Rehabilitation and Therapy 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 …

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 …

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 …

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.

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 …

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 …

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. …

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 …

Stable Lateral Meniscal Posterior Root Tears Left In Situ At Time Of Anterior Cruciate Ligament Reconstruction Are Of Minimal Long-Term Clinical Detriment, Sarah J. Shumborski, Lucy J. Salmon, Claire I. Monk, Leo A. Pinczewski

Physiotherapy Papers and Journal Articles

Purpose: The purpose of this study was to compare long-term patient-reported outcomes in patients undergoing anterior cruciate ligament (ACL) reconstruction with untreated stable lateral meniscal posterior root (LMPR) tears to those with an intact meniscus.

Methods: Four hundred ninety-two subjects were followed for a minimum of 15-years posteACL reconstruction and evaluated by an International Knee Documentation Committee questionnaire. The integrity of the meniscus was classified at surgery. Patients were grouped as either untreated injury to LMPR “with stable tear” (WST) group (n ¼ 52) or intact lateral meniscus “no tear” (NT) group (n ¼ 440). WST group included tears where …

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 …

What Do People Post On Social Media Relative To Low Back Pain? A Content Analysis Of Australian Data, Edel T. O'Hagan, Adrian C. Traeger, Samantha Bunzli, Hayley B. Leake, Siobhan M. Schabrun, Benedict Wand, Sean O'Neill, Ian A. Harris, James H. Mcauley

Physiotherapy Papers and Journal Articles

Objective: Low back pain is the leading contributor to the global disability burden. The Global Spine Care Initiative (GSCI) recommend patient-centred care to stem the cost of low back pain. One way to enhance patientcentred care is by better understanding what is relevant for people with low back pain. Exploring social media posts about low back pain could offer this insight and provide valuable information for health care professionals to facilitate active participation in patient-centred care.

Methods: We used an inductive content analysis method. In the form of social media posts, data on Twitter and Instagram were collected from June …

Implicit Motor Imagery Of The Foot And Hand In People With Achilles Tendinopathy: A Left Right Judgement Study, Ebonie K. Rio, Tasha Stanton, Benedict Wand, James Debenham, Jill Cook, Mark J. Catley, Lorimer Moseley, Prudence Butler, Kylie Cheng, Adrian Mallows, Monique V B Wilson, Michael Girdwood

Physiotherapy Papers and Journal Articles

Objective

To determine if impairment in motor imagery processes is present in Achilles tendinopathy (AT), as demonstrated by a reduced ability to quickly and accurately identify the laterality (left-right judgement) of a pictured limb. Additionally, this study aimed to use a novel data pooling approach to combine data collected at 3 different sites via meta-analytical techniques that allow exploration of heterogeneity.

Design

Multi-site case-control study.

Methods

Three independent studies with similar protocols were conducted by separate research groups. Each study-site evaluated left/right judgement performance for images of feet and hands using Recognise© software and compared performance between people with AT …

Implementing Skill Acquisition Research In High Performance Sport: Reflecting On The Importance Of Autonomy-Support For Successful Collaboration, Khaya Morris-Binelli, Sean Müller, Fleur E.C.A. Van Rens, Dave Staniforth, Brendyn Appleby, Simon M. Rosalie

Physiotherapy Papers and Journal Articles

Perceptual-cognitive-motor skills, such as visual anticipation, are pivotal for superior performance in sport. However, there are only a limited number of skill acquisition specialists working with coaches to develop these skills in athletes. The purpose of this paper is to present a brief reflection on the use of psychological strategies to create an autonomy-supportive environment to embed a skill acquisition research project in high-performance sport. The research project was conducted with the Australian national field hockey high-performance unit and investigated individual differences in expert goalkeepers’ visual anticipation. The paper first discusses the role of a skill acquisition specialist, how they …

Proactive Management Of Acute Oedema Following Hand And Minor Burn Injury, Dale O. Edwick

Theses

Burn injury is a unique trauma. The inflammatory process initiated with burn injury adversely influences all of the Starling equation variables, resulting in increased transvascular fluid filtration, so that oedema as a product of burn injury is more readily formed than in other forms of trauma. Localised wound oedema forms due to minor burn injury, with increasing systemic oedema associated with increased size of burn. It is now recognised that a marked inflammatory and immune response is created with non-severe burn injury, indicating a systemic component with all burns. The effect of oedema formation on the course of the burn …

The Influence Of A Positive Empathetic Interaction On Conditioned Pain Modulation And Manipulation Induced Analgesia In People With Lateral Epicondylalgia, Ahmad Muhsen, Penny Moss, William Gibson, Bruce Walker, Angela Jacques, Stephan A. Schug, Anthony Wright

Physiotherapy Papers and Journal Articles

Objective: Conditioned pain modulation (CPM) and manipulation induced analgesia (MIA) are two forms of endogenous analgesia. Many forms of analgesia can be influenced by the nature of the patient clinician interaction. The aim of this study was to evaluate the influence of an empathetic and supportive interaction on CPM and MIA in people with Lateral Epicondylalgia (LE).

