ORCID Profile
0000-0002-6470-3296
Current Organisation
University of South Australia
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Publisher: Informa UK Limited
Date: 11-2016
Publisher: Elsevier BV
Date: 06-2021
Publisher: Medknow
Date: 2022
Publisher: Springer Science and Business Media LLC
Date: 18-05-2019
DOI: 10.1007/S40279-019-01126-5
Abstract: Studies investigating the association between the Functional Movement Screen (FMS) and sports injury risk have reported mixed results across a range of athlete populations. The purpose of this systematic review was to identify whether athlete age, sex, sport type, injury definition and mechanism contribute to the variable findings. Systematic review and meta-analysis. A systematic search was conducted in October 2018 using PubMed, EBSCOhost, Scopus, EmBase and Web of Science databases. Studies were included if they were peer reviewed and published in English language, included athletes from any competition level, performed the FMS at baseline to determine risk groups based on FMS composite score, asymmetry or pain, and prospectively observed injury incidence during training and competition. Study eligibility assessment and data extraction was performed by two reviewers. Random effects meta-analyses were used to determine odds ratio (OR), sensitivity and specificity with 95% confidence intervals. Sub-group analyses were based on athlete age, sex, sport type, injury definition, and injury mechanism. Twenty-nine studies were included in the FMS composite score meta-analysis. There was a smaller effect for junior (OR = 1.03 [0.67-1.59] p = 0.881) compared to senior athletes (OR = 1.80 [1.17-2.78] p = 0.008) and for male (OR = 1.79 [1.08-2.96] p = 0.024) compared to female (OR = 1.92 [0.43-8.56] p = 0.392) athletes. FMS composite scores were most likely to be associated with increased injury risk in rugby (OR = 5.92 [1.67-20.92] p = 0.006), and to a lesser extent American football (OR = 4.41 [0.94-20.61] p = 0.059) and ice hockey (OR = 3.70 [0.89-15.42] p = 0.072), compared to other sports. Specificity values were higher than sensitivity values for FMS composite score. Eleven studies were included in the FMS asymmetry meta-analysis with insufficient study numbers to generate sport type subgroups. There was a larger effect for senior (OR = 1.78 [1.16-2.73] p = 0.008) compared to junior athletes (OR = 1.21 [0.75-1.96] p = 0.432). Sensitivity values were higher than specificity values for FMS asymmetry. For all FMS outcomes, there were minimal differences across injury definitions and mechanisms. Only four studies provided information about FMS pain and injury risk. There was a smaller effect for senior athletes (OR = 1.28 [0.33-4.96] p = 0.723) compared to junior athletes (OR = 1.71 [1.16-2.50] p = 0.006). Specificity values were higher than sensitivity values for FMS pain. Athlete age, sex and sport type explained some of the variable findings of FMS prospective injury-risk studies. FMS composite scores and asymmetry were more useful for estimating injury risk in senior compared to junior athletes. Effect sizes tended to be small except for FMS composite scores in rugby, ice hockey and American football athletes. CRD42018092916.
Publisher: CSIRO Publishing
Date: 2016
DOI: 10.1071/AH15044
Abstract: Objective South Australia is taking an innovative step in transforming the way its healthcare is organised and delivered to better manage current and future demands on the health system. In an environment of transforming health services, there are clear opportunities for allied health to assist in determining solutions to various healthcare challenges. A recent opinion piece proposed 10 clinician-driven strategies to assist in maximising value and sustainability of healthcare in Australia. The present study aimed to seek the perspectives of allied health clinicians, educators, researchers, policy makers and managers on these strategies and their relevance to allied health. Methods A survey of allied health practitioners was undertaken to capture their perspectives on the 10 clinician-driven strategies for maximising value and sustainability of healthcare in Australia. Survey findings were then layered with evidence from the literature. Results Highly relevant across allied health are the strategies of discontinuation of low value practices, targeting clinical interventions to those getting greatest benefit, active involvement of patients in shared decision making and self-management and advocating for integrated systems of care. Conclusions Allied health professionals have been involved in the South Australian healthcare system for a prolonged period, but their services are poorly recognised, often overlooked and not greatly supported in existing traditional practices. The results of the present study highlight ways in which healthcare services can implement strategies not only to improve the quality of patient outcomes, but also to offer innovative solutions for future, sustainable healthcare. The findings call for concerted efforts to increase the utilisation of allied health services to ensure the ‘maximum value for spend’ of the increasingly scarce health dollar. What is known about the topic? In medicine, clinician-driven strategies have been proposed to minimise inappropriate and costly care and maximise highly appropriate and less expensive care. These strategies were developed based on clinical experiences and with supporting evidence from scientific studies. What does this paper add? Major changes to the health system are required to slow down the growth in healthcare expenditure. This paper describes opportunities in which allied health practitioners can implement similar strategies not only to improve the quality of patient outcomes, but also to offer cost-effective solutions for a sustainable healthcare. What are the implications for practitioners? Allied health practitioners can provide solutions to healthcare challenges and assist in the transformation of healthcare in Australia. However, for this to happen, there should be concerted efforts to increase recognition of and support for the use of allied health services.
Publisher: Springer Science and Business Media LLC
Date: 16-03-2023
DOI: 10.1007/S11136-023-03387-0
Abstract: This study analysed data from a national survey of people living in Australian Residential Aged Care Facilities (RACFs) reporting on what is the best thing about where they live and suggestions for improvement. Data from prior to the Covid-19 pandemic were compared with data during the Covid-19 pandemic. Qualitative data from the Happy Life Index Survey were analysed using summative content analysis to code the responses in the data sets and then organise them into categories. Once categorised, the pre-Covid-19 and mid-Covid-19 data sets were compared using descriptive statistics. A total of 4745 residents, from over 100 RACFs, provided 8512 open-text responses to at least one of the two survey questions. Pre-Covid-19 responses were compared with mid-Covid-19 responses and those trending towards relevance (5–10% change) were identified. There were both positive and negative relevant percent changes for staff number, food (general comments), and friendliness. A trending positive percentage change was observed for staff quality and the internal environment. There was a trending negative relevant percentage change for lifestyle activities, staff generally, level of contentedness, the general environment, general choice, and general views about the service. People living in RACFs notice the changes in staffing levels and visitors during restrictions imposed during infectious outbreaks. During these times, they appreciate the quality of the staff attending to their needs and the quality of their food. Further exploration is needed of the value of lifestyle activities and strategies to promote feelings of contentedness and general wellbeing during times of restriction.
Publisher: Public Library of Science (PLoS)
Date: 30-10-2023
Publisher: Elsevier BV
Date: 2022
Publisher: Human Kinetics
Date: 07-2017
Abstract: Posterior shoulder tightness (PST) and glenohumeral internal-rotation deficit (GIRD) can contribute to shoulder pain suffered by athletes engaged in overhead sporting activities. Stretching is a common intervention to resolve PST and GIRD, but it has weak evidence of effectiveness to date. This systematic review aimed to collect and synthesize effectiveness data from English- and Japanese-language randomized controlled trials (RCTs) investigating stretching interventions for PST and GIRD. 7 English databases and 3 Japanese databases were searched from inception until December 5, 2015. Only English- and Japanese-language RCTs were considered. Risk of bias in the included studies was assessed using the Physiotherapy Evidence Database scale. Data were synthesized qualitatively. Eight English-language and 2 Japanese-language papers of low to high quality were included. There was moderate evidence for positive immediate and short-term effects of cross-body stretch on PST and GIRD in asymptomatic young subjects. Moderate evidence was found to suggest that active sleeper stretch might not be more effective than no intervention to improve PST and GIRD in the short term. Cross-body stretch can be effective to improve PST and GIRD in asymptomatic young subjects immediately or in the short term. Further study with methodological rigor is necessary to investigate the long-term effectiveness of stretching interventions on PST and GIRD in symptomatic patients.
