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.

Browse

Now showing 1 - 20 of 717

Reflecting on Challenges and Opportunities for the Practice of Person-Centred Rehabilitation
(SAGE Publications, 2023-02-01) Kayes, NM; Papadimitriou, Christina
OBJECTIVES: To (1) reflect on challenges to the practice of person-centred rehabilitation; and (2) propose opportunities for the development of person-centred rehabilitation. CHALLENGES: Person-centred practice has received widespread endorsement across healthcare settings and is understood to be an important, positive approach in rehabilitation. However, the rhetoric of this approach does not always translate meaningfully into practice. Emphasis on patient choice, patient involvement in decision making, and increasing patient capacity for self-management have become a proxy for person-centred rehabilitation in lieu of a more fundamental shift in practice and healthcare structures. System (e.g. biomedical orientation), organisational (e.g. key performance indicators) and professional (e.g. identity as expert) factors compete with person-centred rehabilitation. OPPORTUNITIES: Four key recommendations for the development of person-centred rehabilitation are proposed including to: (1) develop a principles-based approach to person-centred rehabilitation; (2) move away from the dichotomy of person-centred (or not) rehabilitation; (3) build person-centred cultures of care in rehabilitation; and (4) learn from diverse perspectives of person-centred rehabilitation. CONCLUSION: Fixed assumptions about what constitutes person-centred rehabilitation may limit our ability to respond to the needs of persons and families. Embedding person-centred ways of working is challenging due to the competing drivers and interests of healthcare systems and organisations. A principles-based approach, enabled by person-centred cultures of care, may achieve the aspirations of person-centred rehabilitation.
Preoperative Predictors for Return to Physical Activity Following Anterior Cruciate Ligament Reconstruction (ACLR): A Systematic Review
(BMC, 2023-06-09) Carter, Hayley; Lewis, Gwyn; Smith, Benjamin
BACKGROUND: Rates of return to physical activity after anterior cruciate ligament reconstruction surgery are sub-optimal. Optimising presurgical treatment may improve return rates. The purpose of this systematic review was to identify modifiable preoperative predictors for return to physical activity after anterior cruciate ligament reconstruction. METHODS: Seven electronic databases (CINAHL, MEDLINE and SPORTDiscus via EBSCOhost, AMED, PsycINFO and EMBASE via OVID and Web of Science) were searched from inception to 31 March 2023. The population of focus was adults aged 18-65 who had undergone primary anterior cruciate ligament reconstruction. Studies needed to identify at least one potential modifiable preoperative predictor variable and the relationship between the predictor(s) and return to physical activity. All time-points of assessment and study designs were included. Data extraction was completed by one reviewer and verified by a second reviewer. Two reviewers completed the risk of bias assessment using the Quality in Prognostic Studies tool and Grading of Recommendations Assessment, Development and Evaluation system. RESULTS: The search identified 2281 studies, eight met the inclusion criteria. Five studies scored 'high', and three studies scored 'moderate' risk-of-bias. All preoperative predictors were of very low-quality evidence. Five different outcome measures were used to assess return to physical activity including Tegner, Marx, Physical Activity Scale, return to play at the elite level and return to preinjury level (undefined). This was measured between 1- and 10-years post-surgery. Nine preoperative physical, six psychosocial and five demographic/clinical factors were assessed and four were found to be predictive. These included quadriceps strength, psychological profile, patient estimated ability to return and graft type (patella tendon, BPTB). CONCLUSION: Very-low level evidence suggests that increasing quadriceps strength, managing patient expectations of their treatment outcomes, improving motivation to resume preinjury activity levels and considering the use of a BPTB graft will support return to physical activity after ACLR. TRIAL REGISTRATION: This study was prospectively registered in PROSPERO: CRD 42020222567.
