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
The Role Of Vestibular Efferents In The Mammalian Vestibulo-ocular Reflex.
Funder
National Health and Medical Research Council
Funding Amount
$323,341.00
Summary
The aim of this study is to determine how a group of nerve fibres that travel from the brain to the balance organ alter balance function in mammals. Balance function in mice will be tested under conditions that modify the balance system response. Results will be compared between normal mice and mutant mice in which these nerves do not function. This work will determine how these nerves alter balance function and whether they are a viable target for future patient treatments.
Dizziness, vertigo, and imbalance affect nearly half the population by the age of 60 and balance-related falls, especially in the elderly, are a serious health concern. Surveys of primary care doctors have shown that dizziness and vertigo are as prevalent as hypertension and angina, and approximately 40% of the population experience dizziness severe enough to seek medical attention. Unfortunately, most symptoms are not relieved by currently available medical treatment. There is, however, a remar ....Dizziness, vertigo, and imbalance affect nearly half the population by the age of 60 and balance-related falls, especially in the elderly, are a serious health concern. Surveys of primary care doctors have shown that dizziness and vertigo are as prevalent as hypertension and angina, and approximately 40% of the population experience dizziness severe enough to seek medical attention. Unfortunately, most symptoms are not relieved by currently available medical treatment. There is, however, a remarkable hidden reserve of 'self-repair' in the balance system that can be triggered under certain conditions. We call this process 'vestibular compensation' and if we can understand those conditions and discover the means by which this reserve affects the nervous system, we may be able harness its power to alleviate the all distressing symptoms of imbalance. Perhaps we may even be able to apply these principles to other critical systems that may need repair. We propose to look at a key region in the central nervous system that is responsible for processing balance signals and may be very important in 'vestibular compensation'. We will try to activate this recovery process under controlled conditions so that we can understand the changes that occur. Specifically we will examine the role of vestibular (balance) neurons in the central nervous system that appear to be modified following trauma of the inner ear balance organs. We will use our new recording techniques to examine these vestibular neurons to see how their intrinsic properties may change and what external or internal factors influences this change. Our aim is to understand what factors promote and what factors inhibit full recovery.Read moreRead less
Combined linear and angular head movements are integral components of our natural head movements. The vestibular sensory apparatus in the labyrinth of the inner ear, which comprises three semicircular canals and two otoliths acts as an inertial guidance system during head motion. The vestibular sensors mediate the angular and linear vestibulo-ocular reflexive eye movements imperative to stabilise vision during the head motions. However, it is unclear how these responses to sudden linear and angu ....Combined linear and angular head movements are integral components of our natural head movements. The vestibular sensory apparatus in the labyrinth of the inner ear, which comprises three semicircular canals and two otoliths acts as an inertial guidance system during head motion. The vestibular sensors mediate the angular and linear vestibulo-ocular reflexive eye movements imperative to stabilise vision during the head motions. However, it is unclear how these responses to sudden linear and angular motion in three dimensions are combined and processed. Diseases of the inner ear can produce incapacitating visual and balance disturbances, yet the normal function of some of the inner ears receptors, in particular the otoliths, cannot be easily tested. Clinical evidence has shown that patients with incapacitating attacks of vertigo can have impairment of either or both the semicircular canals and the otoliths. The aim of this project is to measure quantitatively the semicircular canal-otolith response to transient, high-acceleration combined linear-angular head movements to find a reliable way to test the otolith function. Based on physiological principles and my preliminary experiment, we plan to use an off-axis head rotation procedure, a three-dimensional eye movement recordings and vector analysis technique to assess the linear and angular vestibulo-ocular reflex response from the otoliths and semicircular canals in the labyrinth. The practical significance of answers to these questions is that they will characterise the combined linear and angular vestibulo-ocular reflex responses that stabilise vision during transient head movements. It will provide us with a greater understanding of the visual disturbance that patients experienced during these kinds of head movements following vestibular disease or surgery. Measurement of the linear vestibulo-ocular reflex may also provide a diagnostic test of otolith function clinically in disease states.Read moreRead less
Behavioural And Physiological Tests Of Clinical Indicators Of Vestibular Function.
Funder
National Health and Medical Research Council
Funding Amount
$205,500.00
Summary
Part of the inner ear is responsible for our sense of balance and for maintaining clear vision and stable posture. Recurring vertigo attacks and persistent imbalance can disrupt the most productive years of patients' lives and balance-related falls account for more the half of accidental deaths in the elderly. Despite this most doctors find dizziness difficult to diagnose and impossible to treat, so specialist Balance Disorders Clinics see many patients a year but still have very long waiting ti ....Part of the inner ear is responsible for our sense of balance and for maintaining clear vision and stable posture. Recurring vertigo attacks and persistent imbalance can disrupt the most productive years of patients' lives and balance-related falls account for more the half of accidental deaths in the elderly. Despite this most doctors find dizziness difficult to diagnose and impossible to treat, so specialist Balance Disorders Clinics see many patients a year but still have very long waiting times. There is then clearly a major need to improve the understanding and the treatment of dizzy patients and improvement will come about through scientific understanding of vestibular dysfunction, and technological realization of improvements in the assessment and treatment of patients. This project seeks to identify whether 3 simple new indicators of balance function are valid, using tests on guinea pigs to understand the way in which they work.Read moreRead less
Vestibulo-ocular Responses To Bone Conducted Vibration
Funder
National Health and Medical Research Council
Funding Amount
$282,772.00
Summary
This project is about an entirely new way of clinically evaluating balance function of the inner ear by using bone conducted vibration (BCV). We will make measures of the BCV stimulus in order to specify the stimulus at the receptors, and relate this stimulus to the eye-movement responses it causes. Measuring the exact stimulus and the response will give us a much better understanding of why this stimulus works, allowing us to optimize the clinical tests of balance function.