Medicine and Health Sciences Commons^™

"My Back Is Fit For Movement": A Qualitative Study Alongside A Randomized Controlled Trial For Chronic Low Back Pain, Rodrigo Rn Rizzo, Benedict Wand, Hayley B. Leake, Edel O'Hagan, Matthew K. Bagg, Samantha Bunzli, Adrian C. Traeger, Sylvia M. Gustin, G. Lorimer Moseley, Saurab Sharma, Aidan Cashin, James Mcauley

Physiotherapy Papers and Journal Articles

A new wave of treatments has emerged to target nervous system alterations and maladaptive conceptualizations about pain for chronic low back pain. The acceptability of these treatments is still uncertain. We conducted a qualitative study alongside a randomized controlled trial to identify perceptions of facilitators or barriers to participation in a non-pharmacological intervention that resulted in clinically meaningful reductions across 12 months for disability compared to a sham intervention. We conducted semi-structured interviews with participants from the trial's active arm after they completed the 12-week program. We included a purposeful sample (baseline and clinical characteristics) (n = 20). We used …

Early Movement Matters: Examining The Influence Of Early Postnatal Caregiving Experiences Of Term Infants On Motor And Head Shape Outcomes Across Infancy, Helen E. Beaton

Theses

The nurturing, handling and positioning exposures infants experience during daily caregiving contribute to their physical, motor, cognitive and social–emotional development. A relationship exists between infant sleep and wake-time positioning, the emergence of motor skills and the development of head shape deformities diagnosed as non-synostotic plagiocephaly (NSP). However, the underlying causal mechanism of the specific caregiving behaviours that may play a role remains unclear.

The purpose of the study was to investigate the association between maternal caregiving behaviours and the developmental outcomes of ‘low-risk’ term infants in the first 10 months of life. The first phase of the research involved the …

Exploration Of The Effects Of Developmental Coordination Disorder On Skeletal Development From Childhood Through To Early Adulthood, Jocelyn Tan

Theses

This thesis examined bone development from childhood into early adulthood in individuals with developmental coordination disorder (DCD) using a life course health development framework. One systematic review was conducted, and four original research studies produced with retrospective data from four unique cohorts in childhood, adolescence, and adulthood. Physical activity was assessed via accelerometry in Finnish child and adult populations and via self-reporting in an Australian population at 17 and 20 years. Bone was assessed via peripheral quantitative computed tomography in adolescents and dual energy x-ray absorptiometry in adults at age 20 years in two Australian cohorts. Bone was assessed cross-sectionally …

Caring For Individuals Who Have Used Methamphetamine: A Study Exploring The Experiences Of West Australian Nurses Working In An Authorised Mental Health Institute, John Kriticos

Theses

Background: Methamphetamine (MA) use in Australia has stabilized over the last 22 years, however changing routes of administration and increased purity of the drug has led to greater rates of physical dependency and higher rates of cardiovascular, neurological, and mental health complications. Challenges managing MA related presentations have been reported in Australian Emergency Departments (ED’s), with limited research considering nurses’ experience treating individual(s) who use MA (IWUM) and require prolonged mental health care. Purpose: The aim of this study was to understand nurses’ experiences who care for IWUM in a West Australian hospital’s inpatient mental health service. Methods: Interpretive phenomenological …

Using Audio-Visual Simulation To Elicit Nursing Students’ Noticing And Interpreting Skills To Assess Pain In Culturally Diverse Patients, Michelle A. Kelly, Susan Slatyer, Helen Myers, Shelley Gower, Jaci Mason, Kathie Lasater

Nursing Papers and Journal Articles

Background: Pain is a complex and multi-dimensional phenomenon. Nurses play a vital role in assessing and managing pain and must use sound clinical reasoning to accurately make clinical judgments to notice, interpret and respond to patients’ pain.

Method: Exploratory research on the impact of a newly developed AV simulation on nursing students’ Noticing and Interpreting skills in assessing pain of culturally diverse patients. Data were collected via self-administered pre and post–intervention surveys.

