ORCID Profile
0000-0002-4865-7066
Current Organisations
University of Alberta
,
Fiona Stanley Hospital
,
Silas Street Physiotherapy & Pilates
,
Curtin University
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: Elsevier BV
Date: 04-2018
DOI: 10.1016/J.JPHYS.2018.02.009
Abstract: In people with chronic non-specific low back pain (LBP), what is the predictive and discriminative validity of the STarT Back Tool (SBT) for pain intensity, self-reported LBP-related disability, and global self-perceived change at 1-year follow-up? What is the profile of the SBT risk subgroups with respect to demographic variables, pain intensity, self-reported LBP-related disability, and psychological measures? Prospective cohort study. A total of 290 adults with dominant axial LBP of≥3months' duration recruited from the general community, and private physiotherapy, psychology, and pain-management clinics in Western Australia. The 1-year follow-up measures were pain intensity, LBP-related disability, and global self-perceived change. Outcomes were collected on 264 participants. The SBT categorised 82 participants (28%) as low risk, 116 (40%) as medium risk, and 92 (32%) as high risk. The risk subgroups differed significantly (p<0.05) on baseline pain, disability, and psychological scores. The SBT's predictive ability was strongest for disability: RR was 2.30 (95% CI 1.28 to 4.10) in the medium-risk group and 2.86 (95% CI 1.60 to 5.11) in the high-risk group. The SBT's predictive ability was weaker for pain: RR was 1.25 (95% CI 1.04 to 1.51) in the medium-risk group and 1.26 (95% CI 1.03 to 1.52) in the high-risk group. For the SBT total score, the AUC was 0.71 (95% CI 0.64 to 0.77) for disability and 0.63 (95% CI 0.55 to 0.71) for pain. This was the first large study to investigate the SBT in a population exclusively with chronic LBP. The SBT provided an acceptable indication of 1-year disability, had poor predictive and discriminative ability for future pain, and was unable to predict or discriminate global perceived change. In this cohort with chronic non-specific LBP, the SBT's predictive and discriminative abilities were restricted to disability at 1year. [Kendell M, Beales D, O'Sullivan P, Rabey M, Hill J, Smith A (2018) The predictive ability of the STarT Back Tool was limited in people with chronic low back pain: a prospective cohort study. Journal of Physiotherapy 64: 107-113].
Publisher: Copernicus GmbH
Date: 17-01-2022
Publisher: Elsevier BV
Date: 12-2021
DOI: 10.1016/J.MSKSP.2021.102460
Abstract: Patients' perceptions/expectations may be a factor behind medical imaging referral rates. Few studies have investigated the beliefs that might drive expectations of medical imaging. This study examined whether beliefs of young Australian adults with and without impactful low back pain (LBP) concerning medical scans for LBP align with current evidence. It also investigated if these beliefs were associated with clinical factors (history of impactful LBP, history of previous medical scans, LBP-related disability and the presence of leg pain) or sociodemographic factors (sex, education, income). Cross-sectional observational study. 78 participants from the Raine Study with a history of impactful LBP and 85 participants with no history of impactful LBP completed a study-specific questionnaire with five statements concerning beliefs about medical imaging for LBP. All statements were not aligned with current evidence about the use of medical imaging in LBP management. Only 15-21% (n = 24-34) of the participants held beliefs that were aligned with current evidence. Participants with a university education had slightly more aligned beliefs compared to those whose highest education was completing secondary school. There was no difference in the beliefs of participants based on their history of impactful LBP, or other clinical or sociodemographic factors. As beliefs are likely to drive care-seeking behavior, it is notable that most participants' views about the role of medical imaging for LBP were not aligned with current evidence. Therefore, this suggests a need for community education, especially for those with lower education.
Publisher: Walter de Gruyter GmbH
Date: 25-02-2021
Abstract: The relationship of pain sensitivity with pain and disability in low back pain (LBP) is complicated. It has been suggested increased understanding of dynamic quantitative sensory testing (QST) might be useful in increasing understanding of these relationships. This study aimed to create subgroups based on participant responses to dynamic QST, profile these subgroups based on multidimensional variables (including clinical measures of pain and disability, psychological and lifestyle variables and static QST), and investigate the association of subgroup membership with levels of pain intensity, LBP-related disability and disability risk at 12-month follow up. Participants (n=273) with dominant axial chronic non-specific LBP with duration of pain months were included in this study. At baseline, eligible participants completed a self-report questionnaire to collect demographic, clinical, psychological and lifestyle data prior to dynamic and static QST. Dynamic QST measures were conditioned pain modulation (CPM) and temporal summation (TS). At 12-months follow up, clinical data were collected, including pain intensity and LBP-related disability. Sub-groups were formed by cross-tabulation. Analysis was undertaken to profile dynamic QST subgroup on demographic, clinical, psychological, lifestyle and static QST measures. Associations between dynamic QST subgroups and follow-up clinical variables were examined. Based on dynamic QST, participants were allocated into four subgroups normal CPM and normal TS (n=34, 12.5%) normal CPM and facilitated TS (n=6, 2.2%) impaired CPM and normal TS (n=186, 68.1%) impaired CPM and facilitated TS (n=47, 17.2%). At baseline no differences were demonstrated between subgroups across most clinical variables, or any psychological or lifestyle measures. The two subgroups with impaired CPM were more likely to have a higher number of painful body areas. Cold pain sensitivity was heightened in both the subgroups with facilitated TS. Subgroups did not differ across pain intensity, LBP-related disability and disability risk stratification at follow-up. The profiles of people with axial LBP did not vary significantly across dynamic QST subgroups, save for those in groups with impaired CPM being more likely to have more widespread symptoms and those with facilitated TS having heightened cold pain sensitivity. Further, subgroup membership was not related to future pain and disability. The role of dynamic QST profiles in LBP remains unclear. Further work is required to understand the role of pain sensitivity in LBP. The utility of dynamic QST subgrouping might not be in determining of future disability. Future research might focus on treatment modifying effects of dynamic QST subgroups.
