ORCID Profile
0000-0002-4510-3324
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: Springer Science and Business Media LLC
Date: 31-05-2018
DOI: 10.1007/S00421-018-3903-2
Abstract: To determine whether stiffness of the patellar tendon and quadriceps muscles is altered immediately after and 48 h after a single bout of maximal eccentric exercise of the knee extensor muscles. Thirteen healthy in iduals [group mean (SD) age 22.4 (3.5) years 7 female] performed a single bout of maximal eccentric exercise of the non-dominant knee extensors, using an isokinetic dynamometer. Shear-wave velocity (an index of tissue stiffness) was recorded from the patellar tendon, vastus medialis (VM), rectus femoris (RF) and vastus lateralis (VL), before, following (post Compared to preexercise, MVIC decreased and self-reported pain and stiffness increased at post Maximal eccentric exercise produced an immediate increase in the stiffness of the patellar tendon and RF, resolving by 48 h. As this change was not observed in VL and VM, future studies may explore heterogeneity within synergist muscles following eccentric exercise.
Publisher: Springer Science and Business Media LLC
Date: 14-10-2019
DOI: 10.1007/S00590-019-02548-7
Abstract: To evaluate whether attending a face-to-face pre-operative joint replacement education in a regional setting reduces overall hospital costs and length of stay (LOS) following total knee replacement (TKR) or total hip replacement (THR). A retrospective clinical audit reviewed the medical records of all patients who underwent an elective THR or TKR at Rockh ton Hospital in regional Queensland, Australia, between 03/2015 and 12/2016 (22 months). The pre-operative joint replacement education class was provided by a multidisciplinary team that included a physiotherapist, an occupational therapist, a dietician, a pharmacist and a social worker. In addition to demographic data, we extracted and analysed data related to total acute care and total healthcare cost, prevalence of post-operative complications, discharge destination and comorbidities (using the Functional Comorbidity Index). Out of 326 cases that were included in the analysis, 115 cases with TKR and 51 cases with THR attended a pre-operative education class. Demographic characteristics between those attending and not attending the class were largely similar, except from more females attending in the THR group. There was no difference in hospital costs or LOS between those who attended the class compared to those who did not for both the TKR and THR groups. Outcomes related to total acute stay costs, total cost including travel and education and score for Functional Comorbidities Index were similar between those who attended the class and those who did not. Pre-operative education does not reduce hospital costs (surgery and hospital stay) in Central Queensland.
Publisher: BMJ
Date: 19-01-2018
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 22-11-2021
DOI: 10.1097/PXR.0000000000000068
Abstract: Custom-made foot orthoses (FOs) play an integral part in managing foot disorders. Traditional FO fabrication is time-consuming and labor intensive. Three-dimensional (3D) printed FOs save time and cost compared with the traditional manufacturing process. To date, the differences in dimensions and comfort perception of these orthoses have not been compared in a pathological population. Compare the dimensions between 3D-printed and traditionally made FOs and comfort perception between 3D-printed, traditionally made, and no FOs in in iduals with flatfeet and unilateral heel pain. Within-subject single-blinded randomized crossover study design. Thirteen participants had custom-made FOs using 3D-printing and traditional processes. Orthotic lengths, widths, arch heights, and heel cup heights were compared. Participants performed walking trials under three conditions: (1) no orthoses, (2) 3D-printed orthoses, and (3) traditionally made orthoses. Comfort perception was recorded. Orthotic dimensions were compared using paired t tests, and comfort perception were compared using one-way multiple analysis of variance and Bonferroni post hoc tests. Three-dimensional–printed orthoses were wider, have higher arch heights, and heel cup heights compared with traditionally made FOs (medium to large effect sizes). There was a difference in comfort perception between the three orthotic conditions, F(12,62) = 1.99, P = 0.04 Wilk Λ = 0.521, η p 2 = 0.279. Post hoc tests show that there is no difference in comfort perception between the 3D-printed and traditionally made FOs. Both FOs were significantly more comfortable than no orthoses. Three-dimensional printing seems to be a viable alternative orthotic fabrication option. Future studies should compare the biomechanical effects of 3D-printed and traditionally made FOs.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-2015
Publisher: Wiley
Date: 26-10-2017
DOI: 10.1111/SMS.12986
