementia. The project will entail three studies. The first study will generate empirically based case vignettes that describe a range of dementia case scenarios. These descriptions will then be used in rating exercises (Study 2) to develop new disability weights. The second study involves Australian health practitioners, carers and lay persons reading case vignettes and completing health valuation rating exercises to generate new disability weights for dementia. The third study uses the new disability weights to re-calculate the burden of disease estimates for dementia. The new estimates will be compared to those reported by the 2007 Australian Burden of Disease project. In knowing the accuracy of the estimates, policy makers can use the burden data for dementia with confidence when engaging in service planning for the future.Read moreRead less