Training Dual Task Performance During Gait In Parkinson Disease
Funder
National Health and Medical Research Council
Funding Amount
$386,980.00
Summary
Difficulty performing more than one task at a time is a common and disabling problem experienced by people with Parkinson's Disease (PD), a progressive neurological condition that affects the ability of people to perform well-learned movements like walking with normal speed and size. This research will investigate how to best train people with PD to dual-task when walking. Teaching people with PD how to dual task will enhance their everyday activities and has potential to reduce falls incidence.
Targeted Strength Training To Improve Functional Walking Capacity Of Adolescents And Young Adults With Cerebral Palsy
Funder
National Health and Medical Research Council
Funding Amount
$263,449.00
Summary
Cerebral palsy is the most common cause of disability in children. Caused by damage to the brain in early childhood cerebral palsy leads to muscle weakness and difficulties in walking. There is no cure for cerebral palsy, but we can help the weak muscles . The purpose of this trial is to establish that exercises to strengthen the weakest muscles will help the walking ability of teenagers and young adults with cerebral palsy, as they make the transition to independence and adulthood.
A Prospective Study To Identify The Mechanical Causes And Methods For Early Detection Of Knee Osteoarthritis
Funder
National Health and Medical Research Council
Funding Amount
$431,000.00
Summary
Knee osteoarthritis is a great cost to society, financially and in quality of life. Anti-inflammatory drugs are commonly used to treat the symptoms, but many people receive joint replacements to stop pain and improve function. We need to prevent osteoarthritis, but the causes for this common disease are largely unknown. Animal studies have shown two particular mechanical factors that cause osteoarthritis, which are seen in the walking and running, or gait, patterns of some people. We call these ....Knee osteoarthritis is a great cost to society, financially and in quality of life. Anti-inflammatory drugs are commonly used to treat the symptoms, but many people receive joint replacements to stop pain and improve function. We need to prevent osteoarthritis, but the causes for this common disease are largely unknown. Animal studies have shown two particular mechanical factors that cause osteoarthritis, which are seen in the walking and running, or gait, patterns of some people. We call these pathological gait patterns as they impose larger-than-normal forces on the knee's articular surfaces. We measure these knee forces with our new computer knee model coupled with data that we measure in a gait analysis laboratory. These forces may cause knee osteoarthritis in humans, but this is still unknown. Currently there is no simple medical test to detect the early onset of knee osteoarthritis. The bones in the knee are one of the first structures to show osteoarthritic changes. Using our new computerised analysis of high definition X-ray of the knee we can identify subtle differences in the knee due to osteoarthritis. This will be compared with changes to joint assessed using MRI. Osteoarthritis develops slowly in normal people, so to study progression of knee osteoarthritis we need a human population that has a higher risk of developing the disease. Partial meniscectomy in the knee is a common surgery performed to improve knee function in those who have suffered a knee meniscus injury. However, partial meniscectomy patients have a high risk of developing knee osteoarthritis. Therefore, using partial meniscectomy patients we are investigating if pathological gait patterns cause knee osteoarthritis, measuring the development of the disease with our new X-ray methods. With the gait analysis methods we can also identify the movements that characterise these pathological gait patterns so we can formulate rehabilitation programmes to help prevent knee osteoarthritis.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 Role Of Sarcopenia And Undernutrition In Disability After Hip Fracture
Funder
National Health and Medical Research Council
Funding Amount
$315,391.00
Summary
Hip fracture is one of the most costly and devastating medical events which can befall an elderly individual, and is expected to affect 40,000 Australians per year by the year 2040. It often results in permanent loss of walking abilities and independence, as well as a severely diminished quality of life. For example, 80% of elderly Australians who fracture their hip will not regain their previous level of walking ability, 20% will have died, and up to 25% will be in permanent nursing home reside ....Hip fracture is one of the most costly and devastating medical events which can befall an elderly individual, and is expected to affect 40,000 Australians per year by the year 2040. It often results in permanent loss of walking abilities and independence, as well as a severely diminished quality of life. For example, 80% of elderly Australians who fracture their hip will not regain their previous level of walking ability, 20% will have died, and up to 25% will be in permanent nursing home residence 12 months later. Although hip fracture has been thought of as a problem primarily related to osteoporosis (age-related loss of bone), it is now increasingly clear that other factors such as muscle wasting and weakness, gait and balance problems and poor dietary intake are also risk factors for this condition. Although surgical techniques have advanced to the point that most operations to repair hip fracture are now successful, the rehabilitation outcomes are disappointingly poor compared to other orthopaedic injuries. We believe that this is because recovery after hip fracture is in fact not primarily related to the bone disease itself, but to inadequate muscle bulk and strength. It is likely that already frail patients with a new hip fracture will experience further muscle wasting over time, because of their very low levels of physical activity, poor nutritional intake, depression, social isolation, and impaired memory in some cases. Their poor diet may be related in part to their difficulty in getting out of the home, preparing meals, reduced appetite and poor morale in the post-fracture period. If our theory is correct, then we will be able to prove that disability after hip fracture is closely related to muscle mass, and many common clinical problems contribute to this underlying mechanism of dysfunction. We will test these ideas by following patients who have had a hip fracture for 12 months with periodic detailed assessmentsRead moreRead less
