Medicine and Health Sciences Commons^™

Design And Development Of A Theory-Informed Peer-Led Falls Prevention Education Programme To Translate Evidence Into Practice: A Systematic Approach, Linda Khong, Richard G. Berlach, Keith D. Hill, Anne-Marie Hill

Health Sciences Papers and Journal Articles

Peer-led education has been shown to be an effective approach for raising community-dwelling older adults’ beliefs, knowledge and intention to engage in falls prevention strategies in a recent intervention trial. This article outlines the design and development of the intervention, which was a peer-led falls prevention education programme designed to promote older adult’s motivation to change their behaviour in the area of falls prevention. The elements of the programme that contributed to its efficacy are also described. The programme was designed using a four-step approach and was based on the constructs of a theoretical framework (the COM-B model). Feedback from …

Time For Change: Fitness And Strength Can Be Improved And Sustained In Adolescents With Low Motor Competence, Beth Hands, Paola Chivers, Tegan Grace, Fleur Mcintyre

Health Sciences Papers and Journal Articles

Background: There are few exercise interventions focused on adolescents with low motor competence and most interventions are short with little follow up and engagement over time.

Methods and procedures: Fifty-eight adolescents with low motor competence (39 males, Mean Age=13.6, SD=1.4 years) attended an exercise clinic twice a week for each 13 week program. Two programs ran each year, and participants attended for as long as they felt progress was made or they turned 18 years of age. Performance on the Multistage Fitness Test (MSFT), Curl-ups, Grip Strength, 1RM Leg press and Chest Press, Vertical Jump and Standing Broad Jump (SBJ) …

Mechanical Suppression Of Osteolytic Bone Metastases In Advanced Breast Cancer Patients: A Randomised Controlled Study Protocol Evaluating Safety, Feasibility And Preliminary Efficacy Of Exercise As A Targeted Medicine, Nicolas H. Hart, Daniel A. Galvao, Christobel Saunders, Dennis R. Taaffe, Kynan T. Feeney, Nigel A. Spry, Daphne Tsoi, Hilary Martin, Raphael Chee, Tim Clay, Andrew D. Redfern, Robert U. Newton

Health Sciences Papers and Journal Articles

Background: Skeletal metastases present a major challenge for clinicians, representing an advanced and typically incurable stage of cancer. Bone is also the most common location for metastatic breast carcinoma, with skeletal lesions identified in over 80% of patients with advanced breast cancer. Preclinical models have demonstrated the ability of mechanical stimulation to suppress tumour formation and promote skeletal preservation at bone sites with osteolytic lesions, generating modulatory interference of tumour-driven bone remodelling. Preclinical studies have also demonstrated anti-cancer effects through exercise by minimising tumour hypoxia, normalising tumour vasculature and increasing tumoural blood perfusion. This study proposes to explore the promising …

Efficacy Of A Platelet-Rich Plasma Injection For The Treatment Of Proximal Hamstring Tendinopathy: A Pilot Study, Gavin M. Levy, Phil Lucas, Nigel Hope

Sciences Papers and Journal Articles

Objectives: To determine the efficacy of an ultrasound-guided platelet-rich plasma (PRP) injection in the treatment of patients with proximal hamstring tendinopathy (PHT).

Design: Pilot prospective cohort study

Methods: Administration of a single PRP injection under ultrasound guidance to 29 patients with PHT confirmed on magnetic resonance imaging (MRI). Pain, function and sporting activity were measured via the Victorian Institute of Sport Assessment-Proximal Hamstring Tendons (VISA-H) questionnaire, administered before injection and at 8-weeks follow-up.

