ORCID Profile
0000-0002-0360-733X
Current Organisations
Macquarie University
,
Kensington Physiotherapy and Sports Clinic
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Publisher: JMIR Publications Inc.
Date: 17-01-2022
DOI: 10.2196/32627
Abstract: Osteoarthritis (OA) is a major problem globally. First-line management comprises education and self-management strategies. Online support groups may be a low-cost method of facilitating self-management. The aim of this randomized controlled pilot study is to evaluate the feasibility of the study design and implementation of an evidence-informed, expert-moderated, peer-to-peer online support group (My Knee Community) for people with knee OA. The impacts on psychological determinants of self-management, selected self-management behaviors, and health outcomes were secondary investigations. This mixed methods study evaluated study feasibility (participant recruitment, retention, and costs), experimental intervention feasibility (acceptability and fidelity to the proposed design, including perceived benefit, satisfaction, and member engagement), psychological determinants (eg, self-efficacy and social support), behavioral measures, health outcomes, and harms. Of a total of 186, 63 (33.9%) participants (41/63, 65% experimental and 22/63, 35% control) with self-reported knee OA were recruited from 186 volunteers. Experimental group participants were provided membership to My Knee Community, which already had existing nonstudy members, and were recommended a web-based education resource (My Joint Pain). The control group received the My Joint Pain website recommendation only. Participants were not blinded to their group allocation or the study interventions. Participant-reported data were collected remotely using web-based questionnaires. A total of 10 experimental group participants also participated in semistructured interviews. The transcribed interview data and all forum posts by the study participants were thematically analyzed. Study feasibility was supported by acceptable levels of retention however, there were low levels of engagement with the support group by participants: 15% (6/41) of participants did not log in at all the median number of times visited was 4 times per participant only 29% (12/41) of participants posted, and there were relatively low levels of activity overall on the forum. This affected the results for satisfaction (overall mean 5.9/10, SD 2.7) and perceived benefit (17/31, 55%: yes). There were no differences among groups for quantitative outcomes. The themes discussed in the interviews were connections and support, information and advice, and barriers and facilitators. Qualitative data suggest that there is potential for people to derive benefit from connecting with others with knee OA by receiving support and assisting with unmet informational needs. Although a large-scale study is feasible, the intervention implementation was considered unsatisfactory because of low levels of activity and engagement by members. We recommend that expectations about the support group need to be made clear from the outset. Additionally, the platform design needs to be more engaging and rewarding, and membership should only be offered to people willing to share their personal stories and who are interested in learning from the experiences of others. Australian New Zealand Clinical Trials Registry ACTRN12619001230145 anzctr.org.au/Trial/Registration/TrialReview.aspx?id=377958
Publisher: Informa UK Limited
Date: 06-2011
Publisher: Elsevier BV
Date: 09-2021
Publisher: Elsevier BV
Date: 2015
Publisher: JMIR Publications Inc.
Date: 24-08-2019
Abstract: steoarthritis (OA) is a chronic, disabling, and prevalent disorder. As there is no cure for OA, long-term self-management is paramount. Support groups (SGs) can facilitate self-management among people living with OA. Understanding preferences in design and features of SGs, including online SGs (OSGs), among people with OA can inform future development of SG interventions for this condition. he objective of this study was to investigate health care– and health information–seeking behavior, digital literacy, and preferences for the design of SGs in people with OA. The study also explored the perceived barriers and enablers to being involved in OSGs. n online survey study was conducted with a mixed method design (quantitative and qualitative). In iduals aged ≥45 years with knee, hip, or back pain for ≥3 months were recruited from an extant patient database of the Institute of Bone and Joint Research via email invitations. Quantitative elements of the survey included questions about sociodemographic background health care– and health information–seeking behavior digital literacy and previous participation in, and preferences for, SGs and OSGs. Respondents were classified into 2 groups (Yes-SG and No-SG) based on previous participation or interest in an SG. Group differences were assessed with Chi-square tests (significance level set at 5%). Responses to free-text questions relating to preferences regarding OSG engagement were analyzed qualitatively using an inductive thematic analysis. total of 415 people with OA completed the survey (300/415, 72.3% females 252/415, 61.0% lived in a major city). The Yes-SG group included 307 (307/415, 73.9%) participants. Between the Yes-SG and No-SG groups, there were no differences in sociodemographic characteristics, health care– and health information–seeking behavior, and digital literacy. An online format was preferred by 126/259 (48.7%) of the Yes-SG group. Trained peer facilitators were preferred, and trustworthiness of advice and information were highly prioritized by the respondents. Qualitative analysis for OSG participation revealed 5 main themes. Lack of time and motivation were the main barriers identified. The main enablers were related to accessibility, enjoyment of the experience, and the content of the discussed information. hese findings highlight the preferences in design features and content of SGs and OSGs and may assist in the further development of such groups.
