External Therapeutic Device To Support Rehabilitation Of The Hand Following Trauma Or Surgery
Funder
National Health and Medical Research Council
Funding Amount
$175,000.00
Summary
The loss of hand function will affect every aspect of an individual’s life. This includes the ability to feed and care for themselves and the ability to work and participate in family life. For people recovering from problems such as trauma, burns or surgery affecting the hand, careful management of hand rehabilitation can influence the outcome for the patient significantly. In order to reduce the possibility of mobility difficulties occurring, including loss of joint range of motion, muscle and ....The loss of hand function will affect every aspect of an individual’s life. This includes the ability to feed and care for themselves and the ability to work and participate in family life. For people recovering from problems such as trauma, burns or surgery affecting the hand, careful management of hand rehabilitation can influence the outcome for the patient significantly. In order to reduce the possibility of mobility difficulties occurring, including loss of joint range of motion, muscle and tendon sheath adhesions or non-functional scar tissue formation, continuous passive motion (CPM) is often indicated. Additionally, for people with reduced mobility of the hand due to upper limb paralysis, such as those with cervical spinal cord injury, stroke, cerebral palsy or peripheral nerve injury, disregard for management of the maintenance of the joint range of motion of the effected hand will result in contracture and limited joint range of motion. Such syndromes will reduce hand function, which is already limited by paralysis, and will negatively affect potential outcomes for aggressive rehabilitation techniques, such as tendon transfer surgery and functional neuromuscular stimulation. Therefore, in such cases, CPM is also indicated. Current devices applying CPM have shown to be effective in minimising the syndromes indicated above and these results are summarised in the Background and Research Plan attached to this proposal. Unfortunately, the use of such devices is not always prescribed by clinicians. This is due, mainly, to the limitations of these devices that are in the marketplace. These limitations include lack of secure finger placement, lack of portability, the inability to provide specialised therapy to specific joints and inflexible programming. This proposal introduces an improved device to be developed and these improvements form the proposal aims below. Given such an improved device, which can overcome many of the problems with current CPM machines, it is likely that that the clinical application of CPM will achieve the greater degree of prescription and application in hand rehabilitation. These improvements should overcome the clinical reticence to use these devices and restore a balance by increasing their use to the level that the scientific literature indicates they should have. The overall aim of the proposal is to take the device to a stage where it is ready for clinical trial.Read moreRead less
Improving The Health Of Older Australians At Risk Of Dementia - The Role Of Physical Function And Exercise
Funder
National Health and Medical Research Council
Funding Amount
$533,120.00
Summary
This fellowship will support novel research to examine whether exercise can improve the cognitive and physical health of individuals at risk of dementia such as those with Type 2 Diabetes or cognitive impairment. Outcomes are likely to delay the onset of dementia and enable older Australians at risk of dementia to maintain independence and improved quality of life.
As part of this fellowship, A/Prof Hylton Menz will undertake a comprehensive program of research to improve the health-related quality of life of older people with foot disorders. The research will help further our understanding of the causes and impact of foot disorders, assist in the development of new treatments, and evaluate the effectiveness of these treatments through the conduct of clinical trials.
My primary research interest is in the effectiveness of physiotherapy interventions. A second research interest is in the mechanical and architectural properties of human muscles and tendons.
Low oxygen levels during exercise occur in over half of all people with lung fibrosis and this is associated with poor outcomes. Low oxygen levels are sometimes treated by breathing extra oxygen during physical activity, but a lack of evidence has given rise to wide variations in practice and policy. This study will examine the benefits and costs of ambulatory oxygen therapy for people with lung fibrosis in a multi-site randomised controlled trial.
