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Evaluation Of Exercise Rehabilitation For Survivors Of Intensive Care
Funder
National Health and Medical Research Council
Funding Amount
$359,282.00
Summary
Intensive care medicine has improved survival in critically ill patients. However, international literature reports poor quality of life and physical outcomes in ICU survivors compared to people of the same age. In addition, patients who require a prolonged ICU stay consume a large amount of resources. This project is testing whether an early ICU physiotherapist-directed exercise rehabilitation program continuing until after hospital discharge will improve patient's quality of life, physical fun ....Intensive care medicine has improved survival in critically ill patients. However, international literature reports poor quality of life and physical outcomes in ICU survivors compared to people of the same age. In addition, patients who require a prolonged ICU stay consume a large amount of resources. This project is testing whether an early ICU physiotherapist-directed exercise rehabilitation program continuing until after hospital discharge will improve patient's quality of life, physical function and decrease the use of health resources compared with patients' receiving standard care. Patients in the rehabilitation group will take part in a physiotherapy exercise rehabilitation program including returning to out patient classes after discharge. The physiotherapist will treat patients daily during hospital stay then twice weekly for 8 weeks after discharge. All patients will complete 2 quality of life questionnaires and physical function will be assessed using a new test developed for the acute ICU stay the 6 minute walk test, which measures how far patients can walk quickly in 6 minutes. The timed up and go test will also be used and it measures how quickly patients can get up from a chair and walk. An activity monitor, worn on the wrist, for some of the time after discharge will measure how much exercise and moving about patients are doing at home. Measurements will performed by a physiotherapist, blinded to the group to which patients were randomly allocated, on admission to the ICU (quality of life only by proxy), on discharge from the ICU, discharge from hospital and at 3, 6, 12 months after discharge. Economic evaluation will be performed to examine overall use of resources using information from the questionnaires.Read moreRead less
Pain And Trunk Muscle Control: Effects, Mechanisms And Consequences
Funder
National Health and Medical Research Council
Funding Amount
$296,452.00
Summary
Twenty-one percent of Australians report long-term back problems. This makes back pain the most common chronic pain in Australia and most prevalent disorder among the National Health Priority Areas. For the majority with recurrent and chronic problems, the cause is unknown but changes in control of the spine are thought to be important. It is well accepted that pain and injury to the low back affect the way that we control the back muscles and this leads to changes in spinal function. However, d ....Twenty-one percent of Australians report long-term back problems. This makes back pain the most common chronic pain in Australia and most prevalent disorder among the National Health Priority Areas. For the majority with recurrent and chronic problems, the cause is unknown but changes in control of the spine are thought to be important. It is well accepted that pain and injury to the low back affect the way that we control the back muscles and this leads to changes in spinal function. However, despite considerable investigation of this problem, there is a distinct lack of consensus for how the control of movement is changed during pain, why it changes, and whether these changes lead to further problems in the long term. The objective of this series of studies is to determine how the adaptation to pain changes the control of the spine. We will use a range of techniques that include tests of the strategies used by the brain to control the spine and mathematical models to estimate the effect that these changes have on the spine when people are given back pain by injecting sterile salty water into the back muscles. These studies will be backed up by measures of mechanical properties of the spine and by comparison to people with clinical pain. This combination of methods has not been used previously and is likely to help resolve the problem of how muscle control is chaged in back pain. We will also test a range of hypotheses regarding how pain has its effect on muscle activity. A final series of studies aims to determine whether the failure of these changes in muscle control to resolve after an epiosde of back pain leads to increased recurrence of pain in the long-term. The importance of this project is highlighted by the significance of back pain as a major health issue, the lack of consensus regarding the effect and mechanisms of pain on trunk muscle control (despite extensive investigation), and the potential for the findings to guide rehabilitation and management.Read moreRead less
Discovery Early Career Researcher Award - Grant ID: DE120100402
Funder
Australian Research Council
Funding Amount
$375,000.00
Summary
The effectiveness of intervention in communication and safety climate in the operating room. This project will evaluate the effectiveness of an educational intervention on teamwork behaviours in surgery. It will deliver beneficial effects for communication in service delivery, safety and patient care in support of health care in high risk environments.
