Tai Chi For Independent Living: RCT Of Efficacy Of Tai Chi In Delaying Disability Among Older People.
Funder
National Health and Medical Research Council
Funding Amount
$1,157,574.00
Summary
This study addresses the issue of disability among our ageing population. Preservation of function among our older citizens, and their capacity to live independently, is of significant social, public health and economic benefit. The aims of this study are to (1) test the efficacy of Tai Chi in delaying disability among older people, prior to its onset, (2) investigate the mechanisms by which Tai Chi intervenes in the disability pathway, (3) determine the cost-benefits of Tai Chi for older people ....This study addresses the issue of disability among our ageing population. Preservation of function among our older citizens, and their capacity to live independently, is of significant social, public health and economic benefit. The aims of this study are to (1) test the efficacy of Tai Chi in delaying disability among older people, prior to its onset, (2) investigate the mechanisms by which Tai Chi intervenes in the disability pathway, (3) determine the cost-benefits of Tai Chi for older people. The study will recruit 670 people over 70 years of age and randomly assign them to receive either Tai Chi, or a stretching and relaxation program, for a period of 48 weeks. The groups will then be compared to determine if there is any difference in the development of disability as well as a range of functional outcomes such as strength, balance, depression, arthritic symptoms, life satisfaction, and falls. This will be the first study world-wide to test the impact of any exercise program on delaying the manifestation of disability among older people. Robust evidence that Tai Chi can in fact delay disability will have immediate and significant implications for the maintenance of independence among older people at a critical time for our ageing population. Translation of these research results to practice will decrease demand for support services for community dwelling older people, and for places in supported accommodation facilities. Older people will have improved quality of life, and government and non-government agencies will experience reduced demand for limited resources. This internationally significant study will also contribute to understanding the mechanisms by which disability develops, and create the valuable opportunity for continuing research on attrition of effect and long term adherence to exercise programs.Read moreRead less
Randomized Controlled Trial Of CPAP On Cardiac Function In Patients With Heart Failure And Obstructive Sleep Apnoea
Funder
National Health and Medical Research Council
Funding Amount
$140,906.00
Summary
Heart failure is a very common condition associated with disabling symptoms. The main symptoms are breathlessness, usually during sleep or upon exercise, and fatigue. Recent research has identified that sleep apnoea, a condition that occurs in about 50% of subjects with heart failure, is likely to be responsible for these symptoms. Moreover, treatment specifically aimed at sleep apnoea, namely continuous positive airway pressure (CPAP) delived via a small electric pump and nasal mask worn during ....Heart failure is a very common condition associated with disabling symptoms. The main symptoms are breathlessness, usually during sleep or upon exercise, and fatigue. Recent research has identified that sleep apnoea, a condition that occurs in about 50% of subjects with heart failure, is likely to be responsible for these symptoms. Moreover, treatment specifically aimed at sleep apnoea, namely continuous positive airway pressure (CPAP) delived via a small electric pump and nasal mask worn during sleep, may also improve the symptoms of heart failure. The study will involve subjects with stable heart failure on optimal drug treatment who have evidence of obstructive sleep apnea on an overnight sleep study. Obstructive sleep apnoea (OSA) is a condition in which the throat intermittently narrows or blocks during sleep (often associated with snoring) causing cessation of airflow or apnoeas. Associated with the apnoeas are vigorous efforts by the chest muscles to breathe (creating negative vacuum-like pressures within the chest - and around the heart) at a time of falling oxygen levels. Previous research has suggested that these obstructive apnoeas are detrimental to the heart. Volunteers will be randomized to either a control or a CPAP treated group for a three month period. The control and CPAP groups will receive intensive advice about good eating and sleeping habits as weight gain and sleep loss are factors known to aggravate heart failure and obstructive sleep apnoea. In addition to the lifestyle advice, the CPAP group will also be treated with nasal CPAP. The variables which we will measure include severity of sleep apnoea, exercise capacity, heart function at rest and symptoms. Symptoms will be measured using 4 very detailed and validated questionnaires.Read moreRead less
Physical, Lifestyle And Psychosocial Determinants Of Spinal Pain Development In Adolescents
Funder
National Health and Medical Research Council
Funding Amount
$682,800.00
Summary