Publisher: JMIR Publications Inc.
Date: 09-08-2019
Abstract: nline support groups (OSGs) are one way for people with chronic diseases, their family or friends, and health professionals to communicate, gain information, and provide social support. As the number of peer-to-peer OSGs for chronic musculoskeletal conditions grows, it is important to gain insight into the different designs of groups available, who is accessing them, if and how they may be effective, and what strategies are being used to implement or increase consumer engagement. he objectives of this systematic review of people with musculoskeletal conditions were to (1) describe the design features (functions, usage options, moderation, and expert input) of peer-to-peer OSGs, (2) describe the characteristics of the in iduals using peer-to-peer OSGs, (3) synthesize the evidence on outcomes of participation, and (4) identify strategies used in the delivery and maintenance of OSGs. search comprising terms related to the population (people with musculoskeletal disorders) and the intervention (peer-to-peer OSGs) was conducted in 6 databases. Results were filtered from 1990 (internet inception) to February 2019. Studies identified in the search were screened according to predefined eligibility criteria using a 2-step process. Quantitative studies were appraised by 2 reviewers using the Risk Of Bias In Non-Randomized Studies of Interventions tool. Qualitative studies were appraised by 2 different reviewers using the Critical Appraisal Skills Programme checklist. Extracted data were synthesized narratively. e examined 21 studies with low to moderate risk of bias. Of these studies, 13 studies included OSGs hosted on public platforms, 11 studies examined OSGs that were conducted in English, and 6 studies used moderators or peer leaders to facilitate engagement. Studies either reported the number of OSG members (n=1985 across all studies) or the number of posts (range: 223-200,000). The majority of OSG members were females who were not full-time employees and with varied levels of education. There were no randomized controlled trials measuring the efficacy of OSGs. Qualitative and quantitative studies identified empowerment, social support, self-management behavior, and health literacy as primary constructs to measure OSG efficacy. Neutral or marginal improvement was reported in these constructs. Sharing experiences and a greater level of engagement appeared to have an important influence on OSGs efficacy. The extent to which members posted on the website influenced engagement. cross a erse range of designs, languages, included features, and delivery platforms, peer-to-peer OSGs for chronic musculoskeletal conditions attract predominantly female participants of all ages and education levels. The level of participation of a member appears to be related to their perceived benefit, health literacy, and empowerment. Future studies are needed to identify which design and maintenance strategies have superior efficacy and whether there are concomitant improvements in health outcomes for people with chronic musculoskeletal conditions resulting from participation in OSGs. ROSPERO International Prospective Register of Systematic Reviews CRD42018090326 www.crd.york.ac.uk rospero/display_record.php?ID=CRD42018090326
Publisher: Elsevier BV
Date: 02-2012
DOI: 10.1016/J.CLINBIOMECH.2011.08.011
Abstract: Despite evidence for use of foot orthoses in the treatment of anterior knee pain, there is a paucity of research into their mechanisms of action. This study (i) determined the immediate lower limb kinematics and muscle activity adaptations, and (ii) evaluated the effect of in idual's comfort and foot mobility. Forty in iduals diagnosed with anterior knee pain were measured for lower limb kinematics and electromyographic activity (via surface electrodes) while they jogged in three prefabricated contoured orthoses (hard, medium and soft) and a soft-flat orthosis. Subjects ranked orthoses in order of comfort. Soft orthoses were more comfortable. No immediate adaptations in kinematics and electromyographic activity were observed when orthoses were added to shoes. There were few effects of perceived comfort and foot mobility, one being a significant interaction in frontal plane hip motion (Pillai's V=0.089, P=0.031) with the least comfortable orthosis producing the greatest relative adduction in those with mobile feet (0.54° (standard deviation 0.87)). Other main effects were a significant increase in vastus lateralis activity when wearing the least comfortable orthosis (6.94%, P=0.007) and a delay in offset of medial gastrocnemius in in iduals with less mobile feet (1.51%, P=0.045). It is becoming apparent that it is important to use more comfortable foot orthoses in a condition like anterior knee pain, where there is an associated increased hip adduction and vastus lateralis activity with least comfortable orthoses. Future research is needed to determine adaptations after ongoing wearing of orthoses.