Findings: The majority of participants were able to identify that the patient was in greater pain than reported, however some participants were unable to notice and interpret the …

Individual Differences And Transfer Of Visual Anticipation In Expert Female Field Hockey Goalkeepers, Khaya Morris-Binelli, Sean Muller, Fleur E.C.A. Van Rens, Allen G. Harbaugh, Simon M. Rosalie

Physiotherapy Papers and Journal Articles

Significance: Visual anticipation is vital for performance in several domains such as driving, military, and high-speed interceptive sports, as it enables performers to handle severe time constraints. There has been little investigation into individual differences of anticipation skill transfer within a domain, which can guide training of anticipation to improve performance.

Purpose: The purpose of this study was to investigate individual differences in the transfer of anticipation within a domain, specifically anticipation of the field hockey penalty corner drag-flick across different opponents.

Methods: Eight female Australian international and national field hockey goalkeepers participated. Goalkeepers completed female and male opponent penalty …

The Fit-For-Purpose Model: Conceptualizing And Managing Chronic Nonspecific Low Back Pain As An Information Problem, Benedict M. Wand, Aidan G. Cashin, James H. Mcauley, Matthew K. Bagg, Gemma M. Orange, G. Lorimer Moseley

Physiotherapy Papers and Journal Articles

Chronic nonspecific low back pain (CNSLBP) is a complex and multifaceted problem. The following Perspective Piece tries to help make sense of this complexity by describing a model for the development and maintenance of persistent low back pain that integrates modifiable factors across the biopsychosocial spectrum. The Fit-for-Purpose model (FFPM) posits the view that chronic nonspecific low back pain represents a state in which the person in pain holds strong and relatively intransient internal models of an immutably damaged, fragile, and unhealthy back, and information that supports these models is more available and trustworthy than information that counters them. This …

Quality Improvement Initiatives In The Care And Prevention Of Fragility Fractures In The Asia Pacific Region, Paul J. Mitchell, Seng Bin Ang, Leilani Basa Mercado-Asis, Reynaldo Rey-Matias, Wen-Shiang Chen, Leon Flicker, Edward Leung, David Choon, Sankara Kumar Chandrasekaran, Jacqueline Clare Therese Close, Hannah Seymour, Cyrus Cooper, Philippe Halbout, Robert Daniel Blank, Yanling Zhao, Jae-Young Lim, Irewin Tabu, Maoyi Tian, Aasis Unnanuntana, Ronald Man Yeung Wong, Noriaki Yamamoto, Ding-Cheng Chan, Joon Kiong Lee, On Behalf Of The Asia Pacific Fragility Fracture Alliance

Medical Papers and Journal Articles

Summary: This narrative review summarises ongoing challenges and progress in the care and prevention of fragility fractures across the Asia Pacific region since mid-2019. The approaches taken could inform development of national bone health improvement Road Maps to be implemented at scale during the United Nations ‘Decade of Healthy Ageing’.

Purpose: This narrative review summarises recent studies that characterise the burden of fragility fractures, current care gaps and quality improvement initiatives intended to improve the care and prevention of fragility fractures across the Asia Pacific region.

Methods: The review focuses on published studies, reports and quality improvement …

Physiotherapy For Pain And Disability In Adults With Complex Regional Pain Syndrome (Crps) Types I And Ii, Keith M. Smart, Michael C. Ferraro, Benedict M. Wand, Neil E. O'Connell

Physiotherapy Papers and Journal Articles

Background: Complex regional pain syndrome (CRPS) is a painful and disabling condition that usually manifests in response to trauma or surgery and is associated with significant pain and disability. CRPS can be classified into two types: type I (CRPS I) in which a specific nerve lesion has not been identified and type II (CRPS II) where there is an identifiable nerve lesion. Guidelines recommend the inclusion of a variety of physiotherapy interventions as part of the multimodal treatment of people with CRPS. This is the first update of the review originally published in Issue 2, 2016

Objectives: To determine the …

Care Ethics Framework For Midwifery Practice: A Scoping Review, Kate Buchanan, Elizabeth Newnham, Deborah Ireson, Clare Davison, Sadie Geraghty

Nursing Papers and Journal Articles

Background: As a normative theory, care ethics has become widely theorized and accepted. However, there remains a lack of clarity in relation to its use in practice, and a care ethics framework for practice. Maternity care is fraught with ethical issues and care ethics may provide an avenue to enhance ethical sensitivity.