This project aims to understand the development of back and neck pain in adolescence. By the age of 16 around half of all adolescents have suffered back pain and one third have suffered neck pain. For many adolescents this pain is disabling and over a third of sufferers miss school, miss recreation and seek medical help. The current understanding of back and neck pain in adolescence is quite limited - restricting the effectiveness of initiatives to prevent adolescents having to suffer spinal pai ....This project aims to understand the development of back and neck pain in adolescence. By the age of 16 around half of all adolescents have suffered back pain and one third have suffered neck pain. For many adolescents this pain is disabling and over a third of sufferers miss school, miss recreation and seek medical help. The current understanding of back and neck pain in adolescence is quite limited - restricting the effectiveness of initiatives to prevent adolescents having to suffer spinal pain and of treatment of those adolescents unlucky enough to have an episode. Better understanding and interventions for adolescent spinal pain will also have longer term implications by reducing adult spinal pain. Four out of 5 adults will experience spinal pain. In the USA treating adult back pain is the 4th largest health care cost. Many adults with chronic back pain had their first episode during adolescence. A better understanding of spinal pain in adolescence may help prevent it developing into a lifelong disability. We will collect information from 2,000 adolescents on their experience of back and neck pain and on potential physical, lifestyle and psychosocial risk factors. We believe factors such as their posture, muscle capacity, TV and computer use, mental health and social situation all combine to influence whether a person develops back or neck pain. The project is unique as it will not only collect a broad range of information during adolescence, but will also make use of a large database of health, developmental and psychosocial information already collected from these children since birth. With a better understanding of the development of spinal pain we will be able to develop guidelines to help prevent these problems. We will also be able to develop better treatment plans for sub-groups of adolescents with a particular combination of risk factors. Together these initiatives will assist in understanding and breaking the pathway to chronic spinal pain.Read moreRead less
Long Term Impact, Capacity Gains And Cost-effectiveness Of A Successful Community-wide Child Obesity Prevention Program
Funder
National Health and Medical Research Council
Funding Amount
$703,191.00
Summary
Be Active, Eat Well is the first community-wide obesity prevention project to successfully reduce the weight and waist gain of children. The 'intervention' was to 'boost' community capacity to enable the local organisations to create their own solutions to childhood obesity. This research will continue to assess the project 3 years after that 'boost' to determine the long-term sustainability, impact and cost-effectiveness of this approach to prevent childhood obesity.
Empowerment As A Strategy For Wellbeing In Indigenous Settings: Developing Tools To Systematically Evaluate Outcomes
Funder
National Health and Medical Research Council
Funding Amount
$403,100.00
Summary
This project will add significant strength to one of Australia's key initiatives in the promotion of health and well-being, namely the Family Well Being Program . This program was developed by a group of Aboriginal people based in Adelaide in order to specifically address the effects of colonisation on the emotional health and wellbeing of Indigenous Australians. It is a nationally accredited course and has been delivered in a wide variety of settings and participating groups. Previous evaluatio ....This project will add significant strength to one of Australia's key initiatives in the promotion of health and well-being, namely the Family Well Being Program . This program was developed by a group of Aboriginal people based in Adelaide in order to specifically address the effects of colonisation on the emotional health and wellbeing of Indigenous Australians. It is a nationally accredited course and has been delivered in a wide variety of settings and participating groups. Previous evaluation using in-depth interviews, focus groups and course evaluation forms have revealed long lasting increases in participants' life skills and problem-solving capacity, thereby making them better able to help themselves and the young people around them to deal with emotions and life's challenges. Changes are particularly profound among individuals who have completed the full Four Stage Program (40 week course) and their families and communities. Up to now, the impact and outcome of the Family Well Being Program has not had a way of being objectively measured in the way that other health promotion programs have. This is partly due to the complexity of its aims; empowering people to take control of their lives, as opposed to trying to directly change behaviours that place them at risk of illness. It is also because the definition, pathway and results of becoming an empowered person, group and community are not completely understood and are likely to be expressed differently from one social and cultural group to another. This current project aims to gain a clearer understanding of the meaning, experience, outcomes and values people attach to empowerment; then use this information to design tools to help assess the effectiveness of programs that seek to stimulate empowerment. Activities will include further analysis of existing qualitative data, workshop discussions, piloting tools and implementing them within communities with ongoing Family Well Being programs.Read moreRead less