Publisher: Elsevier BV
Date: 02-2014
DOI: 10.1016/J.BERH.2014.01.006
Abstract: Patellofemoral joint integrity is maintained by an optimal interaction of passive, dynamic and structural restraints. Disruption of these mechanics can lead to structural joint damage and subsequent patellofemoral osteoarthritis, which is a prevalent and disabling condition with few effective conservative management strategies. Due to the influential role of biomechanics in this disease, targeting the specific pathomechanics exhibited by an in idual is logical to improve their likelihood of a positive treatment outcome. This review summarises the effect of different pathomechanical factors on the presence and progression of patellofemoral osteoarthritis. It then presents a synthesis of mechanical effect of treatment strategies specifically addressing these pathomechanics. Identifying the pathomechanics and clinical characteristics of in iduals with patellofemoral osteoarthritis that respond to treatment may assist in the development of in idualised treatment strategies that alleviate symptoms and slow structural damage.
Publisher: Elsevier BV
Date: 02-2019
DOI: 10.1016/J.JSAMS.2018.06.011
Abstract: To determine the incidence of illness, and identify the relationship between sleep, training load and illness in nationally competitive Australian football athletes. Second, to assess multivariate effect between training load and/or sleep variables. Cohort study. Retrospective analyses of prospectively collected cohort data were conducted on forty-four male athletes over a 46-week season. The primary outcome was illness incidence, recorded daily by medical doctors. Independent variables were acute, chronic and acute:chronic ratios of: sleep quality, sleep quantity, internal training load and external training load defined as: total running distance, high speed running distance and sprint distance. Generalised estimating equations using Poisson (count) models were fit to examine both univariate and multivariate associations between independent variables and illness incidence. 67 incidences of illness were recorded, with an incidence rate of 11 illnesses per 1000 running hours. Univariate analysis showed acute and chronic sleep hours and quality, as well as acute sprint and total running distance to be significantly associated with illness. Multivariate analysis identified that only acute sleep quantity was significantly, negatively associated with illness incidence (OR 0.49, CI 0.25-0.94) once all univariate significant variables were controlled for. There was no relationship between external training load and illness when sleep metrics were controlled for. In a cohort of Australian football athletes, whose load was well monitored, reduced sleep quantity was associated with increased incidence of illness within the next 7 days. Monitoring sleep parameters may assist in identifying in iduals at risk of illness.
Publisher: BMJ
Date: 18-09-2012
DOI: 10.1136/BJSPORTS-2011-090204
Abstract: To investigate the short-term clinical efficacy of in-shoe foot orthoses over a wait-and-see policy in the treatment of anterior knee pain (AKP) and evaluate the ability of foot posture measures to predict outcome. Single-blind, randomised control trial. Forty participants (18-40 years) with clinically diagnosed AKP of greater than 6-week duration, who had not been treated with orthoses in the previous 5 years. Prefabricated orthoses perceived as most comfortable from a selection of 3 different hardness values compared with a wait-and-see control group. Participant-perceived global improvement, Kujala Patellofemoral Score, usual and worst pain severity over the previous week and the Patient Specific Functional Scale measures at 6 weeks. Foot orthoses produced a significant global improvement compared with the control group (p = 0.008, relative risk reduction = 8.47%, numbers needed to treat = 2). Significant differences also occurred in measures of function (standardised mean difference = 0.71). Within the intervention group, in iduals who exhibited a change in midfoot width from weight bearing to non-weight bearing of >11.25 mm were more likely to report a successful outcome (correct classification 77.8%). This is the first study to show orthoses provide greater improvements in AKP than a wait-and-see approach. In iduals with greater midfoot mobility are more likely to experience success from treatment. ACTRN12611000492954.
