ORCID Profile
0000-0002-5901-3899
Current Organisations
University of Queensland
,
Princess Alexandra Hospital
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Publisher: Elsevier BV
Date: 07-2017
DOI: 10.1016/J.EJSO.2016.10.026
Abstract: Shoulder pain and dysfunction may occur following neck dissection among people being treated for head and neck cancer. This systematic review aims to examine the prevalence and incidence of shoulder and neck dysfunction after neck dissection and identify risk factors for these post-operative complications. Electronic databases (Pubmed, CINAHL, EMBASE, Cochrane) were searched for articles including adults undergoing neck dissection for head and neck cancer. Studies that reported prevalence, incidence or risk factors for an outcome of the shoulder or neck were eligible and assessed using the Critical Review Form - Quantitative Studies. Seventy-five articles were included in the final review. Prevalence rates for shoulder pain were slightly higher after RND (range, 10-100%) compared with MRND (range, 0-100%) and SND (range, 9-25%). The incidence of reduced shoulder active range of motion depended on surgery type (range, 5-20%). The prevalence of reduced neck active range of motion after neck dissection was 1-13%. Type of neck dissection was a risk factor for shoulder pain, reduced function and health-related quality of life. The prevalence and incidence of shoulder and neck dysfunction after neck dissection varies by type of surgery performed and measure of dysfunction used. Pre-operative education for patients undergoing neck dissection should acknowledge the potential for post-operative shoulder and neck problems to occur and inform patients that accessory nerve preservation lowers, but does not eliminate, the risk of developing musculoskeletal complications.
Publisher: Springer Science and Business Media LLC
Date: 22-09-2017
DOI: 10.1007/S00405-017-4754-X
Abstract: Patients with head and neck cancer can report reduced health-related quality of life several years after treatment. The aim of this study was to identify risk factors for reduced quality of life in patients up to 5 years following neck dissection. This cross-sectional study was conducted at two hospitals in Brisbane, Australia. Patients completed two measures of quality of life: the Neck Dissection Impairment Index (NDII), a region- and disease-specific tool, and the Assessment of Quality of Life-4 Domains, a general tool. Generalised linear modelling was used to determine which demographic and clinical variables were associated with quality of life. The cohort included n = 129 patients (71% male, median age 61, median 3 years since surgery). Positive nodal disease was associated with better quality of life on the NDII [e.g. N2 vs N0 coeff (95% CI) = 22.84 (7.33, 38.37)]. Worse quality of life was associated with adjuvant treatment [e.g. Independent Living domain model: surgery with chemoradiation vs surgery only coeff (95% CI) = -0.11 (-0.22, -0.01)]. Positive nodal disease was associated with better quality of life, which may be a reflection of response shift. Multimodality treatment leads to worse quality of life compared with surgery only.
Publisher: Elsevier BV
Date: 04-2019
DOI: 10.1016/J.APERGO.2018.12.006
Abstract: The aim of this study was to compare the feasibility and impact of sit-stand workstations plus advice, with or without exercise, on back pain and sitting time in office workers at risk of low back pain (LBP). Eligible participants (n = 29/169 17% overall) were randomized to receive a sit-stand workstation and advice with (n = 16) or without (n = 13) progressive resistance exercise training for 4-weeks. Feasibility (recruitment, acceptability, adherence) and impact (LBP severity during a standardized standing task, workplace-sitting time) were assessed. Intervention acceptability (87.5% very satisfied) was good and adherence (60% completed all 12 exercise sessions) was satisfactory. Maximum LBP severity (mean difference of -1.3 (-2.0, -0.6) and workplace sitting time (82.7-99.3 min/8-hr workday reduction) were similarly reduced in both groups. The introduction of a sit-stand workstation with advice was feasible and achieved similar outcomes for LBP and workplace sitting time when administered with or without exercise.