Publisher: Informa UK Limited
Date: 07-2012
DOI: 10.2147/JHL.S33163
Publisher: Wiley
Date: 07-05-2020
DOI: 10.1111/SMS.13686
Publisher: Medical Journals Sweden AB
Date: 2012
Abstract: Whilst prognostic factors for recovery from whiplash associated disorders have been documented, factors related to high physiotherapy use are not well recognized. This study profiles predictors for high use of physiotherapy services from a large dataset from an Australian state insurer for motor vehicle accidents. A dataset of Motor Accident Commission claims in South Australia for whiplash associated disorders (2006-2009) was interrogated. The median number of physiotherapy services per claimant was 15 (range: 1-194). The typical high user of physiotherapy was female, aged 25-59 years, living in a high socio-economic area, with legal representation, who delayed obtaining physiotherapy for at least 28 days after the accident. The largest mean number of days between treatments (5.4 days) in the first 5 treatments related to the lowest subsequent use of physiotherapy services. This represents the first review of physio-therapy service use based on an insurance dataset. A range of factors were related to high use of physiotherapy services. It is hoped that identifying the mean number and spread of physiotherapy interventions for whiplash associated disorders, and the profile of high users of physiotherapy will help gauge the success of strategies to maximize the efficacy of physiotherapy management of whiplash associated disorders.
Publisher: Human Kinetics
Date: 05-2022
Abstract: Purpose: Determine the impact of preseason and between-seasons changes in in idual physical performance on injury risk in elite junior Australian football players and if injuries sustained during a season impact subsequent-season performance improvement. Methods: This prospective cohort study assessed in idual performance measures (sprint speed, jump, agility, and aerobic endurance) during preseason over 4 consecutive seasons. Injury status (injured/not injured) was tracked weekly to determine the relationship between in idual performance and in-season injury occurrence. Mixed models were used to determine the relationship between physical performance and injury, and the effect of injury on physical performance improvement. Results: A total of 206 players played 2 consecutive seasons and were included (17.6 y, 181.9 cm, 75.7 kg). Faster players during preseason experienced higher injury incidence (injuries/season) during that playing season (incidence rate ratio = 0.127 P = .034). Injury incidence was not influenced by between-seasons change in any performance measure. Players injured during their first season maintained their aerobic fitness, which declined in noninjured players ( d = 0.39 P = .013). Players who sustained a lower-limb injury during their first season saw smaller improvements in sprint speed than players who did not get injured ( d = 0.39 P = .035). Conclusion: Faster players experience higher injury incidence than slower players and may require specific prevention interventions. Players who experience a lower-limb injury during the playing season do not improve sprint speed between seasons to the same extent as players who do not get injured, highlighting the need for targeted high-speed running ability development as part of rehabilitation.
Publisher: Informa UK Limited
Date: 21-03-2017
DOI: 10.1080/02699052.2017.1283059
Abstract: Neurogenic heterotopic ossification (NHO) is a complication of a neurological injury following traumatic brain injury (TBI) and may be present around major synovial joints. It is often accompanied by severe pain, which may lead to limitation in activities of daily living. Currently, a common intervention for NHO is surgery, which has been reported to carry many additional risks. This study was designed to assess the effect of extracorporeal shock wave therapy (ESWT) on pain in patients with TBI with chronic NHO. A series of single-case studies (n = 11) was undertaken with patients who had TBI and chronic NHO at the hip or knee. Each patient received four applications of high-energy EWST delivered to the affected joint over 8 weeks. Two-weekly follow-up assessments were carried out, and final assessments were made 3 and 6 months post-intervention. Pain was measured using the Faces Rating Scale, and X-rays were taken at baseline and 6-months post-intervention to physiologically measure the size of the NHO. The application of high-energy ESWT was associated with significant overall reduction of pain in patients with TBI and NHO (Tau-0.412, 95% confidence interval -0.672 to -0.159, p = 0.002). ESWT is a novel non-invasive intervention for reducing pain resulting from NHO in patients with TBI.
Publisher: Elsevier BV
Date: 04-2012
DOI: 10.1016/J.MATH.2011.12.011
Abstract: Patients presenting with recalcitrant symptoms, which are resistant to a range of physical interventions over an extended period of time, need to be examined with care. A 'forensic' approach to the assessment of these patients, with a sensitive approach to the results of the test procedures is required to ensure the practitioner does not miss the more obscure causes. This case report presents a patient who was referred for a clinical assessment for long standing scapular pain, which had been labelled myofascial pain. Through a thorough approach to examination a number of flags appeared which suggested a need for further investigation. These investigations identified that the patient demonstrated a Chiari Malformation Type 1. On review 5 months following neurosurgical intervention her symptoms were significantly reduced. Chiari Malformations Type 1 are often diagnosed in adulthood when symptoms usually first appear. These symptoms may mimic those found with musculoskeletal conditions. Whilst we lack specific clinical tests for this condition, a thorough assessment should identify sufficient 'flags' for referral for further investigations.
Publisher: Elsevier BV
Date: 04-2021
Publisher: Public Library of Science (PLoS)
Date: 22-02-2019
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-2018
DOI: 10.1097/JTE.0000000000000058
Abstract: Student engagement with both face-to-face and online sessions is becoming increasingly important as a metric of teaching success. Understanding engagement needs to move beyond positioning the student as a generic learner and explore the variations in person and context that will enable a transformative approach to blended learning arrangements. This article investigates physical therapy students' perceptions regarding resources they choose to engage with to support their learning. One hundred and fifteen (59% female) average age 21.7 years 7.8% international students in the Bachelor of Physiotherapy and Master of Physiotherapy programs at the University of South Australia. A questionnaire with open-ended questions was administered in class and provided data on students' preferences and perceptions regarding resources that support their learning. Students' attendance, online resource usage, and grade point average were collected and used to explore themes emerging from the data. Students with higher grades described their own behaviors that assisted their learning while students with lower grades focused on external barriers that limited their learning. Participants chose to attend class because this enabled them to ask questions, access explanations and demonstrations, increase concentration, pick up nonverbal communication, and access teacher support. Participants chose to use online activities because this supported them to work at their own pace, or at an optimal time, or concentrate more. Participants reported making choices based on perceptions that a particular behavior would contribute to the immediate process of learning or assessment outcomes, rather than long-term goals such as being able to provide the best patient care. Classroom delivery is successful for students who attribute social interaction as a key aspect to their effective learning while online delivery formats meet the needs of students who engage better in private contexts. Engagement success may increase if face-to-face sessions have flexible access, while online activities include opportunities for interaction and support.
Publisher: Elsevier BV
Date: 11-2022
DOI: 10.1016/J.RADI.2022.08.012
Abstract: The diagnosis of acute appendicitis remains challenging. This review determined the current diagnostic accuracy of CT and ultrasound for suspected acute appendicitis in adults. This systematic review adhered to the PRISMA for diagnostic test accuracy guidelines. A systematic search was undertaken in appropriate databases. Screening of potential titles and abstracts, full-text retrieval, methodological quality assessment using QUADAS, and data extraction was performed. Meta-analyses were performed for relevant subgroups, and sensitivity analysis was completed to account for outliers. GRADE was utilized to assess the certainty of findings. 31 studies evaluating CT, 10 evaluating US, and six evaluating both were included. Pooled sensitivity and specificity for CT was 0.972 [0.958, 0.981] and 0.956 [0.941, 0.967] respectively, and 0.821 [0.738, 0.882] and 0.859 [0.727, 0.933] for US, respectively. When analyzing subgroups based on the use of contrast enhancement, sensitivity and specificity was highest for CT with intravenous and oral contrast (0.992 [0.965, 0.998], 0.974 [0.936, 0.99]), compared to CT with intravenous contrast (0.955 [0.922, 0.974], 0.942 [0.916, 0.960]). Low-Dose CT produced comparable values (0.934 [0.885,0.963], 0.937 [0.911, 0.955]) relative to these subgroups and standard dose non-contrast CT (0.877 [0.774,0.937], 0.914 [0.827, 0.959]). US studies which excluded equivocal findings demonstrated significantly greater values than the remainder of US studies (p < 0.0001). The updated diagnostic test accuracies of CT, US and relevant subgroups should be implemented in light of factors such as dose, cost, and timing. For diagnosis of adult acute appendicitis: • CT with intravenous plus oral contrast enhancement yields statistically significantly greater diagnostic accuracy than CT with intravenous contrast alone. • Low-dose CT yields comparable sensitivity and specificity to standard-dose CT. • Ultrasound studies which exclude equivocal results may overinflate sensitivity and specificity.