Publisher: JMIR Publications Inc.
Date: 03-12-2019
DOI: 10.2196/15987
Abstract: Osteoarthritis (OA) is a chronic, disabling, and prevalent disorder. As there is no cure for OA, long-term self-management is paramount. Support groups (SGs) can facilitate self-management among people living with OA. Understanding preferences in design and features of SGs, including online SGs (OSGs), among people with OA can inform future development of SG interventions for this condition. The objective of this study was to investigate health care– and health information–seeking behavior, digital literacy, and preferences for the design of SGs in people with OA. The study also explored the perceived barriers and enablers to being involved in OSGs. An online survey study was conducted with a mixed method design (quantitative and qualitative). In iduals aged ≥45 years with knee, hip, or back pain for ≥3 months were recruited from an extant patient database of the Institute of Bone and Joint Research via email invitations. Quantitative elements of the survey included questions about sociodemographic background health care– and health information–seeking behavior digital literacy and previous participation in, and preferences for, SGs and OSGs. Respondents were classified into 2 groups (Yes-SG and No-SG) based on previous participation or interest in an SG. Group differences were assessed with Chi-square tests (significance level set at 5%). Responses to free-text questions relating to preferences regarding OSG engagement were analyzed qualitatively using an inductive thematic analysis. A total of 415 people with OA completed the survey (300/415, 72.3% females 252/415, 61.0% lived in a major city). The Yes-SG group included 307 (307/415, 73.9%) participants. Between the Yes-SG and No-SG groups, there were no differences in sociodemographic characteristics, health care– and health information–seeking behavior, and digital literacy. An online format was preferred by 126/259 (48.7%) of the Yes-SG group. Trained peer facilitators were preferred, and trustworthiness of advice and information were highly prioritized by the respondents. Qualitative analysis for OSG participation revealed 5 main themes. Lack of time and motivation were the main barriers identified. The main enablers were related to accessibility, enjoyment of the experience, and the content of the discussed information. These findings highlight the preferences in design features and content of SGs and OSGs and may assist in the further development of such groups.
Publisher: JMIR Publications Inc.
Date: 24-04-2020
DOI: 10.2196/15822
Abstract: Online support groups (OSGs) are one way for people with chronic diseases, their family or friends, and health professionals to communicate, gain information, and provide social support. As the number of peer-to-peer OSGs for chronic musculoskeletal conditions grows, it is important to gain insight into the different designs of groups available, who is accessing them, if and how they may be effective, and what strategies are being used to implement or increase consumer engagement. The objectives of this systematic review of people with musculoskeletal conditions were to (1) describe the design features (functions, usage options, moderation, and expert input) of peer-to-peer OSGs, (2) describe the characteristics of the in iduals using peer-to-peer OSGs, (3) synthesize the evidence on outcomes of participation, and (4) identify strategies used in the delivery and maintenance of OSGs. A search comprising terms related to the population (people with musculoskeletal disorders) and the intervention (peer-to-peer OSGs) was conducted in 6 databases. Results were filtered from 1990 (internet inception) to February 2019. Studies identified in the search were screened according to predefined eligibility criteria using a 2-step process. Quantitative studies were appraised by 2 reviewers using the Risk Of Bias In Non-Randomized Studies of Interventions tool. Qualitative studies were appraised by 2 different reviewers using the Critical Appraisal Skills Programme checklist. Extracted data were synthesized narratively. We examined 21 studies with low to moderate risk of bias. Of these studies, 13 studies included OSGs hosted on public platforms, 11 studies examined OSGs that were conducted in English, and 6 studies used moderators or peer leaders to facilitate engagement. Studies either reported the number of OSG