Medicine and Health Sciences Commons^™

Illusory Touch Temporarily Improves Sensation In Areas Of Chronic Numbness: A Brief Communication, Benedict Martin Wand, Samantha Eve Stephens, Effie Ida Marquita Mangharam, Pamela Jane George, Max Bulsara, Neil Edward O'Connell, G Lorimer Moseley

Physiotherapy Papers and Journal Articles

Background. Creating the visual illusion of touch can improve tactile perception in healthy subjects. Objective. We were interested in seeing if creating the illusion of touch in an insensate area could improve sensation in that area. Methods. Fourteen people with chronic numbness participated in a randomized crossover experiment. The 4 conditions were the following: (a) stimulation over the unaffected limb with mirror visual feedback (experimental condition), (b) stimulation over the affected limb with mirror visual feedback, (c) stimulation over the unaffected limb without mirror visual feedback, and (d) stimulation …

Moving In An Environment Of Induced Sensorimotor Incongruence Does Not Influence Pain Sensitivity In Healthy Volunteers: A Randomised Within-Subject Experiment, Benedict Wand, Lareina Szpak, Pamela J. George, Max Bulsara, Neil Edward O'Connell, G. Lorimer Moseley

Physiotherapy Papers and Journal Articles

Objectives: It has been proposed that in the same way that conflict between vestibular and visual inputs leads to motion sickness, conflict between motor commands and sensory information associated with these commands may contribute to some chronic pain states. Attempts to test this hypothesis by artificially inducing a state of sensorimotor incongruence and assessing self-reported pain have yielded equivocal results. To help clarify the effect sensorimotor incongruence has on pain we investigated the effect of moving in an environment of induced incongruence on pressure pain thresholds (PPT) and the pain experienced immediately on completion of PPT testing.

Methods: Thirty-five healthy …

Exploring The Role And Skill Set Of Physiotherapy Clinical Educators In Work Integrated Learning, Susan Edgar, Joanne Connaughton

Physiotherapy Papers and Journal Articles

Clinical educators are under increasing pressures in the workplace to provide quality education of healthcare students within varying supervision frameworks. Along with facilitating the teaching of clinical skills, clinical educators play a support role for students and so require more than expert clinical abilities in their vital position linking institutions and the healthcare environment. Twelve physiotherapy clinical educators attended one of two focus groups exploring their opinions on the role and skill set of clinical educators in work-integrated learning (WIL).Clinical educators described their role, their skills, challenges they faced supporting the needs of students, as well as future training requirements. …

Movement Restriction Does Not Modulate Sensory And Perceptual Effects Of Exercise-Induced Arm Pain, Markus Hubscher, Simon Tu, Tasha Stanton, G Lorimer Moseley, Benedict M. Wand, John Booth, James H. Mcauley

Physiotherapy Papers and Journal Articles

BACKGROUND:

Movement restriction has been proposed as an important modulator of changes in sensory and perceptual function and motor imagery performance that are observed in musculoskeletal pain syndromes. There are no empirical data to support this view.

PURPOSE:

The primary objective of this experiment was to determine the effects of movement restriction on local and widespread sensory, perceptual and motor imagery changes after exercise-induced muscular pain. Further objectives were to investigate whether changes in sensory perception are correlated with pain intensity and tactile acuity or motor imagery performance.

METHODS:

In forty healthy volunteers, delayed onset muscle soreness (DOMS) of the …

Assessing Tactile Acuity In Musculoskeletal Medicine: How Good Are Two Point Discrimination Tests At The Neck, Hand, Back And Foot?, M Catley, A Tabor, Benedict Wand, G L. Moseley

Physiotherapy Conference Papers

No abstract provided.

Cost Effectiveness Of Patient Education For The Prevention Of Falls In Hospital: Economic Evaluation From A Randomized Controlled Trial, Terry P. Haines, Anne-Marie Hill, Keith D. Hill, Sandra G. Brauer, Tammy Hoffmann, Christopher Etherton-Beer, Steven M. Mcphail

Physiotherapy Papers and Journal Articles

Background

Falls are one of the most frequently occurring adverse events that impact upon the recovery of older hospital inpatients. Falls can threaten both immediate and longer-term health and independence. There is need to identify cost-effective means for preventing falls in hospitals. Hospital-based falls prevention interventions tested in randomized trials have not yet been subjected to economic evaluation.

