Individual Nutrition Therapy And Exercise Regime: A Controlled Trial Of Injured, Vulnerable Elderly (INTERACTIVE Trial).
Funder
National Health and Medical Research Council
Funding Amount
$572,542.00
Summary
Hip fractures are a common and growing problem for older Australians. Unfortunately recovery is incomplete in most people. In this study two factors believed to be important for recovery will be investigated - exercise and nutrition. After a hip fracture the ability to walk is severely compromised, as are appetite and dietary intake. These factors are likely to contribute to the loss of muscle mass and strength frequently observed amongst this patient group. There is considerable evidence to sug ....Hip fractures are a common and growing problem for older Australians. Unfortunately recovery is incomplete in most people. In this study two factors believed to be important for recovery will be investigated - exercise and nutrition. After a hip fracture the ability to walk is severely compromised, as are appetite and dietary intake. These factors are likely to contribute to the loss of muscle mass and strength frequently observed amongst this patient group. There is considerable evidence to suggest that this loss has serious consequences in terms of ability to return to pre-injury levels of function, restriction in independence and ultimately transfer into a hostel or nursing home. Given these facts it makes sense that an exercise program incorporating strength and functional activities, and a nutrition program aimed at achieving nutritional requirements, will improve ability to walk, but there is no conclusive evidence that this is so. Only a small number of studies have tested whether an exercise program improves recovery after a hip fracture and these have mostly commenced weeks or months after the injury when it is likely that there has been irreversible decline in muscle mass and strength. In contrast, most of the nutrition studies commence soon after the injury but provide protein and calories insufficient to meet requirements, provide supplements that patients find difficult to drink or provide the supplements for only a short duration. This study will use the best quality research methods to test whether providing a 6-month individualised exercise and nutrition program to hip fracture patients soon after injury improves walking and other important health outcomes. Patients will be followed for 12 months to determine what difference the exercise and nutrition programs make. If they help then health services will have the evidence they need to recommend this type of program to the growing number of older Australians that suffer a hip fracture.Read moreRead less
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
About 1 in 10 Australians have persisting or chronic low back pain. Most are managed in primary care and the most frequently prescribed treatment is exercise. Chronic low back pain remains a major health problem because not all patients respond to each treatment so on average treatment effects are small. At present there are no guidelines to help clinicians select the best treatment for a patient. As a result a lot of time and money is wasted on treatments which ultimately fail to help the patie ....About 1 in 10 Australians have persisting or chronic low back pain. Most are managed in primary care and the most frequently prescribed treatment is exercise. Chronic low back pain remains a major health problem because not all patients respond to each treatment so on average treatment effects are small. At present there are no guidelines to help clinicians select the best treatment for a patient. As a result a lot of time and money is wasted on treatments which ultimately fail to help the patient. We have begun a research program to solve this primary health care problem. We have focussed on exercise because the treatment is widely available in primary care and of modest cost. The program includes basic research to understand the mechanism of action of exercise and clinical trials testing the effectiveness of different types of exercise. The proposed study falls into the latter category, and is a direct comparison of the two most promising types of exercise used in Australia. The study will also identify clinical features that modify treatment effects, a finding that will allow clinicians to identify which type of exercise is more likely to be effective for an individual patient. This study offers a potential solution to a major health problem with enormous economic and social costs.Read moreRead less
I am a physiotherapist with special expertise in ergonomics. My research aims to improve health outcomes through an understanding the physical impact of new technology use.