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Effective Management Of Acute Whiplash Injuries Requires A Pragmatic Approach: An RCT With Stratified Treatments
Funder
National Health and Medical Research Council
Funding Amount
$382,550.00
Summary
Whiplash injuries from a motor vehicle crash continue to incur substantial personal and financial costs to the community and the insurance industry. The current approaches to an acute whiplash injury in Australia and internationally have failed to lessen the rate of how many people develop chronic neck pain. Between 40 and 60% still have pain 6 months after injury. Motor Accident Insurance Commission (Qld) figures indicate that 20% of patients with chronic whiplash account for 60% of the costs. ....Whiplash injuries from a motor vehicle crash continue to incur substantial personal and financial costs to the community and the insurance industry. The current approaches to an acute whiplash injury in Australia and internationally have failed to lessen the rate of how many people develop chronic neck pain. Between 40 and 60% still have pain 6 months after injury. Motor Accident Insurance Commission (Qld) figures indicate that 20% of patients with chronic whiplash account for 60% of the costs. Transition from an acute to a chronic condition must be prevented. A new direction in management in the acute stage is urgently required as once the pain has become chronic, it is difficult to help. This research will conduct a novel randomised controlled trial for acute whiplash. It will test individually prescribed multi-professional management against usual care with the aim to lessen the numbers who go on to develop chronic pain. It will be the first clinical trial that acknowledges from the outset that the whiplash injuries and affects people in different ways. Our previous research with acute whiplash patients has documented the variations in presentation from physical, physiological and psychological perspectives. In this trial, management will be prescribed as directed by measurable pain, muscle and psychological impairments in the individual, rather than regard all patients as the same as in other trials. This trial will offer individualised treatments; medical, physiotherapy and-or psychological using an empirically derived treatment algorithm. Cost-effectiveness of the program will be evaluated against that incurred during usual care. It is predicted that early multi-professional management will be less expensive in the long term than existing approaches. This RCT stands to extend knowledge in the management of whiplash associated disorders (WAD).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
Plasma protein profiles in normal brain ageing and early stages of dementia. Brain changes related to ageing and dementia are associated with altered proteins that can be detected in the blood. This project will examine blood samples from a number of well-characterised ageing cohorts to discover proteins that may serve as potential markers of brain ageing and the early stages of dementia.
Three-dimensional Simulation of Trabecular Bone Remodelling. Nearly 2 million Australians currently suffer from osteoporosis. Statistics indicate that 25% of Australian women and 17% of men will develop an osteoporotic fracture. The cost of osteoporosis is $7.4 billion per annum; the numbers of affected individuals and costs are expected to continue increasing. Clearly, improvements to osteoporosis diagnosis, fracture risk assessment, and effective treatments are still urgently needed. The p ....Three-dimensional Simulation of Trabecular Bone Remodelling. Nearly 2 million Australians currently suffer from osteoporosis. Statistics indicate that 25% of Australian women and 17% of men will develop an osteoporotic fracture. The cost of osteoporosis is $7.4 billion per annum; the numbers of affected individuals and costs are expected to continue increasing. Clearly, improvements to osteoporosis diagnosis, fracture risk assessment, and effective treatments are still urgently needed. The proposed project aims to create a tool for understanding the mechanisms of bone loss and predicting the effects of osteoporosis therapies. It represents a solid contribution to the knowledge base necessary for advancing osteoporosis research and ultimately reducing the incidence of osteoporotic fracture.Read moreRead less
The early osteoarthritis (OA) phenotype. Australia like many other developed countries is undergoing a major demographic shift involving significant growth in the aged population. From both a patient perspective and a societal perspective, research into the underlying determinants of osteoarthritis such as those outlined in this proposal are of great importance to the aged population. Nearly one in five Australians has arthritis; indeed more Australians have arthritis than any other national hea ....The early osteoarthritis (OA) phenotype. Australia like many other developed countries is undergoing a major demographic shift involving significant growth in the aged population. From both a patient perspective and a societal perspective, research into the underlying determinants of osteoarthritis such as those outlined in this proposal are of great importance to the aged population. Nearly one in five Australians has arthritis; indeed more Australians have arthritis than any other national health priority condition. From an individual point-of-view, the pain and disability due to osteoarthritis (OA) can lead to loss of independence and diminished in quality of life for older adults.Read moreRead less
Knee osteoarthritis: Getting moving with physiotherapy. Knee osteoarthritis (OA) is a prevalent chronic musculoskeletal condition causing pain, disability and reduced quality-of-life. Further rises in the prevalence of knee OA and associated patient and economic costs are expected due to an ageing population and increasing risk factors for OA such as obesity. This research will provide important information about the role of modified footwear and gait retraining in management of knee OA which ca ....Knee osteoarthritis: Getting moving with physiotherapy. Knee osteoarthritis (OA) is a prevalent chronic musculoskeletal condition causing pain, disability and reduced quality-of-life. Further rises in the prevalence of knee OA and associated patient and economic costs are expected due to an ageing population and increasing risk factors for OA such as obesity. This research will provide important information about the role of modified footwear and gait retraining in management of knee OA which can influence current clinical practice. This has the potential to reduce the burden of knee OA from both an individual and societal perspective. Furthermore, the research will result in a commercially available shoe suitable for people with knee OA. Read moreRead less
Factors influencing functional locomotion in older adults. Ageing is associated with increasing limitations of physical function such as walking. Many older people also have concurrent medical conditions which may further limit function. This project adopts a multidisciplinary approach to investigate key factors that affect the ability to perform functional tasks of everyday locomotion, such as stair climbing and obstacle avoidance, in older adults including those affected by osteoarthritis. The ....Factors influencing functional locomotion in older adults. Ageing is associated with increasing limitations of physical function such as walking. Many older people also have concurrent medical conditions which may further limit function. This project adopts a multidisciplinary approach to investigate key factors that affect the ability to perform functional tasks of everyday locomotion, such as stair climbing and obstacle avoidance, in older adults including those affected by osteoarthritis. The results will increase knowledge about the adaptability of the ageing human locomotor system in both health and disease. This will provide a theoretical foundation for creating new strategies to reduce the impact of physical degeneration in older people.Read moreRead less
The Contribution Of Dopamine To Regulation Of Orofacial, Limb And Trunk Control: System Or Function Specific Effects?
Funder
National Health and Medical Research Council
Funding Amount
$493,124.00
Summary
Treatment for Parkinson's disease, including dopamine replacement therapy and deep brain stimulation, fail to produce the same beneficial effects on all movement systems. Whereas limb function is the primary beneficiary of these treatments, other functions such as speech and postural control are less responsive. Critical to the research is the postulate that such differences may have arisen due to the fact that previous studies of dopamine and movement control have investigated distinct motor sy ....Treatment for Parkinson's disease, including dopamine replacement therapy and deep brain stimulation, fail to produce the same beneficial effects on all movement systems. Whereas limb function is the primary beneficiary of these treatments, other functions such as speech and postural control are less responsive. Critical to the research is the postulate that such differences may have arisen due to the fact that previous studies of dopamine and movement control have investigated distinct motor systems via the assessment of distinct movement constructs, making cross system comparisons an impossible task. The proposed research will assess the effect of Parkinson's disease, deep brain stimulation and dopamine on identical muscle functions within the orofacial, trunk and limb muscle systems. To this end, the results generated from this resarch have the potential to reconceptualise working models of brain-muscle relationships. Further the research will provide guidance for future studies that aim to eradicate trade-off effects (e.g. limb function improved but not speech) relating to symptom relief for people with Parkinson's disease.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