Methods: In a double-blind, randomised, controlled trial, 68 participants with LE were assigned to two groups: the empathetic and neutral interaction groups. The interactions were carried out by a trained, professional role play actor, playing the part of a research assistant (RA). The …

Referral Patterns To Continence Physiotherapy Services For Patients With Chronic Respiratory Conditions, Hannah Brien, Cath Bunting, Shane Patman

Physiotherapy Papers and Journal Articles

Chronic respiratory conditions are a widely recognised risk factor for urinary incontinence and current chronic respiratory condition management guidelines state that patients should be screened for urinary incontinence and referred to continence physiotherapists for treatment. This study aimed to firstly confirm anecdotal sentiment that referrals of these patients to continence physiotherapists are low; and, secondly, to investigate barriers to the referral of these patients. Two online de novo surveys were disseminated across the metropolitan area of Perth, Western Australia: one to continence physiotherapists (Survey A) to investigate referral rates, and the other to respiratory physiotherapists, respiratory physicians and general practitioner …

The Resolve Trial For People With Chronic Low Back Pain: Statistical Analysis Plan, Matthew K. Bagg, Serigne Lo, Aidan G. Cashin, Robert D. Herbert, Neil E. O'Connell, Hopin Lee, Markus Hubscher, Benedict M. Wand, Edel O'Hagan, Rodrigo R.N Rizzoli, G Lorimer Moseley, Tasha R. Stanton, Christopher G. Maher, Stephen Goodall, Sopany Saing, James H. Mcauley

Physiotherapy Papers and Journal Articles

Background: Statistical analysis plans describe the planned data management and analysis for clinical trials. This supports transparent reporting and interpretation of clinical trial results. This paper reports the statistical analysis plan for the RESOLVE clinical trial. The RESOLVE trial assigned participants with chronic low back pain to graded sensory-motor precision training or sham-control.

Results: We report the planned data management and analysis for the primary and secondary outcomes. The primary outcome is pain intensity at 18-weeks post randomization. We will use mixed-effects models to analyze the primary and secondary outcomes by intention-to-treat. We will report adverse effects in full. We …

The Association Of Working Alliance, Outcome Expectation, Adherence And Self-Efficacy With Clinical Outcomes For Achilles Tendinopathy: A Feasibility Cohort Study (The Map Study), Adrian Mallows, Jo Jackson, Chris Littlewood, James Debenham

Physiotherapy Papers and Journal Articles

Introduction: This study evaluated the feasibility of a large longitudinal cohort study utilizing an online platform to investigate the association and predictive relationship of working alliance, outcome expectations, adherence and self-efficacy with outcome in Achilles tendinopathy. The objectives were: (1) to determine the recruitment and retention rate and (2) to carry out preliminary data analysis of the selected variables and clinical outcomes.

Methods: A multi-centred, longitudinal feasibility cohort study was used. Eligible participants were directed to a bespoke online platform hosting study information and the outcome measures in the form of an online questionnaire. Responses from the online questionnaire were …

Clinical Validation Of Expert Consensus Statements For Respiratory Physiotherapy Management Of Invasively Ventilated Adults With Community-Acquired Pneumonia: A Qualitative Study, Lisa Van Der Lee, Anne-Marie Hill, Shane Patman

Physiotherapy Papers and Journal Articles

Objectives: To conduct multidisciplinary peer-review of expert consensus statements for respiratory physiotherapy for invasively ventilated adults with community-acquired pneumonia, to determine clinical acceptability for development into a clinical practice guideline.

Research methodology: A qualitative study was undertaken using focus groups (n = 3) conducted with clinician representatives from five Australian states. Participants were senior intensive care physiotherapists, nurses and consultants. Thematic analysis was used, with a deductive approach to confirm clinical validity, and inductive analysis to identify new themes relevant to the application of the 38 statements into practice.

