School of Allied Health

Permanent link for this collectionhttps://hdl.handle.net/10292/10495

The School of Allied Health encompasses Physiotherapy, Podiatry, Occupational Therapy, and Rehabilitation.

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Advancing Standardisation of Motor-cognitive Dual Task Walking Assessments: A Scoping Review of Methodological Practices in Healthy Older Adults
(BMC, 2026-03-16) Olsen, Sharon; McLaren, Ruth; Scrooby, Aidan; Shaikh, Nusratnaaz; Henare, Dion; Taylor, Denise; Chaudhary, Shikha
Background: Dual task (DT) assessments evaluating walking combined with a cognitive task are valuable tools for testing functional capacity and monitoring age-related decline. Despite this, motor-cognitive DT assessments are underutilised in clinical practice. This has been attributed in part to methodological challenges, including heterogeneity in DT measurement protocols and poor reliability of outcome measures. To address these barriers, this scoping review systematically identified motor-cognitive DT walking assessments used with healthy older adults and examined current practice in reporting and standardisation. The purpose was to inform the refinement of DT assessments to enhance their precision and reproducibility, facilitating their future integration into routine clinical practice. Method: A systematic search of five electronic databases identified studies that investigated motor-cognitive DT walking assessments in community-dwelling, cognitively healthy older adults. The reporting and standardisation of measurement procedures was extracted using the COSMIN framework. The findings were analysed descriptively. Results: The review included 38 studies investigating a walking motor task combined with a variety of cognitive tasks. The most common walking tasks were unidirectional gait, the timed up and go (TUG), or walking and turning tasks. The most prevalent cognitive tasks included serial subtraction, animal naming, and reciting alternate alphabet letters. There was substantial variability in the administration of DT assessments and no studies fully reported the procedures for set up, test performance, and data collection. Of particular concern was the poor reporting of general task instructions, task prioritisation, and practice trials. Conclusion: The review identified a lack of standardisation in DT walking measurement procedures, which likely contributes to measurement variability and limits clinical replication. Given that measurement variability inherent in single task assessments is compounded when motor and cognitive tasks are combined, it is critical to address these sources of inconsistency to ensure DT measures detect and accurately reflect true performance changes. Recommendations are made to improve standardisation of DT measurements with the aim of facilitating their broader adoption and implementation in clinical practice.
The Impact of Balance Exercise on Brain Age and Brain Morphometry: Insights From MRI Analysis
(Springer, 2026-01-22) Narula, Varima; Taylor, Denise; McLaren, Ruth; Taylor, Rachael L; Mahon, Susan; Smith, Paul F; Chaudhary, Shikha; Winton, Roger W; Fernandez, Justin; Shim, Vickie; Wang, Alan
Physical exercise is known to delay the cognitive decline in the elderly. However, the effect of low-impact balance exercises such as yoga or Tai chi has not been explored in detail. This cross-sectional observational study used brain magnetic resonance imaging data to quantify and compare various brain structures between neurologically healthy adults aged between 55 and 65, divided into Control Group and Balance Exercise (BE) Group based on the self-reported balance exercise status. Various brain attributes such as brain age, cortical and subcortical volume, thickness, surface area, and mean curvature were extracted and computed using machine learning algorithm software like brainageR and FreeSurfer. Clinical functional assessments (balance, vestibular and cognitive measures) were also conducted for the participants. Statistical analyses were performed to determine any differences between the groups at a significance level of 5%. The BE group showed statistically significantly higher values for the right caudal anterior cingulate thickness, left and right superior temporal volume, left entorhinal volume and mean curvature, left frontal pole thickness, left superior temporal area and left inferior temporal thickness. A statistically significant cluster after correction for multiple comparisons was found in the left rostral middle frontal gyrus with a higher volume for BE group. Clinical functional assessments (balance, vestibular and cognitive) and brain age differences were nonsignificant. The significant brain regions in the BE group are involved in memory, cognition, focus, planning, language and auditory processing, decision making, emotional regulation and mental health and could be responsible for protecting and delaying the cognitive declines in the elderly.
