ORCID Profile
0000-0001-5013-7580
Current Organisation
University of Otago
Does something not look right? The information on this page has been harvested from data sources that may not be up to date. We continue to work with information providers to improve coverage and quality. To report an issue, use the Feedback Form.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 08-11-2022
Publisher: Elsevier BV
Date: 07-2019
DOI: 10.1016/J.MSKSP.2019.04.007
Abstract: Neck pain is common in migraine and tension type headache (TTH). This review aimed to examine the evidence for cervical musculoskeletal impairments in these headaches. Databases PubMed (Medline), EMBASE, CINAHL, SCOPUS, and Web of Science were searched from inception to December 2018. Observational studies using a comparator group were included. Risk of bias was assessed using the Appraisal tool for Cross-Sectional Studies. Results were pooled using random effects meta-analysis. Level of evidence for each outcome was assigned based on risk of bias, consistency of results and magnitude of difference between participants with headache and controls. (PROSPERO registration: CRD42018083683). Of 48 studies included, the majority were rated moderate risk of bias due to possible confounding influences. In total, 17 cervical outcomes were assessed, with confidence in findings ranging from very low to moderate levels. Compared to controls, participants with TTH had greater forward head posture (FHP) (MD = -6.18°, 95% CI [-8.18°, -4.18°]) and less cervical range of motion (ROM) (greatest difference transverse plane MD = -15.0°, 95% CI [-27.7°, -2.3°]. Participants with migraine demonstrated minimally reduced cervical ROM (greatest difference sagittal plane MD = -5.4°, 95% CI [-9.9°, -0.9°]. No differences presented in head posture, strength, craniocervical flexion test performance or joint position error between migraineurs and controls. TTH presented with more findings of cervical musculoskeletal impairments than migraine however levels of confidence in findings were low. Future studies should differentiate episodic from chronic headache, identify coexisting musculoskeletal cervical disorders, and describe neck pain behaviour in headache.
Publisher: Elsevier BV
Date: 07-2019
DOI: 10.1016/J.MSKSP.2019.04.006
Abstract: The three-metre tandem gait test (TG) is used to assess postural control during locomotion following sports concussion. However, values used to determine a pass/fail result are currently based on young athletic populations. Times for test completion may be influenced by several intrinsic or extrinsic factors. The aim of this study was to collate healthy in idual single, dual task as well as dual task cost - motor TG times for a non-elite athlete population, across several age groups, and to investigate several potential influencing factors. Healthy in iduals aged 18-55+, who had never experienced a concussion completed single and dual task TG following the SCAT5 protocol. A separate group (n = 20, age, foot length and body mass index matched) performed the tests with alternate instructions. Mean best TG time for all participants were: single task 21.03 (±5.26s), dual task 29.59 (±9.84s) and DTC-motor 8.57 (±7.5s:41.7%). Age and foot length but not specificity of verbal instructions were related to TG times. Significantly slower single and dual task times were identified for the 55 + age group when compared to the three youngest groups (p 0.05). Healthy in idual data collected exceeded previously reported average times. Faster times were evident in younger participants and those with longer foot length. Results from this study can be used as a reliable guideline to inform clinical decisions around the pass/fail result of TGT across age ranges in non-elite athlete populations post-concussion.
Publisher: Elsevier BV
Date: 08-2023
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 26-05-2022
Publisher: SAGE Publications
Date: 02-2018
Abstract: Objective. To systematically review the literature with meta-analysis to determine whether persistence of sensorimotor or physiological impairment exists between 4 weeks to 6 months post mild traumatic brain injury (mTBI), and assign level of evidence to findings. Method. The databases PubMed, pscyINFO, SPORTdiscus, Medline, CINAHL and Embase were searched from inception to November 2016 using a priori inclusion criteria. Critical appraisal was performed, and an evidence matrix established level of evidence. Meta-analysis of pooled results identified standardized mean difference (SMD) and 95% confidence intervals (95% CI) between mTBI and healthy controls for a variety of physiological and sensorimotor indicators. Results. Eighteen eligible articles, with a mean quality score of 15.67 (SD = 2.33) were included in the final review. Meta-analysis of center of motion variable maximal mediolateral center of motion/center of pressure separation distance SMD [95% CI] approached significance at (−0.42 [−0.84, −0.00], I 2 = 0%) for dual task, level walking indicating a potential reduction in maximal mediolateral excursion during gait in the mTBI group compared to healthy controls. Significantly reduced variability in the standard deviation of heart beat intervals was observed in the mTBI group (−0.51 [−0.74, −0.28], I 2 = 0%). Overall, significant group differences in 36 sensorimotor and physiological variables (eg, balance, gait velocity and motion analysis outcomes, various oculomotor tasks, as well as heart rate variability frequency domains) were identified. Conclusion. Findings demonstrate that persistence of sensorimotor and physiological changes beyond expected recovery times following subacute mTBI in an adult population is possible. These findings have implications for post-injury assessment and management.