Publisher: SAGE Publications
Date: 2020
Publisher: Informa UK Limited
Date: 02-11-2015
Publisher: CRC Press
Date: 02-10-2017
DOI: 10.1201/B11337-17
Publisher: Elsevier BV
Date: 12-2004
Publisher: CSIRO Publishing
Date: 2016
DOI: 10.1071/AH15011
Abstract: Objective The aim of the present study was to identify opportunities to improve the reach and impact of the Australian Medicare 75+ Health Assessment (75+HA) to detect early functional decline (FD). Methods A comparison of two published review articles produced two outputs: (1) assessments identified in the systematic review that underpinned the 75+HA items were ranked for evidence of effectiveness and compared with the volume of research into assessment areas identified by a recent review on indicators of early FD and (2) items in the 75+HA were compared with those in the recent review. Results The review underpinning the 75+HA found 19 assessment areas, with strongest evidence of effectiveness for vision/hearing, teeth/oral, balance/gait, cognitive and service use. The more recent review reported on six domains (eight subdomains) of FD assessment: physical and cognitive elements of the performance capacity domain were the least well assessed, whereas the most comprehensively assessed domains were health service use, performance capacity (mental subdomain), participation (motivation/volition subdomain) and demographics. The 75+HA addresses only some items related to early FD as identified by the recent literature. Conclusion Reassessment of the 75+HA with a view to including current evidence-based assessments for early FD is recommended. Updating the 75+HA items with ways to detect FD earlier may increase its relevance to Australia’s ageing population. What is known about the topic? There are consistent predictions of increasing lifespan of Australians, increasing numbers of older Australians wanting to live independently in the community and the increasing burden on already scarce hospital resources associated with managing the ramifications of declining function in older Australians. The 75+HA is now 15 years old and has not been updated. The imperative is to identify and address early FD in primary care before it becomes a problem. What does this paper add? This paper highlights how the 75+HA can be updated to support a comprehensive and multifactorial assessment of early FD, making it more relevant to the current climate of aging Australians and their desire to age in place. Adding the elements suggested in this paper to the 75+HA may assist in increasing the relevance of the assessment and in the earlier detection of FD. What are the implications for practitioners? A regular comprehensive assessment of key antecedents and features of early FD from multiple stakeholder perspectives will provide a stronger and more evidence-based framework within which to support older Australians to age in place.
Publisher: OMICS Publishing Group
Date: 2014
Publisher: Elsevier BV
Date: 02-2016
DOI: 10.1016/J.MATH.2015.10.008
Abstract: There is no consensus in the English-language literature regarding the best types or dosages of stretching to maximise muscle strength and functional performance. It is possible that primary research published in non-English languages provides different insights, and could add to the body of international knowledge. This systematic review aimed to identify and evaluate Japanese-language randomised controlled trials (RCTs) investigating acute effects of stretching on maximal strength and functional performance. Three Japanese databases and five English databases were searched from inception to 24 March 2015. Only Japanese-language RCTs examining acute effects of stretching on maximal strength and/or functional performance were included. Risk of bias in included studies was assessed using Physiotherapy Evidence Database scale. GRADE (Grading of Recommendation Assessment, Development and Evaluation) approach was applied to evaluate the quality of evidence. Descriptive synthesis was attempted. Seven RCTs with variable methodological quality were included. No two studies were the same, thus meta-analysis was not possible. Descriptively, because of heterogeneity of interventions and outcome measures, it was not possible to identify consensus on the benefits of stretching. GRADE approach indicated low to very low quality evidence for this topic. This review of Japanese-language RCTs provided no additional information to strengthen or challenge the current English-language evidence base on acute effects of stretching on maximal strength and performance. Future Japanese-language studies should address methodological flaws exposed in this review and incorporate functional outcome measures to strengthen the international evidence base.
Publisher: Springer Science and Business Media LLC
Date: 07-2010
Publisher: Springer Science and Business Media LLC
Date: 04-2002
Publisher: Informa UK Limited
Date: 15-03-2004
Publisher: Wiley
Date: 05-07-2014
DOI: 10.1111/JEP.12213
Abstract: Declining capacity to function safely and independently in the community is a manifestation of ageing. Multiple measures are used to define and predict functional decline. This paper explores the use of partial least squares (PLS) analysis to understand the interaction between overtime measures of functional decline. Comprehensive information was captured on in iduals aged 65+ who presented at a large metropolitan Australian hospital Emergency Department (ED) for a complaint, which did not result in a hospital admission. They were followed-up by telephone 1 and 3 months, post-ED discharge. Information was collected each time on home situations (living alone, using community services, using a gait aid and having a formal carer), recent falls, hospitalizations and instrumental activities of daily living (IADLs). PLS analysis was applied to identify overtime relationships between measures. Valid information was provided by 147 in iduals at all three time points. The eight in idual IADL items clustered clearly around physical, mental or combined mental and physical IADLs. These clusters were strongly related to increased use of community supports, gait aid and carer, and living alone. The relationship was less convincingly for hospitalizations, and falls were not explained well. PLS analysis offers a novel and comprehensive way of analysing complex health data, which allows sense to be made of relationships over a 3-month period. This analysis provides a better understanding of declining function over time, than could be provided by current health modelling methods.
Publisher: Informa UK Limited
Date: 06-12-2013
Publisher: University of Toronto Press Inc. (UTPress)
Date: 02-2020
Abstract: Purpose: Pressure to eliminate low-value health care is increasing internationally. This pressure has produced an urgent need to identify evidence-based methods to determine the value of allied health (AH) care, particularly to recognize when additional AH care adds no further benefits. This article reports on the published methods of determining the value of AH care. Method: We systematically scanned PubMed, MEDLINE, AMED, CINAHL, PsycINFO, and the Grey Literature Review database from inception until July 2018 for peer-reviewed English-language literature. Hierarchy of evidence and information on study design and the methods or measures used to determine the value of AH care were extracted. Results: Of 189 articles, 30 were potentially relevant after the full text was read, all were included. Of these, 24 reported on ways of determining the value of AH care, and 6 described the optimal provision of AH episodes of care. No methods were reported that could be applied to establish when enough AH therapy had been provided. Conclusion: This review found a variety of attributes of value in AH care, but no standard value measure or methods to determine what constituted enough AH care. Repeated measurement of the standard attributes of value and costs is required throughout episodes of AH care to better understand the impact of AH care from the different stakeholders’ perspectives.
Publisher: Termedia Sp. z.o.o.