Aim: The purpose of this scoping review is to determine how care ethics is used amongst health professions, and to collate the information in data charts to create a care ethics framework and definition for midwifery practice.

Method: The scoping review was conducted according to the Preferred Reporting …

Cardiorespiratory Fitness Is A Risk Factor For Lower-Limb And Back Injury In Law Enforcement Officers Commencing Their Basic Training: A Prospective Cohort Study, Myles C. Murphy, Nicole Merrick, Andrea B. Mosler, Garth Allen, Paola Chivers, Nicolas H. Hart

Physiotherapy Papers and Journal Articles

We aimed to report the epidemiology of lower-limb and lumbosacral injuries in Police Force recruits. We performed a cohort study of Police Force recruits undergoing a six-month training program with prospective injury data collected between 2018 and 2021. Cardiorespiratory fitness was quantified by the beep-test and police-specific-functional-capacity was quantified using a specifically designed physical performance evaluation (PPE) tool. Injury frequency and prevalence were reported. Fifteen percent (n = 180) of study Police Force recruits (n = 1,181) sustained a lower-limb or lumbosacral injury. The six-month training program significantly improved cardiorespiratory fitness (p < 0.001) and functional capacity (p < 0.001). Increased cardiorespiratory fitness at baseline decreased injury risk (OR = 0.8, 95%CI: 0.66–0.97, p = 0.019). Injury rates decreased over time and females were injured significantly earlier than males (HR = 0.70, 95%CI: 0.52 to 0.95, p = 0.021). Interventions that can pre-condition Police Force recruits prior to the commencement of their basic physical training may reduce the number of lower-limb and lumbosacral injuries.

Repeat Anterior Cruciate Ligament Injury And Return To Sport In Australian Soccer Players After Anterior Cruciate Ligament Reconstruction With Hamstring Tendon Autograft, Jonathan R. Manara, Lucy J. Salmon, Faisal M. Kilani, Gerardo Zelaya De Camino, Claire Monk, Keran Sundaraj, Leo A. Pinczewski, Justin P. Roe

Medical Papers and Journal Articles

Background: Soccer is the most commonly played team sport in the world and a high-risk sport for anterior cruciate ligament (ACL) injury and subsequent ACL reconstruction (ACLR).

Purpose: To assess the rate of further ACL injury in patients who have undergone ACLR with hamstring tendon autograft after soccer injuries in Australia and to determine factors associated with repeat ACL injury and return to soccer.

Study Design: Case-control study; Level of evidence, 3.

Methods: From a prospectively collected database, a series of 1000 consecutive ACLRs using hamstring autografts performed in soccer players were identified. Patients were surveyed at a minimum 5 …

Designing And Evaluating Falls Prevention Education With Residents And Staff In Aged Care Homes: A Feasibility Study, Jacqueline Francis-Coad, Tessa Watts, Caroline Bulsara, Anne-Marie Hill

IHR Papers and Journal Articles

Purpose: The purpose of this study was to co-design a falls prevention education programme with aged care home residents and staff and evaluate its feasibility. The intention of providing the education programme was to assist residents to stay safe and mobile whilst reducing their risk of falling.

Design/methodology/approach: A two-phase mixed methods participatory design using a resident (n = 6) and care staff (n = 5) consumer engagement panel, pre- and post-programme resident (n = 35) survey and semi-structured care staff interviews (n = 8) was undertaken in two countries.

Findings: A poster, brochure, video and staff education guide featuring …

An Investigation Of Registered Nurses’ Knowledge And Decision-Making Processes In Relation To The Management Of Adults With Diabetic Ketoacidosis, Megan Alice Westphalen

Theses

Introduction: Diabetic ketoacidosis (DKA) is an acute complication of diabetes. Registered nurses (RNs) knowledge with regard to DKA has never been investigated in any depth, nor has their decision making ever been examined in this specific context.

