ORCID Profile
0000-0003-2085-7522
Current Organisation
James Cook University
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Publisher: Elsevier BV
Date: 05-2015
Publisher: Wiley
Date: 29-05-2021
DOI: 10.1111/AJR.12703
Abstract: The objective of this study is to measure the activity levels of patients admitted to adult general inpatient rehabilitation units in regional areas. These included physical, social, cognitive and self‐care activities. A secondary aim was to explore differences in activity levels across different diagnostic groups. An observational study using behavioural mapping. Patient activity was mapped every 15 minutes, over a 12‐hour period (07:00‐19:00), on two, non‐consecutive days. 2 inpatient rehabilitation units, inner regional NSW. All patients were admitted for rehabilitation in an adult general rehabilitation unit. Patients presented with erse diagnoses (eg neurological, musculoskeletal, orthopaedic, pulmonary and cardiovascular diseases). The s le had a mean age of 74.4 years with a range of 33‐96 years. The percentage of the day spent in physical, cognitive or social activities was recorded. In addition, the patients’ location and interacting personnel were recorded. Fifty‐six participants across 8 diagnosis groups were observed. A total of 2285 observations were made. Patients were observed being active physically for 10% of their day, socially active for 23%, and cognitively for 6%. Patients engaged in other activities such as watching TV or eating 21% of their time, and completing self‐care activities 7% of their time. Patients were inactive for 27% of their day. There was no statistically significant difference between the diagnostic groups and activity categories. Patients spent a large proportion of their time inactive and alone in rehabilitation. In order to maximise outcome, rehabilitation units can look at new opportunities to maximise activity and promote engagement.
Publisher: Wiley
Date: 19-12-2023
DOI: 10.1002/PRI.1988
Abstract: In iduals with multiple sclerosis (MS) want health advice regarding participation in their choice of exercise. To address this need, a flexible exercise participation programme (FEPP) was developed, underpinned by the MS aerobic exercise guidelines and supported by a physiotherapist using behaviour change techniques. The aim of this study was to investigate the feasibility of the FEPP for in iduals with minimal disability from MS. A feasibility study utilising a single group pre ost‐intervention design was conducted. The 12‐week FEPP was completed by 10 in iduals with MS (EDSS 0–3.5). Exercise progression in duration, intensity or frequency of exercise (in line with MS exercise guidelines) was guided by a self‐perceived weekly energy level score, and weekly telephone coaching sessions using behavioural change techniques. Trial feasibility was assessed via measures of process (recruitment and retention), resources/management (communication time data entry) and scientific feasibility (safety compliance). Secondary FEPP feasibility outcomes included the Goal Attainment Scale (GAS) T‐score, exercise participation (weekly exercise diary), high‐level mobility (HiMAT), vitality (Subjective Vitality Scale), biomarkers for inflammation (cytokines levels [IL2, IL4, IL6, IL10, TNF and IFNγ]), and acceptability (participant survey). Process: In total, 11 (85%) of 13 eligible participants enroled at baseline with 10 (91%) completing the study. Resources/management: Coaching sessions included a baseline interview—mean 39 min (SD: 6.6) and telephone coaching—mean 10 min (SD: 3.8) per week. Outcome measure data collection time—mean 44 min (SD: 2.1). Scientific feasibility: Two participants experienced a fall during their exercise participation. Self‐reported compliance was high (99%). GAS T‐scores increased significantly, indicating achievement of exercise participation goals. Secondary outcomes showed trends towards improvement. The FEPP was feasible, safe and highly acceptable for use with in iduals with MS and warrants a larger trial to explore effectiveness.