Randomised Controlled Trial Of A Tailored Podiatry Intervention To Enhance Mobility And Prevent Falls In Older People
Funder
National Health and Medical Research Council
Funding Amount
$730,975.00
Summary
Foot problems affect 1 in 3 people over the age of 65 years and are associated with reduced walking speed, difficulty performing activities of daily living, impaired balance and increased risk of falls. Although a range of health professionals provide treatment for foot disorders, the most common chronic foot problems in older people (such as corns and calluses, nail disorders and toe deformities) are frequently managed by podiatrists using treatments such as scalpel debridement of lesions, foot ....Foot problems affect 1 in 3 people over the age of 65 years and are associated with reduced walking speed, difficulty performing activities of daily living, impaired balance and increased risk of falls. Although a range of health professionals provide treatment for foot disorders, the most common chronic foot problems in older people (such as corns and calluses, nail disorders and toe deformities) are frequently managed by podiatrists using treatments such as scalpel debridement of lesions, foot orthoses, exercise prescription and footwear modifications. The 1995 National Health Survey reported that persons aged 80 years or over were most likely to have reported visiting a podiatrist in the previous two weeks, followed by those aged 65-79 years. Similarly, the Australian Department of Veterans Affairs, which provides podiatry services to veterans and their dependants, documented 606,706 episodes of podiatry care to 103,540 veterans in 1998-1999, at a cost of $23M. Podiatry therefore plays a substantial role in the maintenance of foot health and mobility in older Australians. Despite the detrimental effects of foot problems and the widespread utilisation of podiatry services by older people, very few studies have been undertaken to ascertain the efficacy of podiatry treatments. Therefore, the aim of this study is to evaluate the efficacy of an individualised podiatry intervention designed to reduce pain, enhance functional mobility and prevent falls in older people. Given the high prevalence of foot-related disability and falls in older people and their associated health care costs, the study findings will be of considerable public health importance. If found to be clinically effective, the intervention could be easily implemented into a range of healthcare settings and adopted in both state and federal falls prevention policies.Read moreRead less
A Population-based Cohort Study Of Brain Ageing - Rates Of Brain Structural Change, Functional Effects, And Mechanisms
Funder
National Health and Medical Research Council
Funding Amount
$1,323,361.00
Summary
This study will provide unique longitudinal Australian data on the effects and causes of brain aging in a population-based sample of older people. The results may assist in preventing dementia and falls, major public health problems in older Australians.
Does Aerobic Or Resistance Training Improve Walking Ability In Chronic Stroke Patients?
Funder
National Health and Medical Research Council
Funding Amount
$152,036.00
Summary
The majority of stroke patients discharged from rehabilitation are often housebound. The criterion which most often limits individuals with stroke from achieving 'community ambulation' is the inability to walk long distances. Current views suggest that an exercise program aimed at improving lower limb strength and aerobic fitness will improve walking ability in those stroke patients with mild to moderate disability. However, there are no reported studies that have rigorously investigated whether ....The majority of stroke patients discharged from rehabilitation are often housebound. The criterion which most often limits individuals with stroke from achieving 'community ambulation' is the inability to walk long distances. Current views suggest that an exercise program aimed at improving lower limb strength and aerobic fitness will improve walking ability in those stroke patients with mild to moderate disability. However, there are no reported studies that have rigorously investigated whether either of these approaches, singularly or combined, is effective for augmenting walking ability in chronic stroke patients. We will use a randomised, double-blinded controlled trial to determine which of strength training, aerobic training or a combination of the two is the most effective approach for improving walking endurance, measured by the 6-minute walk test, in individuals with mild-to-moderate stroke. In addition, we will determine the benefits of each program to subjects' cardiorespiratory fitness, lower limb strength, mobility and psychological function. Subjects will be randomly allocated to one of 4 groups: 1) Aerobic exercise (and sham strength training); 2); Strength training (and sham aerobic training); 3) Combined strength and aerobic training; and 4) Control (sham strength and aerobic training. Sham treatment for strength training is stretching and calisthenics, and for aerobic exercise is passive motorised cycling. All subjects will attend small group sessions for 10 weeks, with 3 sessions per week, and each session about 1 hour duration. The findings from this study are critical in identifying the most effective and efficient approach to improving stroke patient's walking endurance. Improvement in walking endurance will enable many persons following stroke to achieve the level of 'community ambulation'. Last, it will contribute to the 'evidence-based' scientific framework for treatment of stroke patients.Read moreRead less