Incidence and Outcomes of Major Trauma in New Zealand: Findings From a Feasibility Study of New Zealand's First National Trauma Registry
(New Zealand Medical Association, 2019-05-03) Czuba, KJ; Kersten, P; Anstiss, D; Kayes, NM; Gabbe, BJ; Civil, I; Kool, B; Terry, G; Smith, GA; Rohan, M; Vandal, AC; Siegert, RJ
AIMS: The aim of the study was to pilot the feasibility of long-term outcomes data collection from adult major trauma survivors in New Zealand. This initial paper aims to characterise the New Zealand major trauma population in terms of long-term disability and functional outcomes after major trauma. METHODS: A prospective cohort study of adults who had survived major trauma was conducted between June 2015 and December 2016 at two major trauma centres in Auckland. RESULTS: Of 256 trauma referrals, 112 (44%) were confirmed eligible and consented. One hundred completed the survey at six months and 83 at 12 months. A majority of the study sample were male (72%), under 65 years (84%), with a disproportionally higher number of Māori in the sample (23%). At six months post-injury, the majority of participants were categorised as experiencing either moderate disability (37%) or good recovery (42%). Half of the participants experienced moderate pain at both 6 and 12 months post-injury (50% and 52% respectively), and problems with their usual activities at six months post-injury (51%). CONCLUSIONS: Most study participants made a good recovery, but there was still a large group of people experiencing disability, pain and not in paid employment at 12 months post-injury.
Whakawhiti Kōrero, a Method for the Development of a Cultural Assessment Tool, Te Waka Kuaka, in Māori Traumatic Brain Injury
(Wiley, 2015-10-21) Elder, Hinemoa; Kersten, Paula
The importance of tools for the measurement of outcomes and needs in traumatic brain injury is well recognised. The development of tools for these injuries in indigenous communities has been limited despite the well-documented disparity of brain injury. The wairua theory of traumatic brain injury (TBI) in Māori proposes that a culturally defined injury occurs in tandem with the physical injury. A cultural response is therefore indicated. This research investigates a Māori method used in the development of cultural needs assessment tool designed to further examine needs associated with the culturally determined injury and in preparation for formal validation. Whakawhiti kōrero is a method used to develop better statements in the development of the assessment tool. Four wānanga (traditional fora) were held including one with whānau (extended family) with experience of traumatic brain injury. The approach was well received. A final version, Te Waka Kuaka, is now ready for validation. Whakawhiti kōrero is an indigenous method used in the development of cultural needs assessment tool in Māori traumatic brain injury. This method is likely to have wider applicability, such as Mental Health and Addictions Services, to ensure robust process of outcome measure and needs assessment development.
Accelerating Diagnosis of Degenerative Cervical Myelopathy Through Improved Education: A Mixed-methods Study Protocol From Myelopathy.org RECODE-DCM to Define Stakeholders, Knowledge Requirements and an Optimal Intervention Strategy
(BMJ, 2026-03-24) Veremu, Munashe; Deakin, Naomi; Chauhan, Rohil V; Lantz, Justin M; Toumbas, Georgios; Tabrah, Julia; Kumar, Vishal; Zipser, Carl M; Plener, Joshua; Ammendolia, Carlo; Anderson, David B; Dos Santos Rubio, Ellianne J; Tetreault, Lindsay; Parnaik, Rahul; Rodrigues-Pinto, Ricardo; Ong'wen, Otieno Martin; Sarewitz, Ellen; Sadler, Iwan; Roberts, Theresa; Langridge, Neil; Swait, Gabrielle; Hadfield-Law, Lisa; Draper-Rodi, Jerry; Wood, Lianne; Stacpoole, Sybil; Ganau, Mario; Baig, Shehla; Bateman, Antony; Demetriades, Andreas K; Peul, Willem Cornelis Wilco; Davies, Benjamin
INTRODUCTION: Outcomes for degenerative cervical myelopathy (DCM) patients are limited by delayed and missed diagnoses, driven in part by poor professional awareness. Despite DCM being the most common cause of adult spinal cord injury, it remains under-recognised and undertaught in clinical education. Lessons from other common pathology like stroke and acute myocardial infarction highlight the potential of education to improve early diagnosis. This study will develop a professional education strategy to improve early DCM diagnosis. It will define key audiences and identify an effective delivery method, laying the groundwork for a sustained, targeted intervention. METHODS AND ANALYSIS: The study aims to define who needs to know about DCM, what they need to know and how they can learn it. This will be carried out in three phases: phase 1-who and what: to establish the target population and to define core competencies for the educational intervention; phase 2-how: to create and review the educational intervention; phase 3-evaluation: to test whether the framework is an improvement to existing strategies. ETHICS AND DISSEMINATION: Ethical approval is in place from the University of Cambridge (HBREC.2024.24). Results from the study will be disseminated through scientific publication, conference presentation, blog posts and podcasts. PROSPERO REGISTRATION NUMBER: CRD42023461838.