Methods

Incremental cost-effectiveness analysis was undertaken from the health service provider perspective, over the period of hospitalization (time horizon) using the Australian Dollar (A$) at 2008 values. Analyses were based on data from a randomized trial among n = 1,206 acute and …

Physiotherapists Have Accurate Expectations Of Their Patients’ Future Health-Related Quality Of Life After First Assessment In A Subacute Rehabilitation Setting, Steven M. Mcphail, Emily Nalder, Anne-Marie Hill, Terry P. Haines

Physiotherapy Papers and Journal Articles

Background.

Expectations held by health professionals and their patients are likely to affect treatment choices in subacute inpatient rehabilitation settings for older adults. There is a scarcity of empirical evidence evaluating whether health professionals expectations of the quality of their patients’ future health states are accurate.

Methods.

A prospective longitudinal cohort investigation was implemented to examine agreement (kappa coefficients, exact agreement, limits-of-agreement, and intraclass-correlation coefficients) between physiotherapists’ (n=23) prediction of patients’ discharge health-related quality of life (reported on the EQ-5D-3L) and the actual health-related quality of life self-reported by patients (n=272) at their discharge assessment (using the EQ-5D-3L). The mini-mental …

Circumstances Of Falls And Falls-Related Injuries In A Cohort Of Older Patients Following Hospital Discharge, Anne-Marie Hill, Tammy Hoffman, Terry P. Haines

Physiotherapy Papers and Journal Articles

Background:

Older people are at increased risk of falls after hospital discharge. This study aimed to describe the circumstances of falls in the six months after hospital discharge and to identify factors associated with the time and location of these falls.

Methods:

Participants in this randomized controlled study comprised fallers (n = 138) who were part of a prospective observational cohort (n = 343) nested within a randomized controlled trial (n = 1206). The study tested patient education on falls prevention in hospital compared with usual care in older patients who were discharged from hospital and followed for six months …

Tailored Education For Older Patients To Facilitate Engagement In Falls Prevention Strategies After Hospital Discharge—A Pilot Randomized Controlled Trial, Anne-Marie Hill, Christopher Etherton-Beer, Terry P. Haines

Physiotherapy Papers and Journal Articles

Background

The aims of the study were to evaluate the effect of providing tailored falls prevention education in hospital on: i) engagement in targeted falls prevention behaviors in the month after discharge: ii) patients’ self-perceived risk and knowledge about falls and falls prevention strategies after receiving the education.

Methods

A pilot randomized controlled trial (n = 50): baseline and outcome assessments conducted by blinded researchers. Participants: hospital inpatients 60 years or older, discharged to the community. Participants were randomized into two groups. The intervention was a tailored education package consisting of multimedia falls prevention information with trained health professional follow-up, …

Measurement Of Localized Tissue Water - Clinical Application Of Bioimpedance Spectroscopy In Wound Management, L C. Ward, K Sharpe, Dale Edgar, V Finlay, F Wood

Physiotherapy Papers and Journal Articles

Wound healing is a complex process which can be impeded by the presence of accumulated cell fluid or oedema. A simple and convenient method for the assessment of wound oedema would aid improvement in patient care. In this proof of concept study we investigated whether bioelectrical impedance spectroscopy has the potential to provide such a tool. A number of important observations were made. Firstly, the method was highly reproducible and data can be obtained from electrodes located at different positions around the region of interest; important given the highly variable topography of surface wounds, e.g. burns. Secondly, the method was …

Chronic Lower Back Pain: A Maladaptive Perceptions Model, Benedict M. Wand

Physiotherapy Conference Papers

High quality evidence suggests that current approaches to the management of CLBP show only limited effectiveness; one explanation of this finding is that current models of management are misdirected or incomplete. This talk proposes a model of CLBP underpinned by data on the psychological contributors to the LBP experience and recent evidence of neuroplastic changes in the brains of people with CLBP (see below). The model suggests that maladaptive cognitive perception about the nature of the back problem and future consequences drive behaviours that might bring about maladaptive neuroplastic changes. These central nervous system changes may enhance sensitivity, influence normal …