Setting: Adult intensive care.

Findings: Senior intensive care clinicians from physiotherapy …

Systematic Reviews That Include Only Published Data May Overestimate The Effectiveness Of Analgesic Medicines For Low Back Pain: A Systematic Review And Meta-Analysis, Matthew K. Bagg, Edel O'Hagan, Pauline Zahara, Benedict Wand, Markus Hubscher, G. Lorimer Moseley, James H. Mcauley

Physiotherapy Papers and Journal Articles

Objective: Systematic reviews of analgesics for low back pain generally include published data only. Obtaining data from unpublished trials is potentially important because they may impact effect sizes in meta-analyses. We determined whether including unpublished data from trial registries changes the effect sizes in meta-analyses of analgesics for low back pain.

Study Design and Setting: Trial registries were searched for unpublished data that conformed to the inclusion criteria of n = 5 individual source systematic reviews. We reproduced the meta-analyses using data available from the original reviews and then reran the same analyses with the addition of new unpublished data. …

Understanding Falls In People With Intellectual Disability In Western Australia, Portia Ho

Theses

Adults with intellectual disability (ID) experience earlier age-related changes, compared with other age-matched populations, but concurrently their life expectancy is increasing. Falls often result in serious injuries and reduced health-related quality of life, however there is limited research regarding falls in older adults with ID. The purpose of this research was to investigate falls among community dwelling older adults with ID, including the epidemiology, risk factors and experiences when engaging with health services after a fall.

A meta-analysis of the incidence and prevalence of falls in adults with ID was initially conducted to inform the research aims. Prospective research was …

Outcomes Of Resistance Exercise Training In Adults With Acute Burn Injury, Paul M. Gittings

Theses

Decreased quality-of-life and impairments in physical function, muscle strength and muscle volume are known complications of a burn injury. As such, rehabilitation is an important aspect of the burn care journey. Rehabilitation of burn injury is currently hampered by a lack of tools to reliably measure muscle strength and lower limb function, as well as an incomplete understanding of the effect of resistance training after a burn injury. Specifically, there is currently no data on the safety or efficacy of resistance training immediately after a burn injury.

The series of studies presented in this thesis aimed to: 1) systematically review …

Transcutaneous Electrical Nerve Stimulation (Tens) For Chronic Pain - An Overview Of Cochrane Reviews (Review), William Gibson, Benedict M. Wand, Catherine Meads, Mark J. Catley, Neil E. O'Connell

Physiotherapy Papers and Journal Articles

Background: Chronic pain, considered to be pain lasting more than three months, is a common and often difficult to treat condition that can significantly impact upon function and quality of life. Treatment typically includes pharmacological and non-pharmacological approaches. Transcutaneous electrical nerve stimulation (TENS) is an adjunct non-pharmacological treatment commonly recommended by clinicians and often used by people with pain.

Objectives: To provide an overview of evidence from Cochrane Reviews of the effectiveness of TENS to reduce pain in adults with chronic pain (excluding headache or migraine). To provide an overview of evidence from Cochrane Reviews of the safety of …

Student Motivation To Learn: Is Self-Belief The Key To Transition And First Year Performance In An Undergraduate Health Professions Program?, Susan Edgar, Sandra E. Carr, Joanne Connaughton, Antonio Celenza

Physiotherapy Papers and Journal Articles

Background: Student motivation to learn has been undervalued to date though has been identified as an area influencing student success and retention at university. The transition into university has been highlighted as a key period affecting student outcomes as well as well-being. Early identification of those students at risk may assist the transition for many students moving into higher education. Previous research has identified the Motivation and Engagement Scale – University/College (MES-UC) as a valid instrument for measuring motivation to learn in physiotherapy students. The aim of this study was to determine the relationship between a student’s motivation to learn …

Encouraging Students To Draw On Work Experiences When Articulating Achievements And Capabilities To Enhance Employability, Denise A. Jackson, Susan Edgar

Physiotherapy Papers and Journal Articles

Employability drives higher education policy yet despite the investment in developing ‘rounded’ graduates, students experience difficulties in articulating their achievements and capabilities during graduate recruitment. The purpose of this research was to trial and evaluate a career development intervention aimed at drawing on work experiences when applying for graduate roles. Students (N = 136) from two contrasting disciplines, Business and Physiotherapy, and two institutions participated in a two-staged intervention. A focus group was also conducted with career advisors (N = 9) to examine student engagement with career development learning. Findings indicated that students were confident in their ability …