Time Trends and Predictors of Gout Remission Over Six Years
(Wiley, 2025-06-18) Tabi-Amponsah, Adwoa Dansoa; Stewart, Sarah; Gamble, Greg; Stamp, Lisa K; Taylor, William J; Dalbeth, Nicola
OBJECTIVES: This study aims to describe the trends in remission rates over six years of follow-up among people with gout taking urate-lowering therapy (ULT), and to identify variables that predict remission. METHODS: A post hoc analysis was conducted using data from the Cardiovascular Safety of Febuxostat or Allopurinol in Patients with Gout (CARES) trial, which enrolled people with gout and cardiovascular disease randomised to febuxostat or allopurinol. Gout remission over six years of follow-up was measured in participants with at least one year of follow-up data using the simplified gout remission definition, requiring the fulfilment of three domains, a) no gout flares during the past year, b) at least two serum urate measurements <0.36mmol/l during the past year, and c) no tophus. Logistic regression was used to identify baseline predictors of remission. RESULTS: Achievement of remission increased from 37.4% of participants (1593/4259) at year 1 to 63.1% (322/510) at year 6. Across the six years, 59.4% of participants achieved remission at least once. More participants on febuxostat achieved remission during the first two years, primarily due to a higher number achieving the serum urate remission domain. In multivariable analysis, baseline age, race, greater disease severity, presence of comorbidities, and febuxostat treatment were variables significantly associated with remission. CONCLUSION: On ULT, fulfilment of remission increases over time and remission can be achieved in the majority of patients. Baseline predictors, including demographics, comorbidities and disease severity, may be useful to identify people with gout who need more proactive management to achieve remission.
Psychometric Evaluation of the Comprehensive Autistic Trait Inventory in Autistic and Non-Autistic Adults
(SAGE Publications, 2025-07-16) English, Michael; Poulsen, Rebecca; Maybery, Murray; McAlpine, David; Sowman, Paul; Pellicano, Elizabeth
Measures of autistic traits are only useful - for pre-diagnostic screening, exploring individual differences, and gaining personal insight - if they efficiently and accurately assess autism as currently conceptualised while maintaining psychometric validity across different demographic groups. We recruited 1322 autistic and 1279 non-autistic adults who varied in autism status (non-autistic, diagnosed autistic, self-identifying autistic) and gender (cisgender men, cisgender women, gender diverse) to assess the psychometric properties of the Comprehensive Autistic Trait Inventory, a recently developed measure of autistic traits that examines six trait domains using 42 self-report statements. Factor fit for the six subscales was appropriate, as was total-scale and subscale reliability. Importantly, measurement invariance was demonstrated based on both autism status and gender, indicating that Comprehensive Autistic Trait Inventory scores of these group members can be directly compared. Autistic traits were highly similar between diagnosed and self-identifying autistic adults, while gender-diverse participants showed more autistic traits than their cisgender counterparts. A total-scale discrimination threshold of 147.5 calculated was suggested which corresponded to sensitivity and specificity of 77.20 and 87.41, respectively. Our analysis indicates that the Comprehensive Autistic Trait Inventory is a practical measure of autistic traits in non-autistic and autistic participants that is useful for researchers and clinicians and for affirming self-identity.Lay abstractThe Comprehensive Autistic Trait Inventory (CATI) is a free questionnaire designed to measure autistic traits in both autistic and non-autistic adults. The CATI includes 42 items focusing on six areas: Social Interactions, Communication, Social Camouflage, Self-Regulating Behaviours, Cognitive Flexibility, and Sensory Sensitivity. Here, we set out to determine whether the CATI can accurately measure autistic traits in both autistic (both diagnosed and self-identifying) and non-autistic people, as well as people of different genders. We also wanted to explore the extent to which trait scores differed between these groups of individuals. Our study recruited over 2600 participants, including 1322 autistic and 1279 non-autistic adults. Our findings suggest that the CATI works the way it was designed to. It is a reliable and accurate tool for measuring autistic traits, can distinguish between autistic and non-autistic people, and appears appropriate for people of different genders. Notably, we found that people who self-identify as autistic have similar trait scores to those with a clinical diagnosis of autism and that gender-diverse people scored higher on autistic traits compared to cisgender people. Our data suggest that the CATI is a useful tool for measuring autistic traits in autistic and non-autistic people and for understanding the way that autistic people vary from one another. It should be helpful for researchers and clinicians, and support a public understanding of autism.