Publisher: Elsevier BV
Date: 12-2019
Publisher: Springer Science and Business Media LLC
Date: 16-05-2018
DOI: 10.1007/S11764-018-0697-5
Abstract: The purpose of this study was to examine the relationship between physical impairments, quality of life and disability in patients following neck dissection, with consideration of patient and clinical characteristics. Cross-sectional study of patients < 5 years after neck dissection for head and neck cancer. Quality of life and self-reported disability were measured with the Neck Dissection Impairment Index, Quick Disabilities of the Arm, Shoulder and Hand, and Neck Disability Index. Active neck and shoulder range of motion and isometric muscle strength were also assessed. Generalised linear modelling was used to explore relationships between variables. Eighty-four participants (68% male, median age 61 years) demonstrated reduced quality of life (median (interquartile range) score = 76 (49, 93) from 0 (worst) to 100 (best)), and mild levels of upper limb (14 (2, 32)) and neck disability (14 (6, 28)) (from 0 (best) to 100 (worst)). Bilateral neck dissection was associated with reduced quality of life (coeff (95% CI) = - 12.49 (- 24.69, - 0.29)). Post-operative chemoradiation therapy was associated with reduced quality of life (- 21.46 (- 37.57, - 5.35)) and neck disability (0.71 (0.10, 1.32)). Measures of shoulder flexibility or strength were associated with quality of life and self-reported disability. Quality of life and musculoskeletal disability after neck dissection are associated with factors from multiple domains including physical motor function and treatment modality. Having reduced shoulder flexibility or strength is related to functional deficits and quality of life after neck dissection for head and neck cancer.
Publisher: Elsevier BV
Date: 06-2016
DOI: 10.1016/J.PHYSIO.2015.04.006
Abstract: The Nintendo Wii Fit integrates virtual gaming with body movement, and may be suitable as an adjunct to conventional physiotherapy following lower limb fractures. This study examined the feasibility and safety of using the Wii Fit as an adjunct to outpatient physiotherapy following lower limb fractures, and reports s le size considerations for an appropriately powered randomised trial. Ambulatory patients receiving physiotherapy following a lower limb fracture participated in this study (n=18). All participants received usual care (in idual physiotherapy). The first nine participants also used the Wii Fit under the supervision of their treating clinician as an adjunct to usual care. Adverse events, fracture malunion or exacerbation of symptoms were recorded. Pain, balance and patient-reported function were assessed at baseline and discharge from physiotherapy. No adverse events were attributed to either the usual care physiotherapy or Wii Fit intervention for any patient. Overall, 15 (83%) participants completed both assessments and interventions as scheduled. For 80% power in a clinical trial, the number of complete datasets required in each group to detect a small, medium or large effect of the Wii Fit at a post-intervention assessment was calculated at 175, 63 and 25, respectively. The Nintendo Wii Fit was safe and feasible as an adjunct to ambulatory physiotherapy in this s le. When considering a likely small effect size and the 17% dropout rate observed in this study, 211 participants would be required in each clinical trial group. A larger effect size or multiple repeated measures design would require fewer participants.
Publisher: Springer Science and Business Media LLC
Date: 11-07-2015
Publisher: Informa UK Limited
Date: 11-12-2022
DOI: 10.1080/09638288.2020.1855677
Abstract: To reach expert consensus on a definition for recovery following minor and moderate road traffic crash-related injuries and key factors that influence recovery, and to explore expert perspectives on risk identification methods. A three-round Delphi study was conducted in which 47 experts (insurance representatives, health care professionals and researchers) were consulted. Strong expert agreement (86%) was reached for the definition: " An accepted definition for recovery following minor and moderate road traffic crash-related injury was established, which could facilitate communication and engagement between different rehabilitation stakeholders. Strong consensus was achieved on nine key factors that influenced recovery. Further research is needed to evaluate whether injured persons agree with this definition and on the utility of risk identification methods.Implications for rehabilitationExpert consensus was established for a definition of recovery following minor and moderate road traffic crash-related injuries and nine key influencing factors.An established definition could facilitate communication and engagement between all rehabilitation stakeholders, which could improve the recovery process of the injured person.Rehabilitation professionals need to be familiar with the role of psychosocial factors, such as recovery expectations, resilience and coping skills, in the recovery process.The use of physical and psychological outcome measures at regular intervals could help to identify risk of poor recovery following minor and moderate road traffic crash-related injuries.