Allied Health Activity: The Challenges of Legitimising and Prioritising Meaningful Work
(Physiotherapy New Zealand, 2026-03-21) McNicholl, Seamus G; Reid, Duncan; Bright, Felicity
With growing service demand and constrained budgets, allied health services across New Zealand hospitals are focused on prioritising high-impact and high-value care. To inform understandings of what constitutes “high-value care”, this study aimed to identify what allied health service activities are valued in a New Zealand District Health Board (DHB) setting. Semi-structured interviews were used to explore the perceptions of patients (n = 2), allied health staff (n = 4), and managers (n = 3) within one DHB as an exemplar. Following transcription, the data were analysed using conventional content analysis. There were differing perspectives between each participant group on high-value allied health care. Important allied health workplace activities were grouped into three categories: building relationships, providing meaningful allied health care, and backstage workplace activity. This research reveals the differences in perspective between what patients value and what organisations value. This tension may mean that allied health professionals struggle to prioritise and legitimise those aspects of care that matter most to patients.
Challenges and Opportunities of General Practitioners and Physiotherapists Managing Return to Play Following Sports Related Concussion: A Qualitative Study
(Physiotherapy New Zealand, 2026-03-21) Hancock, Colin; Chua, Jason; Theadom, Alice; Reid, Duncan
Physiotherapists in Aotearoa New Zealand, face challenges implementing evidence-based practice (EBP) for non-ambulatory children with cerebral palsy and intellectual disabilities (NACCPID) working within Hoffman’s model of EBP. Key challenges in the evidence component include limited NACCPID specific research. This project aims to review the literature on physiotherapy interventions for school-aged NACCPID to inform clinical practice and identify areas for future research within the Aotearoa New Zealand context. An integrative review was conducted, following Kutcher and LeBaron’s (2022) method. A systematic search, conducted in 2023, yielded 2,240 articles that were narrowed to 24 after applying inclusion criteria. Coding and thematic analysis were conducted in NVivo 12 following content analysis methods. Final codes were organised within the Te Whare Tapa Whā framework through collaborative review with a cultural advisor. This enabled a holistic view of health, addressing physical, mental, social, and spiritual wellbeing, incorporating Māori perspectives. Ten themes were generated relating to physiotherapy interventions for NACCPID: 1) individual needs; 2) self-esteem and positive emotions; 3) body systems; 4) optimising ability to move the body; 5) using the body to perform a task; 6) collaboration; 7) (in)dependence; 8) participation and inclusion; 9) resourcing; and, 10) accessible environments. Notably, power wheelchair training appears to have significant beneficial effects across all aspects of health, and it is important that the child and families’ individual needs, wants, likes, circumstances, and values are considered when choosing an intervention.