Exploring How Effective, Acceptable, and Practical a CBT–Sensory Modulation Approach Is for Supporting Children Aged 4–7 Experiencing Anxiety
(Wiley, 2026-05-15) Mavhunga, Tafadzwa; Sutton, Daniel; Foster, Mandie
Background Childhood anxiety is an increasing concern globally, with rates rising significantly following the COVID-19 pandemic. However, there are relatively few evidence-based interventions specifically designed to directly target and involve younger children under 7 years old. To address this gap, a six-session manualised programme was developed to assist children aged 4–7 in managing their anxiety. The programme integrates Cognitive Behavioural Therapy (CBT) with Sensory Modulation (SM) strategies, providing simple and practical tools to aid young children in coping with anxiety. This study aimed to evaluate the effectiveness, acceptability, and practicality of this CBT-SM intervention when delivered through community-based child and adolescent mental health services (CAMHS). Methods A single-case experimental design (SCED) was employed, involving six children diagnosed with anxiety across two sites. At least three children were reported to have sensory challenges. A psychologist assessed the children's anxiety at three intervals: at the beginning of the study, after the intervention was completed, and 4 weeks later. Parents also completed questionnaires measuring behavioural issues (both internalising and externalising) and the impact of anxiety on daily life at baseline, prior to treatment, and after treatment. Results The study revealed significant reductions in anxiety and improvements in overall functioning. Both parents and therapists reported the programme as acceptable. Notably, four out of six children (67%) no longer met the criteria for an anxiety diagnosis following the intervention and at follow-up. Conclusions These findings provide preliminary support for the effectiveness, acceptability, and practicality of this innovative CBT-SM approach in assisting young children in managing anxiety.
Development and Acceptability of a Patient Decision Aid for People With Degenerative Cervical Myelopathy: An International Mixed-Methods Study
(BMJ Publishing Group, 2026-04-03) Gamble, AR; Anderson, DB; McKay, MJ; Davies, B; Macpherson, S; Van Gelder, J; Hoffmann, T; McCaffery, K; Stevens, SX; Ammendolia, C; Chauhan, RV; Zipser, CM; Boerger, TF; Tetreault, LA; Fehlings, MG; Dustan, E; Nugent, C; Holmgren, H; Demetriades, AK; Lantz, JM; Dhillon, R; Maher, CG; Zadro, JR
OBJECTIVES: To develop and user-test a patient decision aid for people diagnosed with degenerative cervical myelopathy and who are considering surgery. DESIGN: Mixed-methods study describing the development of a patient decision aid. SETTING: A draft decision aid was developed by a multidisciplinary steering group (including study authors with degenerative cervical myelopathy, health professionals and researchers) informed by the best available evidence, authorship consensus and existing patient decision aids. PARTICIPANTS: Patient-participants and health professional-participants who manage people with degenerative cervical myelopathy were recruited through social media and the steering group's research and practice network. Quantitative questionnaires were used to gather baseline data, descriptive feedback, refine the decision aid and assess its acceptability. Qualitative semi-structured interviews were conducted online to gather feedback on the decision aid and were analysed using reflexive thematic analysis. RESULTS: We conducted 32 interviews: 19 patient-participants and 13 health professional-participants who manage people with degenerative cervical myelopathy (neurosurgeons, neurologists, physiotherapists, orthopaedic surgeons, general practitioners, rehabilitation and pain specialists and consultant occupational physicians and chiropractors). Participants were from 10 countries (Australia, Canada, Cyprus, Germany, Ireland, New Zealand, Sweden, Switzerland, United Kingdom and USA). Most participants rated the decision aid's acceptability as good-to-excellent and agreed with most aspects of the decision aid (eg, defining degenerative cervical myelopathy, management recommendations, potential benefits and harms, questions to consider asking a health professional). CONCLUSION: Our patient decision aid was rated as an acceptable tool by both health professional-participants who treat degenerative cervical myelopathy and patient-participants with lived experience of degenerative cervical myelopathy. This decision aid can be used by clinicians and people with degenerative cervical myelopathy to help with shared decision making following a diagnosis of degenerative cervical myelopathy. A study testing the potential benefits of this decision aid in a clinical setting is recommended.