Publisher: Springer Science and Business Media LLC
Date: 29-10-2019
DOI: 10.1186/S13643-019-1178-2
Abstract: Musculoskeletal injuries are the most common non-fatal injury from road traffic crashes. Even when the injuries are mild, they can cause pain which can affect return to work rates and work ability post-crash. Workplace output losses are the biggest cost from traffic crash-related injuries. There is a need to identify effective interventions that can improve work-related outcomes (e.g. time to return to work, sick leave, and work ability) in this group and a need to understand the intervention components, external factors, and participant characteristics that may be associated with improvement. A systematic review will be conducted using seven databases and search terms related to road traffic crash, musculoskeletal injury, work-related outcomes, and study design. Intervention studies will be eligible if they report on at least one work-related outcome, include adults with a traffic crash-related musculoskeletal injury (e.g. fracture or whiplash), include a comparison group, and are written in English. Interventions can be medical, therapeutic, work-based, multicomponent, or other. Two researchers will independently screen titles and abstracts, review full texts for inclusion in the review, and perform the data extraction. The main outcomes of the review will be time until return to work and duration of sick leave. The results will be narratively described, with meta-analyses conducted where possible. This review will explore the effectiveness of interventions in in iduals with traffic crash-related musculoskeletal injury on work-related outcomes and will act as a useful source for researchers, policy makers, and stakeholders when developing and implementing interventions in this group. PROSPERO CRD42018103746
Publisher: Bond University
Date: 02-05-2023
DOI: 10.53300/001C.71404
Abstract: Background : Clinical documentation is a critical form of communication in healthcare settings. As defined by the Physiotherapy Practice Thresholds, clinical documentation that complies with relevant professional and legal obligations is a requirement for all physiotherapists in Australia and New Zealand. Aims : The aims of this study were to explore the experiences of clinical documentation and perceived support and training needs for physiotherapy students whilst on clinical placement, from the perspective of students and clinical educators. Method : A qualitative approach was used to investigate physiotherapy student (n=18) and clinical educator (n=17) experiences and perspectives. Interviews from eight focus groups were professionally transcribed, and reflexive thematic analysis was applied to the data to determine common themes. Results : Four overarching themes were generated 1) Recognising the value of documentation, 2) Variance of expectations, 3) Challenges in measuring performance, and 4) Clinical placement readiness and requirements. Conclusion : The main findings from this study identify the unique challenges that students experience to meet documentation requirements on clinical placement. This study highlights the shared responsibility of university education providers and clinical placement facilities to support students to understand the importance of clinical documentation and assist in improving their documentation skills.
Publisher: MDPI AG
Date: 11-2021
Abstract: Musculoskeletal injuries occur frequently after road traffic crashes (RTCs), and the effect on work participation is not fully understood. The primary aim of this review was to determine the impact of sustaining a musculoskeletal injury during an RTC on the rate of return to work (RTW), sick leave, and other work outcomes. The secondary aim was to determine factors associated with these work-related outcomes. An electronic search of relevant databases to identify observational studies related to work and employment, RTC, and musculoskeletal injuries was conducted. Where possible, outcome data were pooled by follow-up period to answer the primary aim. Fifty-three studies were included in this review, of which 28 were included in meta-analyses. The pooled rate of RTW was 70% at 1 month, 67% at 3 months, 76% at 6 months, 83% at 12 months, and 70% at 24 months. Twenty-seven percent of participants took some sick leave by one month follow-up, 13% by 3 months, 23% by 6 months, 36% by 12 months, and 22% by 24 months. Most of the factors identified as associated with work outcomes were health-related, with some evidence also for sociodemographic factors. While 70% of people with RTC-related musculoskeletal injury RTW shortly after accident, many still have not RTW two years later.
Publisher: MDPI AG
Date: 20-01-2022
DOI: 10.3390/HEALTHCARE10020202
Abstract: Older people are particularly vulnerable to hospital re-presentation following discharge. Ideal discharge planning processes facilitate the transition from hospital to home and prevent subsequent re-presentations to hospital. The objective of this study was to examine discharge planning processes in two Australian hospitals, compare them between sites and to best-practice recommendations. An ethnographic observational study of discharge planning processes was conducted at two general medical inpatient wards at a large tertiary hospital and a smaller regional hospital in Brisbane, Australia. Participants were patients and ward staff involved in discharge planning during a hospital admission. A literature review was conducted to elicit best-practice recommendations for discharge planning. Data for this study (duration: 112 h) were collected directly using field notes by a research assistant embedded in the ward. A directed qualitative content analysis approach was used for data analysis. Results were compared to best-practice recommendations. Findings indicate that both hospitals implemented various best-practice interventions to enhance communication, collaboration, coordination and patient/family engagement for optimal discharge planning. Strategies used were context specific and effective to varying degrees. Clear responsibilities and goals within the multidisciplinary team helped to create cohesive, well-functioning teams. More work is needed to engage patients and families in discharge planning, and to encourage health professionals to consider patients and family as active team members in the discharge planning process.