Date: 2023
Publisher: Elsevier BV
Date: 2023
Publisher: Springer Science and Business Media LLC
Date: 18-03-2021
DOI: 10.1186/S12913-021-06190-0
Abstract: Evidence based practice in health care has become increasingly popular over the last decades. Many guidelines have been developed to improve evidence informed decision making in health care organisations, however it is often overlooked that the actual implementation strategies for these guidelines are as important as the guidelines themselves. The effectiveness of these strategies is rarely ever tested specifically for the allied health therapy group. Cochrane, Medline, Embase and Scopus databases were searched from 2000 to October 2019. Level I and II studies were included if an evidence informed implementation strategy was tested in allied health personnel. The SIGN method was used to evaluate risk of bias. The evidence was synthesised using a narrative synthesis. The National Health and Medical Research Council (NHMRC) model was applied to evaluate the grade for recommendation. A total of 490 unique articles were identified, with 6 primary studies meeting the inclusion criteria. Three different implementation strategies and three multi-faceted components strategies were described. We found moderate evidence for educational meetings, local opinion leaders and patient mediated interventions. We found stronger evidence for multi-faceted components strategies. Few studies describe the effectiveness of implementation strategies for allied healthcare, but evidence was found for multi-faceted components for implementing research in an allied health therapy group population. When considering implementation of evidence informed interventions in allied health a multi-pronged approach appears to be more successful.
Publisher: Elsevier BV
Date: 10-2018
DOI: 10.1016/J.JSAMS.2017.11.009
Abstract: This study examines the acute morphological changes (up to three days) in the normal, asymptomatic Achilles tendon (AT) in response to a single bout of exercise in relation to tendon dimensions and vascularity. Within-subject pre-post design. Participants conducted a 7.7km pack march on a sealed road in a time of 1h 16min (approximately 6kmh The tendon showed no significant change in sagittal diameter and cross-sectional area at 20mm proximal to the calcaneus and at the insertion immediately post-exercise. Tendon vascularity increased significantly in 91% of the left ATs and 87% of the right ATs in response to the pack march. Three days after the pack march an increase in sagittal diameter at the insertion and 20mm proximal to the calcaneus was observed and increased vascularity was still present in 22% of the ATs. This study highlighted the tendon's response to exercise and has shown that at three days post-exercise that the tendon had not recovered to pre-exercise levels with respect to tendon dimensions and vascularity.
Publisher: Wiley
Date: 2006
DOI: 10.1002/PRI.340
Abstract: Adolescent spinal pain is a worldwide concern, with few longitudinal studies to validate concerns that an increasing number of adolescents report pain with age. The aim of the present study was to track reports of low back pain (LBP) in adolescents each year over a five-year period (between the ages of 13 and 17 years). A longitudinal, observational, repeated-measures study, commencing in 1999. We followed a group of South Australian students throughout five years of high schooling, reporting on prevalence of recent low back pain each year. In 1999, data were collected from 434 13-year-olds (82.5% eligible students). In the subsequent four years, the response rate from the 1999 s le was, respectively, 72.2%, 69.1%, 56.2% and 40.1%. A significant increasing prevalence of recent LBP was reported for girls and boys. The odds of girls reporting recent LBP in the final study year (fifth year) compared with the first year was 4.4 (95% CI 1.9-10.1),for boys 1.6 (95% CI 0.7-3.7). New cases of girls' recent LBP decreased consistently over the study (90% in 2000, 46.1% in 2001, 42.1% in 2002 and 33% in 2003). New boys' cases decreased in the second and third study years (85% in 2000, 45% in 2001) then increased (45.8% in 2002, 63.6% in 2003), suggesting less established patterns of occurrence. New cases of LBP reflected a decreasing percentage of total LBP reports over each study year for girls (suggesting increasing consistency of LBP occurrence with age). A different pattern was observed for boys, with a reversal of the downward trend after age 15 years, showing an increased percentage of LBP reports that reflected new cases in the final two study years.
Publisher: Cambridge University Press (CUP)
Date: 04-05-2020
DOI: 10.1017/BRIMP.2020.5
Abstract: To synthesise the current best evidence on both pharmacological and non-pharmacological behaviour management interventions for adult patients in the acute hospital setting with traumatic brain injury (TBI) or post-traumatic amnesia (PTA). A comprehensive search of 10 electronic databases was completed. Systematic reviews (SRs) published in English before September 2018 were included. Initial search resulted in 4604 citations, 2916 for title and abstract screening with duplicates removed, and 2909 articles failed to meet the inclusion criteria leaving seven reviews for inclusion. Five reporting pharmacological management approaches, two reporting non-pharmacological management approaches, and one reporting both pharmacological and non-pharmacological management approaches. Methodological quality was assessed independently by two reviewers using the Critical Appraisal Skills Programme Tool for SRs. Data were extracted from the studies based on the recommendations of the Joanna Briggs Institute (JBI) Methodology for JBI Umbrella Reviews. The SRs were of low-to-moderate quality overall. High-quality SRs were characterised by low numbers of studies and significant biases. The evidence relating to pharmacological interventions demonstrates low level and variable quality. The evidence relating to non-pharmacological interventions was limited and of low quality. The current evidence for the management of challenging behaviours in patients with acute TBI/PTA is generally equivocal, potentially reflecting the heterogeneity of patients with TBI and their clinical behaviours. More studies with rigorous methodologies are required to investigate the most suitable pharmacological and non-pharmacological behavioural interventions for the acute phase of TBI or PTA.
Publisher: Elsevier BV
Date: 12-2014
DOI: 10.1016/J.MATH.2014.05.009
Abstract: The use of goniometers to measure joint angles is a key part of musculoskeletal practice. Recently smartphone goniometry applications have become available to clinicians. This study examined the intra- and inter-measurer reliability of novice and experienced clinicians and the concurrent validity of assessing knee range of motion using a smartphone application (the Knee Goniometer App (Ockendon(©))) (KGA) and a standard universal goniometer (UG). Three clinicians, each with over seven years' experience as musculoskeletal physiotherapists and three final year physiotherapy students, measured 18 different knee joint angles three times, using both the universal goniometer and the smartphone goniometric application. The universal goniometer and the smartphone goniometric application were reliable in repeated measures of knee flexion angles (average Concordance Correlation Coefficient (CCC) > 0.98) with both experienced clinicians and final year physiotherapy students (average CCCs > 0.96). There were no significant differences in reliability between the experienced and the novice practitioners for either device. Agreement between the universal goniometer and smartphone goniometric application measurements was also high for all examiners with average CCCs all above 0.96. The Standard Error of Measurement ranged between 1.56° (0.52-2.66) for the UG and 0.62° (0.29-1.27) for the KGA. The universal goniometer and the smartphone goniometric application were reliable in repeated measures of knee flexion angles. Smaller error of measurement values for the smartphone goniometric application might indicate superiority for assessment where clinical situations demand greater precision of knee range of motion.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-2007
Publisher: Elsevier BV
Date: 02-2012
Publisher: PeerJ
Date: 15-03-2021
DOI: 10.7717/PEERJ.10706
Abstract: Myofascial release (MFR) and Mulligan Sustained Natural Apophyseal Glides (SNAGs) are manual therapy techniques routinely practiced in the management of non-specific low back pain (NSLBP). As a solo intervention or along with other therapies, both methods have reported positive results for in iduals with NSLBP. However, which technique improves NSLBP-related pain, restricted range of motion (ROM) and disability, warrants further research. To study the comparative effects of MFR and SNAGs on pain, disability, functional ability, and lumbar ROM in NSLBP. A parallel-group study was conducted at tertiary care hospitals. Sixty-five Sub-acute or chronic NSLBP patients were allocated to receive strengthening exercises along with either MFR ( n = 33) or SNAGs ( n = 32) for six treatment sessions over one week. An independent assessor evaluated outcome measures such as the Visual Analog Scale (VAS), Patient-Specific Function Scale (PSFS), and ROM at baseline, immediate (after 1st treatment), and short-term (post-sixth day of the intervention). The Modified Oswestry disability index (MODI) was assessed at baseline and short-term. Within-group analysis found clinically and statistically significant ( p 0.05) changes for VAS and PSFS at immediate and short-term for both the groups. The lumbar extension also showed improvement immediately and in the short-term. Improvement in Lumbar flexion was seen only in the SNAGs group over the short-term. A statistically significant improvement was seen for MODI in both the groups but was not clinically significant in the MFR group. The analysis observed no statistically significant difference ( p 0.05) between the groups at both the immediate and short-term. Pain and restricted function associated with NSLBP can be improved using SNAGs or MFR, along with strengthening exercises. For limited lumbar flexion ROM, Mulligan SNAGs have a better outcome than MFR over the short-term. Hence, both manual therapy techniques can be incorporated along with exercises for immediate and short-term management of sub-acute to chronic NSLBP. Clinical Trial Registration . CTRI/2018/12/016787 ( ctri.nic.in/Clinicaltrials/ ).
