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
Burden Of Disease: Costing An Effective Package Of Care For Mental Disorders
Funder
National Health and Medical Research Council
Funding Amount
$272,735.00
Summary
The Global Burden of Disease project, a WHO-World Bank-Harvard collaboration, presented an unprecedented picture of global health across the developed and developing world, providing much-needed information for planning health services. Health was measured at the population level, and combined the number of life years lost due to death and disablement to give a total amount of life lost per disorder. One surprise of the project was the importance of mental disorders, accounting for 43% of life y ....The Global Burden of Disease project, a WHO-World Bank-Harvard collaboration, presented an unprecedented picture of global health across the developed and developing world, providing much-needed information for planning health services. Health was measured at the population level, and combined the number of life years lost due to death and disablement to give a total amount of life lost per disorder. One surprise of the project was the importance of mental disorders, accounting for 43% of life years lost due to disability in countries like Australia. Service planning to reduce this burden requires knowledge of cost-effective treatments.This project will trial a method used for combining burden and cost-effectiveness data to design an essential package of services to address the treatment shortfall in mental disorders. This research will assist in our understanding of why burden due to mental disorders persists, and the extent to which current treatment knowledge is able to address this burden within existing budgetary constraints. This will be achieved by: 1) detailing the costs and population outcome of current services in Australia for mental disorders, to determine which disorders are currently adequately treated and which disorders require further intervention, 2) calculating the costs and outcome of best practice interventions from clinical practice guidelines, to understand the extent to which current treatment knowledge can reduce burden due to mental disorders, 3) examining the equity consequences of such a package of ideal interventions, with the understanding that the treatment endpoint is not the same for all disorders. This is a secondary analysis, representing a method for translating existing cost and outcome data for individual treatments into their costs and consequences for health planning at the population level.Read moreRead less
Balance disorders are very common, but particularly in those conditions that involve the brain 'balance centres' are often difficult for doctors to diagnose. When diseases are difficult to diagnose, then recommending helpful treatment is particularly challenging. We will use a group of specialized tests to better understand these balance conditions in order to help patients receive accurate diagnoses and therefore, better treatment.
Balance disorders are very common, but particularly in those conditions that involve the brain 'balance centres' are often difficult for doctors to diagnose. When diseases are difficult to diagnose, then recommending helpful treatment is particularly challenging. We will use a group of specialized tests to better understand these balance conditions in order to help patients receive accurate diagnoses and therefore, better treatment.
Molecular Mediators, Epigenetic Modulators And Therapeutic Targets For Cognitive Disorders
Funder
National Health and Medical Research Council
Funding Amount
$763,845.00
Summary
Brain disorders constitute an enormous, and growing, burden. My research investigates how genes and environment combine to cause disorders of cognition, including dementia, schizophrenia and autism. The research will provide new insights into these disorders, at the level of molecules, cells and behaviour. I will explore how genetic and environmental factors interact, with a focus on mental activity, physical exercise and stress, which affect a range of neurological and psychiatric disorders.
Ocular Motility In Autism And Asperger S Disorder: Dissociation Of Motor Deficits.
Funder
National Health and Medical Research Council
Funding Amount
$131,235.00
Summary
We will use ocular motor technology to investigate motor dysfunction in autism and Asperger's disorder, to advance our understanding of the neurobiological bases of these disorders. This will help clarify whether neural networks are differentially disrupted in these disorders, as our previous clinical research suggests. This dissociation and the subsequent development of an ocular motor clincal screen may improve diagnosis, and potentially treatment, of these devastating conditions.