Inter-rater Reliability And Predictive Validity Of A New Functional Capacity Evaluation For Chronic Back Pain
Funder
National Health and Medical Research Council
Funding Amount
$105,794.00
Summary
Back pain costs the Australian community tens of billions of dollars. Back pain is one of the main causes of work injury and lost time from work. The longer a person is off work, the harder it is to get them back to work. Workers' compensation systems around Australia aim at getting the injured worker with back pain back to work as soon as possible. One of the difficulties in this process is determining what the person with back pain can physically do in the workplace. An evaluation technique, c ....Back pain costs the Australian community tens of billions of dollars. Back pain is one of the main causes of work injury and lost time from work. The longer a person is off work, the harder it is to get them back to work. Workers' compensation systems around Australia aim at getting the injured worker with back pain back to work as soon as possible. One of the difficulties in this process is determining what the person with back pain can physically do in the workplace. An evaluation technique, called functional capacity evaluation (known as FCE), is one method used to find out what the person with back pain physically can and cannot do. In a FCE, a trained health professional such as an occupational therapist, observes the person performing a range of physical activities like the ones he or she may have to perform in a job. The therapist closely observes the person performing activities such as lifting, carrying, kneeling, crouching, balancing, and walking and notes any limitations in the person's ability to complete the activities. The therapist makes comments about what difficulties the person may have on the job and recommendations about how these could be reduced or eliminated. The information gained from these evaluations can be valuable for the treating doctor in deciding whether the person is ready to go back to work and what duties the person can and cannot do on the job. Because of such value they provide, FCE is commonly used in rehabilitation programs endorsed by workers' compensation systems around Australia. This widespread use and endorsement of FCE occurs despite limited research on the soundness of the ratings made from these evaluations. There is a need to see whether recommendations made from FCEs are consistent between therapists (i.e. reliable) and to see if the FCE accurately predicts the person's physical capacity for work. This research will examine these issues with injured workers with back pain.Read moreRead less
Improving Functional Capacity In Patients With Chronic Lung Disease With High Intensity Respiratory Muscle Training
Funder
National Health and Medical Research Council
Funding Amount
$340,880.00
Summary
Patients with chronic respiratory disease have limited exercise capacity, which severely impairs their quality of life. The mechanisms responsible for this impairment may relate to their lung disease, or to the long-term effects that inactivity has on the cardiovascular and musculoskeletal systems. Pulmonary rehabilitation programs involving whole-body exercise are now widely used as an addition to standard medical therapy as a way of decreasing symptoms and optimising function. While these gene ....Patients with chronic respiratory disease have limited exercise capacity, which severely impairs their quality of life. The mechanisms responsible for this impairment may relate to their lung disease, or to the long-term effects that inactivity has on the cardiovascular and musculoskeletal systems. Pulmonary rehabilitation programs involving whole-body exercise are now widely used as an addition to standard medical therapy as a way of decreasing symptoms and optimising function. While these generalised, broad-based programs result in modest improvements in peripheral muscle function, cardiovascular function, functional exercise capacity and quality of life, it is now apparent they have little or no effect on respiratory muscle function, which is also greatly impaired in COPD. The aims of this study are to answer two longstanding questions that are fundamental to rehabilitation programs in patients with COPD (i) does a program of specific respiratory muscle training alone improve whole-body exercise capacity, dyspnoea, and-or quality of life? and (ii) does the addition of a program of specific respiratory muscle training to a standard whole-body exercise rehabilitation program result in improvemed exercise capacity, dyspnoea and-or quality of life to a greater degree than a program of whole-body exercise training alone? The study is of importance to patients with COPD by investigating the mechanisms underlying the improvement in exercise capacity following a rehabilitation program and the role of respiratory muscle training in such a program. By more accurately defining the mechanisms of exercise limitation we may be able to maximise the benefits obtained during a rehabilitation program, including improved work capacity, reduction in the degree of breathlessness and improved quality of life.Read moreRead less