Publisher: Elsevier BV
Date: 04-2022
DOI: 10.1016/J.JSAMS.2021.10.014
Abstract: Identify how modified Lower-Quarter Y-Balance Test (mYBT-LQ) and Upper-Quarter Balance Test (mYBT-UQ) scores relate to injury risk and measures of physical performance in elite adolescent Australian Football (AF) athletes. Prospective cohort study. Pre-season mYBT-LQ, mYBT-UQ, and physical performance measures (speed, jump height, and agility) were obtained in 257 elite adolescent male AF athletes. Injury status was tracked across the 18-game season to determine the relationship between mYBT scores and injury risk based on time-to-event analysis. Cross-sectional analysis of mYBT-LQ scores and performance measures determined the relationships between these variables. There were no significant associations between injury risk and any single mYBT parameter. However, athletes with high posteromedial asymmetry and good agility performance (top 25% of the cohort) had moderately increased injury risk with and tended to without a previous injury history (Hazard Ratio = 3.26 [95% Confidence Interval: 1.01, 10.54 p = 0.048] and 2.69 [95% Confidence Interval = 0.92, 7.82 p = 0.069], respectively). There were significant correlations between faster agility times and higher composite limb-length normalised mYBT-LQ (r = -0.210 CI = -0.324, -0.090), limb-length normalised average posteromedial reach score (r = -0.227 CI = -0.340, -0.108), and limb-length normalised average posterolateral reach score (r = -0.250: CI = -0.361, -0.132). In isolation, the mYBT is not useful for identifying injury risk in junior AF athletes, and only small correlations between mYBT-LQ and physical performance variables were identified. However, high mYBT-LQ posteromedial asymmetry is associated with increased injury risk for athletes with good agility performance. This should be considered within athlete preparation programs.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 02-03-2021
DOI: 10.1519/JSC.0000000000003903
Abstract: Bennett, H, Fuller, J, Milanese, S, Jones, S, Moore, E, and Chalmers, S. The relationship between movement quality and physical performance in elite adolescent Australian football players. J Strength Cond Res 36(10): 2824–2829, 2022—The assessment of movement quality is commonplace in competitive sport to profile injury risk and guide exercise prescription. However, the relationship between movement quality scores and physical performance measures is unclear. Moreover, whether improvements in these measures are associated remain unknown. Over a 4-year period, 918 in idual elite adolescent Australian Rules Footballers completed the Functional Movement Screen (FMS) and physical performance testing (5- and 20-m sprint, vertical jump, planned agility, and 20-m shuttle run test), allowing the analysis of relationships between FMS parameters and performance measures. In addition, 235 athletes completed testing over 2 consecutive years, allowing the analysis of relationships between changes in these outcomes. Small associations were observed between FMS composite score, hurdle step performance, in-line lunge performance, trunk stability push-up performance, rotary stability, and measures of speed, power, agility, and aerobic fitness (ρ = 0.071–0.238). Across consecutive seasons, significant improvements were observed in the deep squat subtest ( d = 0.21), FMS composite score ( d = 0.17), and 5- ( d = 0.16) and 20-m sprint times ( d = 0.39). A negative association between change in rotary stability and change in jump height (ρ = −0.236) from one season to the next was detected. Results suggest FMS scores have limited relationships with measures of performance in footballers. To optimize athletic performance, once acceptable movement capabilities have been established, training should not prioritize improving movement quality over improvements in strength, power, and change of direction ability.
Publisher: Informa UK Limited
Date: 02-01-2023
Publisher: Wiley
Date: 24-06-2023
DOI: 10.1111/BJHP.12677
Abstract: Methods for assessing acceptability of healthcare interventions have been inconsistent until the development of the theoretical framework of acceptability (TFA). Despite its rapid adoption in healthcare research, the TFA has rarely been used to assess acceptability of surgical interventions. We sought to explore the sufficiency of the TFA in this context and provide methodological guidance to support systematic use of this framework in research. Acceptability was assessed in a consecutive s le of 15 patients at least 3 months post‐joint replacement surgery via theory‐informed semi‐structured interviews. A detailed description of the application of the TFA is reported. This includes: development of the interview guide (including questions to assess theoretical sufficiency), analysis of interview data and interpretation of findings. Interview data were substantially codable into the TFA constructs but required the addition of a construct, labelled ‘perceived safety and risk’, and relabelling and redefining an existing construct (new label: ‘opportunity costs and gains’). Methodological recommendations for theory‐informed interview studies include producing interview support material to enhance precision of the intervention description, conducting background conversations with a range of stakeholders in the healthcare setting, and conducting first inductive and then deductive thematic analysis. The sufficiency of the TFA could be enhanced for use when assessing interventions with an identifiable risk profile, such as surgery, by the inclusion of an additional construct to capture perceptions of risk and safety. We offer these methodological recommendations to guide researchers and facilitate consistency in the application of the TFA in theory‐informed interview studies.
Publisher: Elsevier BV
Date: 2002
DOI: 10.1016/S0004-9514(14)60202-6
Abstract: This paper reports on a survey regarding physiotherapists' knowledge, use and attitudes to non-steroidal anti-inflammatory drugs (NSAIDs), some of which have recently been re-scheduled to non-prescription dispensing. A written survey instrument was developed and administered to 750 physiotherapists in South Australia, Tasmania and the Australian Capital Territory (50% of the registered physiotherapists). Responses were received from 285 physiotherapists. The survey identified opportunities for patient misuse and misadventures with NSAIDs in conjunction with physiotherapy management. Differences in physiotherapist understanding of the dosage and actions of oral and topic administrations of NSAIDs were highlighted, as were the moral and ethical responsibilities of physiotherapists to patients considering taking NSAIDs. The study identified the need for regular professional updates on quality use of NSAIDs.
Publisher: Elsevier BV
Date: 06-2013
DOI: 10.1016/J.PHYSIO.2012.05.004
Abstract: This study investigated the preferred learning styles, related to clinical education of a cohort of final year physiotherapy students. A cross sectional observation study using a questionnaire survey. Undergraduate physiotherapy program at James Cook University, Townsville, Queensland. 48 final year physiotherapy students representing 89% of the total cohort (48/54). Survey questionnaire using Kolb's Learning Style Inventory (Version 3.1). The preferred learning styles were spread uniformly across the three learning styles of Converging, Assimilating and Accommodating, with the least preferred method of learning style the Diverging style. This suggests that in the clinical environment this student cohort are least likely to prefer to develop their learning from actually experiencing the scenario i.e. in front of a real life patient (concrete experience), and were more likely prefer this learning to come from a theoretical perspective, allowing them to consider the problem/scenario before experiencing it. When transforming this experience into knowledge, they prefer to use it on a 'real life' patient (active experimentation). Whilst understanding learning styles have been promoted as a means of improving the learning process, there remains a lack of high level evidence. The findings of this study reinforce those of other studies into the learning styles of physiotherapy students suggesting that physiotherapy students share common learning style profiles.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-2017
Abstract: Knee osteoarthritis is common. The evidence regarding the effectiveness of braces and orthoses for patients with knee osteoarthritis is inconclusive according to English-language literature. English-language reviews to date have not included Japanese-language studies. This study aimed to collect and synthesise Japanese-language randomised controlled trials investigating the effectiveness of braces and orthoses for patients with knee osteoarthritis. Systematic review. Eight databases were systematically searched from inception to 29 July 2015. Only Japanese-language randomised controlled trials were included. Risk of bias was assessed using Physiotherapy Evidence Database scale. A meta-analysis was not appropriate due to the heterogeneity in the included studies. Seven randomised controlled trials with low to high risks of bias were included. Six of seven included studies were conducted by the same author group. Limited evidence supported the positive effects of short-lever elastic knee braces to improve pain and functional disability in specific outcomes. No evidence was found to support the use of foot orthoses, such as laterally wedged insoles, medial arch support and metatarsal arch pad. Our systematic review found no conclusive evidence about the effectiveness of any braces and orthoses for patients with medial knee osteoarthritis. Future Japanese-language studies should address methodological flaws exposed in this review and strengthen the international evidence base. Clinical relevance This is the first systematic review of Japanese-language randomised controlled trials investigating orthoses for patients with knee osteoarthritis. Clinicians can consider the use of short-lever elastic knee braces to improve specifically pain on squat or walking. Evidence found in this review does not support the use of foot orthoses.
