Bridging The Gap Between Laboratory And Clinic Using Low Cost, High Tech Physical Function Assessment Tools
Funder
National Health and Medical Research Council
Funding Amount
$428,065.00
Summary
Gold-standard testing protocols for assessing standing balance, gait and activities of daily living is often a primary focus for therapeutic interventions. They often incorporate multiple force platforms and 3D motion analysis, which provide valuable information however the time, cost and infrastructure required excludes their use in normal clinical practice. This fellowship examines the potential efficacy of low cost, widely available alternatives such as video gaming devices and smart phones.
Assessment Of Vestibular Function And Balance In Humans
Funder
National Health and Medical Research Council
Funding Amount
$205,500.00
Summary
This proposal focuses upon the function of the vestibular apparatus and the related problem of impaired balance. The vestibular apparatus contains receptors which help us to maintain balance. Their clinical assessment is difficult because they are small and lie deep within the skull. With previous NH and MRC support, I have been able to develop a series of new tests to assess the function of the vestibular apparatus and these are having significant clincal impact. Amongst the findings has been a ....This proposal focuses upon the function of the vestibular apparatus and the related problem of impaired balance. The vestibular apparatus contains receptors which help us to maintain balance. Their clinical assessment is difficult because they are small and lie deep within the skull. With previous NH and MRC support, I have been able to develop a series of new tests to assess the function of the vestibular apparatus and these are having significant clincal impact. Amongst the findings has been a clear demonstration that vestibular function declines with age, starting relatively early. This proposal builds upon the findings of the previous application. Two main types of investigations are planned. In one a new technique of activating the vestibular apparatus (localised skull vibration) will be used to study the brain areas that receive its signals (evoked potentials). This will be the first time that it has been possible to study the connections between the balance organs and the cortex of the brain in intact humans. I will apply the technique to patients with disturbed vestibular function to improve our knowledge of how the brain adapts to disease of these organs. In the second part of this study, a series of recordings will be done measuring sway under a variety of conditions both in normal volunteers and in patients with some common disease states affecting balance. This should reveal new information about both the factors that affect normal balance function and why balance is disturbed in these diseases.Read moreRead less
Improving Postural Stability In People With Parkinson's Disease Using Textured Insoles.
Funder
National Health and Medical Research Council
Funding Amount
$968,538.00
Summary
Falls are a major health and injury problem for people with Parkinson's disease (PD). In this study we propose to undertake a randomised control trial to determine the efficacy of textured insoles to improve postural stability and reduce falls risk in people with Parkinson’s disease. The success of such an inexpensive device would result in improved health outcomes for individuals and large savings in health care through a reduction in fall-related injuries.
Optimising The Diagnosis And Management Of Treatment Refractory Benign Positioning Vertigo
Funder
National Health and Medical Research Council
Funding Amount
$286,466.00
Summary
Benign Positioning Vertigo, the most common and correctable cause of dizziness, is caused by freely floating calcium carbonate crystals in the semicircular canals of the inner ear. Localizing the affected semicircular canal holds the key to effective treatment.A proportion of sufferers will not respond to conventional repositioning treatments due to incorrect diagnoses. This study will explore refractory BPV in detail, develop test methods that accurately localize the affected canal and devise t ....Benign Positioning Vertigo, the most common and correctable cause of dizziness, is caused by freely floating calcium carbonate crystals in the semicircular canals of the inner ear. Localizing the affected semicircular canal holds the key to effective treatment.A proportion of sufferers will not respond to conventional repositioning treatments due to incorrect diagnoses. This study will explore refractory BPV in detail, develop test methods that accurately localize the affected canal and devise treatments for resistant BPV subtypes.Read moreRead less
Dynamic Postural Stability And Falls Prediction In Older People During Walking In Real-world Environments.
Funder
National Health and Medical Research Council
Funding Amount
$680,793.00
Summary
The increased occurrence of falls with advancing age (33-50% of people aged >65 years) is a significant cause of mortality (1014 deaths in 1998), morbidity, and disability, affecting not only the individuals concerned, but the health care system (45,069 fall related hospitalizations in 1998 in Australia) and the broader community (National falls Prevention Initiative, 2004). Although there are a number of falls risk tests, most rely on determination of body sway while standing when the body i ....The increased occurrence of falls with advancing age (33-50% of people aged >65 years) is a significant cause of mortality (1014 deaths in 1998), morbidity, and disability, affecting not only the individuals concerned, but the health care system (45,069 fall related hospitalizations in 1998 in Australia) and the broader community (National falls Prevention Initiative, 2004). Although there are a number of falls risk tests, most rely on determination of body sway while standing when the body is static rather than in motion. Given that up to 70% of falls occur during walking and performing transfers, there is a clear need to develop tests of falls risk prediction that incorporate indices of postural stability measured during more dynamic activities. Test development needs to be underpinned by clear evidence of how age-related sensory and motor deficits affect postural stability during walking. The studies outlined in this application will develop and utilise new accelerometer-based technologies to determine the fundamental mechanisms underlying balance control during walking in older people. Specifically, this project will aim to develop a clear understanding of how changes in factors as vision, neuromuscular function (strength, stiffness) and proprioception contribute to the overall decline in stability and balance during walking in older people. Combined with physiological assessment measures developed by the research team, the research will allow the development of a more definitive predictive test of stability and falls risk. This test will be able to be used by health professionals for assessment of older people to determine the most effective therapeutic and-or exercise interventions to target those individuals at risk. This technology will also be adaptable to a biofeedback device to allow individuals to monitor their own stability.Read moreRead less
The aim of my project grant is to develop a portable electrodiagnostic test to classify balance disorders by compiling a statistically validated database of eye movement patterns associated with specific balance disorders. What is unique about this electrodiagnostic balance disorder test, which distinguishes it from but also complement conventional balance function tests, is its ability not only to show an impairment of balance function, but it can differentiate between balance disorders.
This research program is aimed at finding effective prevention strategies for the important issue of falls in older people. It will: a) conduct studies to improve our understanding of fall risk in people with Parkinson’s disease and dementia; b) undertake a study to improve our management of dizziness; c) seek treatments for fear of falling, and d) evaluate home exercise interventions for older people at risk of falls and strength and cued walking training for people with Parkinson’s disease.