4DFlowNet: Super-resolution 4D Flow MRI Using Deep Learning and Computational Fluid Dynamics
(Frontiers Media S.A., 2020-05-04) Ferdian, E; Suinesiaputra, A; Dubowitz, DJ; Zhao, D; Wang, A; Cowan, B; Young, AA
4D flow magnetic resonance imaging (MRI) is an emerging imaging technique where spatiotemporal 3D blood velocity can be captured with full volumetric coverage in a single non-invasive examination. This enables qualitative and quantitative analysis of hemodynamic flow parameters of the heart and great vessels. An increase in the image resolution would provide more accuracy and allow better assessment of the blood flow, especially for patients with abnormal flows. However, this must be balanced with increasing imaging time. The recent success of deep learning in generating super resolution images shows promise for implementation in medical images. We utilized computational fluid dynamics simulations to generate fluid flow simulations and represent them as synthetic 4D flow MRI data. We built our training dataset to mimic actual 4D flow MRI data with its corresponding noise distribution. Our novel 4DFlowNet network was trained on this synthetic 4D flow data and was capable in producing noise-free super resolution 4D flow phase images with upsample factor of 2. We also tested the 4DFlowNet in actual 4D flow MR images of a phantom and normal volunteer data, and demonstrated comparable results with the actual flow rate measurements giving an absolute relative error of 0.6–5.8% and 1.1–3.8% in the phantom data and normal volunteer data, respectively.
Recognising the Silent Squeeze: Why Physiotherapists Should Pay Attention to Degenerative Cervical Myelopathy [Editorial]
(Physiotherapy New Zealand, 2026-03-21) Chauhan, Rohil V; Segar, Anand H; Rice, David; White, Steven G
Physiotherapy Interventions for School-aged Non-ambulatory Children With Cerebral Palsy Combined With Intellectual Disability – An Integrative Review
(Physiotherapy New Zealand, 2026-03-21) Adams, Karen; Hill, Julia; Adlam, Marni; Blamires, Julie
Physiotherapists in Aotearoa New Zealand, face challenges implementing evidence-based practice (EBP) for non-ambulatory children with cerebral palsy and intellectual disabilities (NACCPID) working within Hoffman’s model of EBP. Key challenges in the evidence component include limited NACCPID specific research. This project aims to review the literature on physiotherapy interventions for school-aged NACCPID to inform clinical practice and identify areas for future research within the Aotearoa New Zealand context. An integrative review was conducted, following Kutcher and LeBaron’s (2022) method. A systematic search, conducted in 2023, yielded 2,240 articles that were narrowed to 24 after applying inclusion criteria. Coding and thematic analysis were conducted in NVivo 12 following content analysis methods. Final codes were organised within the Te Whare Tapa Whā framework through collaborative review with a cultural advisor. This enabled a holistic view of health, addressing physical, mental, social, and spiritual wellbeing, incorporating Māori perspectives. Ten themes were generated relating to physiotherapy interventions for NACCPID: 1) individual needs; 2) self-esteem and positive emotions; 3) body systems; 4) optimising ability to move the body; 5) using the body to perform a task; 6) collaboration; 7) (in)dependence; 8) participation and inclusion; 9) resourcing; and, 10) accessible environments. Notably, power wheelchair training appears to have significant beneficial effects across all aspects of health, and it is important that the child and families’ individual needs, wants, likes, circumstances, and values are considered when choosing an intervention.
Reliability of Ankle Dorsiflexor Muscle Strength, Rate of Force Development, and Tibialis Anterior Electromyography After Stroke
(F1000 Research Ltd, 2026-03-04) Olsen, Sharon; Taylor, Denise; Niazi, Imran Khan; Mawston, Grant; Rashid, Usman; Alder, Gemma; Stavric, Verna; Nedergaard, Rasmus Bach; Signal, Nada
Background Measures of hemiparetic ankle dorsiflexor muscle strength and rate of force development (RFD) are often used to determine the efficacy of rehabilitation interventions after stroke. However, evidence supporting the reliability of these measures is limited. This brief report provides a secondary analysis investigating the between-session reliability of isometric ankle dorsiflexor muscle strength, rate of force development (RFD), and tibialis anterior electromyography (TA EMG), in people with chronic stroke. Method Participants (n=15) completed three maximal isometric contractions of the ankle dorsiflexor muscles as fast as possible using a rigid dynamometer. Tests were repeated seven days later. Outcomes included ankle dorsiflexor isometric maximal voluntary contraction (MVC), RFD in the first 200ms (RFD200ms), time to reach 90% MVC, and peak TA EMG. Data were analysed for 13 participants using intra-class correlation coefficients (ICC) and standard error of the measure percentage (SEM%). Results Reliability was higher when analysing the mean of three trials rather than the best of three trials. There was excellent reliability for isometric dorsiflexor MVC (ICC 0.97 [95% CI 0.92, 0.99], SEM% 7%). However, for other outcomes, while the ICC indicated good reliability, the lower bound of the 95% confidence interval of the ICC fell in the moderate range for TA EMG (ICC 0.86 [95% CI 0.60, 0.96], SEM% 25%) and time to reach 90% MVC (ICC 0.80 [95% CI 0.53, 0.93], SEM% 23%) and in the poor range for dorsiflexor RFD200ms (ICC 0.79 [95% CI 0.48, 0.92], SEM% 24%). Conclusion The findings raise concerns about the reliability of measures of rapid force production in the dorsiflexor muscles after stroke. Given the functional significance of the ankle dorsiflexors, larger studies should be conducted to further investigate these concerns and explore reliable methods for measuring rapid force production in the hemiparetic dorsiflexor muscles.