Effective Management Of Acute Whiplash Injuries Requires A Pragmatic Approach: An RCT With Stratified Treatments
Funder
National Health and Medical Research Council
Funding Amount
$382,550.00
Summary
Whiplash injuries from a motor vehicle crash continue to incur substantial personal and financial costs to the community and the insurance industry. The current approaches to an acute whiplash injury in Australia and internationally have failed to lessen the rate of how many people develop chronic neck pain. Between 40 and 60% still have pain 6 months after injury. Motor Accident Insurance Commission (Qld) figures indicate that 20% of patients with chronic whiplash account for 60% of the costs. ....Whiplash injuries from a motor vehicle crash continue to incur substantial personal and financial costs to the community and the insurance industry. The current approaches to an acute whiplash injury in Australia and internationally have failed to lessen the rate of how many people develop chronic neck pain. Between 40 and 60% still have pain 6 months after injury. Motor Accident Insurance Commission (Qld) figures indicate that 20% of patients with chronic whiplash account for 60% of the costs. Transition from an acute to a chronic condition must be prevented. A new direction in management in the acute stage is urgently required as once the pain has become chronic, it is difficult to help. This research will conduct a novel randomised controlled trial for acute whiplash. It will test individually prescribed multi-professional management against usual care with the aim to lessen the numbers who go on to develop chronic pain. It will be the first clinical trial that acknowledges from the outset that the whiplash injuries and affects people in different ways. Our previous research with acute whiplash patients has documented the variations in presentation from physical, physiological and psychological perspectives. In this trial, management will be prescribed as directed by measurable pain, muscle and psychological impairments in the individual, rather than regard all patients as the same as in other trials. This trial will offer individualised treatments; medical, physiotherapy and-or psychological using an empirically derived treatment algorithm. Cost-effectiveness of the program will be evaluated against that incurred during usual care. It is predicted that early multi-professional management will be less expensive in the long term than existing approaches. This RCT stands to extend knowledge in the management of whiplash associated disorders (WAD).Read moreRead less
The Efficacy Of Manipulation For Recent Onset Neck Pain
Funder
National Health and Medical Research Council
Funding Amount
$393,974.00
Summary
Neck pain is extremely common, with a point prevalence of 46% in the general community. Neck pain can cause significant disability, and is the second most common injury causing people to take time off work. Neck pain and its associated disability clearly poses a substantial social and economic burden. Neck manipulation (high velocity thrust of the joints, often associated with a click) is widely used by physiotherapists for the management of recent onset neck pain, but there is no clear evidence ....Neck pain is extremely common, with a point prevalence of 46% in the general community. Neck pain can cause significant disability, and is the second most common injury causing people to take time off work. Neck pain and its associated disability clearly poses a substantial social and economic burden. Neck manipulation (high velocity thrust of the joints, often associated with a click) is widely used by physiotherapists for the management of recent onset neck pain, but there is no clear evidence for its efficacy. In addition, the use of manipulation is associated with serious, although rare, adverse events such as stroke or even death. The risk-benefit analysis, therefore, does not clearly favour manipulation because efficacy has not been established, while the risks are serious, but infrequent. The findings of the proposed study will clearly and precisely determine the efficacy of manipulation compared with the safer treatment technique of mobilisation (gentle oscillatory pressure applied to the joints), information that is currently unavailable. This information is of vital importance to many different disciplines, including health professionals, insurance companies, and to administrators for development of health policy. Our findings will thus provide evidence-based guidelines for the use of manipulation, and will ultimately lead to safer practice of physiotherapy for neck pain.Read moreRead less