Results: The study sample consisted of 22 females and 7 males with a mean age of 45.2 years (95% CI40.8–49.5). When comparing pre-injection VISA-H scores (mean: 43.90; …

Addressing Challenges In Gaining Informed Consent For A Research Study Investigating Falls In People With Intellectual Disability, Portia Ho, Caroline Bulsara, Shane Patman, Jenny Downs, Anne-Marie Hill

Nursing Papers and Journal Articles

Background: People with intellectual disability encounter multiple barriers to accessing quality, evidence based health care which is detrimental to their quality of life (Qol) and mortality. Engaging people with intellectual disability when conducting research is vital to address these QoL issues. People with intellectual disability have the right to engage in research pertinent to them but at present, they are under-represented in research and there are limited methods available to ensure that people with intellectual disability are fully supported to provide informed consent. Therefore the aim of this paper is to describe an informed consent process and reflect on the …

Evaluating The Impact Of A Falls Prevention Community Of Practice In A Residential Aged Care Setting: A Realist Approach, J Francis-Coad, C Etherton-Beer, C Bulsara, N Blackburn, P Chivers, A Hill

Physiotherapy Papers and Journal Articles

Background: Falls are a major socio-economic problem among residential aged care (RAC) populations resulting in high rates of injury including hip fracture. Guidelines recommend that multifactorial prevention strategies are implemented but these require translation into clinical practice. A community of practice (CoP) was selected as a suitable model to support translation of the best available evidence into practice, as it could bring together likeminded people with falls expertise and local clinical knowledge providing a social learning opportunity in the pursuit of a common goal; falls prevention. The aims of this study were to evaluate the impact of a falls prevention …

Evaluating The Impact Of Operating A Falls Prevention Community Of Practice On Falls In A Residential Aged Care Setting, Jacqueline Francis-Coad, Terry Haines, Christopher Etherton-Beer, Debbie Nobre, Anne-Marie Hill

Physiotherapy Papers and Journal Articles

Background/Purpose: Falls are a leading adverse event in residential aged care (RAC) settings with prevention a global aim. The purpose of this study was to determine whether operating a falls prevention community of practice (CoP) delivering evidence-based prevention interventions could change the rate of falls and injurious falls in a RAC setting.

Methods: A prospective quasi-experimental pre/post design was conducted. Participants were 13 RAC sites (779 beds) of a single RAC organization, with 20 multidisciplinary staff volunteering as CoP members.

Results: Falls rates pre CoP were 10.1/1,000 occupied bed days (OBD) compared with 10.9 /1,000 OBD post CoP operation [coefficient …

Evaluation Of Older People's Knowledge, Awareness, Motivation And Perceptions About Falls And Falls Prevention In Residential Aged Care Homes: A Tale Of Two Cities, Jacqueline Francis-Coad, Tessa Watts, Christopher Etherton-Beer, Gerwyn Panes, Howard Griffiths, Michelle Anderson, Tracy Williams, Beth Griffiths, Debbie Nobre, Anne-Marie Hill

Physiotherapy Papers and Journal Articles

Falls prevention strategies can only be effective in reducing falls amongst older people if they are adopted and enacted in their daily lives. There is limited evidence identifying what older people in residential aged care (RAC) homes understand about falls and falls prevention, or what may limit or enable their adoption of strategies. This study was conducted in two countries and explored older people’s knowledge and awareness of falls and their preferences, opportunities and motivation to undertake falls prevention strategies. A cross-sectional survey was administered to participants (N = 70) aged 65 years and over, living in six RAC homes …

Impact Of Tailored Falls Prevention Education For Older Adults At Hospital Discharge On Engagement In Falls Prevention Strategies Postdischarge: Protocol For A Process Evaluation, Chiara Naseri, Steven M. Mcphail, Julie Netto, Terrence P. Haines, Meg E. Morris, Christopher Etherton-Beer, Leon Flicker, Den-Ching A. Lee, Jacqueline Francis-Coad, Anne-Marie Hill

Physiotherapy Papers and Journal Articles

Introduction: Older adults recently discharged from hospital have greater incidence of adverse events, functional decline, falls and subsequent readmission. Providing education to hospitalised patients on how to prevent falls at home could reduce postdischarge falls. There has been limited research investigating how older adults respond to tailored falls prevention education provided at hospital discharge. The aim of this study is to evaluate how providing tailored falls prevention education to older patients at the point of, and immediately after hospital discharge in addition to usual care, affects engagement in falls prevention strategies in the 6-months postdischarge period, including their capability and …

Healing Conversations: Developing A Practical Framework For Clinical Communication Between Aboriginal Communities And Healthcare Practitioners, Andrea Mckivett, David Paul, Nicky Hudson