Publisher: Wiley
Date: 30-06-2015
DOI: 10.1002/MUS.24574
Abstract: Despite reports on the association of radial nerve (RN) size and lateral epicondylalgia (LE), Filipino normative values on RN size in healthy elbows are not established. An association with upper extremity anthropometric measurements is likewise not reported. Musculoskeletal ultrasound measurements of the RN at the level of the lateral epicondyle (RN-LE), posterior interosseous nerve at the level of the radial head and supinator (PIN-RH and PIN-sup), and superficial RN (SRN) in the elbows of healthy Filipinos were made in Manila from January-September 2011. A total of 198 elbows of 99 healthy participants aged 43 years (range, 33-48 years) [median(IQR)] were investigated. Men have larger PIN-RH, PIN-sup, and SRN compared with women. Arm length was associated with PIN-RH, PIN-sup, and SRN (P < 0.05). Activities and elbow circumference measurements (at 2 levels) were associated with PIN-RH. RN reference values can now be used for comparison in elbows with LE.
Publisher: Informa UK Limited
Date: 05-2010
DOI: 10.2147/JPR.S10025
Publisher: SAGE Publications
Date: 09-2018
Abstract: Physical comfort is a key ergonomic consideration when evaluating combat helmets because discomfort, which can exhibit as pressure spots, headaches, and migraines, can lead to distraction and have a detrimental effect on operational performance. Debate exists as to whether comfort and discomfort are two separate states or whether they are two points on the same scale. The aim of this study was to identify which distinction was relevant for the assessment of a combat helmet and to use this as a basis for selecting an outcome measure from a wide group of measures reported in literature. However, no existing measure was deemed suitable by users (dismounted soldiers) and a new outcome measure for the assessment of physical discomfort of combat helmets was developed with the users.
Publisher: Informa UK Limited
Date: 03-2014
DOI: 10.2147/JPR.S49620
Publisher: Informa UK Limited
Date: 02-2012
DOI: 10.2147/JMDH.S28891
Publisher: SAGE Publications
Date: 09-2018
Abstract: When designing Human Factors and Ergonomics evaluations, in addition to considering validity and reliability, it is important to ensure that measures and methodologies have utility for the chosen application. Ensuring utility requires consideration of domain specific aspects including practicality, feasibility, and access to users. The intention of this paper is to describe the process and outcome of deriving a series of considerations that can be used by Human Factors/Ergonomics practitioners when designing an evaluation of soldier clothing and equipment to help ensure that it is useful and practical for the dismounted domain. The aim is to help with dissemination of knowledge that is obtained by practitioners during their careers and forms a foundation that other practitioners can augment with their own experience.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2015
Publisher: Research Square Platform LLC
Date: 15-06-2020
DOI: 10.21203/RS.3.RS-35349/V1
Abstract: Background- Evidence based practice in health care has become increasingly popular over the last decades. Many guidelines have been developed to improve evidence informed decision making in health care organisations, however it is often overlooked that the actual implementation strategies for these guidelines are as important as the guidelines themselves. The effectiveness of these strategies is rarely ever tested specifically for the allied health therapy group.Objectives - To explore the evidence for implementation strategies within allied health. This review sought to explore the effectiveness of implementation strategies for promoting evidence informed interventions in allied healthcare.Data sources- Cochrane, Medline, Embase and Scopus were searched from 2000 onwards.Study eligibility : Level I and II studies were included if an evidence informed implementation strategy was tested in allied health personnel.Study appraisal and synthesis methods: The SIGN method was used to evaluate risk of bias. The National Health and Medical Research Council (NHMRC) model was applied to evaluate the grade for recommendation.Results- A total of 490 unique articles were identified, with 6 primary studies meeting the inclusion criteria. Three different implementation strategies and three multi-faceted components strategies were described. We found moderate evidence for educational meetings, local opinion leaders and patient mediated interventions. We found stronger evidence for multi-faceted components strategies.Conclusion- Few studies describe the effectiveness of implementation strategies for allied healthcare, but evidence was found for multi-faceted components for implementing research in an allied health therapy group population.
Publisher: Oxford University Press (OUP)
Date: 15-10-2015
Abstract: Musculoskeletal symptoms are reportedly common among musicians. Flautists may be at high risk of symptoms, due to their asymmetrical playing posture. To determine the prevalence and incidence of musculoskeletal symptoms among flautists. A systematic search of four databases, with reference and citation lists of included studies, screened for additional studies. Included studies were assigned to the Oxford Centre for Evidence-based Medicine levels of evidence and critical appraisal was performed using a previously published tool. Data extracted included the country, s le size, data collection methods, response rates, s le demographics and data pertaining to the prevalence or incidence of musculoskeletal symptoms among flautists. Seven studies (evidence levels 1 and 3) were included. These were at moderate to high risk of bias. There was wide variation in the populations and the types of musculoskeletal symptoms investigated. Lifetime prevalence of any musculoskeletal symptoms of any duration varied from 15 to 95% depending on the populations and symptoms investigated. In schoolchildren, this was as high as 79%, and 95% in university students. The upper extremities were most commonly affected, with minimal differences in the prevalence of symptoms between right and left sides. Due to the differences in the types of data collected, different groups of flautists could not be directly compared. The lack of studies with high evidence levels and low risk of bias in this area precludes a clear understanding of the prevalence and location of musculoskeletal symptoms in flautists, although current evidence suggests that the prevalence is high.
Publisher: Research Square Platform LLC
Date: 04-01-2021
DOI: 10.21203/RS.3.RS-35349/V2
Abstract: Background- Evidence based practice in health care has become increasingly popular over the last decades. Many guidelines have been developed to improve evidence informed decision making in health care organisations, however it is often overlooked that the actual implementation strategies for these guidelines are as important as the guidelines themselves. The effectiveness of these strategies is rarely ever tested specifically for the allied health therapy group. Objectives- To explore the evidence for implementation strategies within allied health. This review sought to explore the effectiveness of implementation strategies for promoting evidence informed interventions in allied healthcare. Data sources- Cochrane, Medline, Embase and Scopus were searched from 2000 onwards. Study eligibility : Level I and II studies were included if an evidence informed implementation strategy was tested in allied health personnel. Study appraisal and synthesis methods: The SIGN method was used to evaluate risk of bias. The National Health and Medical Research Council (NHMRC) model was applied to evaluate the grade for recommendation. Results- A total of 490 unique articles were identified, with 6 primary studies meeting the inclusion criteria. Three different implementation strategies and three multi-faceted components strategies were described. We found moderate evidence for educational meetings, local opinion leaders and patient mediated interventions. We found stronger evidence for multi-faceted components strategies. Conclusion- Few studies describe the effectiveness of implementation strategies for allied healthcare, but evidence was found for multi-faceted components for implementing research in an allied health therapy group population.