Publisher: Elsevier BV
Date: 06-2013
DOI: 10.1016/J.MATH.2012.10.010
Abstract: Single leg loading tests are used clinically to examine balance and loading strategies in in iduals with lower limb pain. Interpretation of these tests is through pain responses and comparisons with the asymptomatic leg. The purpose of this study was to examine normal differences in trunk and pelvic movement between legs during the single leg stand, single leg squat, hip hitch and hip drop tests, and to compare observational and quantitative assessments of trunk movement during the single leg squat test. Thirty-one asymptomatic females (age = 21.7 ± 3.1 years) performed each test in a random sequence and quantitative analysis of coronal plane trunk lean (magnitude and direction), and femoro-pelvic angle was conducted using photographic image analysis. Within- and between-side minimal significant differences (MD) for femoro-pelvic angle were defined for each test. All tests had excellent within-side reliability (intra-class correlation coefficients (ICC) = 0.87-0.97, standard error of measurement (SEM) = 0.6-1.2°). The between-side MD for femoro-pelvic angle was 6.3, 6.5, 9.7, and 6.7° for the single leg stand, single leg squat, hip hitch and hip drop tests respectively. The magnitude of trunk lean was small, increased with test complexity and was not consistent in relation to the stance leg. Excellent agreement (87-93%) for the direction of trunk movement between observers, and between observational and quantitative analysis (80-96%) was established for the single leg squat test. The patterns of trunk motion, and thresholds for significant difference in femoro-pelvic angle established in this study, will assist the interpretation of single leg loading tests in in iduals with lower limb pain disorders.
Publisher: Copernicus GmbH
Date: 17-01-2022
DOI: 10.5194/CP-2021-186
Abstract: Abstract. Reconciling palaeodata with model simulations of the Pliocene climate is essential for understanding a world with atmospheric CO2 concentration near 400 parts per million by volume. Both models and data indicate an lified warming of the high latitudes during the Pliocene, however terrestrial data suggests Pliocene high latitude temperatures were much higher than can be simulated by models. Here we show that understanding the Pliocene high latitude terrestrial temperatures is particularly difficult for the coldest months, where the temperatures obtained from models and different proxies can vary by more than 20 °C. We refer to this mismatch as the ‘warm winter paradox’. Analysis suggests the warm winter paradox could be due to a number of factors including: model structural uncertainty, proxy data not being strongly constrained by winter temperatures, uncertainties on data reconstruction methods and also that the Pliocene high latitude climate does not have a modern analogue. Refinements to model boundary conditions or proxy dating are unlikely to contribute significantly to the resolution of the warm winter paradox. For the Pliocene, high latitude, terrestrial, summer temperatures, models and different proxies are in good agreement. Those factors which cause uncertainty on winter temperatures are shown to be much less important for the summer. Until some of the uncertainties on winter, high latitude, Pliocene temperatures can be reduced, we suggest a data-model comparison should focus on the summer. This is expected to give more meaningful and accurate results than a data-model comparison which focuses on the annual mean.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 25-10-2022
DOI: 10.1097/J.PAIN.0000000000002411
Abstract: There is a need to better understand biological factors that increase the risk of persistent musculoskeletal (MSK) pain and heightened pain sensitivity. Knowing the heritability (how genes account for differences in people's traits) can enhance the understanding of genetic vs environmental influences of pain and pain sensitivity. However, there are gaps in current knowledge, including the need for intergenerational studies to broaden our understanding of the genetic basis of pain. Data from Gen1 and Gen2 of the Raine Study were used to investigate the heritability of MSK pain and pressure and cold pain sensitivity. Participants included parents (Gen1, n = 1092) and their offspring (Gen2, n = 688) who underwent a battery of testing and questionnaires including pressure and cold pain threshold testing and assessments of physical activity, sleep, MSK pain, mental health, and adiposity. Heritability estimates were derived using the Sequential Oligogenic Linkage Analysis Routines software. Heritability estimates for MSK pain and pressure pain sensitivity were significant, accounting for between 0.190 and 0.289 of the variation in the phenotype. By contrast, heritability of cold pain sensitivity was not significant. This is the largest intergenerational study to date to comprehensively investigate the heritability of both MSK pain and pain sensitivity, using robust statistical analysis. This study provides support for the heritability of MSK pain and pain sensitivity to pressure, suggesting the need for further convergence of genetic and environmental factors in models for the development or maintenance of these pain disorders.