Publisher: MDPI AG
Date: 11-09-2020
DOI: 10.3390/HEALTHCARE8030334
Abstract: Despite its high prevalence, there is no systematic approach to documenting and coding obesity in hospitals. This study aimed to determine the prevalence of obesity among inpatients, the proportion of obese patients recognised as obese by hospital administration, and the cost associated with their admission. A cross-sectional study was undertaken in three hospitals in Queensland, Australia. Inpatients present on three audit days were included in this study. Data collected were age, sex, height, and weight. Body mass index (BMI) was calculated in accordance with the World Health Organization’s definition. Administrative data were sourced from hospital records departments to determine the number of patients officially documented as obese. Total actual costing data were sourced from hospital finance departments. From a combined cohort of n = 1327 inpatients (57% male, mean (SD) age: 61 (19) years, BMI: 28 (9) kg/m2), the prevalence of obesity was 32% (n = 421). Only half of obese patients were recognised as obese by hospital administration. A large variation in the cost of admission across BMI categories prohibited any statistical determination of difference. Obesity is highly prevalent among hospital inpatients in Queensland, Australia. Current methods of identifying obesity for administrative/funding purposes are not accurate and would benefit from reforms to measure the true impact of healthcare costs from obesity.
Publisher: Elsevier BV
Date: 09-2018
DOI: 10.1016/J.GAITPOST.2018.07.001
Abstract: The hip is one of the most common joints affected by osteoarthritis (OA) and it has been identified as a key risk factors for falls. Physical impairments associated with OA, such as joint pain, muscle weakness, joint stiffness and sensory dysfunction, can all negatively affect balance and increase risk of falling. Is balance performance altered in older adults with hip osteoarthritis? To determine whether static, dynamic, reactive or functional balance performance is altered in older people with hip osteoarthritis. Quantitative measures of postural control, including clinical and lab-based assessment of static, dynamic, reactive and/or functional balance performance, compared with a healthy control group or to the asymptomatic limb. A total of 5407 articles were identified and 14 papers were included (10 with standardised mean different (SMD) data, four without SMD data). Based on data from single studies, there were medium/large effects for increased medio-lateral displacement when standing with eyes open, increased anterior-posterior and total sway path length when standing with eyes closed, greater overall instability when standing on an unstable surface, and increased displacement toward the stance leg in a lateral step in hip OA compared with controls. Balance impairments were identified in some measures, limiting the conclusions as to whether balance deficits are a problem in hip OA. Inconsistent findings suggest that balance may not be a primary contributor to increased falls risk in older adults with hip OA. Other factors, such as musculoskeletal deficits, may contribute to higher falls rate in this population.
Publisher: Cambridge University Press (CUP)
Date: 23-11-2023
Abstract: To explore how vocational rehabilitation (VR) is currently delivered for in iduals with acquired brain injury (ABI) across multiple stakeholder groups and identify areas for improvement in service delivery using the Consolidated Framework for Implementation Research (CFIR). Seven focus groups were conducted with rehabilitation clinicians outreach providers, insurers/regulators, VR providers and disability employment service providers ( n = 44) experienced in VR of in iduals with ABI. All groups were audio-recorded and transcribed verbatim. Data analysis was guided by the CFIR constructs. All stakeholder groups believed they offered quality VR interventions given available resources and legislation, but many clients fell through the ‘cracks’. Themes that were identified included: a) number and complexity of systems supporting VR b) fractured communication across systems, c) lack of knowledge by both stakeholders and clients in navigating systems, d) lack of expertise in supporting the vocational needs of clients with ABI and e) perceived limited awareness of ABI by employers. Stakeholders and clients need support to navigate Australia’s complex VR pathways. Limited specialist ABI clinicians, VR providers and disability employment services were identified as barriers for effective VR. Domains of the CFIR were appropriate for organising and understanding how VR is delivered.
Publisher: Springer Science and Business Media LLC
Date: 18-02-2023
DOI: 10.1007/S10741-023-10301-W
Abstract: Given the under-utilisation of cardiac rehabilitation despite its benefits, there has been a shift towards alternative delivery models. The recent coronavirus disease 2019 (COVID-19) pandemic has accelerated this shift, leading to a growing interest in home-based cardiac rehabilitation including telerehabilitation. There is increasing evidence to support cardiac telerehabilitation, with studies generally demonstrating comparable outcomes and potential cost-benefits. This review aims to provide a synopsis of the current evidence on home-based cardiac rehabilitation with a focus on telerehabilitation and practical considerations.