Medical Papers and Journal Articles

In recognition of the ongoing health disparities experienced by Aboriginal and Torres Strait Islander peoples (hereafter Aboriginal), this scoping review explores the role and impact of the clinical communication process on Aboriginal healthcare provision. A medical education lens is applied, looking at the utility of a tailored clinical communication framework to assist health practitioners work more effectively with Aboriginal peoples and communities. The initial framework, building on existing communication guides, proposes four domains: content, process, relational and environmental. It places emphasis on critical self-reflection of the health practitioner’s own cultural identity and will be guided by collective Aboriginal world-views in …

Educating For Indigenous Health Equity: An International Consensus Statement, Rhys Jones, Lynden Crowshoe, Papaarangi Reid, Betty Calam, Elana Curtis, Michael Green, Tania Huria, Kristen Jacklin, Martina Kamaka, Cameron Lacey, Jill Milroy, David Paul, Suzanne Pitama, Leah Walker, Gillian Webb, Shaun Ewen

Medical Papers and Journal Articles

The determinants of health inequities between Indigenous and non-Indigenous populations include factors amenable to medical education’s influence, for example, the competence of the medical workforce to provide effective and equitable care to Indigenous populations. Medical education institutions have an important role to play in eliminating these inequities. However, there is evidence that medical education is not adequately fulfilling this role, and in fact may be complicit in perpetuating inequities.

This article seeks to examine the factors underpinning medical education’s role in Indigenous health inequity, in order to inform interventions to address these factors. The authors developed a consensus statement that …

Critically Appraised Paper: Preoperative Physiotherapy Education Halved Postoperative Pulmonary Complications In Patients After Upper Abdominal Surgery [Commentary], Shane Patman

Physiotherapy Papers and Journal Articles

No abstract available for this paper.

Investigating Falls In Adults With Intellectual Disability Living In Community Settings And Their Experiences Of Post-Fall Care Services: Protocol For A Prospective Observational Cohort Study, Portia Ho, Caroline Bulsara, Shane Patman, Max Bulsara, Jenny Downs, Anne-Marie Hill

Physiotherapy Papers and Journal Articles

Background: Falls among older adults with intellectual disability (ID) are recognised as a serious health problem potentially resulting in reduced health-related quality of life and premature placement in residential care. However there are limited studies that have investigated this problem and thus falls rates among older adults with ID remain uncertain. Furthermore, people with ID rely heavily on familial and professional care support to address health problems, such as after having a fall. No studies have explored the post-fall care that people with ID receive.

Method: This research will be carried out in two phases using a convergent mixed methods …

What’S Old Is New Again: The Sacroiliac Joint As A Cause Of Lateralizing Low Back Pain, Jennifer Saunders, Manuel Cusi, Hans Van Der Wall

Medical Papers and Journal Articles

It has not been easy to identify mechanical failure of the sacroiliac joint (SIJ) with traditional imaging. The integrated model of function (Lee and Vleeming, 1998) suggests that under normal circumstances, form and force closure combined contribute to sacral nutation and “locking” the SIJ for optimal load transfer. This model is supported by clinical evidence and scintigraphic findings that contribute to successful therapy in 80% of cases. Single-photon emission computed tomography and x-ray computed tomography (SPECT-CT), a hybrid device, was used in a study of 1200 patients (64% female and 36% male patients with an average age of 42 years; …

Improving The Validity Of Script Concordance Testing By Optimising And Balancing Items, Michael Wan, Elina Tor, Judith Nicky Hudson

Medical Papers and Journal Articles

Background: A script concordance test (SCT) is a modality for assessing clinical reasoning. Concerns had been raised about the plausible validity threat to SCT scores if students deliberately avoided the extreme answer options to obtain higher scores. The aims of the study were firstly to investigate whether students’ avoidance of the extreme answer options could result in higher scores, and secondly to determine whether a ‘balanced approach’ by careful construction of SCT items (to include extreme as well as median options as model responses) would improve the validity of an SCT.