Publisher: Wiley
Date: 11-01-2019
DOI: 10.1002/EJP.1351
Abstract: Investigation of movement and sensory profiles across STarT Back risk subgroups. A chronic low back pain cohort (n = 290) were classified as low, medium or high risk using the STarT Back Tool, and completed a repeated spinal bending task and quantitative sensory testing. Pain summation, time taken and the number of protective behaviours with repeated bending were measured. Sensory tests included two-point discrimination, temporal summation, pressure/thermal pain thresholds and conditioned pain modulation. Subgroups were profiled against movement and sensory variables. The high-risk subgroup demonstrated greater pain summation following repeated forward bending (p < 0.001). The medium-risk subgroup demonstrated greater pain summation following repeated backward bending (p = 0.032). Medium- and high-risk subgroups demonstrated greater forward/backward bend time compared to the low-risk subgroup (p = 0.001, p = 0.005, respectively). Medium- and high-risk subgroups demonstrated a higher number of protective behaviours per forward bend compared to the low-risk subgroup (p = 0.008). For sensory variables, only two-point discrimination differed between subgroups, with medium- and high-risk subgroups demonstrating higher thresholds (p = 0.016). This study showed altered movement characteristics and sensory discrimination across SBT risk subgroups in people with CLBP. Membership of the high SBT risk subgroup was associated with greater pain and disability levels, greater pain summation following repeated bending, slower bending times, a greater number of protective behaviours during forward bending, and a higher TPD threshold. Treatment outcomes for higher risk SBT subgroups may be enhanced by interventions specifically targeting movement and sensory alterations. In 290 people with chronic low back pain movement profile and two-point discrimination threshold differed across risk subgroups defined by the STarT Back Tool. Conversely, pain sensitivity did not differ across these subgroups. These findings may add further guidance for targeted care in these subgroups.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 06-2002
DOI: 10.1097/00007632-200206010-00019
Abstract: A normative, single-group study was conducted. To determine whether there is a difference in electromyographic activation of specific lumbopelvic muscles with the adoption of common postures in a pain-free population. Clinical observations indicate that adopting passive postures such as sway standing and slump sitting can exacerbate pain in in iduals with low back pain. These in iduals often present with poor activation of the lumbopelvic stabilizing musculature. At this writing, little empirical evidence exists to document that function of the trunk and lumbopelvic musculature are related to the adoption of standardized standing and sitting postures. This study included 20 healthy adults, with equal representation of the genders. Surface electromyography was used to measure activity in the superficial lumbar multifidus, internal oblique, rectus abdominis, external oblique, and thoracic erector spinae muscles for four standardized standing and sitting postures. The internal oblique, superficial lumbar multifidus, and thoracic erector spinae muscles showed a significant decrease in activity during sway standing (P = 0.027, P = 0.002, and P = 0.003, respectively) and slump sitting (P = 0.007, P = 0.012, and P = 0.003, respectively), as compared with erect postures. Rectus abdominis activity increased significantly in sway standing, as compared with erect standing (P = 0.005). The findings show that the lumbopelvic stabilizing musculature is active in maintaining optimally aligned, erect postures, and that these muscles are less active during the adoption of passive postures. The results of this study lend credence to the practice of postural retraining when facilitation of the lumbopelvic stabilizing musculature is indicated in the management of specific spinal pain conditions.
Publisher: SAGE Publications
Date: 27-12-2022
DOI: 10.1177/20494637211062045
Abstract: Background: Back pain is complex. Social support and significant other interactions influence the pain experience. Purpose: To statistically derive subgroups of people with chronic low back pain based upon their interactions with significant others, and profile subgroups across multidimensional variables. Research Design: Longitudinal cohort study. Study S le: People with chronic axial low back pain ( n = 262). Data Collection and Analysis: Latent class analysis of significant other interaction data was used to derive subgroups of people with chronic low back pain. Subgroups were profiled across baseline multidimensional variables and one-year follow-up pain intensity, disability and bothersomeness. Results: Three clusters were identified: Cluster 1 (7.6%) characterised by the lowest distracting, punishing and solicitous interactions. Cluster 2 (16.0%) characterised by the highest distracting and solicitous responses and social support. Cluster 3 (76.3%) characterised by the highest punishing and lowest social support. Cluster 1 reported less disability than Clusters 2 and 3. Mindfulness was significantly different across all subgroups with Cluster 1 being most mindful and Cluster 3 least mindful. Depression, anxiety and stress were significantly higher in Cluster 3 than Cluster 1. Pain catastrophising was higher for Cluster 2 than Clusters 1 and 3. Cluster 2 had lower pressure pain threshold than Clusters 1 and 3. Conclusions: These results support the association between significant other interactions and the experience of back pain. Considering significant other interactions in clinical practice may be important for managing some people’s presentation.
No related grants have been discovered for Michelle Kendell.