Moving In An Environment Of Induced Sensory-Motor Incongruence Does Not Influence Pain Sensitivity In Healthy Volunteers: A Randomised Within-Subject Cross-Over Experiment, Benedict M. Wand, Lareina Szpak, Pamela George, Max Bulsara, Neil E. O'Connell, G Lorimer Moseley

Physiotherapy Conference Papers

A mismatch between the brain's motor control and sensory systems has been suggested as one mechanism whereby maladaptive neuroplastic changes contribute to the experience of chronic pain. Several studies have investigated this hypothesis by artificially inducing a state of sensory-motor incongruence using mirrors. The data to date appear to suggest that creating an environment of sensori-motor incongruence induces various sensory changes and feeling of peculiarity, however the effect on pain is less clear. The aim of this study was to test the hypothesis that healthy participants would demonstrate reduced pain thresholds and report greater intensity of pain in a condition …

Treatment-Based Classification Of Low Back Pain – Who Are The Unclear Classifications?, T R. Stanton, J M. Fritz, A T. Apeldoorn, Benedict M. Wand, M J. Hancock

Physiotherapy Conference Papers

A recent focus in low back pain research has been to identify patient subgroups that respond best to certain treatments. To integrate these subgroup findings into a useable form, a treatment-based classification algorithm for LBP was created.^1,2 To allow the algorithm to be comprehensive – eg, provide a classification for all patients – additional criteria are provided to assist therapists’ decisions for patients who do not clearly meet a treatment subgroup (unclear classifications).

Recent research found that approximately 34% of patients will receive unclear classifications using the algorithm.³ It has also been shown that the reliability of the …

Functional Changes In The Primary Somatosensory Cortex In Complex Regional Pain Syndrome (Crps): A Systematic Review, Flavia Di Pietro, Tasha R. Stanton, Luke Parkitny, James H. Mccauley, Martin Lotze, Benedict M. Wand, G Lorimer Moseley

Physiotherapy Conference Papers

The brain plays a key role in CRPS. A widely-studied brain region in pain research is the primary somatosensory cortex (S1), a somatotopic map of our body’s surface which functionally reorganises in pain [1]. Changes in the S1 representation of the CRPS-affected body part have contributed to new CRPS treatments, e.g. graded motor imagery. This systematic review and meta-analysis aimed to determine whether CRPS is associated with: a) a change in the size of the S1 representation of the affected body part; b) altered S1 activity, in terms of activation levels and latency of responses.

Low Back Pain-Related Beliefs And Self-Reported Practice Behaviours Among Final-Year Cross-Discipline Health Students, A Briggs, H Slater, A Smith, A Parkin-Smith, K Watkins, Benedict Wand, J Chua

Physiotherapy Conference Papers

No abstract provided.

Discovering Which Experiences Physiotherapy Students Identify As Learning Facilitators In Practical Laboratories: An Action Research Project, J Francis-Coad, A Hill

Physiotherapy Conference Papers

Purpose: Students enrolled in courses that focus on patient contact participate in practical laboratories to learn clinical skills but this can be challenging in a pre-clinical environment. A simulated case based format using role play in small groups is commonly undertaken. Students may find it difficult to actively engage in learning and effective role playing without prior clinical experience. The aim of this study was to discover what type of experiences facilitated student learning in practical laboratory sessions.

Method: Design: Action research study.

Participants: Thirty two undergraduate second year physiotherapy students who were engaging in practical laboratories.

Data …

Low Dose Ct Vs Plain Abdominal Radiography For The Investigation Of The Acute Abdomen, Long K. Nguyen, Daniel D. Wong, Daniel M. Fatovich, Justin M. Yeung, Jennifer Persaud, Christopher J. Wood, David De Vos, Richard M. Mendelson

Physiotherapy Papers and Journal Articles

Background: To compare low-dose abdominal computed tomography (LDCT) with plain abdominal radiography (AR) in the primary investigation of acute abdominal pain to determine if there is a difference in diagnostic yield, the number of additional investigations required and hospital length of stay (LOS).