Abstract: To compare tendon elastic and structural properties of healthy in iduals with those with Achilles or patellar tendinopathy. Sixty-seven participants (22 Achilles tendinopathy, 17 patellar tendinopathy, and 28 healthy controls) were recruited between March 2015 and March 2016. Shear wave velocity (SWV), an index of tissue elastic modulus, and tendon thickness were measured bilaterally at mid-tendon and insertional regions of Achilles and patellar tendons by an examiner blinded to group. Analysis of covariance, adjusted for age, body mass index, and sex was used to compare differences in tendon thickness and SWV between the two tendinopathy groups (relative to controls) and regions. Tendon thickness was included as a covariate for analysis of SWV. Compared to controls, participants with Achilles tendinopathy had lower SWV at the distal insertion (Mean difference MD 95% CI: -1.56 -2.49 to -0.62 m/s P < .001) and greater thickness at the mid-tendon (MD 0.19 0.05-0.33 cm P = .007). Compared to controls, participants with patellar tendinopathy had higher SWV at both regions (MD 1.25 0.40-2.10 m/s P = .005) and greater thickness proximally (MD 0.17 0.06-0.29 cm P = .003). Compared to controls, participants with Achilles and patellar tendinopathy displayed lower Achilles tendon elastic modulus and higher patellar tendon elastic modulus, respectively. More research is needed to explore whether maturation, aging, or chronic load underlie these findings and whether current management programs for Achilles and patellar tendinopathy need to be tailored to the tendon.
Publisher: BMJ
Date: 21-10-2014
DOI: 10.1136/BJSPORTS-2013-092535
Abstract: Tendinopathy manifests as activity-related tendon pain with associated motor and sensory impairments. Tendon tissue changes in animals present in injured as well as contralateral non-injured tendon. This review investigated evidence for bilateral sensory and motor system involvement in unilateral tendinopathy in humans. A comprehensive search of electronic databases, and reference lists using keywords relating to bilateral outcomes in unilateral tendinopathy was undertaken. Study quality was rated with the Epidemiological Appraisal Instrument and meta-analyses carried out where appropriate. Analysis focused on comparison of measures in the non-symptomatic side of patients against pain-free controls. The search revealed 5791 studies, of which 20 were included (117 detailed reviews, 25 met criteria). There were 17 studies of lateral epicondylalgia (LE) and one each for patellar, Achilles and rotator cuff tendinopathy. Studies of LE were available for meta-analysis revealing the following weighted pooled mean deficits: pressure pain thresholds (-144.3 kPa 95% CI -169.2 to -119.2 p<0.001), heat pain thresholds (-1.2°C 95% CI -2.1 to -0.2, p<0.001), cold pain thresholds (3.1°C 95% CI 1.8 to 4.4, p<0.001) and reaction time (37.8 ms 95% CI 24.8 to 50.7, p<0.001). Deficits in sensory and motor systems present bilaterally in unilateral tendinopathy. This implies potential central nervous system involvement. This indicates that rehabilitation should consider the contralateral side of patients. Research of unilateral tendinopathy needs to consider comparison against pain-free controls in addition to the contralateral side to gain a complete understanding of sensory and motor features.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-2014
Publisher: Wiley
Date: 27-03-2021
DOI: 10.1002/PRI.1906
Abstract: Pain‐free grip (PFG) force is commonly used to monitor treatment outcomes in lateral elbow tendinopathy (LET) however, it is unclear whether changes in forearm and elbow position affect PFG force values. This study aims to examine the effect of elbow/shoulder and forearm position on non‐normalised and normalised PFG force in in iduals with unilateral LET. A cohort study including 21 subjects with clinically diagnosed unilateral LET (13 females, mean [SD] age 50 [8] years) performed PFG force (symptomatic arm) and maximal grip (asymptomatic arm) tasks using four upper limb positions: (1) shoulder neutral, elbow flexed (90°), forearm pronated (2) shoulder neutral, elbow flexed (90°), forearm neutral (3) shoulder flexed (90°), elbow extended, forearm pronated and (4) shoulder flexed (90°), elbow extended, forearm neutral. PFG force was normalised to the maximal grip of the asymptomatic side. Repeated‐measures analyses of variance were used to compare non‐normalised and PFG force normalised to maximal grip between positions. Both non‐normalised and normalised PFG forces were greater in position 2 than position 1, position 3 and position 4 (elbow‐by‐forearm interaction non‐normalised p = 0.002, normalised p = 0.004). There were no differences between positions 1, 3 and 4 for either non‐normalised or normalised PFG strength. This study shows that PFG force was higher when performed with forearm neutral supination ronation, elbow flexion and shoulder neutral than other tested positions, and irrespective of whether PFG force was normalised to the maximal grip force of the contralateral limb. This indicates that arm position should be standardised for comparison.