Research Significance: Nursing research literature acknowledges that nurses have an important role in the management of patient with DKA. However, there is very little empirical evidence available to support this claim. The purpose of this study is to provide evidence of the level of knowledge, the decision-making processes and the factors that influence nurses’ decision making whilst managing patients with DKA.

Methodology: A …

A Study On Post-Burn Healing: Optimising Scar Outcome Through The Use Of A Silicone-Based Film-Forming Wound Dressing, Fiona Poelchow

Theses

Introduction

The development of scarring is a normal physiological response during burn wound healing for any except the most trivial of injuries. Burn scarring can cause considerable functional and psychological anguish in burn survivors. Prolonged wound healing has been shown to affect scarring outcomes. Superficial cutaneous wound injuries carry a risk of scarring and altered pigmentation after the wound has healed. The primary aim of this study was to explore the effects of topical silicone on the rate of wound healing in superficial wounds. Secondary aims included investigation of scar and pain outcomes.

Methods

This thesis presents two studies which …

The Accuracy And Validity Of Self-Reported Throwing Loads And The Characteristics Of Throws By Elite Cricket Players In Australia, Zachariah G. Hoyne

Theses

Objectives: To determine the relationship between elite cricket player’s self-reported and independently observed throwing volume. Examine whether sex, playing position, or time to upload self-reported data post training influences the accuracy of self-reported throwing loads. Describe the type and number of throws performed during elite cricket training, and identify characteristics such as type, distance and accuracy of throws.

Design: Cross-sectional study.

Methods: A total of eight female and 18 male professional cricket players participated in the study. Overarm throws from 12 training sessions during the 2020-21 cricket year were observed. Player self-reported throwing volume data were retrieved …

Personalised Antimicrobial Dosing In Paediatric Cystic Fibrosis, Sahand Imani

Theses

Children with cystic fibrosis (CF) are predisposed to recurrent pulmonary exacerbations throughout their lifetime. This is characterised by an acute worsening of respiratory symptoms in the setting of bacterial infection and results in significant morbidity and mortality. Appropriate antimicrobial therapy is fundamental to management, in particular aminoglycoside antibiotics. Tobramycin is the preferred aminoglycoside of choice, usually administered intravenously for 7 to 14 days.

Tobramycin dosing can be challenging in patients with CF. This is due to the underlying pharmacokinetic derangements (e.g., volume of distribution, organ function) frequently observed in this population. Accordingly, the use of standard dosing (based on age …

Does Acupuncture/Dry Needling Improve Pain And Itch In Abnormal Hypertrophic Scars, Catherine Tuckey

Theses

This research program investigated the use of acupuncture intervention as an adjunct for hypertrophic scar (HTS) management. Mechanistic evidence from ex vivo and animal studies suggests that acupuncture has the potential to modulate neurogenic inflammation to influence pain and itch associated with HTS. Further, acupuncture may mediate non-neuronal cells involved in the proliferation and remodelling stage of healing to promote scar maturation. Previous studies using acupuncture for scar management demonstrated positive outcomes, however low-quality clinical trials and case studies provide limited evidence for treatment benefit.

A treatment protocol was designed to investigate the effects of locally applied acupuncture compared to …

From Isolation To Inclusion: Embracing Local Perspectives In Examining The Treatment Model Of Care For Aboriginal Persons Affected By Tuberculosis Or Leprosy In The Kimberley Region, North Western Australia, Stefanie Jane Oliver

Theses

In the remote Kimberley region of North Western Australia, tuberculosis (TB) and leprosy continue to affect a small number of Aboriginal people, despite historical efforts to eliminate either disease. Treatment, predominantly antibiotic therapy, is a principal therapeutic intervention used to cure TB and leprosy and halt infection transmission. Decisions made around treatment therefore impact not only the individual person affected, but also their families and communities. The well-worn models of Directly Observed Therapy (DOT) and case management are used nationally to assist treatment continuity and completion. Neither model has been substantiated for cultural appropriateness nor for meeting the specific needs …

Influence Of Age And Maturation Status On Sprint Acceleration Characteristics In Junior Australian Football, Toby Edwards, Jonathon Weakley, Harry G. Banyard, Ashley Cripps, Benjamin Piggott, G. Gregory Haff, Christopher Joyce