Publisher: Wiley
Date: 28-09-2021
DOI: 10.1002/PRI.1922
Abstract: The flexible exercise participation program (FEPP) is a novel intervention developed to enable in iduals with multiple sclerosis (MS) participate and progress in an exercise or sport of their choice. The FEPP is underpinned by guidelines on aerobic exercise for in iduals with MS and is supported by a physiotherapist using behaviour change techniques. As part of a FEPP feasibility trial, the aim of this nested study was to explore the experience of participation in the FEPP from the perspective of in iduals with MS. The objectives were to (i) determine the acceptability of the FEPP and (ii) identify recommendations for improvement. A mixed methods study using a sequential explanatory design was conducted. Part I consisted of a quantitative participant survey. Survey data were analysed descriptively using SPSS and informed the protocol for part II – qualitative interviews. Interview data were analysed thematically using NVivo. Part III consisted of integration of quantitative and qualitative data to allow greater explanation of survey responses. In iduals with MS who had participated in the FEPP feasibility trial were invited to take part in the study. The FEPP was highly acceptability to the 10 participants. Five themes emerged to describe the experience of participating in the FEPP: (i) exploring exercise boundaries, (ii) measuring energy, (iii) acknowledging accountability, (iv) adjusting to exercising in a pandemic and (v) sustaining participation. Recommendations for improving the FEPP included changes to energy level monitoring and incorporation of peer support mechanisms. Participants found the FEPP highly acceptable and valued the flexibility to choose their own activity and the health professional support. Based on participant recommendations, future versions of the FEPP will include daily rather than weekly monitoring of exercise and peer support to further enable in iduals with MS to find the right balance with exercise and sport.
Publisher: Informa UK Limited
Date: 05-05-2023
Publisher: Elsevier BV
Date: 03-2020
DOI: 10.1016/J.PHYSIO.2019.04.003
Abstract: To investigate the effect of exercise on high-level mobility (i.e. mobility more advanced than independent level walking) in in iduals with neurodegenerative disease. A systematic literature search was conducted in Medline, CINAHL, Scopus, SportDiscus and PEDro. Randomised controlled trials of exercise interventions for in iduals with neurodegenerative disease, with an outcome measure that contained high-level mobility items were included. High-level mobility items included running, jumping, bounding, stair climbing and backward walking. Outcome measures with high-level mobility items include the High Level Mobility Assessment Tool (HiMAT) Dynamic Gait Index Rivermead Mobility Index (RMI) or modified RMI Functional Gait Assessment and the Functional Ambulation Category. Quality was evaluated with the Cochrane Risk of Bias Tool. Twenty-four studies with predominantly moderate to low risk of bias met the review criteria. High-level mobility items were included within primary outcome measures for only two studies and secondary outcome measures for 22 studies. Eight types of exercise interventions were investigated within which high-level mobility tasks were not commonly included. In the absence of outcome measures or interventions focused on high-level mobility, findings suggest some benefit from treadmill training for in iduals with multiple sclerosis or Parkinson's disease. Progressive resistance training for in iduals with multiple sclerosis may also be beneficial. With few studies on other neurodegenerative diseases, further inferences cannot be made. Future studies need to specifically target high-level mobility in the early stages of neurodegenerative disease and determine the impact of high-level mobility interventions on community participation and maintenance of an active lifestyle. Systematic review registration number PROSPERO register for systematic reviews (registration number: CRD42016050362).
Publisher: Wiley
Date: 22-04-2019
DOI: 10.1002/PRI.1776
Abstract: The aim of this study was to explore the experience of participation in sport and exercise for in iduals with multiple sclerosis (MS) with minimal disability. The objectives were to gain an understanding of key factors that influence participation in sport and exercise and to determine support required by in iduals with MS to participate in their choice of sport and exercise for as long as possible. A qualitative, descriptive study utilizing three focus groups was conducted. Data were analysed thematically aided by NVivo software. Participants were in iduals with MS who had an Expanded Disability Status Scale score of 0-4, indicating full ambulation. All participants were living in northern Queensland, Australia. Sixteen in iduals participated 63% of whom regularly participated in sport or exercise. All participants viewed sport and exercise positively and identified inherent benefits of exercise. Five key themes emerged to describe the experience of participating in sport and exercise: "personally engaging with exercise," "influencing barriers and enablers of exercise," "sustaining independence," "integrating exercise into lifestyle," and "getting the balance right." Most participants felt that advice and guidance from health professionals about the optimum mode and dose (how much and how often) of exercise was lacking. Participation in sport and exercise was valued by in iduals with MS with minimal disability for sustaining independence and an active lifestyle. Personalized exercise advice from health professionals was the key support identified by participants to assist them to maintain an active lifestyle for as long as possible.