Publisher: Springer Science and Business Media LLC
Date: 22-04-2016
DOI: 10.1007/S40279-016-0539-4
Abstract: Lateral epicondylalgia (LE) refers to pain at the lateral elbow and is associated with sensory and motor impairments that may impact on neuromuscular control and coordination. This review aimed to systematically identify and analyse the literature related to the comparison of neuromuscular control of forearm muscles between in iduals with and without LE. A comprehensive search of electronic databases and reference lists using keywords relating to neuromuscular control and LE was undertaken. Studies that investigated electromyography (EMG) measures of forearm muscles in in iduals with symptoms of LE were included if the study involved comparison with pain-free controls. The Epidemiological Appraisal Instrument was used to assess study quality. Data extracted from each study were used to calculate the standardised mean difference and 95 % confidence intervals to investigate differences between groups. The search revealed a total of 1920 studies, of which seven were included from 44 that underwent detailed review. Due to differences in outcome measures and tasks assessed, meta-analysis was not possible. The seven included studies used 60 different EMG outcomes, of which 16 (27 %) revealed significant differences between groups. Two were properties of motor unit potentials during wrist extension. Four were measures of increased time between recruitment of wrist extensor muscles and onset of grip force. Seven were measures of litude of EMG during tennis strokes. Three were measures of motor cortex organisation. Features of neuromuscular control differ between in iduals with LE and pain-free controls. This implies potential central nervous system involvement and indicates that rehabilitation may be enhanced by consideration of neuromuscular control in addition to other treatments.
Publisher: Wiley
Date: 12-03-2018
DOI: 10.1111/SMS.13025
Publisher: Elsevier BV
Date: 08-2018
DOI: 10.1016/J.JELEKIN.2018.05.003
Abstract: Intramuscular electromyography electrodes targeting flexor digitorum profundus (FDP) are inserted via the anterior or medial aspect of the forearm. These two methods pose different risks to neurovascular structures which overly FDP. This study aimed to compare the insertion depth and consider advantages and limitations of two different techniques to insert intramuscular electrodes into FDP. Using ultrasound imaging, neurovascular structures were identified along the path of FDP electrode insertion at the junction of the proximal and middle third of the ulna, bilaterally, in ten healthy in iduals. Insertion depth was compared between the anterior and medial approaches for the mid muscle belly and targeted insertion to the index finger fascicle of FDP. In our s le the ulnar artery was superficial to the FDP muscle when viewed anteriorly and was beyond the furthest border of FDP when viewed medially. Compared to the anterior approach, the medial insertion depth was 1.5 cm (95%CI 1.4-1.7, p < 0.001) less to the mid-belly of FDP and 0.6 cm (95%CI 0.4-0.7, p < 0.001) less to the index finger fascicle of FDP. The medial approach involves less depth and lower risk for perforation of neurovascular structures when inserting intramuscular electrodes into the FDP muscle.
