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
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.
Reducing Knee Load And Slowing Disease Progression With Conservative Interventions In Knee Osteoarthritis
Funder
National Health and Medical Research Council
Funding Amount
$271,503.00
Summary
Knee arthritis is a painful, disabling, costly condition particularly affecting the elderly. As there is presently no cure for arthritis, interventions that slow progression of the disease will reduce the personal and societal burden of arthritis. Recently it has been postulated that specific exercise that targets how the muscles are controlled by the nervous system may have greater disease-modifying effects than exercise aimed at strengthening the muscles. Data are beginning to highlight the co ....Knee arthritis is a painful, disabling, costly condition particularly affecting the elderly. As there is presently no cure for arthritis, interventions that slow progression of the disease will reduce the personal and societal burden of arthritis. Recently it has been postulated that specific exercise that targets how the muscles are controlled by the nervous system may have greater disease-modifying effects than exercise aimed at strengthening the muscles. Data are beginning to highlight the complexity of muscle strategies adopted by the nervous system to compensate for joint derangement in knee arthritis. It is our contention that there may be specific strategies that provide more optimal knee joint loading in relation to slowing disease progression. The first part of this project is to investigate knee control in people with knee arthritis and to evaluate whether this influences disease progression. This will provide the basis for refinement and optimisation of rehabilitation interventions for this patient group. The second part of this project will investigate whether strengthening the hip muscles in patients with knee arthritis influences knee load and hence disease progression. Hip muscle strengthening is currently not routinely included as part of the management of knee arthritis. If the results of this project find it to be effective, then hip muscle strengthening can be recommended for treating knee arthritis.Read moreRead less
Effects Of Laterally Wedged Insoles On Symptoms And Disease Progression In Knee Osteoarthritis
Funder
National Health and Medical Research Council
Funding Amount
$480,850.00
Summary
Knee arthritis is a painful, disabling, costly condition particularly affecting the elderly. As there is presently no cure for knee arthritis, strategies that slow progression of the disease will reduce the personal and societal burden of arthritis. Most research has focussed on drug therapies, which are effective in reducing pain and disability but have side effects and are expensive. Insoles worn inside the shoes are a simple, cheap, self-administered intervention with the potential to slow di ....Knee arthritis is a painful, disabling, costly condition particularly affecting the elderly. As there is presently no cure for knee arthritis, strategies that slow progression of the disease will reduce the personal and societal burden of arthritis. Most research has focussed on drug therapies, which are effective in reducing pain and disability but have side effects and are expensive. Insoles worn inside the shoes are a simple, cheap, self-administered intervention with the potential to slow disease progression in certain patients, in addition to managing symptoms. However, to date there has been little quality research investigating the effectiveness of insoles in knee arthritis. This study aims to see whether 12 months of wearing insoles can lead to improvements in knee pain and function and slow disease progression in 200 people with knee arthritis. It will use state-of-the-art technology, magnetic resonance imaging, to measure changes in the amount of knee cartilage. This research is timely and the findings will be of major significance as there is increasing world-wide attention on slowing progression of knee arthritis. Insoles are one of the few non-drug therapies with the potential to influence both symptoms and disease progression. If the results show that insoles are beneficial, then this research will: 1. Better inform clinical guidelines to firmly recommend insoles to manage knee arthritis 2. Provide the basis for developing education strategies for health care practitioners and patients about the benefits of insoles 3. Provide the impetus to make insoles more readily available directly to patients 4. Ultimately lead to better patient outcomesRead moreRead less
I am a speech pathologist working to improve psychosocial outcomes for adults with traumatic brain injury by improving their communication and social skills.
Pain And Trunk Muscle Control: Effects, Mechanisms And Consequences
Funder
National Health and Medical Research Council
Funding Amount
$296,452.00
Summary
Twenty-one percent of Australians report long-term back problems. This makes back pain the most common chronic pain in Australia and most prevalent disorder among the National Health Priority Areas. For the majority with recurrent and chronic problems, the cause is unknown but changes in control of the spine are thought to be important. It is well accepted that pain and injury to the low back affect the way that we control the back muscles and this leads to changes in spinal function. However, d ....Twenty-one percent of Australians report long-term back problems. This makes back pain the most common chronic pain in Australia and most prevalent disorder among the National Health Priority Areas. For the majority with recurrent and chronic problems, the cause is unknown but changes in control of the spine are thought to be important. It is well accepted that pain and injury to the low back affect the way that we control the back muscles and this leads to changes in spinal function. However, despite considerable investigation of this problem, there is a distinct lack of consensus for how the control of movement is changed during pain, why it changes, and whether these changes lead to further problems in the long term. The objective of this series of studies is to determine how the adaptation to pain changes the control of the spine. We will use a range of techniques that include tests of the strategies used by the brain to control the spine and mathematical models to estimate the effect that these changes have on the spine when people are given back pain by injecting sterile salty water into the back muscles. These studies will be backed up by measures of mechanical properties of the spine and by comparison to people with clinical pain. This combination of methods has not been used previously and is likely to help resolve the problem of how muscle control is chaged in back pain. We will also test a range of hypotheses regarding how pain has its effect on muscle activity. A final series of studies aims to determine whether the failure of these changes in muscle control to resolve after an epiosde of back pain leads to increased recurrence of pain in the long-term. The importance of this project is highlighted by the significance of back pain as a major health issue, the lack of consensus regarding the effect and mechanisms of pain on trunk muscle control (despite extensive investigation), and the potential for the findings to guide rehabilitation and management.Read moreRead less
Spinal complaints present the greatest social and economic burden of musculoskeletal conditions in Australia. This reflects current realities: the cause remains unknown; 80% of the population is affected; and isolated professions perform a staggering array of interventions. The CCRE aims to target these realities and improve Australia's capacity to prevent and manage spinal disorders by supporting innovative interdisciplinary research and training. This community- and university-based centre wil ....Spinal complaints present the greatest social and economic burden of musculoskeletal conditions in Australia. This reflects current realities: the cause remains unknown; 80% of the population is affected; and isolated professions perform a staggering array of interventions. The CCRE aims to target these realities and improve Australia's capacity to prevent and manage spinal disorders by supporting innovative interdisciplinary research and training. This community- and university-based centre will align highly successful clinical and basic researchers in collaboration with a national network of spine scientists to foster interdisciplinary clinical researcher training, develop new diagnostics and therapeutics, and translate findings to the community. Through clinical research the centre aims to: (i) Advance understanding of physiology and pathophysiology of spinal pain (ii) Translate findings from basic research to clinical practice (iii) Establish coordinated multidisciplinary research to reduce the burden of spinal pain (iv) Predict and prevent the transition from acute to chronic states (v) Train a new generation of transdisciplinary clinical scientists (vi) Rapidly assess new treatment possibilities in pre-clinical studies (vii) Develop innovative technologies for diagnostics and therapeutics (viii) Encourage Australian commercialisation opportunities for new discoveries (ix) Encourage community-user participation in direction of research programs (x) Disseminate new findings and information of evidence-based practice to patients, clinicians, insurers, government and the scientific and wider communityRead moreRead less