Publisher: Elsevier BV
Date: 02-2022
DOI: 10.1016/J.MSKSP.2021.102490
Abstract: Clinically relevant scores of neck disability have been observed in adults post mild traumatic brain injury (mTBI), even in those who initially report to be recovered. Potentially cervical musculoskeletal and/or cervical sensorimotor impairments may underlie these persistent symptoms post mTBI. To determine whether cervical impairments exist beyond expected recovery times following concussion compared to healthy controls (HC). Observational cohort study. Participants aged 18-60 years consisting of 39 HC, and 72 in iduals, 4 weeks to 6 months post mTBI of which 35 considered themselves asymptomatic (Asymp), and 37 symptomatic (Symp). Cervical outcome measures included range and velocity of motion, flexor muscle endurance, presence of at least one dysfunctional cervical joint, joint position error -neutral and torsion, movement accuracy, smooth pursuit neck torsion test (SPNT) and balance. In iduals in the Symp mTBI group demonstrated significantly reduced: flexion and rotation range, rotation velocity, flexor endurance and movement accuracy as well as increased postural sway and a higher percentage had positive cervical joint dysfunction (p < 0.01]. The mTBI group who considered themselves recovered (Asymp)demonstrated significantly lower rotation range, flexor endurance, and a higher percentage had positive cervical joint dysfunction and positive SPNT (p < 0.05) compared to HCs. In iduals reporting symptoms post mTBI demonstrated cervical spine musculoskeletal and sensorimotor impairments beyond expected recovery times. Those not reporting symptoms had fewer but some cervical impairments. The need for a comprehensive neck assessment should be considered, perhaps even in those not reporting symptoms.
Publisher: University of Queensland Library
Date: 2020
Publisher: Elsevier BV
Date: 05-2022
DOI: 10.1016/J.APMR.2021.10.029
Abstract: To identify whether adults 4 weeks to 6 months post mild traumatic brain injury (mTBI) have sensorimotor impairments compared with controls without mTBI. A secondary aim was to determine if impairments were evident irrespective of participant perceived absence of symptoms. Observational cohort study. Tertiary university and hospital. Participants included 113 in iduals (N=113) aged 18-60 years, consisting of 39 controls with no prior concussion history and 74 in iduals 4 weeks to 6 months post mTBI, of which 35 considered themselves asymptomatic (ASYMP) and 37 symptomatic (SYMP). Not applicable. Assessments of oculomotor, vestibulo-ocular reflex (VOR) control, balance, single- and dual-task tandem walk, and vestibular positional testing. Poorer balance and tandem walk performance as well as a higher frequency of positive oculomotor, VOR, and vestibular positional tests were evident in the mTBI group compared with controls. In particular ≥2 positive oculomotor findings were evident in 53.7% of the participants with mTBI compared with 10.8 % of controls. The mTBI group who considered themselves recovered (ASYMP) demonstrated significantly increased dual-task tandem walk time, and a higher proportion 53% had ≥2 positive oculomotor tests compared with controls. Persistent sensorimotor impairments, particularly evidenced by disturbed oculomotor function and deficits in dual-task tandem walking were identified among adults 4 weeks to 6 months post mTBI. These disturbances were evident regardless of whether ongoing symptoms were reported. The findings support recommendations for routine clinical assessment of sensorimotor function post mTBI with implications for injury prevention.