Publisher: Informa UK Limited
Date: 03-02-2022
DOI: 10.1080/09593985.2022.2030445
Abstract: Pain-free grip strength is an important outcome measure in lateral elbow tendinopathy (LET) yet, the reliability and minimum detectable change (MDC) in functional positions are unknown. The purpose of this study is to examine the between- and within-session pain-free grip strength reliability and MDC in LET. Twenty-three in iduals with LET completed three pain-free grip strength trials with the elbow flexed and extended. The first trial and the mean of three trials were analyzed. Between-session data were collected 2-28 days apart. Within-session data were collected 20-30 min apart. Between-session intraclass correlation coefficients (ICCs) were good (ICC Using the mean of three trials is recommended, and clinicians can be confident of true change if between-session differences are >92 N and within-session differences are >52 N.
Publisher: Wiley
Date: 12-2016
DOI: 10.1111/SMS.12584
Abstract: Lateral epicondylalgia (LE) is associated with a reduced wrist extensor muscle activity and altered biomechanics. This study compared the coordination between forearm muscles during gripping in in iduals with LE and pain-free controls. Intramuscular electrodes recorded myoelectric activity from extensor carpi radialis brevis/longus (ECRB/ECRL), extensor digitorum communis (EDC), flexor digitorum superficialis rofundus (FDS/FDP), and flexor carpi radialis (FCR), bilaterally, in 15 participants with unilateral LE and 15 pain-free controls. Participants performed a gripping task at 20% maximum force in four arm positions. The contribution of each muscle was expressed as a proportion of the summed electromyography of all muscles. In in iduals with LE, ECRB contributed less to total electromyography in the symptomatic arm but not the asymptomatic arm than pain-free controls. The contribution of EDC and FDP to total electromyography was greater in both the symptomatic and asymptomatic arm of the LE group, than pain-free controls. No other differences were observed between groups. Subtle differences in muscle activation were present with differing arm positions. These findings indicate forearm muscle activity is modified in LE. It is unknown whether this is cause or effect. Changes in the asymptomatic side may imply involvement of central mechanisms.
Publisher: Bond University
Date: 24-02-2022
DOI: 10.53300/001C.33042
Abstract: The study aimed to quantify the clinical activity profile of physiotherapy students within a regional student-led musculoskeletal clinic. A retrospective clinical audit examined all occasions of service (OOS) delivered during 2018. Demographic data and student to clinical educator (CE) ratio were also collected. Descriptive statistics were used to describe patient demographics. The average OOS per student per week between student to CE ratios (i.e., 2:1 and 3:1 group) were analysed using a repeated measures ANOVA. A total of 214 clients were included (mean age 40.9 years (SD 20.4) with 66.5% being female (n = 133)). The shoulder (19.3%) was the most assessed/treated region, followed by the knee (18.9%), and ankle/foot (16.2%). Analysis revealed a main effect of week (p .001), but not for student to CE ratio (p=0.125). There was no interaction of week by student to CE ratio (p=0.528). Post hoc analysis revealed the average OOS per student per week was lower for week 1 than in weeks 2, 3, and 4, with a small but statistically significant decrease in average OOS from week 4 to 5. Overall, students attending a regional student-led musculoskeletal clinic see a variety of clinical presentations, from clients across the lifespan, with increasing OOS across the placement.
Publisher: Elsevier BV
Date: 06-2016
DOI: 10.1016/J.CLINBIOMECH.2016.04.017
Abstract: Lateral epicondylalgia is a common musculoskeletal disorder and is associated with deficits in the motor system including painful grip. This study compared coordination of forearm muscles (muscle synergies) during repeated gripping between in iduals with and without lateral epicondylalgia. Twelve participants with lateral epicondylalgia and 14 controls performed 15 cyclical repetitions of sub-maximal (20% maximum grip force of asymptomatic arm), pain free dynamic gripping in four arm positions: shoulder neutral with elbow flexed to 90° and shoulder flexed to 90° with elbow extended both with forearm pronated and neutral. Muscle activity was recorded from extensor carpi radialis brevis/longus, extensor digitorum, flexor digitorum superficialis rofundus, and flexor carpi radialis, with intramuscular electrodes. Muscle synergies were extracted using non-negative matrix factorisation. Analysis of each position and participant, demonstrated that two muscle synergies accounted for >97% of the variance for both groups. Between-group differences were identified after electromyography patterns of the control group were used to reconstruct the patterns of the lateral epicondylalgia group. A greater variance accounted for was identified for the controls than lateral epicondylalgia (p=0.009). This difference might be explained by an additional burst of flexor digitorum superficialis electromyography during grip release in many lateral epicondylalgia participants. These data provide evidence of some differences in synergistic organisation of activation of forearm muscles between in iduals with and without lateral epicondylalgia. Due to study design it is not possible to elucidate whether changes in the coordination of muscle activity during gripping are associated with the cause or effect of lateral epicondylalgia.