Health Sciences Papers and Journal Articles

This study aimed to investigate the influence of chronological age and maturation status on sprint acceleration characteristics in junior Australian football (AF) players. Biological maturity of 109 subjects was assessed and subjects were grouped according to predicted years from peak height velocity (PHV) (pre-, mid-, and post-PHV) and chronological age (13 years, 14 years, and 15 years). A one-way multivariate analysis of variance and magnitude-based decisions were used to determine between-group differences. Instantaneous velocity was measured during two maximal 30m sprints via radar gun with the velocity-time data used to derive the force, velocity, and power characteristics. Chronologically, the greatest …

Employability As Sustainable Balance Of Stakeholder Expectations - Towards A Model For The Health Professions, Martin Cake, Melinda Bell, Liz Mossop, Caroline F. Mansfield

Health Sciences Papers and Journal Articles

The conceptual complexity of employability remains a barrier for its integration into discipline-based curricula. In the health professions, a particular challenge lies in integrating employability with the dominant paradigms of competency and professionalism. In this study, we explore these contextual challenges, and present the rationale and conceptual basis for a potential re-framing of employability within the context of this discipline group. We propose a novel definition and a conceptual model of employability better aligned to the needs of health professions. While employability has proven difficult to define broadly, it is framed around the expectations of both the employer and employee, …

Confidence, Interest And Intentions Of Final-Year Nursing Students Regarding Employment In General Practice, Kaara Ray B. Calma, Susan Mcinnes, Elizabeth Halcomb, Anna Williams, Marijka Batterham

Nursing Papers and Journal Articles

Background: Rising health care burden has increased demand for general practice nurses. Exploring final-year nursing students’ perceived levels of confidence, interest and intention to work in this area can inform preparation and recruitment of new graduates into this workforce.

Aim: To explore final-year nursing students’ confidence, interest and intention to work in general practice.

Methods: Final-year nursing students from five universities situated in New South Wales, Australia were surveyed between March and June 2019. The survey comprised investigator-developed questions and validated tools adapted for use in general practice.

Findings: Of the 355 included responses, 34.1% respondents had a clinical placement …

Self-Reported Measures Of Training Exposure: Can We Trust Them, And How Do We Select Them?, Myles Murphy, Philip Glasgow, Andrea Britt Mosler

Physiotherapy Papers and Journal Articles

Editorial

Do People With Unilateral Mid-Portion Achilles Tendinopathy Who Participate In Running-Related Physical Activity Exhibit A Meaningful Conditioned Pain Modulation (Cpm) Effect: A Pilot Study, Myles C. Murphy, Ebonie K. Rio, Paola Chivers, James Debenham, Sean I. Docking, Mervyn Travers, William Gibson

Physiotherapy Papers and Journal Articles

Objectives: Our primary objective was to report the presence of a conditioned pain modulation (CPM) effect in people with localised mid-portion Achilles tendinopathy and whether changes occur over a 12- week period. Our secondary objectives were to quantify the proportion of participants who present for tendinopathy research with previous interventions or co-morbidities, which may impact the CPM-effect and investigate modulating factors.

Design: Prospective, observational cohort pilot study. Method: 215 participants presented for this Achilles tendinopathy research and were screened for inclusion with nine being included. Included participants had the CPM-effect (cold-pressor test) assessed using pressure pain thresholds at the Achilles …

Quantification Of The Negative Impact Of Sedation And Inotropic Support On Achieving Early Mobility In Burn Patients In Icu: A Single Center Observational Study, Lauren Bright, Lisa Van Der Lee, Dana Hince, Fiona M. Wood, Dale W. Edgar

IHR Papers and Journal Articles

Introduction: Early rehabilitation for burns survivors in the intensive care unit (ICU) is arguably more challenging than the general population. Early achievement of functional verticality milestones (FVMs) has the potential to ameliorate the detrimental effects of bed rest and immobility observed in ICU patients and reduce healthcare costs. However, the time to achieving FVMs after burn injury is influenced by factors such as sedation practices, cardiovascular stability, mechanical ventilation, acute skin reconstruction and length of stay (LOS) during the acute intensive care period.