Publisher: SAGE Publications
Date: 02-05-2017
Abstract: To evaluate the effectiveness of treatment delivered via real-time telerehabilitation for the management of musculoskeletal conditions, and to determine if real-time telerehabilitation is comparable to conventional methods of delivery within this population. Six databases (Medline, Embase, Cochrane CENTRAL, PEDro, psycINFO, CINAHL) were searched from inception to November 2015 for literature which reported on the outcomes of real-time telerehabilitation for musculoskeletal conditions. Two reviewers screened 5913 abstracts where 13 studies ( n = 1520) met the eligibility criteria. Methodological quality was assessed using the Downs & Black ‘Checklist for Measuring Quality’ tool. Results were pooled for meta-analysis based upon primary outcome measures and reported as standardised mean differences and 95% confidence intervals (CI). Aggregate results suggest that telerehabilitation is effective in the improvement of physical function (SMD 1.63, 95%CI 0.92-2.33, I 2 =93%), whilst being slightly more favourable (SMD 0.44, 95%CI 0.19-0.69, I 2 =58%) than the control cohort following intervention. Sub-group analyses reveals that telerehabilitation in addition to usual care is more favourable (SMD 0.64, 95%CI 0.43-0.85, I 2 =10%) than usual care alone, whilst treatment delivered solely via telerehabilitation is equivalent to face-to-face intervention (SMD MD 0.14, 95% CI −0.10–0.37, I 2 = 0%) for the improvement of physical function. The improvement of pain was also seen to be comparable between cohorts (SMD 0.66, 95%CI −0.27–1.60, I 2 =96%) following intervention. Real-time telerehabilitation appears to be effective and comparable to conventional methods of healthcare delivery for the improvement of physical function and pain in a variety of musculoskeletal conditions.
Publisher: Elsevier BV
Date: 06-2019
DOI: 10.1016/J.MSKSP.2019.02.002
Abstract: To further explore symptoms in patients beyond the expected recovery period post mild Traumatic Brain Injury (mTBI) that are potentially indicative of impairment. Ninety-four in iduals (62 diagnosed with mTBI within the previous 4-24 weeks and 32 healthy controls) participated in the study. Participants in the mTBI group were further grouped as symptomatic (n = 33) or asymptomatic (n = 29) based on their spontaneous report of symptoms at the time of screening. Measures included a demographic questionnaire, 8 impairment specific self-report clinical tools, and a standard post-mTBI self-report symptom scale (Head Injury Scale (HIS)). Compared to the control group, scores for all instruments (including the HIS) were higher in the symptomatic mTBI group (P < 0.05), and higher for the neck disability and hyperarousal measures in the asymptomatic mTBI group (p 0.093). Overall 94% of the symptomatic and 62% of the asymptomatic participants post-mTBI, recorded scores considered to be clinically relevant on at least one impairment screening tool. In contrast, only 28% of the asymptomatic mTBI group recorded a clinically relevant score for the HIS. Symptoms indicative of persisting impairments beyond the expected recovery period were apparent in a substantial proportion of in iduals post mTBI. Furthermore, a high percentage of in iduals initially reporting as symptom free demonstrated clinically relevant scores on at least one impairment screening tool. Findings also suggest that a standard post-mTBI self-report symptom scale may often not detect the presence of persisting symptoms.
Publisher: American Physiological Society
Date: 12-2021
DOI: 10.1152/AJPREGU.00177.2021
Abstract: Previous research has highlighted that squat-stand maneuvers (SSMs) augment coherence values within the cerebral pressure-flow relationship to ∼0.99. However, it is not fully elucidated if mean arterial pressure (MAP) leads to this physiological entrainment independently, or if heart rate (HR) and/or the partial pressure of carbon dioxide (Pco 2 ) also have contributing influences. A 2:1 control-to-case model was used in the present investigation [participant number ( n) = 40 n = 16 age-matched (AM) n = 16 donor control (DM) n = 8 heart transplant recipients (HTRs)]. The latter group was used to mechanistically isolate the extent to which HR influences the cerebral pressure-flow relationship. Participants completed 5 min of squat-stand maneuvers at 0.05 Hz (10 s) and 0.10 Hz (5 s). Linear transfer function analysis (TFA) examined the relationship between different physiological inputs (i.e., MAP, HR, and Pco 2 ) and output [cerebral blood velocity (CBV)] during SSM and cardiac baroreceptor sensitivity (BRS). Compared with DM, cardiac BRS was reduced in AM ( P 0.001), which was further reduced in HTR ( P 0.045). In addition, during the SSM, HR was elevated in HTR compared with both control groups ( P 0.001), but all groups had near-maximal coherence metrics ≥0.98 at 0.05 Hz and ≥0.99 at 0.10 Hz ( P ≥ 0.399). In contrast, the mean HR-CBV/Pco 2 -CBV relationships ranged from 0.38 (HTR) to 0.81 (DM). Despite near abolishment of BRS and blunted HR following heart transplantation, long-term HTR exhibited near-maximal coherence within the MAP-CBV relationship, comparable with AM and DM. Therefore, these results show that the augmented coherence with SSM is driven by blood pressure, whereas elevations in TFA coherence as a result of HR contribution are likely correlational in nature.
No related grants have been discovered for Olivia GALEA.