Publisher: Elsevier BV
Date: 06-2019
DOI: 10.1016/J.PHYSIO.2019.01.002
Abstract: Erectile dysfunction (ED) and premature ejaculation (PE) often have underlying musculoskeletal abnormalities. Despite this, traditional management has focused on pharmaceutical prescription. To investigate the efficacy of pelvic floor muscle training in treating ED and PE. A computerized literature search of CINAHL All studies where participants were males greater than 18years with ED or PE, with no history of neurological injury or previous major urological surgery were included. Two independent reviewers assessed methodological quality using the Crowe Critical Appraisal Tool. Disagreements between reviewers were resolved by consensus. Ten trials were included for review. Among the measures of ED, all trials showed comparative improvement and cure rates in response to treatment. Within PE outcomes, the majority of trials showed comparative improvement rates, with a greater range in overall cure rates in response to treatment. Training protocols varied significantly in overall therapist contact, concurrent interventions, intervention length, training frequency and intensity. The included studies were of low to moderate methodological quality with discrepancies in reporting. Study heterogeneity was not conducive to data pooling. Pelvic floor muscle training appears effective in treating ED and PE however, no optimal training protocol has been identified. PROSPERO CRD42016047261.
Publisher: BMJ
Date: 03-2020
DOI: 10.1136/BMJOPEN-2019-035378
Abstract: In iduals with minimal disability from multiple sclerosis (MS) requested advice on finding the right balance, between too much and too little exercise, when participating in their choice of sport or exercise. To optimise exercise participation during the early stages of the disease, a flexible exercise participation programme (FEPP) has been developed. The FEPP is novel because it provides guidance and support for in iduals with MS to participate and progress in their preferred sport or exercise. The primary objective was to assess the feasibility of the FEPP. The secondary objective was to assess the feasibility of a larger trial to demonstrate the efficacy of the FEPP. A stage I feasibility study of the FEPP, using a single group preintervention ost-intervention design, will be conducted with 16 participants with minimal disability from MS (Expanded Disability Status Scale level of 0–3.5). The 12-week FEPP will guide participants to independently participate in their preferred sport or exercise at a location of their choice. Exercise progression will be guided by in idual energy levels and a weekly telephone coaching session with a physiotherapist. Participation in exercise or sport will be recorded in parallel with assessment of disease biomarkers (plasma cytokines interleukin (IL)-2, IL-4, IL-6, IL-10, interferon (IFN)-γ and tumour necrosis factor (TNF)), subjective vitality and high-level mobility. Acceptability of the FEPP will be assessed using a sequential explanatory mixed methods design where the findings of a participant survey will inform the interview guide for a series of focus groups. Feasibility of a larger trial will be assessed via process, resources, management and scientific metrics. Progression to a larger trial will depend on the achievement of specified minimum success criteria. Ethical approval has been obtained for this study from the James Cook University Human Research Ethics Committee (H7956). Dissemination of findings is planned via peer-reviewed journals, conference presentations and media releases. The protocol date was 21 December 2019, V.1. The trial is registered with Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN12620000076976.
