Clinical Efficacy And Physiological Mechanisms Of Nerve And Tendon Gliding Exercises For Carpal Tunnel Syndrome
Funder
National Health and Medical Research Council
Funding Amount
$370,068.00
Summary
Compression of one of the major nerves at the wrist (carpal tunnel syndrome) is a very common condition that significantly impacts on the well-being of the patient. To date, there is no good evidence that traditionally advocated interventions are effective in the long term. This project will evaluate the effects of a novel, active treatment strategy and will investigate the underlying mechanisms that may be associated with exercises that aim to mobilise the nerve and tendons at the wrist.
A Randomised Control Trial Of Physiotherapy And Corticosteroid Injections Of Lateral Epicondylalgia In Primary Care.
Funder
National Health and Medical Research Council
Funding Amount
$193,775.00
Summary
Musculoskeletal conditions account for the third leading cause of health systems expenditure in Australia. Lateral epicondylalgia (tennis elbow) is such a condition and is often treated in primary care. Both the individual and community are affected by this condition: 7 per 1000 patients seeing their medical doctor have this condition. Most are not tennis related. On average 10-30% of sufferers take 12 weeks off work. The condition may last 6-48 months and it tends to become stubborn to treatmen ....Musculoskeletal conditions account for the third leading cause of health systems expenditure in Australia. Lateral epicondylalgia (tennis elbow) is such a condition and is often treated in primary care. Both the individual and community are affected by this condition: 7 per 1000 patients seeing their medical doctor have this condition. Most are not tennis related. On average 10-30% of sufferers take 12 weeks off work. The condition may last 6-48 months and it tends to become stubborn to treatment and recurs often. Two popular treatment options that are commonly prescribed for the management of lateral epicondylalgia are physiotherapy and corticosteroid injections. To date there is little evidence supporting physiotherapy, especially current best practice methods such as manual therapy and therapeutic exercise. The lack of evidence is largely due to a small number of studies of physiotherapy, most of which are of poor quality and of treatments that are currently deemed to be less than optimal. A larger number of studies of corticosteroid injections have shown that corticosteroid injections are beneficial in the short term (3-6 weeks), but not over 12 months where they are associated with greater recurrence rates. Manual therapy has been shown to have short term pain relieving effects and therapeutic exercise exerts long standing improvements in this condition. It is proposed that the addition of manual therapy to therapeutic exercise will have superior short- and long-term effects. This project will conduct a randomised clinical trial to evaluate this proposition and also the factors associated with success, failure or recurrence rates. A cost-benefit analysis will also be conducted to calculate the relative economic merits of the treatments. A tangible outcome of this project will be the development of clinical guidelines for the most effective method of treating lateral epicondylalgia in primary health care.Read moreRead less
Cell Biology Of Stress Fractures: Activation Of Remodelling At Sites Of Non-union
Funder
National Health and Medical Research Council
Funding Amount
$493,817.00
Summary
Stress fractures are debilitating injuries. We characterised a model of stress fractures in rat ulnae, learning that they heal by activated remodelling, that key genes are expressed in a temporal pattern, and that part of the fracture remains un-healed, similar to many clinical cases. Now, we will examine cell localisation of important genes necessary for remodelling, and test the efficacy of different growth factors to activate a healing response in the non-healed section of the fracture.
Molecular And Histopathological Investigation Of Stress Fracture Healing And Effects Of Anti-inflammatory Drugs.