Publisher: Informa UK Limited
Date: 05-12-2022
Publisher: BMJ
Date: 26-09-2022
DOI: 10.1136/OEMED-2022-108275
Abstract: To determine the impact of a 12-week ergonomic/exercise programme compared with an ergonomic/health education programme on the development of neck pain in office workers over 12 months. This cluster-randomised trial prospectively recruited office workers from public and private organisations. Only non-neck pain cases at baseline were included (n=484). All participants received an ergonomic workstation review then randomly allocated to receive a neck/shoulder progressive exercise programme (20 min, 3 ×/week intervention group) or health education sessions (60 min, 1 ×/week active control) for 12 weeks. Generalised estimating equations evaluated group differences in the point prevalence of neck pain cases (defined as those with a neck pain score of ≥3 on a 0 (no pain) to 9 (worst pain) scale) over time (3, 6, 9 and 12 months) with cumulative incidence of neck pain cases evaluated descriptively. While no significant group × time interaction was evident, the 12-month point prevalence of neck pain cases in the intervention group (10%) was half that of the active control group (20%) (adjusted OR 0.46, 95% CI 0.21 to 1.01, p=0.05). Lower cumulative incidence of neck pain cases was observed in the intervention (17%) compared with active control group (30%) over the 12 months. A combined ergonomics and exercise intervention may have more benefits in preventing neck pain cases in office workers than an ergonomic and health education intervention. Group differences were modest and should be interpreted with caution when considering strategies for primary prevention of neck pain in the office worker population. ACTRN12612001154897
Publisher: Springer Science and Business Media LLC
Date: 20-06-2022
Publisher: Springer Science and Business Media LLC
Date: 12-09-2016
Publisher: Springer Science and Business Media LLC
Date: 20-11-2018
Publisher: Springer Science and Business Media LLC
Date: 09-07-2022
DOI: 10.1007/S10926-021-09994-3
Abstract: Purpose To identify factors impeding or facilitating Return to Work (RTW) after minor to serious musculoskeletal Road Traffic Injuries (RTI). Methods Six electronic databases were searched for studies published 1997-2020. Quantitative and qualitative studies were included if they investigated barriers or facilitators associated with RTW in people with minor to serious musculoskeletal RTI aged over 16 years. Methodological quality was assessed using McMaster Critical Review Form for Quantitative studies and McMaster Critical Review Form for Qualitative Studies. Results are presented narratively as meta-analysis was not possible. Results Eleven studies (10 quantitative and 1 qualitative) were included. There was strong evidence that in iduals with higher overall scores on the (short-form or long-form) Örebro Musculoskeletal Pain Questionnaire (ÖMPQ) at baseline were less likely to RTW, and in iduals with higher RTW expectancies at baseline were more likely to RTW after musculoskeletal RTI. There was weak evidence for higher disability levels and psychiatric history impeding RTW after musculoskeletal RTI. Conclusions Post-injury scores on the ÖMPQ and RTW expectancies are the most influential factors for RTW after minor to serious musculoskeletal RTI. There is a need to identify consistent measures of RTW to facilitate comparisons between studies.
Publisher: BMJ
Date: 07-2019
DOI: 10.1136/BMJOPEN-2018-026240
Abstract: Peripheral neuropathy is a major risk factor for falls in adults with diabetes. Innovative footwear devices which artificially manipulate the sensory environment at the feet, such as textured shoe insoles, are emerging as an attractive option to mitigate balance and walking problems in neuropathic populations. This study aims to explore whether wearing textured insoles for 4 weeks alters balance performance in adults with diabetic peripheral neuropathy. A prospective, single-blinded randomised controlled trial with parallel groups will be conducted on 70 adults with diabetic peripheral neuropathy. Adults with a diagnosis of peripheral neuropathy (secondary to type 2 diabetes), aged ≥18 years, ambulant over 20 m (with/without an assistive device), will be recruited. Participants will be randomised to receive a textured insole (n=35) or smooth insole (n=35), to be worn for 4 weeks. During baseline and post intervention assessments, standing balance (foam/firm surface eyes open/closed) and walking tasks will be completed barefoot, wearing standard shoes only, and two different insoles (smooth, textured). The primary outcome measure will be centre of pressure (CoP) velocity, with higher values indicating poorer balance. Secondary outcome measures include walking quality (gait velocity, base of support, stride length and double-limb support time), physical activity levels, foot sensation (light-touch pressure, vibration) and proprioception (ankle joint position sense), and other balance parameters (CoP path length, anteroposterior and mediolateral excursion). Patient-reported outcomes will be completed evaluating foot health, frequency of falls and fear of falling. Data will be analysed using a repeated measures mixed models approach (including covariates) to establish any differences between-groups, for all outcome measures, over the intervention period. Ethical approval has been obtained from the institutional Human Research Ethics Committee (#2017000098). Findings will be disseminated at national and international conferences, through peer-reviewed journals, workshops and social media. ACTRN12617000543381 Pre-results.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 14-09-2023