Publisher: Elsevier BV
Date: 06-2019
DOI: 10.1016/J.PHYSIO.2019.01.002
Abstract: Erectile dysfunction (ED) and premature ejaculation (PE) often have underlying musculoskeletal abnormalities. Despite this, traditional management has focused on pharmaceutical prescription. To investigate the efficacy of pelvic floor muscle training in treating ED and PE. A computerized literature search of CINAHL All studies where participants were males greater than 18years with ED or PE, with no history of neurological injury or previous major urological surgery were included. Two independent reviewers assessed methodological quality using the Crowe Critical Appraisal Tool. Disagreements between reviewers were resolved by consensus. Ten trials were included for review. Among the measures of ED, all trials showed comparative improvement and cure rates in response to treatment. Within PE outcomes, the majority of trials showed comparative improvement rates, with a greater range in overall cure rates in response to treatment. Training protocols varied significantly in overall therapist contact, concurrent interventions, intervention length, training frequency and intensity. The included studies were of low to moderate methodological quality with discrepancies in reporting. Study heterogeneity was not conducive to data pooling. Pelvic floor muscle training appears effective in treating ED and PE however, no optimal training protocol has been identified. PROSPERO CRD42016047261.
Publisher: BMJ
Date: 09-2019
DOI: 10.1136/BMJOPEN-2019-032092
Abstract: Machado-Joseph disease (MJD) is the most common spinocerebellar ataxia worldwide. Prevalence is highest in affected remote Aboriginal communities of the Top End of Australia. Aboriginal families with MJD from Groote Eylandt believe ‘staying strong on the inside and outside’ works best to keep them walking and moving around, in accordance with six key domains that form the ‘Staying Strong’ Framework. The aim of this current study was to review the literature to: (1) map the range of interventions/strategies that have been explored to promote walking and moving around (functional mobility) for in iduals with MJD and (2) align these interventions to the ‘Staying Strong’ Framework described by Aboriginal families with MJD. Scoping review. Searches were conducted in July 2018 in MEDLINE, EMBASE, CINAHL, PsychINFO and Cochrane Databases. Peer-reviewed studies that (1) included adolescents/adults with MJD, (2) explored the effects of any intervention on mobility and (3) included a measure of mobility, function and/or ataxia were included in the review. Thirty studies were included. Few studies involved participants with MJD alone (12/30). Most studies explored interventions that aligned with two ‘Staying Strong’ Framework domains, ‘exercising your body’ (n=13) and ‘searching for good medicine’ (n=17). Few studies aligned with the domains having ‘something important to do’ (n=2) or ‘keeping yourself happy’ (n=2). No studies aligned with the domains ‘going country’ or ‘families helping each other’. Evidence for interventions to promote mobility that align with the ‘Staying Strong’ Framework were focused on staying strong on the outside (physically) with little reflection on staying strong on the inside (emotionally, mentally and spiritually). Findings suggest future research is required to investigate the benefits of lifestyle activity programmes that address both physical and psychosocial well-being for families with MJD.
Publisher: Springer Science and Business Media LLC
Date: 29-11-2014
DOI: 10.1007/S00455-014-9584-Z
Abstract: Recent and specific data on the prevalence and/or incidence of oropharyngeal dysphagia in the general population are scarce. This study focuses on obtaining this data by means of a literature review and telephone survey. A literature review was performed to obtain data on the prevalence of dysphagia in the general population. Secondly, a quasi-random telephone survey using the functional health status questionnaire EAT-10 was conducted with the aim of establishing prevalence data on oropharyngeal dysphagia in the Netherlands. The literature review revealed six articles which met the inclusion criteria. The prevalence data on oropharyngeal dysphagia in the general population varied between 2.3 and 16 %. For the telephone survey, a total of 6,700 in iduals were contacted by telephone, of which, 2,600 (39 %) participated in the study. Of the 2,600 participants, as many as 315 (12.1 %) were identified as having swallowing abnormalities and showed increased risk of oropharyngeal dysphagia with age. Prevalence data on oropharyngeal dysphagia in the Dutch general population were as high as 12.1 %. This data are in line with the retrieved prevalence data from the literature.
Publisher: Cambridge Media
Date: 03-2022
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 12-03-2021
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Moira Smith.