School of Clinical Sciences
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The School of Clinical Sciences plays an important role in specialist teaching and research conducted by its academic staff and postgraduate students. This places AUT students at the forefront of much of the ground-breaking research undertaken in New Zealand, especially in the fields of Midwifery, Nursing, Occupational Therapy, Oral Health, Paramedicine, Physiotherapy, Podiatry.
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- ItemParents’ Experiences of Their Child’s Best Interests During a Hospital Stay in Australia(SAGE Publications, 2024-04-03) Quaye, Angela Afua; Foster, Mandie; Whitehead, Lisa; Hallström, Inger KristenssonDetermining the child’s best interests in a hospital setting will ideally involve the combined views of children, parents, and healthcare professionals. However, few studies have explored parents’ experiences of their child’s best interests when they engage with the healthcare system. Therefore, this study aimed to explore parents’ experiences of their child’s best interests during hospitalisation. A descriptive qualitative inductive design using face-to-face parent–child combined interviews, analysed by latent content analysis, was used. Sixteen parents recruited from a tertiary hospital in Western Australia were interviewed. Collaboration, development of trustworthy relationships, and effective communication were essential in shaping parents’ experiences of their child’s best interests during hospitalisation.
- ItemThe Role and Function of Body Communication in Physiotherapy Practice: A Qualitative Thematic Synthesis(Physiotherapy New Zealand, 2024-03-28) Good, Clinton H; Bright, FAS; Mooney, SarahCommunication is essential to physiotherapy practice. While verbal communication has been a primary focus in research, less is known about body communication. Body communication refers to communication achieved by means other than words, such as touch, eye contact, prosody, and proxemics. This review aims to provide detailed knowledge of the roles and functions of body communication in physiotherapy practice and identify areas for future research. We undertook a systematic search and thematic synthesis of published qualitative literature in October 2022. Four databases were searched with results screened to identify articles providing insight into the roles and functions of body communication. Quality appraisal of included studies was completed. Thematic synthesis was used to generate findings. Thirty-three studies met the inclusion criteria. Four themes were constructed to reflect the roles and functions of body communication in physiotherapy practice: conveying the physiotherapist’s attention and interest; enabling patients to contribute to care; guiding physiotherapy intervention through bodily dialogue; and building the therapeutic relationship. The findings demonstrate how body communication shapes the therapeutic process and how sensitive and responsive body communication supports a more reciprocal and person-centred approach to care. Research is needed to obtain more in-depth and nuanced accounts of body communication to support the clinical application of findings.
- ItemA Randomized Controlled Trial Comparing Different Sites of High-Velocity Low Amplitude Thrust on Sensorimotor Integration Parameters(Springer Science and Business Media LLC, 2024-01-12) Niazi, IK; Navid, MS; Merkle, C; Amjad, I; Kumari, N; Trager, RJ; Holt, K; Haavik, HIncreasing evidence suggests that a high-velocity, low-amplitude (HVLA) thrust directed at a dysfunctional vertebral segment in people with subclinical spinal pain alters various neurophysiological measures, including somatosensory evoked potentials (SEPs). We hypothesized that an HVLA thrust applied to a clinician chosen vertebral segment based on clinical indicators of vertebral dysfunction, in short, segment considered as “relevant” would significantly reduce the N30 amplitude compared to an HVLA thrust applied to a predetermined vertebral segment not based on clinical indicators of vertebral dysfunction or segment considered as “non-relevant”. In this double-blinded, active-controlled, parallel-design study, 96 adults with recurrent mild neck pain, ache, or stiffness were randomly allocated to receiving a single thrust directed at either a segment considered as “relevant” or a segment considered as “non-relevant" in their upper cervical spine. SEPs of median nerve stimulation were recorded before and immediately after a single HVLA application delivered using an adjusting instrument (Activator). A linear mixed model was used to assess changes in the N30 amplitude. A significant interaction between the site of thrust delivery and session was found (F1,840 = 9.89, p < 0.002). Pairwise comparisons showed a significant immediate decrease in the N30 complex amplitude after the application of HVLA thrust to a segment considered “relevant” (− 16.76 ± 28.32%, p = 0.005). In contrast, no significant change was observed in the group that received HVLA thrust over a segment considered “non-relevant” (p = 0.757). Cervical HVLA thrust applied to the segment considered as “relevant” altered sensorimotor parameters, while cervical HVLA thrust over the segment considered as “non-relevant” did not. This finding supports the hypothesis that spinal site targeting of HVLA interventions is important when measuring neurophysiological responses. Further studies are needed to explore the potential clinical relevance of these findings.