Publisher: Elsevier BV
Date: 03-2022
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2018
DOI: 10.1097/01.REO.0000000000000102
Abstract: Incidence of lymphedema appears to be higher in women with vulvar/vaginal cancer than in those with other forms of gynecological cancer. The objective of this work was to determine the point prevalence and incidence of lymphedema in women with vulvar/vaginal cancer and to describe symptom burden and quality of life (QOL). Prospective longitudinal cohort study conducted in Brisbane, Australia, including adult women with newly diagnosed vulvar/vaginal cancer. The primary outcome was self-reported swelling of the legs, vulvar area, or pelvis/abdomen or a clinical diagnosis of lymphedema. Severity of associated symptoms and QOL (Functional Assessment of Cancer Therapy–General) were also reported. Assessments were conducted over 2 years. All participants (vulvar: n = 20 vaginal: n = 2 mean [SD] age = 57 [12] years) received surgical treatment, and 8 (36%) also received adjuvant therapy. By 24 months postdiagnosis, only 2 (9%) women had no evidence of lymphedema all others self-reported swelling (n = 10 45%), had a clinical diagnosis (n = 1 5%), or both (n = 9 41%). Three or more symptoms of moderate or greater intensity were reported by 7 (44%) women at 2 years. The presence of lower limb symptoms (including mild intensity) was associated with reduced QOL (any symptom: QOL estimate = −13.29 95% CI, −19.30 to −7.27 P .001). Small s le size limits interpretation of findings. These findings demonstrate that the majority of women receiving treatment of vulvar/vaginal cancer experience lymphedema and symptoms of swelling are associated with lower QOL. Monitoring of swelling via patient self-report may identify women at risk of low QOL outcomes after treatment of vulvar/vaginal cancer.
Publisher: Wiley
Date: 09-08-2023
DOI: 10.1002/CAM4.6432
Abstract: The ability to return to work and remain at work is an important recovery milestone after a cancer diagnosis. With the projected number of colorectal cancer patients of working age likely to increase, it is important to identify when a person is ready to resume work. There are many employment‐related tools available to help people return to work after injury or illness however, it is unknown which may be suitable for a person with colorectal cancer. To identify tools related to employment readiness in colorectal cancer survivors and to chart the relevant factors of employment assessed by these tools. Literature searches were performed in PubMed, CINAHL, Embase and Medline, the Cochrane library and PsycINFO using search terms around cancer, survivorship and employment to identify all peer‐reviewed articles published in English up to June 2022. Thirty‐five studies used a total of 77 tools focused on assessing employment issues experienced by people with cancer in general. Four tools were used with colorectal cancer survivors. None considered all relevant employment‐related factors for colorectal cancer survivors. Tools used to identify return‐to‐work and remain‐at‐work were not specific to colorectal cancer. There are a range of existing tools that collate some, but not all, of the domains and outcome criteria required to meet the employment needs of colorectal cancer survivors. To optimize work outcomes for the working colorectal cancer population, a specified tool is warranted.
Publisher: Informa UK Limited
Date: 15-09-2022
Publisher: Cambridge University Press (CUP)
Date: 20-12-2023
Abstract: Innovative shoe insoles, designed to enhance sensory information on the plantar surface of the feet, could help to improve walking in people with Multiple Sclerosis. To compare the effects of wearing textured versus smooth insoles, on measures of gait, foot sensation and patient-reported outcomes, in people with Multiple Sclerosis. A prospective, randomised controlled trial was conducted with concealed allocation, assessor blinding and intention-to-treat analysis. Thirty ambulant men and women with multiple sclerosis (MS) (Disease Steps rating 1–4) were randomly allocated to wear textured or smooth insoles for 12 weeks. Self-reported insole wear and falls diaries were completed over the intervention period. Laboratory assessments of spatiotemporal gait patterns, foot sensation and proprioception, and patient-reported outcomes, were performed at Weeks 0 (Baseline 1), 4 (Baseline 2) and 16 (Post-Intervention). The primary outcome was the size of the mediolateral base of support (stride/step width) when walking over even and uneven surfaces. Independent t -tests were performed on change from baseline (average of baseline measures) to post-intervention. There were no differences in stride width between groups, when walking over the even or uneven surfaces ( P ≥ 0.20) at post-intervention. There were no between-group differences for any secondary outcomes including gait (all P values 0.23), foot sensory function (all P values ≥ 0.08) and patient-reported outcomes (all P values ≥ 0.23). In our small trial, prolonged wear of textured insoles did not appear to alter walking or foot sensation in people with MS who have limited foot sensory loss. Further investigation is needed to explore optimal insole design. Australian and New Zealand Clinical Trials Registry (ACTRN12615000421538).