Methods: This randomized controlled trial was approved by the institutional review board, and informed consent was obtained. Patients presenting to the emergency department with an acute abdomen and who would normally be investigated with AR were randomized to either AR or LDCT. The estimated radiation dose of the LDCT protocol was 2–3 mSv compared to 1.1 mSv …

Tactile Thresholds Are Preserved Yet Complex Sensory Function Is Impaired Over The Lumbar Spine Of Chronic Non-Specific Low Back Pain Patients: A Preliminary Investigation, Benedict M. Wand, Flavia Di Pietro, Pamela George, Neil E. O'Connell

Physiotherapy Conference Papers

Evidence indicates that chronic non-specific low back pain (CNSLBP) is associated with alteration in the brain’s cortical representation of the back, resulting in body perception disturbance and contributing to the condition [1,2]. This study investigated perception via ‘cortical’ sensory tests, in this case two-point discrimination and graphaesthesia—whose results partly depend on the integrity of cortical representation [2]. The hypothesis was dysfunction in these higher-order tasks, with simple tactile thresholds remaining unchanged. Furthermore a relationship between cortical sensation and severity of the condition was predicted.

Patient Satisfaction With Musculoskeletal Physiotherapy Care In Australia Is High, Vivian Yung, Martin Mackey, Benedict M. Wand, Roger Adams, Roger Nelson, Paul Beattie, Julia Hush

Physiotherapy Conference Papers

Patient satisfaction is an important outcome of care and is intrinsically valuable to clinicians. The level of patient satisfaction with musculoskeletal physiotherapy care in Australia is unknown. Increased understanding of patient satisfaction will benefit patients by facilitating clinicians to optimise clinical service delivery.

Non-Invasive Brain Stimulation Techniques For Chronic Pain. A Cochrane Systematic Review And Meta-Analysis, Neil E. O'Connell, Louise Marston, Benedict M. Wand, Sally Spencer, Lorraine H. De Souza

Physiotherapy Conference Papers

Poster Presentation

Non-invasive brain stimulation techniques aim to induce an electrical stimulation of the brain in an attempt to reduce chronic pain by directly altering brain activity. They include repetitive transcranial magnetic stimulation (rTMS), cranial electrotherapy stimulation (CES) and transcranial direct current stimulation (tDCS). These approaches to pain treatment are relatively novel. It is important to assess the existing literature robustly to ascertain the current level of supporting evidence and to inform future research and potential clinical use.

Evaluation Of A Treatment-Based Classification Algorithm For Low Back Pain, Tasha R. Stanton, Julie Fritz, Mark J. Hancock, Jane Latimer, Chris G. Maher, Benedict M. Wand, Eric Parent

Physiotherapy Conference Papers

Poster Presentation

Theme: How can we better translate evidence into clinical practice?

Background: Several studies have investigated criteria for classifying patients with low back pain into treatment-based subgroups. A comprehensive algorithm was recently created to translate these criteria into a clinical decision-making guide. This study investigated the translation of the individual subgroup criteria into a comprehensive algorithm by studying the prevalence of patients meeting each treatment subgroup, more than one treatment subgroup, and none of the treatment subgroups. The reliability of the classification decision was also investigated.

Transcranial Direct Current Stimulation Of The Motor Cortex In The Treatment Of Chronic Non-Specific Low Back Pain. A Randomised, Double-Blind Exploratory Study, Neil E. O'Connell, John Cossar, Louise Marston, Benedict M. Wand, David Bunce, Lorraine H. De Souza, David W. Maskill, Andrew Sharp, G Lorimer Moseley

Physiotherapy Conference Papers

This exploratory study aimed to test the proof of principle that active anodal transcranial direct current stimulation (tDCS) applied to the motor cortex reduces pain significantly more than sham stimulation in a group of participants with chronic non-specific low back pain.