members (n=1985 across all studies) or the number of posts (range: 223-200,000). The majority of OSG members were females who were not full-time employees and with varied levels of education. There were no randomized controlled trials measuring the efficacy of OSGs. Qualitative and quantitative studies identified empowerment, social support, self-management behavior, and health literacy as primary constructs to measure OSG efficacy. Neutral or marginal improvement was reported in these constructs. Sharing experiences and a greater level of engagement appeared to have an important influence on OSGs efficacy. The extent to which members posted on the website influenced engagement. Across a erse range of designs, languages, included features, and delivery platforms, peer-to-peer OSGs for chronic musculoskeletal conditions attract predominantly female participants of all ages and education levels. The level of participation of a member appears to be related to their perceived benefit, health literacy, and empowerment. Future studies are needed to identify which design and maintenance strategies have superior efficacy and whether there are concomitant improvements in health outcomes for people with chronic musculoskeletal conditions resulting from participation in OSGs. PROSPERO International Prospective Register of Systematic Reviews CRD42018090326 www.crd.york.ac.uk rospero/display_record.php?ID=CRD42018090326
Publisher: Elsevier BV
Date: 03-2019
DOI: 10.1016/J.JOCA.2018.11.010
Abstract: Conduct a systematic review of systematic reviews and randomised controlled trials (RCTs) from the past year evaluating rehabilitation for people with osteoarthritis, and provide narrative synthesis of findings focused on core recommended treatments for osteoarthritis (exercise, education, biomechanical interventions, weight loss). A comprehensive search strategy was used to search PubMed, EMBASE and Cochrane databases (16 From 1994 records, 13 systematic reviews and 36 RCTs were included. 73% of these evaluated knee osteoarthritis (36 studies). The remaining studies evaluated hand osteoarthritis (6 studies), hip, hip/knee and general osteoarthritis (each 2 studies), and neck osteoarthritis (1 study). Exercise was the most common intervention evaluated (31%). Updated recommendations for exercise prescription and preliminary guidance for psychological interventions are provided. Level 1 and 2 osteoarthritis rehabilitation literature continues to be dominated by knee osteoarthritis studies. Consistent with current clinical guidelines, exercise should be a core treatment for osteoarthritis, but future studies should ensure that exercise programs follow published dose guidelines. There is a clear need for research on rehabilitation for hip, hand, foot/ankle, shoulder and spine osteoarthritis.
Publisher: Elsevier BV
Date: 03-2019
DOI: 10.1016/J.PHYSIO.2018.04.003
Abstract: The literature pertaining to changes in physical activity (PA) in people who have undergone lower limb arthroplasty is controversial, but it is unknown whether this is due to participant characteristics or how physical activity is measured. To determine whether PA changes after total knee or hip arthroplasty and what explains contradictory results between different published studies. Five online databases were searched for keywords and MeSH headings. Reference lists were also hand-searched. Cohort studies and the control groups of clinical trials that examined PA levels prior to total arthroplasty as well as 6- and/or 12-month post-operative included. PA could be measured using accelerometery, pedometery or patient reported outcomes. PA outcomes were categorised into frequency, intensity, duration and type. Meta-analysis was performed when possible. Eleven studies, examining 277 in iduals with THA and 406 people with TKA were included. Studies differed in the outcome measure reported, device used and placement of accelerometers. When measured as steps per day, pooled data revealed a small increase in the frequency of PA at 12 months post-TKA (SMD 0.44 [0.2, 0.67] I The true nature of changes in PA post-surgery remains largely unclear. While frequency of PA may increase, the balance of evidence indicates that PA does not substantially increase post total joint arthroplasty. Improvements in the consistency of device type, placement and outcome measure would substantially assist in improving knowledge in this area. CRD42015029686.