Publisher: Wiley
Date: 08-12-2015
DOI: 10.1111/SMS.12341
Abstract: Using ultrasound shear wave elastography, the aims of this study were: (a) to evaluate the effect of massage on stiffness of the medial gastrocnemius (MG) muscle and (b) to determine whether this effect (if any) persists over a short period of rest. A 7-min massage protocol was performed unilaterally on MG in 18 healthy volunteers. Measurements of muscle shear elastic modulus (stiffness) were performed bilaterally (control and massaged leg) in a moderately stretched position at three time points: before massage (baseline), directly after massage (follow-up 1), and following 3 min of rest (follow-up 2). Directly after massage, participants rated pain experienced during the massage. MG shear elastic modulus of the massaged leg decreased significantly at follow-up 1 (-5.2 ± 8.8%, P = 0.019, d = -0.66). There was no difference between follow-up 2 and baseline for the massaged leg (P = 0.83) indicating that muscle stiffness returned to baseline values. Shear elastic modulus was not different between time points in the control leg. There was no association between perceived pain during the massage and stiffness reduction (r = 0.035 P = 0.89). This is the first study to provide evidence that massage reduces muscle stiffness. However, this effect is short lived and returns to baseline values quickly after cessation of the massage.
Publisher: Wiley
Date: 11-09-2018
DOI: 10.1111/SMS.13265
Publisher: Bond University
Date: 09-03-2021
DOI: 10.53300/001C.21424
Abstract: Clinical education requires students to integrate theoretical knowledge and skills into real-life clinical environments. Most clinical education opportunities remain within metropolitan hospitals where student education is often secondary to patient care. In response, many Universities are developing student-led clinics that focus on the student educational experience, whilst providing high-quality patient care. Understanding factors associated with student satisfaction within student-led physiotherapy clinics, particularly in regional areas, is necessary to build the regional and rural workforce. Thirty-eight students from a 3rd and 4th year Bachelor of Physiotherapy (Hons) undergraduate degree completed written open-ended student feedback at the completion of a five-week placement within a student-led allied health clinic in Rockh ton, Queensland between 2018 and 2019. These data were collected as feedback for the clinic and were not related to course evaluations. All responses were then transformed into one document per question and analysed following an inductive approach and semantic thematic analysis. Using thematic analysis, five key themes were identified to impact student satisfaction: 1) clinical educators and clinic staff 2) feedback to students 3) professional development opportunities 4) low patient numbers and a lack of clinical presentations and 5) facilities, equipment, and resources. This study has identified several key factors associated with positive and negative student satisfaction within a regional student-led physiotherapy clinic. Implementing factors associated with positive student satisfaction will likely enhance student learning experience and improve the clinical placement experience, potentially improving recruitment opportunities in a regional setting.