The Immediate Effect of Lateral Wedging on First Metatarsophalangeal Joint Kinematics and Centre of Pressure
(Elsevier BV, 2026-03-11) Jackson, Aaron; Sheerin, Kelly; Yoon, SangHoon; Wyatt, Hannah; Reid, Duncan; Carroll, Matthew
Background Lateral wedges are often prescribed to increase the first metatarsophalangeal joint (MPJ) range of motion or alter the centre of pressure (COP) in the foot. This study explored the effect of lateral wedge design and placement on first MPJ extension and COP during walking and running gait. Methods A randomised crossover design was used and 24 healthy participants ran and walked in 10 insole conditions comprising differing combinations of inclination, placement and contour. First MPJ extension and foot COP were examined. Time-series data were analysed across the stance phase using statistical parametric mapping. Results Lateral wedges significantly reduced first MPJ extension during both walking (p < 0.001; 100% of stance) and running (p = 0.004; 14–72%, and p = 0.017; 76–99% of stance). Similarly, lateral wedge placement reduced first MPJ joint extension during walking (p < 0.001; 100% of stance) and running (p = 0.003; 13–69%, and p = 0.012; 78–100%). Full-length or 6° lateral wedges shifted the COP medially relative to the midline of the foot (p = 0.01). Compared to sham, lateral wedges placed on contoured insoles exhibited a smaller reduction in first MPJ during walking (p = 0.008) and shifted the COP medially during both walking (p < 0.001) and running (p = 0.020). Conclusion Where the intention of using lateral wedging is to shift the COP medially, these data indicate that a wedge which is of higher inclination (6°) or spanning the full-length of the insole, should be used. Conversely, if the goal is to reduce extension at the first MPJ, these findings suggest that both 3° and 6° inclination wedges are suitable, with either forefoot or full-length applications proving effective.
Australian Podiatry Research in Paediatrics: A Bibliometric Analysis
(Wiley, 2026-03-12) Banwell, Helen A; Tehan, Peta; Carroll, Matthew; Williams, Cylie M
Background The purpose of this study was to undertake a bibliographic analysis of foot and lower leg research relating to paediatric podiatry by Australian or affiliated Australian authors. Methods The Scopus database search was conducted to identify all foot and lower limb research articles involving an Australian cohort of participants, published by Australian authors, or those affiliated with Australian institutions, pertaining to paediatric podiatry, in English from 1970 to 2024. We used bibliometric analysis through an open‐source tool based on the R language. We described citations, journals, authors and institutions; countries and publications were manually categorised according to research type, level of evidence and funding source. Results The search strategy yielded 280 eligible articles, which received a total of 8331 citations and were published by 793 authors in 104 journals. The most frequent journal was Gait & Posture (35 articles; 12%), and the most published institution was the University of Sydney (170 affiliations). Most of the Australian paediatric articles published focused on detection, screening and diagnosis ( n = 70, 25%) and only 33 articles (12%) provided Level I evidence. Seventy‐three paediatric articles (25%) received Category 1 funding; 154 articles (55%) reported no research funding. Conclusion Paediatric podiatry research represents 17% of Australian foot and lower limb research. Despite the smaller population base, paediatric research attracts a high level of engagement, moderate citation rates and low funding rates when compared to adult population studies. Paediatric podiatry research is primarily produced via Level 3 evidence. This highlights the need for an increase in the robustness of research methodologies in paediatric podiatry research to strengthen the quality and applicability of evidence informing clinical care for children and adolescent populations.