Publisher: Springer Science and Business Media LLC
Date: 05-05-2020
DOI: 10.1186/S12955-020-01364-6
Abstract: The Patient Activation Measure (PAM-13) was developed using Rasch analysis to assess knowledge, skills and confidence in the management of one’s health. Previous studies report positive relationships between PAM-13 scores, self-management behaviours and longitudinal health outcomes in adults with chronic disease. There is little extant measurement property evidence for the use of PAM-13 in specific osteoarthritis (OA) populations. This study tested measurement properties of the PAM-13 in people living with hip and knee OA. Item response frequency analysis was conducted. Rasch analysis evaluated the fit of the PAM-13 data to the Rasch model. Model-data fit was evaluated using infit and outfit statistics person/item reliability and person separation indices were computed. Unidimensionality was evaluated using Principal Components Analysis of Rasch residuals and the data were assessed for item redundancy. Differential Item Functioning (DIF) examined bias in respondent subgroups and correlations tested relationships between PAM-13 and other patient-reported outcomes. Two-hundred-and-seventeen PAM-13 surveys were completed there were no missing responses, floor or ceiling effects. Person and item reliability were acceptable (0.98 and 0.87 respectively) with good separation (person separation index 2.58). Unidimensionality was evaluated, with 49.4% of the variance explained by the first eigenvector. There was evidence of potential local response-dependence. The Rasch fit statistics were acceptable (except for item-2). There were some issues identified with targeting of the PAM-13 items to people with higher ability and the item difficulty order was different to that proposed in original cohorts. Significant DIF was identified for sex and educational level for a small number of items. PAM-13 scores were moderately correlated with depressive symptoms on the Depression Anxiety Stress Scale and Assessment of Quality of Life-6D. There were small correlations between PAM-13 and Knee injury and Osteoarthritis Outcome Score pain and activities of daily living scores. This study provides some evidence of adequate person and item reliability, unidimensionality, and construct validity to support the use of PAM-13 to measure patient activation in people living with hip and knee OA. Possible limitations regarding targeting, different item difficulty order, DIF and local response dependence should be investigated in future research.
Publisher: JMIR Publications Inc.
Date: 04-08-2021
Abstract: steoarthritis (OA) is a major problem globally. First-line management comprises education and self-management strategies. Online support groups may be a low-cost method of facilitating self-management. he aim of this randomized controlled pilot study is to evaluate the feasibility of the study design and implementation of an evidence-informed, expert-moderated, peer-to-peer online support group (My Knee Community) for people with knee OA. The impacts on psychological determinants of self-management, selected self-management behaviors, and health outcomes were secondary investigations. his mixed methods study evaluated study feasibility (participant recruitment, retention, and costs), experimental intervention feasibility (acceptability and fidelity to the proposed design, including perceived benefit, satisfaction, and member engagement), psychological determinants (eg, self-efficacy and social support), behavioral measures, health outcomes, and harms. Of a total of 186, 63 (33.9%) participants (41/63, 65% experimental and 22/63, 35% control) with self-reported knee OA were recruited from 186 volunteers. Experimental group participants were provided membership to My Knee Community, which already had existing nonstudy members, and were recommended a web-based education resource (My Joint Pain). The control group received the My Joint Pain website recommendation only. Participants were not blinded to their group allocation or the study interventions. Participant-reported data were collected remotely using web-based questionnaires. A total of 10 experimental group participants also participated in semistructured interviews. The transcribed interview data and all forum posts by the study participants were thematically analyzed. tudy feasibility was supported by acceptable levels of retention however, there were low levels of engagement with the support group by participants: 15% (6/41) of participants did not log in at all the median number of times visited was 4 times per participant only 29% (12/41) of participants posted, and there were relatively low levels of activity overall on the forum. This affected the