Publisher: Oxford University Press (OUP)
Date: 04-10-2021
DOI: 10.1093/PTJ/PZAB230
Abstract: The aim of this study was to investigate whether there is evidence of bilateral upper limb strength deficits in in iduals with unilateral lateral elbow tendinopathy (LET). The electronic databases Medline via Ovid, PubMed, and Scopus were searched from inception to March 2020. Included studies encompassed maximal strength outcomes of any upper limb and appendicular musculature in in iduals with LET and an asymptomatic comparator. Study quality was rated using a modified version of the Epidemiological Appraisal Instrument. Hedges g effect sizes (ES) and 95% CIs were calculated for comparisons of maximal strength in the LET group and an asymptomatic control group. Meta-analysis using a random-effects model was performed when possible. Fourteen studies were included. Quality appraisal resulted in a mean Epidemiological Appraisal Instrument score of 46% (SD = 10%). Meta-analysis revealed strength deficits in shoulder abduction (pooled ES = -0.37 [95% CI = -0.62 to -0.12]) and shoulder external rotation (pooled ES = -0.55 [95% CI = -0.83 to -0.28]) of the symptomatic limb compared with an asymptomatic control group. Meta-analysis also revealed maximal strength deficits in the upper trapezius (pooled ES = -0.26 [95% CI = -0.49 to -0.02]) of the asymptomatic limb compared with an asymptomatic control group. There was also consistent evidence for strength deficits in the serratus anterior, lower trapezius, and wrist extensor muscles and deficits in grip strength of the symptomatic limb as well as strength deficits in the wrist extensor muscles of the asymptomatic limb in in iduals with unilateral LET. In in iduals with LET, there were maximal strength deficits in shoulder abduction, shoulder external rotation, serratus anterior and lower trapezius muscles, and wrist extension, as well as deficits in grip strength of the symptomatic limb compared with an asymptomatic control group. In addition, there appeared to be strength deficits in the upper trapezius muscle, wrist extension, and metacarpophalangeal joint flexion and extension, as well as deficits in grip strength of the asymptomatic limb in in iduals with LET compared with an asymptomatic control group. These results suggest bilateral strength deficits. These findings highlight the importance of a thorough physical examination and appropriate strengthening intervention for the upper limb with a focus on shoulder and scapular stabilizers, in addition to forearm muscles, in in iduals with LET. In people with tennis elbow, widespread strength deficits, including weakness of the shoulder, forearm, and wrist muscles, may exist. Interestingly, some of these weaknesses appear on both the affected and the unaffected sides in people with tennis elbow. A physical therapist can help strengthen these areas.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 12-2016
DOI: 10.1097/AJP.0000000000000365
Abstract: To examine the acute effects of isometric exercise of different intensities on pain perception in in iduals with chronic lateral epicondylalgia. Participants performed 3 experimental tasks completed in a randomized order on separate days: control (no exercise) and isometric wrist extension (10×15 s) at load 20% below (infrathreshold), and 20% above (suprathreshold) an in idual’s pain threshold. Self-reported pain intensity (11-point numeric rating scales), pressure pain threshold, and pain-free grip were assessed by a blinded examiner before, immediately after, and 30 minutes after task performance. Relation analysis between pain ratings and clinical variables, including pain and disability and kinesiophobia was performed. Twenty-four in iduals with unilateral lateral epicondylalgia of median 3-month duration participated. Pain intensity during contraction was significantly higher during suprathreshold exercise than infrathreshold exercise (mean difference in numeric rating scale 1.0 95% confidence interval, 0.4-1.5 P =0.002). Pain intensity during suprathreshold exercise was significantly correlated with pain and disability ( R =0.435, P =0.034) and kinesiophobia ( R =0.556, P =0.005). Pain intensity was significantly higher immediately after performance of suprathreshold exercise, compared with infrathreshold exercise ( P =0.01) and control ( P .001) conditions, whereas infrathreshold exercise and control conditions were comparable. Thirty minutes later, pain levels remained significantly higher for suprathreshold exercise compared with infrathreshold exercise ( P =0.043). Pressure pain threshold and pain-free grip showed no significant effects of time, condition, or time×condition ( P .05). In iduals with lateral epicondylalgia demonstrated increased pain intensity after an acute bout of isometric exercise performed at an intensity above, but not below, their in idual pain threshold. Further investigation is needed to determine whether measurement of an in idual’s exercise induced pain threshold may be important in reducing symptom flares associated with exercise.
No related grants have been discovered for Luke Heales.