Objectives/Aims: The aims of this study were to identify the association between early achievement of FVMs and …

Parent Carer Quality Of Life And Night-Time Attendance In Non-Ambulant Youth With Neuromuscular Disorders, Vivienne Travlos, Shane Patman, Jenny Downs, Dana Hince, Andrew C. Wilson

Physiotherapy Papers and Journal Articles

Purpose: To describe and explore carer quality of life (QoL) and night-time attendance to their child in parents of non-ambulant youth with Neuromuscular Disorders.

Methods: A cross-sectional population-based, comprehensive survey including the Adult Carer QoL (ACQoL) questionnaire, measures of social context and youths’ physical status. Associations between carerQoL or frequency of parents’ night-time attendance with independent variables were explored using linear and logistic regression models, respectively.

Results: Parents’ perceived lower carer-QoL (mean 76.5/120, SD 18.5) when they attended to their child twice a night or more (n = 17/35) and with shorter time since their child was prescribed noninvasive ventilation …

The Efficacy Of Resistance Training In Addition To Usual Care For Adults With Acute Burn Injury: A Randomised Controlled Trial, Paul M. Gittings, Benedict M. Wand, Dana A. Hince, Tiffany L. Grisbrook, Fiona M. Wood, Dale W. Edgar

Physiotherapy Papers and Journal Articles

Resistance training immediately after a burn injury has not been investigated previously. This randomised, controlled trial assessed the impact of resistance training on quality of life plus a number of physical, functional and safety outcomes in adults with a burn injury. Patients were randomly assigned to receive, in addition to standard physiotherapy, four weeks of high intensity resistance training (RTG) or sham resistance training (CG) three days per week, commenced within 72h of the burn injury. Outcome data was collected at six weeks, three and six months after burn injury. Quality of life at 6 months was the primary endpoint. …

Are You Translating Research Into Clinical Practice? What To Think About When It Does Not Seem To Be Working, Myles Calder Murphy, William Gibson, G. Lorimer Moseley, Ebonie Kendra Rio

Physiotherapy Papers and Journal Articles

Introduction : The value of clinical research can be lost in translation and implementation. One often overlooked issue is whether clinicians can determine if their patient is similar to research participants and, ipso facto, whether the clinician treating that patient will have the same effects as what was reported in a research study. We present five questions and clinical tips for clinicians.

Do People With Acute Low Back Pain Have An Attentional Bias To Threat-Related Words?, Ian Skinner, Markus Hubscher, Hopin Lee, Adrian C. Traeger, G. Lorimer Moseley, Benedict M. Wand, Sylvia M. Gustin, James H. Mcauley

Physiotherapy Papers and Journal Articles

Objectives: It has been hypothesised that attentional bias to environmental threats can contribute to persistent pain. It is unclear whether people with acute low back pain (LBP) have an attentional bias to environmental threats. We investigated if attentional bias of threat related words is different in people with acute LBP and pain-free controls.

Methods: People with acute LBP and pain-free people completed a free viewing eye tracking task. Participants were simultaneously presented with two words, a threat related word and a neutral control word. Threat related words were general threat, affective pain and sensory pain. We conducted linear mixed models …

Identifying Participants With Knee Osteoarthritis Likely To Benefit From Physical Therapy Education And Exercise: A Hypothesis-Generating Study, So Tanaka, Tomohiko Nishigami, Benedict Martin Wand, Tasha R. Stanton, Akira Mibu, Masami Tokunaga, Takaaki Yoshimoto, Takahiro Ushida

Physiotherapy Papers and Journal Articles

Background: The purpose of this investigation was to undertake a hypothesis generating study to identify candidate variables that characterize people with knee osteoarthritis who are most likely to experience a positive response to exercise.

Methods: One hundred and fifty participants with knee osteoarthritis participated in this observational, longitudinal study. All participants received a standard exercise intervention that consisted of 20-min sessions two to three times a week for three months. The classification and regression tree methodology (CART) was used to develop prediction of positive clinical outcome. Positive pain and disability outcomes (dependent variables) were defined as an improvement in pain …