results for satisfaction (overall mean 5.9/10, SD 2.7) and perceived benefit (17/31, 55%: i yes /i ). There were no differences among groups for quantitative outcomes. The themes discussed in the interviews were i connections and support /i , i information and advice /i , and i barriers and facilitators /i . Qualitative data suggest that there is potential for people to derive benefit from connecting with others with knee OA by receiving support and assisting with unmet informational needs. lthough a large-scale study is feasible, the intervention implementation was considered unsatisfactory because of low levels of activity and engagement by members. We recommend that expectations about the support group need to be made clear from the outset. Additionally, the platform design needs to be more engaging and rewarding, and membership should only be offered to people willing to share their personal stories and who are interested in learning from the experiences of others. ustralian New Zealand Clinical Trials Registry ACTRN12619001230145 anzctr.org.au/Trial/Registration/TrialReview.aspx?id=377958
Publisher: Elsevier BV
Date: 06-2017
DOI: 10.1016/J.JSAMS.2016.10.012
Abstract: To identify the most accurate method of predicting peak height velocity in adolescents. Systematic review. A comprehensive literature search of six electronic databases and reference lists was conducted. Studies that met selection criteria of (1) observational longitudinal cohort study (2) reproducible method/s of predicting peak height velocity (3) minimum six-month follow-up (4) healthy male and/or female adolescent subjects, with the exception of participants with adolescent idiopathic scoliosis, were considered for review. Studies were screened using a modified quality assessment checklist, with only those scoring >50% included. The type of surrogate measure of peak height velocity, its reliability and ability to predict peak height velocity were extracted from the year or stage immediately preceding peak height velocity. We defined "predict" as when both the estimates of effect and 95% confidence intervals of the surrogate occurred prior to the actual age of PHV. The nine included studies examined three anthropometric, three equation and four radiographic-based surrogates for PHV. Of these, the radiographic measures were reported to exhibit moderate to high intra- and inter-rater reliability. Three of the four radiographic surrogates predicted PHV. Two anthropometric measures also predicted PHV but reliability of the measures is unknown. All equation-based methods predicted the timing of PHV to occur later than it actually happened when applied in the year prior to expected PHV. In the year/stage immediately preceding peak height velocity, radiograph-based methods appear to be accurate and reliable surrogates.
Publisher: Elsevier BV
Date: 08-2013
DOI: 10.1016/J.CLINBIOMECH.2013.07.008
Abstract: Neuromuscular alterations are increasingly reported in in iduals with knee osteoarthritis (KOA) during level walking. We aimed to determine which neuromuscular alterations are consistent in KOA in iduals and how these may be influenced by osteoarthritis severity, varus alignment and/or joint laxity. Electronic databases were searched up to July 2012. Cross-sectional observational studies comparing lower-limb neuromuscular activity in in iduals with KOA, healthy controls or with different KOA cohorts were included. Two reviewers assessed methodological quality. Effect sizes were used to quantify the magnitude of observed differences. Where studies were homogenous, effect sizes were pooled using a fixed-effects model. Fourteen studies examining neuromuscular alterations in indices of co-contraction, muscle litude and muscle activity duration were included. Data pooling revealed that moderate KOA in iduals exhibit increased co-contraction of lateral knee muscles (ES 0.64 [0.3 to 0.97]) and moderately increased rectus femoris (ES 0.73 [0.23 to 1.22]), vastus lateralis (ES 0.77 [0.27 to 1.27]) and biceps femoris (ES 1.18 [0.67 to 1.7]) mean litude. Non-pooled data indicated prolonged activity of these muscles. Increased medial knee neuromuscular activity was prevalent for those exhibiting varus alignment and medial knee joint laxity. Interpretation In iduals with KOA exhibited increased co-contraction, litude and duration of lateral knee muscles regardless of disease severity, limb alignment or medial joint laxity. In iduals with severe disease, varus alignment and medial joint laxity demonstrate up-regulation of medial knee muscles. Future research investigating the efficacy of neuromuscular rehabilitation programs should consider the effect of simultaneous up-regulation of medial and lateral knee muscles on disease progression.