Methods: Using the paired sample t-test, the actual average …

Embodying The Illusion Of A Strong, Fit Back In People With Chronic Low Back Pain. A Pilot Proof-Of-Concept Study, Tomohiko Nishigami, Benedict Wand, Roger Newport, Natasha Ratcliffe, Kristy Themelis, David Moen, Cat Jones, G Lorimer Moseley, Tasha R. Stanton

Physiotherapy Papers and Journal Articles

Objective: This proof-of-concept pilot study aimed to investigate if a visual illusion that altered the size and muscularity of the back could be embodied and alter perception of the back.

Methods: The back visual illusions were created using the MIRAGE multisensory illusion system. Participants watched real-time footage of a modified version of their own back from behind. Participants undertook one experimental condition, in which the image portrayed a muscled, fit-looking back (Strong), and two control conditions (Reshaped and Normal) during a lifting task. Embodiment, back perception as well as pain intensity and beliefs about the back during lifting were assessed. …

Grip And Muscle Strength Dynamometry In Acute Burn Injury: Evaluation Of An Updated Assessment Protocol, Paul M. Gittings, Dana A. Hince, Benedict M. Wand, Fiona M. Wood, Dale W. Edgar

Physiotherapy Papers and Journal Articles

External stabilization is reported to improve reliability of hand held dynamometry, yet this has not been tested in burns. We aimed to assess the reliability of dynamometry using an external system of stabilization in people with moderate burn injury and explore construct validity of strength assessment using dynamometry.

Participants were assessed on muscle and grip strength three times on each side. Assessment occurred three times per week for up to four weeks. Within session reliability was assessed using intraclass correlations calculated for within session data grouped prior to surgery, immediately after surgery and in the sub-acute phase of injury. Minimum …

Trunk Muscle Activity During Drop Jump Performance In Adolescent Athletes With Back Pain, T. Palsson, J. Caneiro, R. Hirata, D. Griffin, William Gibson, Mervyn Travers

Physiotherapy Papers and Journal Articles

It was with great interest we read the recently published article “Trunk Muscle Activity during Drop Jump Performance in Adolescent Athletes with Back Pain.” Investigating back pain (BP) in adolescents is commendable as there is growing evidence that for many, an experience of BP as early as 14 years of age may relate to ongoing pain in adulthood (Coenen et al., 2017). Indeed, the conventional narrative is changing as individual physical factors such as posture, use of schoolbags, and hypermobility are only weakly associated with adolescent BP. Rather, factors which predict BP at a young age are considered to …

Visually-Induced Analgesia In A Deep Tissue Experimental Pain Model: A Randomised Cross-Over Experiment, Megan Van Selm, William Gibson, Mervyn Travers, Lorimer Moseley, Dana A. Hince, Benedict Wand

Physiotherapy Papers and Journal Articles

Background: Visualizing one’s own painful body part appears to have an effect on reported pain intensity. Furthermore, it seems that manipulating the size of the viewed image can determine the direction and extent of this phenomenon. When visual distortion has been applied to clinical populations the analgesic effects have been in opposition to those observed in some experimental pain models. To help resolve this problem we explored the effect of visualisation and magnification of the visual image on reported pain using a delayed onset muscle soreness (DOMS) pain model.

Methods: We induced DOMS in the quadriceps of 20 healthy volunteers. …

An Objective Measure For The Assessment And Management Of Fluid Shifts In Acute Major Burns, Pippa Kenworthy, Michael Phillips, Tiffany L. Grisbrook, William Gibson, Fiona M. Wood, Dale W. Edgar

Physiotherapy Papers and Journal Articles

Background: Major burns are life threatening. Fluid resuscitation is required for survival to maintain intravascular volumes and prevent hypovolemic shock. Bioimpedance spectroscopy (BIS) has been recognised as a potential method of monitoring fluid shifts after burn and in other disease states. The aims of this study were to examine the reliability of BIS across different dressing conditions and electrode positions, establish the influence of Acticoat™ on BIS variable measures and determine the validity of whole-body BIS to assess net fluid shift in the presence of moderate to major burns.