What Factors Determine Patient Satisfaction With Musculoskeletal Physiotherapy Care In Australia?, Julia Hush, Vivian Yung, Martin Mackey, Benedict M. Wand, Roger Adams, Roger Nelson, Paul Beattie

Physiotherapy Conference Papers

Patient satisfaction is an important patient-focussed indicator of the quality of physiotherapy care. We have completed an evaluation of patient satisfaction with musculoskeletal physiotherapy in Australia using the 20-item MedRisk Instrument for Measuring Patient Satisfaction With Physical Therapy Care (MRPS). In this paper we report on factors that influence patient satisfaction in this cultural context.

Treating Chronic Nonspecific Low Back Pain With A Sensorimotor Retraining Approach: An Exploratory Multiple-Baseline Study Of 3 Participants, Benedict M. Wand, Neil E. O'Connell, Flavia Di Pietro, Max Bulsara

Physiotherapy Conference Papers

Chronic nonspecific low back pain (CNSLBP) is a common healthcare problem for which current interventions are only moderately successful [1]. There is growing evidence of extensive cortical reorganisation and perceptual disturbances which may contribute to the condition [2]. The aim of this study was to test whether a graded sensorimotor retraining program, aimed at influencing cortical representation, would reduce pain intensity, interference of pain on daily life and self reported disability.

Factors Associated With Older Patients' Engagement In Exercise After Hospital Discharge, Anne-Marie Hill, Tammy Hoffmann, Steven Mcphail, Christopher Beer, Keith D. Hill, Sandra G. Brauer, Terrence P. Haines

Physiotherapy Papers and Journal Articles

Objectives: To identify factors that are associated with older patients' engagement in exercise in the 6 months after hospital discharge.

Design: A prospective observational study using qualitative and quantitative evaluation.

Setting: Follow-up of hospital patients in their home setting after discharge from a metropolitan general hospital.

Participants: Participants (N=343) were older patients (mean age ± SD, 79.4±8.5y) discharged from medical, surgical, and rehabilitation wards and followed up for 6 months after discharge.

Interventions: Not applicable.

Main Outcome Measures: Self-perceived awareness and risk of falls measured at discharge with a survey that addressed elements of the Health Belief Model. Engagement and …

Falls After Discharge From Hospital: Is There A Gap Between Older Peoples’ Knowledge About Falls Prevention Strategies And The Research Evidence?, Anne-Marie Hill, Tammy Hoffmann, Christopher Beer, Steven Mcphail, Keith D. Hill, David Oliver, Sandra G. Brauer, Terry P. Haines

Physiotherapy Papers and Journal Articles

Purpose: The aim of this study was to examine whether older people are prepared to engage in appropriate falls prevention strategies after discharge from hospital.

Design and Methods: We used a semi-structured interview to survey older patients about to be discharged from hospital and examined their knowledge regarding falls prevention strategies to utilize in the post-discharge period. The study was part of a prospective cohort study, nested within a larger, randomized controlled trial. Participants (n = 333) were asked to suggest strategies to reduce their falls risk at home after discharge, and their responses were compared with current reported …

A Randomized Trial Comparing Digital Video Disc With Written Delivery Of Falls Prevention Education For Older Patients In Hospital, Anne-Marie Hill, Steven Mcphail, Tammy Hoffman, Keith Hill, David Oliver, Christopher Beer, Sandra Brauer, Terry P. Haines

Physiotherapy Papers and Journal Articles

Objectives: To compare the effectiveness of a digital video disc (DVD) with that of a written workbook delivering falls prevention education to older hospital patients on self-perceived risk of falls, perception of falls epidemiology, knowledge of prevention strategies, and motivation and confidence to engage in self-protective strategies. To compare the effect of receiving either education approach versus no education on patients' perception of falls epidemiology.

Design: Randomized trial (DVD vs workbook) with additional quasi-experimental control group.

Settings: Geriatric, medical, and orthopedic wards in Perth and Brisbane, Australia.

Participants: One hundred (n=51 DVD, n=49 workbook) hospital inpatients aged 60 and older …