Publisher: BMJ
Date: 08-2023
DOI: 10.1136/BMJOPEN-2022-071045
Abstract: This cluster randomised implementation trial will assess the effect of two behavioural change interventions on the proportion of people with structural knee osteoarthritis (OA) referred and attending exercise-based professionals (physiotherapists and exercise physiologists). The interventions are designed to increase awareness of guidelines, benefits and access pathways for exercise therapy. We hypothesise either strategy will result in more people with knee OA being referred and attending physiotherapy/exercise physiology than current standard of care. We will recruit 30 radiology clinics. 10 clinics will be randomly assigned to each trial arm with 1020 people with knee OA consecutively recruited (102 people per practice) into each arm. Intervention arm 1 is an educational reminder message targeted at primary care practitioners with a hyperlink to national guidelines regarding knee OA clinical management. It will be included in the reporting template of a plain knee X-ray. Intervention arm 2 is the reminder message and a patient-facing infographic explaining the benefits and access pathways for exercise. Both interventions will be delivered once, by the radiology clinics, when a person undergoes plain X-ray for non-traumatic knee pain/dysfunction. The primary outcome is referral to physiotherapist/exercise physiology. The secondary outcome is attendance to that appointment. Both outcomes are self-reported via an online survey administered 4 weeks after the X-ray. Additional survey questions explore facilitators and barriers to appointment attendance and acceptability of the interventions. A subs le of the intervention groups will be recruited for semistructured telephone-based interviews to further explore these latter outcomes. The study protocol was approved by Macquarie University Human Research Ethics Committee (#520221190343842) and prospectively registered with the Australian New Zealand Clinical Trials Registry. The findings of the trial will be disseminated through peer-reviewed scientific journals and conferences. We will engage with Australian physician colleges and main-stream media to distribute findings. ACTRN12622001414707p.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 08-2011
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 10-2010
Publisher: Wiley
Date: 24-09-2013
DOI: 10.1002/ACR.22015
Abstract: To identify which gait deviations are consistently associated with knee osteoarthritis (KOA) and how these are influenced by disease severity, the involved compartment, and sex. Five electronic databases and reference lists of publications were searched. Cross-sectional, observational studies comparing temporospatial variables, joint kinematics, and joint moments between in iduals with KOA and healthy controls or between KOA subgroups were considered for review. Only publications scoring ≥50% on a modified methodology quality index were included. Because of the number of gait deviations examined, only biomechanical variables reported by ≥4 publications were further analyzed. Where possible, a meta-analysis was performed using effect sizes (ES) calculated from discrete variables. In total, 41 publications examining 20 variables were included. The majority of consistent gait deviations associated with KOA were exhibited by those with severe disease in the temporospatial domain. In iduals with severe KOA exhibited greater stride duration than controls (ES 1.35 [95% confidence interval (95% CI) 1.03, 1.67]) and a decrease in cadence (ES -0.75 [95% CI -1.12, -0.39]) compared with controls. The evidence for kinematic and joint moment change was primarily limited or conflicting. There was a lack of evidence for alterations in the external knee adduction moment. In iduals with KOA exhibit a range of gait deviations compared with controls. Despite its common usage in KOA gait studies, we did not find consistent evidence that knee adduction moment differs between those with and without KOA or between disease severity levels. Further research examining the reasons for a lack of difference in many gait variables in those with knee OA is needed.
Publisher: Elsevier BV
Date: 11-2013
DOI: 10.1016/J.APMR.2013.05.010
Abstract: To compare lower-limb kinematic asymmetries during gait in in iduals with unilateral and bilateral symptomatic osteoarthritis and controls. Cross-sectional. Laboratory. Participants (N=54) had symptomatic unilateral (n=18) or bilateral (n=18) knee osteoarthritis. Healthy controls were sex- and age-matched and similar in height and weight to osteoarthritis groups (n=18). Three-dimensional motion analysis was conducted while participants walked on a treadmill at 1.1m/s. Maximum joint angles and velocities of the knee and hip during stance, knee flexion, knee adduction, and hip adduction at initial contact, pelvic drop, stride length, and average toe out. There was a significant limb effect for knee flexion at initial contact (P=.01). The bilateral osteoarthritis group demonstrated the largest between-limb asymmetry (2.83° 95% confidence interval, .88-4.78 effect size [ES]=.67). The bilateral osteoarthritis group also displayed tendencies toward between-limb asymmetry in hip adduction at initial contact and peak knee adduction during stance ESs were small (ES=.33 and .48). Lower-limb kinematics was symmetrical in the control and unilateral knee osteoarthritis groups. Between-limb asymmetries are present even at mild to moderate stages of knee osteoarthritis. During this stage, between-limb asymmetry appears to be more prevalent in patients with bilateral symptomatic disease, suggesting that patients with unilateral disease maintain kinematic symmetry for longer in the knee osteoarthritis process. Further, early treatment strategies should target the restoration of gait symmetry and involve kinematics changes in both lower limbs. Future research is needed to determine the efficacy of such strategies with respect to kinematic asymmetry, pain, and disease progression.
No related grants have been discovered for Kathryn Mills.