Enabling Action: Re-envisaging Education of Health Professionals in Aotearoa New Zealand
(Sage, 2022-07-30) Shaw, S; Atkins, D; Hoskyn, K; Stretton, T; Hamer, H
Health care in Aotearoa New Zealand is changing with the aim of becoming truly universal. Development of a new curriculum model in the education of health professionals can aid this goal through increased focus on community needs and flexibility for multiple health professional registrations. Universal health care and disability support is promoted as a defining feature of Aotearoa New Zealand, yet inequities are blatantly evident, with increasing calls for equity. Complexity of the issue and the multitude of stakeholders favour action research founded on Vision Matāuranga, a problem-solving philosophy based on the innovation potential of Māori knowledge, resources and people. Action research embraces collaboration with stakeholders to identify and implement solutions. Government ministries determine policy, with Responsible Authorities accrediting educational institutions, which in turn provide educational programs. Changing what and how students learn can increase their understanding of equity and community needs when they become practitioners, with the voice of service users being paramount.
Exploring the Experience of Sleep and Fatigue in Male and Female Adults Over the 2 Years Following Traumatic Brain Injury: A Qualitative Descriptive Study
(BMJ Publishing Group Limited, 2016-04-08) Theadom, A; Rowland, V; Levack, W; Starkey, N; Wilkinson-Meyers, L; McPherson, K; TBI Experiences Group
Objectives: To explore the experience of fatigue and sleep difficulties over the first 2 years after traumatic brain injury (TBI). Design: Longitudinal qualitative descriptive analysis of interviews completed as part of a larger longitudinal study of recovery following TBI. Data relating to the experience of fatigue and/or sleep were extracted and coded by two independent researchers. Setting: Community-based study in the Hamilton and Auckland regions of New Zealand. Participants: 30 adult participants who had experienced mild, moderate or severe brain injury within the past 6 months (>16 years of age). 15 participants also nominated significant others to take part. Interviews were completed at 6, 12 and 24 months postinjury. Results: Participants described feeling unprepared for the intensity, impact and persistent nature of fatigue and sleep difficulties after injury. They struggled to learn how to manage their difficulties by themselves and to adapt strategies in response to changing circumstances over time. Four themes were identified: (1) Making sense of fatigue and sleep after TBI; (2) accepting the need for rest; (3) learning how to rest and; (4) need for rest impacts on ability to engage in life. Conclusions: Targeted support to understand, accept and manage the sleep and fatigue difficulties experienced may be crucial to improve recovery and facilitate engagement in everyday life. Advice needs to be timely and revised for relevance over the course of recovery.
A Critical Review of the Psychometric Properties of the Nijmegen Questionnaire for Hyperventilation Syndrome
(Physiotherapy New Zealand | Kōmiri Aotearoa, 2015-03-01) Ogilvie, V; Kersten, P
The Nijmegen Questionnaire is commonly used by physiotherapists and other health professionals in clinical and research settings. This outcome measure was developed by researchers at the Nijmegen University in the Netherlands as a screening tool for the hyperventilation syndrome in the 1980s. However, the literature that supports the efficacy of its use is scarce. This paper examines the evidence in relation to the conceptual basis, validity, and reliability of the Nijmegen Questionnaire. A systematic review of the literature was carried out to identify studies that are related to the above measurement properties for the questionnaire. Studies identified were evaluated for their methodological qualities using the COSMIN checklist. The clinical utility of this instrument is also discussed. Issues associated with the development and validating process of this outcome measure are identified. There is also a lack of evidence in cultural validation given that the Nijmegen Questionnaire was developed in the Netherlands. While this is the only questionnaire currently available that is designed specifically for the screening of hyperventilation syndrome, administrators need to be aware of the issues identified in relation to validity and reliability when interpreting the results. Applying more robust validating processes to establish the efficacy of the Nijmegen Questionnaire appears to be a priority for researchers to improve the quality of health services for individuals suffering from hyperventilation syndrome.