- ItemNon-Specific Low Back Pain: An Inductive Exploratory Analysis through Factor Analysis and Deep Learning for Better Clustering(MDPI AG, 2023-06-13) Robinault, L; Niazi, IK; Kumari, N; Amjad, I; Menard, V; Haavik, HNon-specific low back pain (NSLBP) is a significant and pervasive public health issue in contemporary society. Despite the widespread prevalence of NSLBP, our understanding of its underlying causes, as well as our capacity to provide effective treatments, remains limited due to the high diversity in the population that does not respond to generic treatments. Clustering the NSLBP population based on shared characteristics offers a potential solution for developing personalized interventions. However, the complexity of NSLBP and the reliance on subjective categorical data in previous attempts present challenges in achieving reliable and clinically meaningful clusters. This study aims to explore the influence and importance of objective, continuous variables related to NSLBP and how to use these variables effectively to facilitate the clustering of NSLBP patients into meaningful subgroups. Data were acquired from 46 subjects who performed six simple movement tasks (back extension, back flexion, lateral trunk flexion right, lateral trunk flexion left, trunk rotation right, and trunk rotation left) at two different speeds (maximum and preferred). High-density electromyography (HD EMG) data from the lower back region were acquired, jointly with motion capture data, using passive reflective markers on the subject’s body and clusters of markers on the subject’s spine. An exploratory analysis was conducted using a deep neural network and factor analysis. Based on selected variables, various models were trained to classify individuals as healthy or having NSLBP in order to assess the importance of different variables. The models were trained using different subsets of data, including all variables, only anthropometric data (e.g., age, BMI, height, weight, and sex), only biomechanical data (e.g., shoulder and lower back movement), only neuromuscular data (e.g., HD EMG activity), or only balance-related data. The models achieved high accuracy in categorizing individuals as healthy or having NSLBP (full model: 93.30%, anthropometric model: 94.40%, biomechanical model: 84.47%, neuromuscular model: 88.07%, and balance model: 74.73%). Factor analysis revealed that individuals with NSLBP exhibited different movement patterns to healthy individuals, characterized by slower and more rigid movements. Anthropometric variables (age, sex, and BMI) were significantly correlated with NSLBP components. In conclusion, different data types, such as body measurements, movement patterns, and neuromuscular activity, can provide valuable information for identifying individuals with NSLBP. To gain a comprehensive understanding of NSLBP, it is crucial to investigate the main domains influencing its prognosis as a cohesive unit rather than studying them in isolation. Simplifying the conditions for acquiring dynamic data is recommended to reduce data complexity, and using back flexion and trunk rotation as effective options should be further explored.
- ItemIndividual Distribution of Muscle Hypertrophy Among Hamstring Muscle Heads: Adding Muscle Volume Where You Need Is Not So Simple(Wiley, 2024-03-21) Frouin, A; Le Sant, G; Barbier, L; Jacquemin, E; McNair, PJ; Ellis, R; Nordez, A; Lacourpaille, LPurpose: The aim of this study was to determine whether a 9-week resistance training program based on high load (HL) versus low load combined with blood flow restriction (LL-BFR) induced a similar (i) distribution of muscle hypertrophy among hamstring heads (semimembranosus, SM; semitendinosus, ST; and biceps femoris long head, BF) and (ii) magnitude of tendon hypertrophy of ST, using a parallel randomized controlled trial. Methods: A total of 45 participants were randomly allocated to one of three groups: HL, LL-BFR, and control (CON). Both HL and LL-BFR performed a 9-week resistance training program composed of seated leg curl and stiff-leg deadlift exercises. Freehand 3D ultrasound was used to assess the changes in muscle and tendon volume. Results: The increase in ST volume was greater in HL (26.5 ± 25.5%) compared to CON (p = 0.004). No difference was found between CON and LL-BFR for the ST muscle volume (p = 0.627). The change in SM muscle volume was greater for LL-BFR (21.6 ± 27.8%) compared to CON (p = 0.025). No difference was found between HL and CON for the SM muscle volume (p = 0.178). There was no change in BF muscle volume in LL-BFR (14.0 ± 16.5%; p = 0.436) compared to CON group. No difference was found between HL and CON for the BF muscle volume (p = 1.0). Regarding ST tendon volume, we did not report an effect of training regimens (p = 0.411). Conclusion: These results provide evidence that the HL program induced a selective hypertrophy of the ST while LL-BFR induced hypertrophy of SM. The magnitude of the selective hypertrophy observed within each group varied greatly between individuals. This finding suggests that it is very difficult to early determine the location of the hypertrophy among a muscle group.