A Clinical Trial Of Manipulative Therapy And/or NSAIDs For Significant Acute Low Back Pain
Funder
National Health and Medical Research Council
Funding Amount
$521,625.00
Summary
Acute low back pain is a disabling condition with many sufferers being unable to perform their family or work duties due to severe pain. Treatment of acute LBP is also costly, this condition being one of the most frequent problems managed by general practitioners. Guidelines about how to treat patients with acute low back pain have suggested that advice and paracetamol should be the first line of treatment. In patients with insufficient pain relief two of the most frequently used additional trea ....Acute low back pain is a disabling condition with many sufferers being unable to perform their family or work duties due to severe pain. Treatment of acute LBP is also costly, this condition being one of the most frequent problems managed by general practitioners. Guidelines about how to treat patients with acute low back pain have suggested that advice and paracetamol should be the first line of treatment. In patients with insufficient pain relief two of the most frequently used additional treatments are anti-inflammatory medication and manipulative physiotherapy. However, to date it is not known whether the addition of one or both of these treatments results in faster recovery for the patient. Our clinical trial will clarify whether the addition of (i) anti-inflammatory medication and-or (ii) manipulative physiotherapy, to advice and paracetamol given by the doctor results in a faster recovery for the patient with acute low back pain. This results of this study will make it possible for general practitioners to manage acute low back pain in an evidence-based way.Read moreRead less
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
The Efficacy Of Manipulation For Recent Onset Neck Pain
Funder
National Health and Medical Research Council
Funding Amount
$393,974.00
Summary
Neck pain is extremely common, with a point prevalence of 46% in the general community. Neck pain can cause significant disability, and is the second most common injury causing people to take time off work. Neck pain and its associated disability clearly poses a substantial social and economic burden. Neck manipulation (high velocity thrust of the joints, often associated with a click) is widely used by physiotherapists for the management of recent onset neck pain, but there is no clear evidence ....Neck pain is extremely common, with a point prevalence of 46% in the general community. Neck pain can cause significant disability, and is the second most common injury causing people to take time off work. Neck pain and its associated disability clearly poses a substantial social and economic burden. Neck manipulation (high velocity thrust of the joints, often associated with a click) is widely used by physiotherapists for the management of recent onset neck pain, but there is no clear evidence for its efficacy. In addition, the use of manipulation is associated with serious, although rare, adverse events such as stroke or even death. The risk-benefit analysis, therefore, does not clearly favour manipulation because efficacy has not been established, while the risks are serious, but infrequent. The findings of the proposed study will clearly and precisely determine the efficacy of manipulation compared with the safer treatment technique of mobilisation (gentle oscillatory pressure applied to the joints), information that is currently unavailable. This information is of vital importance to many different disciplines, including health professionals, insurance companies, and to administrators for development of health policy. Our findings will thus provide evidence-based guidelines for the use of manipulation, and will ultimately lead to safer practice of physiotherapy for neck pain.Read moreRead less
Client Centred Palliative Rehabilitation: An Evaluation Of Its Efficacy
Funder
National Health and Medical Research Council
Funding Amount
$90,570.00
Summary
�I don�t want to sit here waiting to die�. Many people towards end of life want their palliative care to continue to be rehabilitative as well as supportive, yet no study to formally evaluate the effectiveness of a patient-centred palliative rehabilitation program has been conducted in Australia. This study aims to identify patient and carer-centred rehabilitation goals such as independence in self care, and develop, trial and evaluate a rehabilitation program to address these goals. The program ....�I don�t want to sit here waiting to die�. Many people towards end of life want their palliative care to continue to be rehabilitative as well as supportive, yet no study to formally evaluate the effectiveness of a patient-centred palliative rehabilitation program has been conducted in Australia. This study aims to identify patient and carer-centred rehabilitation goals such as independence in self care, and develop, trial and evaluate a rehabilitation program to address these goals. The program would be transfer stage conditions such as cancer, cardiac or renal failure.Read moreRead less
Participation following traumatic brain injury in rural, regional and remote areas. The results of this project will lead to improved rehabilitation programs and better outcomes for people with brain injury, especially in regional, rural and remote areas, by targeting the ultimate goal more directly: participation - getting people back into their home, work and community roles. Participation is associated with improved social networks, wellbeing, independence and quality of life, so health care ....Participation following traumatic brain injury in rural, regional and remote areas. The results of this project will lead to improved rehabilitation programs and better outcomes for people with brain injury, especially in regional, rural and remote areas, by targeting the ultimate goal more directly: participation - getting people back into their home, work and community roles. Participation is associated with improved social networks, wellbeing, independence and quality of life, so health care burdens and costs are reduced, and people can lead more productive lives. The project's emphasis on country areas will benefit rural health care, and also help specialist metropolitan brain injury services to understand the specific rehabilitation issues facing people from the bush.Read moreRead less
Gene therapy to enhance auditory prosthesis performance for cochlear implants. The cochlear implant is the most effective neural prosthesis, restoring hearing to the deaf. The research aims to develop a new type of implant compatible with delivery of therapeutic genes to the cells lining the cochlea. Gene therapy DNA constructs will be developed that will enhance neural survival and growth, improving cochlear implant performance. The research will provide advances in understanding how to tran ....Gene therapy to enhance auditory prosthesis performance for cochlear implants. The cochlear implant is the most effective neural prosthesis, restoring hearing to the deaf. The research aims to develop a new type of implant compatible with delivery of therapeutic genes to the cells lining the cochlea. Gene therapy DNA constructs will be developed that will enhance neural survival and growth, improving cochlear implant performance. The research will provide advances in understanding how to transfer genes into cochlear tissue, as well as development of gene cassettes for effective neural repair. The work will advance the field of bionics, an area where Australia is establishing international preeminence.Read moreRead less