Funder
National Health and Medical Research Council
Funding Amount
$412,652.00
Summary
Stress fractures are debilitating injuries affecting children, adolescents and adults in sport, and army recruits. They also occur in horse and greyhound racing, often resulting in euthanasia of the animals involved. They incur considerable costs in medical expenses, time lost from sport and interruption to military training. But, there is almost no information on the mechanism of healing of these fractures. Non-steroidal anti-inflammatory drugs (NSAIDs) are still the most widely used medication ....Stress fractures are debilitating injuries affecting children, adolescents and adults in sport, and army recruits. They also occur in horse and greyhound racing, often resulting in euthanasia of the animals involved. They incur considerable costs in medical expenses, time lost from sport and interruption to military training. But, there is almost no information on the mechanism of healing of these fractures. Non-steroidal anti-inflammatory drugs (NSAIDs) are still the most widely used medication in management of musculoskeletal injuries, yet their effect on healing of stress fractures is unknown. NSAIDs delay fracture healing, but until recently there has been no standardised way of studying stress fractures. We have created, for the first time, a well-characterised, non-invasive model of stress fractures in the forearm of rats that closely resembles the clinical situation. This provides a novel and unique opportunity to determine the histological and molecular mechanism of stress fracture healing, and to investigate effects of antiinflammatory-analgesic medications on this process. Rats will have an experimental stress fracture produced in one forelimb, and its healing will be examined up to ten weeks using microscopic investigation and analysis of the genes that are turned off or on to initiate the process. Groups of rats will also be treated with antiinflammatory drugs such as ibuprofen, specific COX-2 inhibitors and a new class of drugs that target early immune responses called C5a receptor antagonists. The analgesic Paracetamol will also be investigated as an alternative to the NSAIDs described above. There is widespread use of anti-inflammatory agents in managing stress fractures, so it is vital that their effects on stress fracture healing be examined. This project has enormous significance for optimising approaches for clinical management of stress fractures and for understanding the interaction of anti-inflammatory or analgesic agents in that process.Read moreRead less
Evaluation Of An Online Injury Surveillance System In Community Sport
Funder
National Health and Medical Research Council
Funding Amount
$60,741.00
Summary
Despite high rates of injury, there is currently no way to accurately record injuries in community sport. To address this issue an online injury tracking system has been developed for community sports clubs. This research will test the utility of this system within community Australian football clubs and compare it with other injury recording methods. With better methods of injury recording, we will improve our understanding of injury risks. In turn, this information can be used to make sport sa ....Despite high rates of injury, there is currently no way to accurately record injuries in community sport. To address this issue an online injury tracking system has been developed for community sports clubs. This research will test the utility of this system within community Australian football clubs and compare it with other injury recording methods. With better methods of injury recording, we will improve our understanding of injury risks. In turn, this information can be used to make sport safer.Read moreRead less
Right Care, Right Time, Right Place: Improving Outcomes For People With Spinal Cord Injury Through Early Intervention And Improved Access To Specialised Care
Funder
National Health and Medical Research Council
Funding Amount
$1,095,436.00
Summary
This novel study’s purpose is to improve the care and quality of life of people afflicted by spinal cord injury. The study will map the early clinical journey from injury to specialized spinal care, identifying factors which impact on health and quality of life up to a year after injury. The focus will be on whether a delay of more than 24 hours to specialized care worsens the outcomes. This will be the first Australian study examining the early care of patients with a spinal cord injury.
Changes In Motor Control And Kinaesthetic Sensations After Eccentric Exercise.
Funder
National Health and Medical Research Council
Funding Amount
$287,250.00
Summary
It is a well-known observation that after a period of intense exercise we are unsteady on our feet and are clumsy when attempting to make precision movements. Such impressions are particularly marked after eccentric exercise, during which the contracting muscles are forcibly lengthened. Activities such as walking downhill, skiing and horse riding involve eccentric exercise. The debilitating consequences of this kind of exercise are attributed, not just to the post-exercise effects of fatigue, bu ....It is a well-known observation that after a period of intense exercise we are unsteady on our feet and are clumsy when attempting to make precision movements. Such impressions are particularly marked after eccentric exercise, during which the contracting muscles are forcibly lengthened. Activities such as walking downhill, skiing and horse riding involve eccentric exercise. The debilitating consequences of this kind of exercise are attributed, not just to the post-exercise effects of fatigue, but to loss of muscle force from damage to fibres. Eccentric exercise also leads to longer term effects. The breakdown of the damaged tissue leads to sensations of stiffness and soreness the next day. This application proposes experiments aimed at studying a number of effects of eccentric exercise on motor control, and establishing the muscle, spinal and brain levels at which they occur. Three studies are planned. In the first, the question will be explored whether we are less able to use the motor areas of our brains to execute voluntary contractions after exercise. So fatigue is not just a matter of exhausted muscles but perhaps also exhausted brains. We will use brain and spinal cord stimulation to explore this point. Then we plan to listen to single motor units, the basic elements of muscle control, to try to understand the mechanism by which the brain minimises the debilitating effects of fatigue. Finally we want to examine subjects' ability to locate their limbs in space as a means of providing a basis for the clumsiness we experience after intense exercise. These are all important issues relevant to clinical medicine and rehabilitation as well as sports science and exercise.Read moreRead less