Methods: An observational longitudinal cohort study was conducted from December 2014 …

Paracetamol, Nsaids And Opioid Analgesics For Chronic Low Back Pain: A Network Meta-Analysis (Protocol), Matthew K. Bagg, Andrew J. Mclachlan, Christopher G. Maher, Steven J. Kamper, Christopher M. Williams, Nicholas Henschke, Benedict M. Wand, G L. Moseley, Markus Hubscher, Neil E. O'Connell, Maurits W. Van Tulder, Adriani Nikolakopoulou, James H. Mcauley

Physiotherapy Papers and Journal Articles

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows:

To answer the clinical question: ‘what analgesic medicine shall I prescribe this patient with chronic low back pain to reduce their pain?’.

The objectives are to determine the analgesic effects, safety, effect on function, and relative rank according to analgesic effect, safety and effect on function of a single course of opioid analgesics, NSAIDs or paracetamol or combinations of these medicines.

Expert Consensus For Respiratory Physiotherapy Management Of Mechanically Ventilated Adults With Community-Acquired Pneumonia: A Delphi Study, Lisa Van Der Lee, Anne-Marie Hill, Shane Patman

Physiotherapy Papers and Journal Articles

Rationale and aims: Patients with community‐acquired pneumonia (CAP) are frequently admitted to an intensive care unit. Physiotherapy may be provided to optimize respiratory function; however, there is significant variability in clinical practice and limited research directing best practice for this cohort. This study aimed to determine expert consensus for best physiotherapy practice for invasively ventilated adults with CAP.

Method: A modified Delphi technique involved an international expert panel completing three rounds of an online questionnaire. The initial 35‐statement questionnaire, based on a systematic literature review and survey of current clinical practice, covered physiotherapy assessment and treatment of intubated patients with …

Recent Data From Radiofrequency Denervation Trials Further Emphasise That Treating Nociception Is Not The Same As Treating Pain, Matthew K. Bagg, James H. Mcauley, G Lorimer Moseley, Benedict M. Wand

Physiotherapy Papers and Journal Articles

Chronic low back pain is a condition that current health care provision is failing and we suggest that recent evidence from the interventional pain medicine field points to what these failings are. Radiofrequency denervation is performed on the presumption that denervation of a peripheral structure will eradicate or significantly reduce pain and improve function. The results of six moderately sized and well conducted clinical trials that demonstrate no efficacy and no real-world effectiveness for denervation procedures are a stark illustration of how flawed this approach is. We suggest that these results represent a line-in-the-sand for back pain research and management. …

Non-Invasive Brain Stimulation Techniques For Chronic Pain, Neil E. O'Connell, Louise Marston, Sally Spencer, Lorraine H. Desouza, Benedict M. Wand

Physiotherapy Papers and Journal Articles

Stimulating the brain without surgery in the management of chronic pain in adults

Bottom line: There is a lack of high-quality evidence to support or refute the effectiveness of non-invasive brain stimulation techniques for chronic pain.

Background: Electrical stimulation of the brain has been used to address a variety of painful conditions. Various devices are available that can electrically stimulate the brain without the need for surgery or any invasive treatment. There are five main treatment types: repetitive transcranial magnetic stimulation (rTMS) in which the brain is stimulated by a coil applied to the scalp, cranial electrotherapy stimulation (CES) in …

Is Heavy Eccentric Calf Training Superior To Wait-And-See, Sham Rehabilitation, Traditional Physiotherapy And Other Exercise Interventions For Pain And Function In Mid-Portion Achilles Tendinopathy?, Myles Murphy, Mervyn Travers, William Gibson

Physiotherapy Papers and Journal Articles

Background: Mid-portion Achilles tendinopathy (AT) is prevalent amongst athletic and non-athletic populations with pain, stiffness and impaired function typically reported. While different management options exist, loading protocols remain the best available intervention and have been shown to be effective in the management of AT. Trials investigating loading in AT have used a variety of different protocols, and recent narrative reviews suggest that no protocol is superior to another when comparing outcomes in pain and function. However, there has been no systematic review or meta-analysis completed to determine this. Furthermore, the narrative review did not consider wait-and-see or sham interventions, thus …

Reducing Falls In Older Adults Recently Discharged From Hospital: A Systematic Review And Meta-Analysis, Chiara Naseri, Terry P. Haines, Christopher Etherton-Beer, Steven Mcphail, Meg E. Morris, Leon Flicker, Julie Netto, Jacqueline Francis-Coad, Den-Ching A. Lee, Ronald Shorr, Anne-Marie Hill

Physiotherapy Papers and Journal Articles

Background: Older adults are known to have increased falls rates and functional decline following hospital discharge, with substantial economic healthcare costs. This systematic review aimed to synthesise the evidence for effective falls prevention interventions in older adults recently discharged from hospital.