Publisher: OMICS Publishing Group
Date: 2013
Publisher: Wiley
Date: 16-02-2016
DOI: 10.1002/PRI.1661
Abstract: Physiotherapy or Physical Therapy (PT) is the most commonly practised allied health discipline globally. International PT workforce reforms are underway to deal with increasing patient numbers, shrinking medical and nursing workforces and lengthy waiting lists. It is timely to consider international differences in PT, with the aims of identifying opportunities for shared learning and forming stronger international alliances to support consistent and evidence-based workforce reforms. This paper synthesizes freely available information on PT training and service delivery across the UK, Australia and United States (California). The paper considers differences in roles, workplaces, training, legislation and registration, continuing professional development, and accountability. There are similarities between UK, Australia and United States (California) in many areas of PT roles, training, registration, legislation and professional practice. However, none has a standard national mechanism by which to demonstrate PT accountability, patient safety or quality care. Moreover, there are different approaches to workforce reforms. There is considerable duplication in physiotherapy governance. There are opportunities for targeted international collaborations regarding workforce reforms such as extending scope of practice, and determining and implementing internationally agreed ways of demonstrating PT accountability. The findings of this review have significant policy implications, and identify areas for collaborative research. Copyright © 2016 John Wiley & Sons, Ltd.
Publisher: Informa UK Limited
Date: 07-2019
Publisher: Springer Science and Business Media LLC
Date: 30-10-2018
Publisher: Informa UK Limited
Date: 11-2016
Publisher: University of Toronto Press Inc. (UTPress)
Date: 08-2020
Publisher: Informa UK Limited
Date: 12-2013
Publisher: Wiley
Date: 21-09-2015
DOI: 10.1002/SONO.12032
Publisher: Informa UK Limited
Date: 15-04-2016
DOI: 10.1080/00140139.2016.1158324
Abstract: Load restraint systems in automobile transport utilise tie-down lashings placed over the car's tyres, which are tensioned manually by the operator using a ratchet assembly. This process has been identified as a significant manual handling injury risk. The aim of this study was to gain insight on the current practices associated with tie-down lashings operation, and identify the gaps between current and optimal practice. We approached this with qualitative and quantitative assessments and one numerical simulation to establish: (i) insight into the factors involved in ratcheting (ii) the required tension to hold the car on the trailer and (iii) the tension achieved by drivers in practice and associated joint loads. We identified that the method recommended to the drivers was not used in practice. Drivers instead tensioned the straps to the maximum of their capability, leading to over-tensioning and mechanical overload at the shoulder and elbow. We identified the postures and strategies that resulted in the lowest loads on the upper body during ratcheting (using both hands and performing the task with their full body). This research marks the first step towards the development of a training programme aiming at changing practice to reduce injury risks associated with the operation of tie-down lashings in the automobile transport industry. Practitioner Summary: The study investigated current practice associated with the operation of tie-down lashings through qualitative (interviews) and quantitative (biomechanical analysis) methods. Operators tended to systematically over-tension the lashings and consequently overexert, increasing injury risks.
Publisher: SAGE Publications
Date: 07-2006
DOI: 10.1111/J.1468-2982.2006.01120.X
Abstract: The epidemiological and clinical literature identifies strong associations between adult headache, cervical and thoracic spine dysfunction and spinal posture. This paper reports on the prevalence and incidence of headache, neck and upper back pain which occurred in the previous week, in urban Australians aged 13–17 years. Commencing in 1999, we followed a cohort of South Australian students through 5 years of secondary schooling. Of our commencing cohort of students, 132 (30±) provided data on bodily pain every year. For both girls and boys, there was a significantly decreasing prevalence of headache over the study period, while neck pain and upper back pain increased. There was a significantly increasing trend over time for boys with upper back pain. Twenty percent of girls and boys consistently reported headache, neck pain or upper back pain over 5 years. The progression of early adolescent headaches to mid-adolescent neck and upper back pain potentially reflects the adolescents’ biomechanical responses to intrinsic and extrinsic imposts. This requires further investigation to understand the causes of adolescent headache, neck and upper thoracic pain.
Publisher: Elsevier BV
Date: 09-2008
DOI: 10.1016/J.JMPT.2008.08.005
Abstract: This article provides a historical perspective and an overview of different ways of measuring sagittal plane cervical posture in clinical and research settings. Measures of cervical posture are considered, in terms of their purpose, their reliability and validity, and their capacity to provide knowledge about cervical posture. Despite technological advances in measurement techniques, there is still much to learn about cervical posture in terms of understanding how the neck balances the head against the force of gravity. The in idual spinal segments of the neck assume different relative positions, depending on the in idual's genetics anatomical construction occupational demands muscle strength and endurance as well as mental state, personality, and culture. Valid measures which can capture this objectively and reliably continue to challenge clinicians and researchers.
Publisher: Elsevier BV
Date: 09-2020
Publisher: Elsevier BV
Date: 08-2011
DOI: 10.1016/J.MATH.2011.02.007
Abstract: Evidence based practice has been defined as "the explicit, conscientious and judicious attempt to find the best possible available research evidence to assist the health professionals to make the best decision for their in idual clients." (Sackett et al., 1996). In clinical manual therapy practice, this involves integrating research evidence with clinical experience and patient values. Currently randomised controlled trials are considered the highest level of research design in terms of strength of the evidence provided, due to the methodological control of potential sources of bias. However, the mechanisms that ensure internal validity of an RCT, i.e. randomisation, and intervention standardisation, threaten the generalisibility, and therefore relevance of the evidence to manual therapy. Manual therapy represents a complex intervention and therapists need to review the notion of 'research evidence', in the context of the clinical practice of manual therapy. Reviewing the construct of what constitutes an intervention, increasing post-hoc analysis of subject sub groupings and revisiting 'lower levels' of research design are all suggested as possible approaches.
Publisher: Informa UK Limited
Date: 12-2013
Publisher: Journal of Orthopaedic & Sports Physical Therapy (JOSPT)
Date: 02-2020
Abstract: To describe the location and severity of pain during Functional Movement Screen (FMS) testing in junior Australian football players and to investigate its effect on FMS composite score and injury risk. Prospective cohort study. Junior male Australian football players (n = 439) completed preseason FMS testing. Pain location and severity (on a 0-to-10 numeric pain-rating scale [NPRS]) were assessed for painful subtests. The FMS composite score was calculated using 3 scoring approaches: "traditional," a score of zero on painful subtests "moderate," a score of zero on painful subtests if an NPRS pain severity was greater than 4 and "raw," did not adjust painful FMS subtest scores. Players were monitored throughout the competitive season and considered injured when 1 or more matches were missed due to injury. One hundred seventy players reported pain during FMS testing. The pain-scoring approach affected mean composite score values (raw, 14.9 moderate, 14.5 traditional, 13.6 Pain was common during FMS testing in junior Australian football players and had a notable effect on the FMS composite score, but minimal effect on subsequent injury risk.
Publisher: Wiley
Date: 28-03-2022
DOI: 10.1002/SONO.12306
Abstract: Increases in demand for therapeutic ultrasound‐guided musculoskeletal injections have led to longer waiting times for appointments. With the right training, sonographers are well placed to perform these low‐risk procedures. This study evaluated the effect of musculoskeletal injections administered by trained sonographers with respect to patient safety and satisfaction. Patients were recruited from three radiology clinics staffed with appropriately trained sonographers. Patients who agreed to have their injection completed by a sonographer completed satisfaction surveys immediately after their appointment, with adverse reactions also recorded. Longer‐term outcomes were recorded 7–10 days later. 97% of 804 participating patients were completely satisfied with the service they received. Reported adverse events were low, with % and 8% immediately and at follow up respectively. There was demonstrated patient satisfaction with staff and the service, and support for the importance of this service in reducing the extensive waiting times experienced. This study indicates that appropriately trained sonographers can provide ultrasound‐guided musculoskeletal injections at a level of safety which is comparable to similar injection procedures explored in the literature. The high level of satisfaction of the patients suggest that this service should be extended and expanded to address patient concerns regarding long waiting times.