Publisher: Elsevier BV
Date: 11-2019
DOI: 10.1016/J.AAP.2019.105280
Abstract: This study aimed to develop an industry-specific tool to identify risk of poor physical and mental recovery following minor to moderate injuries sustained in a road traffic crash (RTC). Existing tools are often designed for implementation by health professionals rather than insurer case managers who may not have a background in health. This study is a secondary analysis of a longitudinal cohort study using data collected at 2-6 months and 24 months post-RTC. Participants were claimants (n = 254 Mean age = 50 years 65% female) with mild-moderate injuries recruited through the common-law 'fault-based' compulsory third party scheme in Queensland, Australia. Sociodemographic, functional and psychological health factors were collected at baseline (2-6 months post RTC) and used as potential predictors for physical and mental health-related quality of life (Short Form 36 v2) at the 2-year follow-up. The LASSO (Least Absolute Shrinkage and Selection Operator) analysis identified six disability items (from the World Health Organization Disability Assessment Schedule 2) to predict poor physical and one item to predict poor mental health-related quality of life. Logistic regressions of these items in addition to age and gender were used to develop a screening tool. Using the tool, 90% of those at risk of poor physical and 80% of those at risk of poor mental health-related quality of life were identified correctly. To conclude, this study presents an 8-item, context-specific tool to help injury managers identify in iduals at risk of poor physical and mental health recovery following mild-moderate RTC-related injuries. The tool requires validation in a new cohort and confirmation of acceptability by end-users.
Publisher: Wiley
Date: 25-07-2017
Abstract: To measure patient‐perceived upper limb and neck function following neck dissection and to investigate potential associations between clinical factors, symptoms, and function. Cross‐sectional. Two tertiary hospitals in Brisbane, Australia. Inclusion criteria: patients treated with neck dissection (2009‐2014). Exclusion criteria: aged years, accessory nerve or sternocleidomastoid sacrifice, previous neck dissection, preexisting shoulder/neck injury, and inability to provide informed consent (cognition, insufficient English). Primary outcomes were self‐reported function of the upper limb (Quick Disabilities of the Arm, Shoulder, and Hand) and neck (Neck Disability Index). Secondary outcomes included demographics, oncological management, self‐efficacy, and pain. Generalized linear models were prepared to examine relationships between explanatory variables and self‐reported function. Eighty‐nine participants (male n = 63, 71% median age, 62 years median 3 years since surgery) reported mild upper limb and neck dysfunction (median [quartile 1, quartile 3] scores of 11 [3, 32] and 12 [4, 28], respectively). Significant associations were found between worse upper limb function and longer time since surgery (coefficient, 1.76 95% confidence interval [CI], 0.01‐3.51), having disease within the thyroid (17.40 2.37‐32.44), postoperative radiation therapy (vs surgery only) (13.90 6.67‐21.14), and shoulder pain (0.65 0.44‐0.85). Worse neck function was associated with metastatic cervical lymph nodes (coefficient, 6.61 95% CI, 1.14‐12.08), shoulder pain (0.19 0.04‐0.34), neck pain (0.34 0.21‐0.47), and symptoms of neuropathic pain (0.61 0.25‐0.98). Patients can experience upper limb and neck dysfunction following nerve‐preserving neck dissection. The upper quadrant as a whole should be considered when assessing rehabilitation priorities after neck dissection.