Methods: Literature searches of six databases of quantitative studies conducted from 1990 to June 2017, reporting falls outcomes of falls prevention interventions for community-dwelling older adults discharged from hospital were included. Study quality was assessed using a standardised JBI critical appraisal tool (MAStARI) and data pooled using Rev-Man Review Manager®

Results: Sixteen studies (total sample size N= 3,290, from …

The Translation, Validity And Reliability Of The German Version Of The Fremantle Back Awareness Questionnaire, Katja Ehrenbrusthoff, Cormac G. Ryan, Christian Gruneberg, Benedict Wand, Denis J. Martin

Physiotherapy Papers and Journal Articles

Background: The Fremantle Back Awareness Questionnaire (FreBAQ) claims to assess disrupted self-perception of the back. The aim of this study was to develop a German version of the Fre-BAQ (FreBAQ-G) and assess its test-retest reliability, its known-groups validity and its convergent validity with another purported measure of back perception.

Methods: The FreBaQ-G was translated following international guidelines for the transcultural adaptation of questionnaires. Thirty-five patients with non-specific CLBP and 48 healthy participants were recruited. Assessor one administered the FreBAQ-G to each patient with CLBP on two separate days to quantify intra-observer reliability. Assessor two administered the FreBaQ-G to each patient …

Mental Wellbeing In Non-Ambulant Youth With Neuromuscular Disorders: What Makes The Difference?, Vivienne Travlos, Jenny Downs, Andrew Wilson, Dana Hince, Shane Patman

Physiotherapy Papers and Journal Articles

The physical and social challenges associated with neuromuscular disorders may impact mental wellbeing in non-ambulant youth during the more vulnerable period of adolescence. This cross-sectional survey investigated non-ambulant youths’ mental wellbeing and relationships with physical health, participation and social factors. The conceptual model was the International Classification of Functioning, Disability and Health (ICF). Thirty-seven youth aged 13 – 22 years old (mean age 17.4 years; n = 30 male; n = 24 Duchenne Muscular Dystrophy) and their parents provided biopsychosocial data through a comprehensive self-report questionnaire. The primary outcome measure was the Warwick Edinburgh Mental Wellbeing Scale (WEMWBS). Relationships between …

Culturally And Linguistically Diverse Palliative Care Patients' Journeys At The End-Of-Life, Anna Green, Natalia Jerzmanowska, Marguerite Green, Elizabeth Lobb

Medical Papers and Journal Articles

Objective: To understand the clinical and psychosocial journey of culturally and linguistically diverse (CALD) palliative care patients.

Method: This study was conducted at a subacute hospital with a specialist palliative care unit and a community palliative care service in a metropolitan region of New South Wales, Australia. Medical records of 100 deceased patients from CALD backgrounds over a 12-month period from 2014 to 2015 were recorded on a data mining tool. The cohort had transitioned to either community or inpatient palliative care services with a life-limiting illness. We used descriptive statistical analyses to identify the patients’ end-of-life journeys in the …

Community Peer-Led Falls Prevention Presentations: What Do The Experts Suggest?, Linda Khong, Richard G. Berlach, Keith D. Hill, Anne-Marie Hill

IHR Papers and Journal Articles

Falls among older adults are a major problem. Despite considerable progress in falls prevention research, older adults often show low motivation to engage in recommended preventive strategies. Peer-led falls prevention education for older adults may have potential for bridging the research evidence-practice gap, thereby promoting the uptake of falls prevention strategies. We evaluated peer educators’ presentations of falls prevention education to community-dwelling older adults in regard to established criteria that were consistent with adult learning principles, the framework of health behaviour change, falls prevention guidelines, and recommendations for providing falls prevention information. We conducted a within-stage mixed model study using …