Publisher: SAGE Publications
Date: 12-2021
DOI: 10.1177/23259671211064645
Abstract: Shoulder and elbow overuse injuries are the most common problems in baseball players. No scoping review has compared the findings from different types of evidence. To map the broad evidence from 3 types of evidence (epidemiological, biomechanical, and narrative) on potential risk factors for shoulder and elbow injuries in baseball and identify gaps in the existing literature to guide future research. Scoping review. Eight electronic databases were searched from inception to May 14, 2020. Any peer-reviewed papers that investigated or discussed potential risk factors for shoulder and elbow injuries in baseball were included. A total of 302 studies (107 epidemiological studies, 85 biomechanical studies, and 110 narrative reviews) were included. Risk factors were categorized into 9 domains: sports profiles, physical characteristics/functions, pitching mechanics, performance, behavioral, psychosocial, biological and developmental, injury/sports profiles, and environmental factors. Studies were consistent in supporting limited shoulder range of motion (ROM) and player positions (pitchers or catchers) as risk factors for shoulder injuries. For elbow injuries, the majority of the included studies suggested that being pitchers or catchers and working with higher ball velocity can be risk factors. Findings were consistent in some risk factors, such as limited shoulder ROM and positions. However, findings were inconsistent or limited for most factors, and substantial research gaps were identified. Research assessing those factors with inconsistent or limited evidence in the current literature were recognized to be priorities for future studies.
Publisher: BMJ
Date: 08-2019
DOI: 10.1136/BMJOPEN-2018-023080
Abstract: To describe the range and nature of available research regarding sources of information that patients access to inform their decisions about elective surgery. Scoping review. Peer-reviewed studies published until February 2019 from the six scientific literature databases were searched and included in the study: Medline, PubMed, CINAHL, Academic Search Premier, EMBASE and SCOPUS. Web searches for grey literature were conducted in Google, South Australia Department of Health, Commonwealth Department of Health (Australia) and My Aged Care from the Department of Social Services (Australia). Studies with a focus on elective surgery information sources oriented to patients were eligible for inclusion. Only studies written in English were sought and no publication date or study restrictions were applied. Included literature was described by National Health and Medical Council hierarchy of evidence, and data were extracted on country and year of publication, type of literature, who provided it and any information on end users. Information sources were categorised by type and how information was presented. A pool of 1039 articles was reduced to 26 after screening for duplicates and non-relevant studies. Face-to-face exchanges were the most likely source of information prior to elective surgery (59.3%), printed information (55.6%) followed by e-learning (51.9%) and multimedia (14.8%). The face-to-face category included information provided by the physician/general practitioners/specialists, and family and friends. Printed information included brochures and p hlets, e-learning consisted of internet sites or videos and the use of multimedia included different mixed media format. There is considerable variability regarding the types of information patients use in their decision to undergo elective surgery. The most common source of health information (face-to-face interaction with medical personnel) raises the question that the information provided could be incomplete and/or biased, and dependent on what their health provider knew or chose to tell them.
Publisher: Informa UK Limited
Date: 2014
DOI: 10.2147/CIA.S56086
Publisher: Mary Ann Liebert Inc
Date: 02-2007
Abstract: The construction of stable engineered tissue depends on the formation of a functional connective tissue produced by cells locally. A major component of connective tissue is collagen. Its deposition into a stable matrix depends on the enzymatic extracellular conversion of procollagen to collagen. This step is very slow in vitro and we hypothesized that this is due to a lack of crowdedness and insufficient excluded volume effect (EVE) in culture media. We used neutral (670 kDa) and negatively charged dextran sulfate (DxS, 500 kDa) to create EVE in cell cultures and to enhance in vitro matrix formation by accelerating procollagen conversion. Biochemical analyses in 2 human fibroblast lines revealed mostly unprocessed procollagen in uncrowded culture medium, whereas in the presence of DxS, procollagen conversion occurred and most of the collagen was associated with the cell layer. Immunocytochemistry confirmed DxS-related collagen deposition that colocalized with fibronectin. The large neutral dextran showed, in identical concentration ranges, no effects that correlated well with its smaller hydrodynamic radius as determined by dynamic light scattering. This predicted a 10 times bigger crowding power of DxS and benchmarks it as a potentially promising crowding agent facilitating the formation of extracellular matrix in vitro.
Publisher: Springer Science and Business Media LLC
Date: 17-04-2002
Abstract: Backpack loads produce changes in standing posture when compared with unloaded posture. Although 'poor' unloaded standing posture has been related to spinal pain, there is little evidence of whether, and how much, exposure to posterior load produces injurious effects on spinal tissue. The objective of this study was to describe the effect on adolescent sagittal plane standing posture of different loads and positions of a common design of school backpack. The underlying study aim was to test the appropriateness of two adult 'rules-of-thumb'-that for postural efficiency, backpacks should be worn high on the spine, and loads should be limited to 10% of body weight. A randomised controlled experimental study was conducted on 250 adolescents (12-18 years), randomly selected from five South Australian metropolitan high schools. Sagittal view anatomical points were marked on head, neck, shoulder, hip, thigh, knee and ankle. There were nine experimental conditions: combinations of backpack loads (3, 5 or 10% of body weight) and positions (backpack centred at T7, T12 or L3). Sagittal plane photographs were taken of unloaded standing posture (baseline), and standing posture under the experimental conditions. Posture was quantified from the x (horizontal) coordinate of each anatomical point under each experimental condition. Differences in postural response were described, and differences between conditions were determined using Analysis of Variance models. Neither age nor gender was a significant factor when comparing postural response to backpack loads or conditions. Backpacks positioned at T7 produced the largest forward (horizontal) displacement at all the anatomical points. The horizontal position of all anatomical points increased linearly with load. There is evidence refuting the 'rule-of-thumb' to carry the backpack high on the back. Typical school backpacks should be positioned with the centre at waist or hip level. There is no evidence for the 10% body weight limit.
Publisher: Informa UK Limited
Date: 21-03-2017
DOI: 10.1080/02699052.2017.1283060
Abstract: Neurogenic heterotopic ossification (NHO) occurs as a complication of traumatic brain injury (TBI). Management of clinically significant NHO remains variable. Complications of mature NHO include limitation of mobility. The effect of the extracorporeal shock wave therapy (ESWT) on range of motion at hip and knee, and function in patients with TBI with chronic NHO was investigated. A series of single-case studies applying ESWT to chronic NHO at the hip or knee of 11 patients with TBI were undertaken at a rehabilitation hospital. Participants received four applications of high-energy EWST delivered to the affected hip or knee over a period of 8 weeks. Two-weekly follow- up assessments were carried out final assessments were made 3 and 6 months post-intervention. Range of motion (ROM) and Functional Reach (FR) or Modified Functional Reach (MFR) were measured. Application of high-energy ESWT was associated with significant improvement in ROM (flexion) of the NHO-affected knee (Tau = 0.833, 95% CI 0.391-1.276, p = 0.002) and significant improvement of FR (Overall Tau 0.486, 95% CI 0.141-0.832, p = 0.006) no significant improvement in hip ROM or MFR. ESWT may improve mobility and balance of patients with TBI who have chronic NHO.
Publisher: Informa UK Limited
Date: 06-2011
DOI: 10.2147/JMDH.S20265
No related grants have been discovered for Steve Milanese.