Understanding the Complexities of Recruitment and Retention of Allied Health Professionals in Rural Health Settings Across Aotearoa: A Qualitative Study
(BMC, 2026-01-30) George, Jane; Kayes, Nicola; Larmer, Peter
Background: Rural and remote communities in Aotearoa New Zealand face significant challenges in recruiting and retaining Allied Health Professionals (AHPs). While targeted investment exists to increase the numbers of doctors and nurses entering the rural workforce, comparatively little attention has been given to Allied Health Scientific and Technical professions. This study aimed to explore what matters to AHPs’ in rural contexts and how these insights could inform recruitment and retention practices. Methods: Drawing on Interpretive Descriptive methodology, semi-structured interviews were conducted with 18 AHPs from diverse professions, ethnicities and geographical locations across Aotearoa who had experience working in rural and/or remote settings. All participants were female, ranging in age from 23 to 63 years, representing seven allied health professions; social work (n = 7), physiotherapy (n = 4), occupational therapy (n = 2), music therapy (n = 2), psychology (n = 1), dietetics (n = 1), and pharmacy (n = 1). Participants identified as Pākehā | New Zealander (n = 11), Māori (n = 4), Samoan (n = 1), and beyond the Pacific (n = 2). Interviews explored career journeys, rural practice experiences, and employment decision factors. Data were analysed using six-phase Reflexive Thematic Analysis with ongoing researcher reflexivity and supervisory input. Results: Three key themes were constructed: (1) Sense of Connection and Belonging, highlighting the importance of feeling connected to teams, community and place; (2) Safe and Supported Practice, emphasising appropriate resources, professional development, and leadership relationships; (3) Creating Roles People Want to Come For, encompassing recruitment experiences, variety of work, growth pathways and scope of practice. These themes were infused with a cross-cutting concept of ‘Fit’, a felt sense of being in the right place, personally and professionally that emerged as a protective factor during challenges and key element for retention decisions. Conclusion: Successful recruitment and retention requires attention to both professional and personal factors, with particular emphasis on creating environments where AHPs feel valued, supported to develop their practice, and connected to their communities. The Fit concept offers a novel framework integrating professional, personal and place-based elements for understanding rural workforce retention. These insights provide evidence-based guidance for health policy makers, rural health organisations, professional bodies and tertiary education providers seeking to address persistent rural workforce shortages.
Can Offset Analgesia Magnitude Provide Additional Information About Endogenous Pain Modulation in People With Knee Osteoarthritis? An Experimental Study
(Lippincott, Williams & Wilkins, 2024-10-30) Johansson, Elin; Puts, Sofie; Rice, David; Beckwée, David; Leemans, Lynn; Bilterys, Thomas; Schiphof, Dieuwke; Bautmans, Ivan; Coppieters, Iris; Nijs, Jo
Objectives: To investigate the relationship between offset analgesia magnitude and the responsiveness to conditioned pain modulation (CPM), temporal summation of (second) pain (TSP), and clinical pain severity in people with knee osteoarthritis (KOA). Methods: Electrical stimuli were applied to 88 participants with KOA to measure offset analgesia at the volar forearm of the dominant hand, and CPM and TSP at the most symptomatic knee and ipsilateral volar wrist. Clinical pain severity was assessed using the pain subscale of the Knee injury and Osteoarthritis Outcome Score (KOOSPAIN). Linear mixed effects models evaluated pain modulatory effects across all tests, and Spearman's partial correlations assessed associations between offset analgesia, CPM, TSP, and KOOSPAIN while accounting for covariates of interest. Participants unable to validly finish all psychophysical tests were excluded from effect and correlation analyses but were evaluated for predictors of non-valid completion using bivariate Stochastic Search Variable Selection. Results: Significant pain modulation was observed across all psychophysical tests (P < 0.05) and no meaningful predictors of non-valid test completion were found. Offset analgesia magnitude did not significantly correlate with CPM, TSP, or KOOSPAIN (p ≥ 0.05), with a maximum partial correlation coefficient of ρ = 0.21. Discussion: Offset analgesia was not associated with CPM, TSP, or KOOSPAIN in people with KOA. Despite the lack of case-control studies comparing offset analgesia between people with KOA and healthy controls, these findings suggest that offset analgesia may provide information about endogenous pain modulation beyond CPM and TSP, though its clinical translation remains uncertain.