Assessment Of Physical Therapies To Improve Secretion Clearance In Patients With Cystic Fibrosis
Funder
National Health and Medical Research Council
Funding Amount
$302,310.00
Summary
People with cystic fibrosis (CF) produce thick mucus that is not cleared normally from the lungs. This retained mucus often becomes infected, which progressively damages the lungs. Various physical therapies which may help clear secretions are being used in CF. These include several types of devices which provide positive pressure to the airways. However, it is not known to what extent these devices, or other interventions such as manual chest physiotherapy and exercise, enhance mucus clearance. ....People with cystic fibrosis (CF) produce thick mucus that is not cleared normally from the lungs. This retained mucus often becomes infected, which progressively damages the lungs. Various physical therapies which may help clear secretions are being used in CF. These include several types of devices which provide positive pressure to the airways. However, it is not known to what extent these devices, or other interventions such as manual chest physiotherapy and exercise, enhance mucus clearance. As a result, it is not currently possible to scientifically prescribe intervention(s) to enhance mucus clearance in CF. This is partly because much of the research that has been performed in this area has been poorly-designed or has used inaccurate measures. Also, recent research has shown that these therapies may have significant effects beside their effect on mucus clearance. For instance, bacterial infection and the exchange of oxygen and carbon dioxide between the blood supply and air in the lung may all be affected by these interventions. Notably, the extent of benefit or detriment seen in these parameters does not always correlate with the effect on mucus clearance. We therefore believe a series of experiments is necessary to provide evidence upon which the scientific selection of mucus clearance therapies may be based. We have developed a new technique which allows clearance of mucus from the airways to be objectively measured in three-dimensions (3D). We intend to use the 3D technique to examine the effects of three different positive pressure devices, exercise, and manual chest physiotherapy on mucus clearance. Based on the outcomes of this research, we intend to compare the most appropriate therapy to performing no mucus clearance therapy in a short term trial. This trial will assess changes in the following: bacterial infection, mucus plugging in the airways, how well the lungs move air and exchange oxygen and carbon dioxide, and the patient's quality of life.Read moreRead less
Embedding Sustainable Physical Activity Into The Everyday Life Of Adults With Intellectual Disability
Funder
National Health and Medical Research Council
Funding Amount
$601,613.00
Summary
Adults with intellectual disability are much less physically active than the general community. In Australia, only around half the proportion of adults with intellectual disability compared with the general community meet national guidelines for physical activity. The overarching aim of the project is to sustainably increase physical activity in everyday life among adults with intellectual disability, at least to the level of the general community, to significantly improve their fitness and well ....Adults with intellectual disability are much less physically active than the general community. In Australia, only around half the proportion of adults with intellectual disability compared with the general community meet national guidelines for physical activity. The overarching aim of the project is to sustainably increase physical activity in everyday life among adults with intellectual disability, at least to the level of the general community, to significantly improve their fitness and well-being.Read moreRead less
A hierarchical quantum mechanical and classical simulation of biological ion channels. I aim to develop a methodology incorporating molecular quantum
mechanics and classical Brownian mechanics in a way that can be
applied practically to large macromolecular systems, thus relating
fine structural details to experimentally measurable
properties. Specifically, I will apply this methodology to study ion
channels in which the challenge is to relate electronic and atomic
structure to the conduct ....A hierarchical quantum mechanical and classical simulation of biological ion channels. I aim to develop a methodology incorporating molecular quantum
mechanics and classical Brownian mechanics in a way that can be
applied practically to large macromolecular systems, thus relating
fine structural details to experimentally measurable
properties. Specifically, I will apply this methodology to study ion
channels in which the challenge is to relate electronic and atomic
structure to the conductance properties of the channel. Accurately
determining these relationships provides a pathway to developing cures
for many neurological, cardiac, and muscular diseases.
Read moreRead less
Bilateral Cochlear Implants for Children: Does a Second Implant Improve Language, Psychosocial and Other Outcomes? Severe-profound congenital hearing loss engenders significant costs to society. In 2005, specialised education cost -- on average $25,000 per child, loss of productivity cost -- $6.7 billion, and social security benefits were paid to approximately 129,000 individuals who were unemployed due to hearing loss. If bilateral cochlear implantation results in improved language, social dev ....Bilateral Cochlear Implants for Children: Does a Second Implant Improve Language, Psychosocial and Other Outcomes? Severe-profound congenital hearing loss engenders significant costs to society. In 2005, specialised education cost -- on average $25,000 per child, loss of productivity cost -- $6.7 billion, and social security benefits were paid to approximately 129,000 individuals who were unemployed due to hearing loss. If bilateral cochlear implantation results in improved language, social development, and academic outcomes, the community benefits arising will be greatly improved quality of life for these individuals and significant savings to society. In partnership with Cochlear Ltd, this study will provide some of the first data worldwide comparing the effects of an additional implant on language, social and educational outcomes.Read moreRead less