Publisher: Springer Science and Business Media LLC
Date: 08-2021
Publisher: Wiley
Date: 22-01-2019
Abstract: To compare the neck and shoulder motor function of patients following neck dissection, including comparison with a group of healthy volunteers. Cross‐sectional study. Two tertiary hospitals in Brisbane, Australia. Participants included patients 0.5 to 5 years after unilateral nerve‐sparing neck dissection and healthy control subjects. Demographic and clinical information was collected with cervical and shoulder motor function measures (scapular resting position, active range of motion, and isometric muscle strength). Differences between groups were examined via regression analyses that included statistical adjustment for the potential effect of age, sex, body mass index, and other disease‐related variables. The 57 patients (68%, men median age, 62 years) were typically older than the 34 healthy controls (47%, men median age, 46 years). There were no differences between types of nerve‐preserving neck dissection for any of the motor function measures. When adjusted for age, sex, and body mass index, healthy volunteers (vs patients) had significantly greater cervical range (eg, extension coefficient [95% CI]: 11.04° [4.41°‐17.67°]), greater affected shoulder range (eg, abduction: 16.64° [1.19°‐31.36°]), and greater isometric strength of the cervical flexors (eg, men: 4.24 kgf [1.56‐6.93]) and shoulder flexors (eg, men: 8.00 kgf [1.62‐14.38]). Strength and flexibility of the neck and shoulder are impaired following neck dissection in comparison with healthy controls. Clinicians and researchers are encouraged to consider the neck—and the neck dissection as a whole—as a source of motor impairment for these patients and not just the status of the accessory nerve.
Publisher: Elsevier BV
Date: 03-2023
DOI: 10.1016/J.AUCC.2022.01.005
Abstract: Critical care outreach teams support ward staff to manage patients who are seriously ill or after discharge from the intensive care unit (ICU). Respiratory deterioration is a common reason for (re)admission to the ICU. Physiotherapists are health professionals with skills to address acute respiratory concerns. Experienced respiratory physiotherapists play a role in supporting junior clinicians, particularly in managing deteriorating patients on the ward. The objective of this study was to evaluate a novel respiratory physiotherapy critical care outreach-style service. The primary objective was to describe service referrals and the patient cohort. Other objectives were to compare the effects of this model of care on ICU readmission rates to a historical cohort and explore clinician perceptions of the model of care and its implementation. A new physiotherapy model of care worked alongside an existing nurse-led outreach service to support physiotherapists with the identification and management of patients at risk of respiratory deterioration or ICU (re)admission. Purpose-built and pre-existing databases were used for prospective data collection and for a historical ICU readmissions control group. Questionnaires and semistructured group interviews were utilised to evaluate clinician satisfaction and perceptions. The service accepted referrals for 274 patients in 6 months (on average 2.25/working day commonly after trauma [29%] and abdominal surgery [19%]). During the implementation period of the model of care, fewer preventable respiratory ICU readmissions were reported (n = 1/20) than in the historical cohort (n = 6/19: Fisher's exact test, p < 0.05). Likelihood of respiratory ICU readmission, compared to all-cause readmissions, was not affected (intervention: 31%, historical control: 41% odds ratio: 0.63 [95% confidence interval: 0.29 to 1.4]). Postimplementation surveys and focus groups revealed clinicians highly valued the support and perceived a positive impact on patient care. Critical care outreach-style physiotherapy services can be successfully implemented and are positively perceived by clinicians, but any effect on ICU readmissions is unclear.
Publisher: Wiley
Date: 28-03-2023
DOI: 10.1002/MDC3.13718
Abstract: Successful management for functional neurological disorder (FND) requires multidisciplinary involvement starting with providing a definitive diagnosis. To observe clinical management of patients with FND during hospital admission. A prospective observational study was conducted over six Australian hospitals over a 4‐month period. Data collected included patient demographics, communication of the diagnosis of FND, access to the multidisciplinary team, hospital length of stay (LOS), and emergency department (ED) presentations. A total of 113 patients were included. Median LOS was 6 (interquartile range, 3–14) days. Thirty‐five (31%) presented to ED with 9 (8%) re‐presenting two or more times after hospital discharge. Total hospital utilization cost was AUD$3.5million. A new diagnosis was made in 82 (73%) patients. Inpatient referrals were made to neurology (81, 72%), psychology (29, 26%), psychiatry (27, 24%), and physiotherapy (100, 88%). Forty‐four (54%) were not told of the diagnosis. Twenty (24%) did not have their diagnosis documented in their medical record. Of the 19 (23%) not reviewed by neurology on non‐neurosciences wards, 17 (89%) did not have their diagnosis communicated and 11 (58%) did not have it documented. Twenty‐five (42%) referred to neurology were not provided with a diagnosis. Current gaps in service provision during inpatient hospital admissions in Australia include low rates of communication of a diagnosis, particularly when patients are not located on a neurosciences ward, and limited and variable access to inpatient multidisciplinary teams. Specialized services are needed to improve education, clinical pathways, communication, and health outcomes while reducing healthcare system costs.
No related grants have been discovered for Elise Gane.