Analysis of Gout Remission Definitions in a Randomised Controlled Trial of Colchicine Prophylaxis for People With Gout Initiating Allopurinol
(The Journal of Rheumatology Publishing, 2024-08-01) Tabi-Amponsah, Adwoa Dansoa; Stamp, Lisa K; Horne, Anne; Drake, Jill; Stewart, Sarah; Gamble, Greg; Petrie, Keith J; Dalbeth, Nicola
OBJECTIVE: To investigate the effect of colchicine prophylaxis on gout remission when commencing urate lowering therapy (ULT), and illness perceptions of people in remission, using two definitions of gout remission. METHODS: Data from a 12-month double-blind placebo-controlled trial of 200 people with gout commencing allopurinol were analyzed. Participants were randomly assigned to prophylaxis with 0.5mg daily colchicine or placebo for six months, followed by six months of additional follow-up. Gout remission was assessed using the 2016 preliminary definition or simplified definition without patient reported outcomes. Illness perceptions were assessed using a gout-specific brief illness perception questionnaire (BIPQ). RESULTS: In the first six months, few participants were in remission according to either the 2016 preliminary definition (3% for colchicine and 4% for placebo) or the simplified definition (7% for colchicine and 12% for placebo). In the second six months, after study drug (colchicine or placebo) discontinuation, fewer participants in the colchicine group than in the placebo group were in remission according to the 2016 preliminary definition (4% vs. 14%, p=0.03), and the simplified definition (14% vs 28%, p=0.02). Participants fulfilling remission using either definition had more favorable perceptions about their gout symptoms and illness concerns, as well as consequences, when using the simplified definition. CONCLUSION: Using either definition, six months of colchicine prophylaxis when initiating ULT does not provide an advantage in the fulfilment of gout remission. People fulfilling either definition report fewer symptoms, lower concern about their gout, and when using the simplified definition, are less affected by gout.
The Influence of Multiple Cognitive Workload Levels of an Exergame on Dorsal Attention Network Connectivity at the Source Level
(Elsevier BV, 2024-07-06) Ghani, U; Niazi, I; Signal, N; Kumari, N; Amjad, I; Haavik, H; Taylor, D
This study investigates how adding a cognitive task on a balance board (exergame) affects connectivity in the dorsal attention network (DAN) during an exergame task. Healthy young adults performed a soccer ball-moving task by tilting a balance board with their feet while their brain activity was measured using electroencephalography (EEG). In this exergame, the speed of obstacles in front of the goal manipulated the cognitive workload. Higher speed means a higher cognitive workload. The study found significant changes in functional connectivity within DAN regions, specifically in the alpha band. During the shift from easy to medium cognitive task, we observed a significant increase in connectivity (p= 0.0436) between the right inferior temporal (ITG R) and the Left middle temporal (MTG L). During the transition from easy to hard cognitive tasks, strengthened interactions (p= 0.0324) between inferior temporal (ITG) and parsopercularis (pOPPER) were found. This suggests that the proposed balanceboard-based exergame enhances the functionality of specific brain regions, such as ITG and MTG regions, and improves connectivity in the frontal cortex. We also found a correlation between brain activity and performance data, highlighting that increased cognitive workload resulted in decreased performance and heightened frontal alpha activity. These findings align with research suggesting that adding cognitive games to physical activity-based tasks in rehabilitation programs can boost brain activity, resulting in improved decision-making and visual processing skills. This information can help clinicians tailor rehabilitation methods that target specific brain regions.

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