Impact of T2-Weighted Whole-Spine Sagittal MRI Sequences on Diagnostic and Patient Care Trajectories: An Illustrative Case Series
(Elsevier BV, 2026-03-09) Chauhan, Rohil; Simpson, Olivia; Segar, Anand; Rice, David; White, Steven
Background: T2-weighted whole-spine sagittal MRI (WSSMRI) sequences provide a rapid, comprehensive assessment of the neuroaxis and can reveal pathology beyond the symptomatic region. Despite minimal additional acquisition time, these sequences remain underutilized in specialist practice. Research question: How are WSSMRI sequences used clinically to alter diagnostic and surgical decision-making? Material and methods: Three non-consecutive, purposively selected patients assessed in an orthopaedic spine center for thoracolumbar complaints are presented. All patients underwent dedicated thoracolumbar MRI for their primary complaint, supplemented with T2-weighted WSSMRI sequences acquired on a Siemens Magnetom Lumina 3T scanner using digitally stitched cervicothoracic and thoracolumbar sagittal sequences, with 90 seconds image acquisition. Clinical information, imaging findings, and downstream management decisions were drawn from medical records with signed informed consent. Results: In the first case, a 69-year-old male referred for lumbar radiculopathy was found to have concurrent cervical cord compression with myelomalacia, leading to surgical sequencing that prioritized cervical decompression ahead of lumbar intervention. The second case, a 52-year-old female with low back pain, revealed Chiari malformation type 1.5 with syringomyelia, prompting neurosurgical referral and ongoing clinical and radiological surveillance despite initial symptoms being attributed to lumbar pathology. The third case, a 48-year-old female with chronic post-traumatic axial thoracolumbar pain, demonstrated multilevel occult vertebral compression fractures on WSSMRI, which led to investigation and initiation of multidisciplinary osteoporosis management. In each instance, WSSMRI sequences identified pathology outside the symptomatic region and directly influenced care trajectories. Discussion and conclusion: T2-weighted WSSMRI is a rapid, low-burden adjunct to routine thoracolumbar imaging that can uncover clinically significant findings and alter management. While its broader integration into practice offers clear benefits, challenges regarding incidental findings and downstream costs warrant further consideration.
The Effect of Postoperative Rehabilitation on Outcomes in Patients With Degenerative Cervical Myelopathy (DCM): A Systematic Review
(Elsevier, 2026-02-02) Chanelle, Montpetit; Kobaisi, Adam; Lantz, Justin; Chauhan, Rohil; Anderson, David; Fortin, Maryse
Introduction: Degenerative cervical myelopathy (DCM) is the leading cause of adult spinal cord dysfunction, often requiring surgery. However, the role of postoperative rehabilitation in optimizing patient outcomes remains unclear. Research question: What are the effects of postoperative rehabilitation on clinical outcomes following DCM surgery? Material and methods: This systematic review was registered with PROSPERO (CRD42024582484). PubMed, Scopus, and Web of Science were searched through September 2025. Eligible studies included randomized controlled trials (RCTs), and other research on rehabilitation interventions for postoperative outcomes (e.g., function, pain, neurological recovery) in patients undergoing DCM surgery. Studies without confirmed DCM, non-peer-reviewed articles, or lacking a rehabilitation protocol were excluded. Risk of bias was assessed using the RoB 2 and ROBINS-I. Descriptive summaries were conducted, categorizing studies into active, passive, and mixed interventions. The evidence quality was rated using the GRADE approach. Results: Ten studies with a total of 766 patients were included, made up of 5 RCTs and 5 cohort studies. Seven studies had high risk of bias, and three had moderate risk of bias. Mixed rehabilitation interventions combining physical, behavioral, and psychosocial strategies yielded the most consistent improvements in neurological function, quality of life, and self-efficacy. Intervention timing ranged from a few days postoperatively to 6 months. A meta-analysis was not performed due to study heterogeneity. Discussion and Conclusion: Postoperative rehabilitation for DCM shows promise, particularly with multimodal, goal-oriented, and patient-centered approaches. However, evidence is limited by the high risk of bias, poor methodological detail and lack of standardization.
Trans, Gender-diverse and Non-binary Individuals Experienced Safe and Positive Care Within a Gender-affirming Physiotherapy Service: A Qualitative Study
(Informa UK Limited, 2025-10-22) Neish, C; Marshall, E; Ellis, R; Ker, A; Ross, M
Background: People who are transgender, gender-diverse or non-binary (TGDNB) face barriers to safe and affirming care, and experience disparate health outcomes. The broader lesbian, gay, bisexual, transgender, queer, intersex, asexual and other related identities (LGBTQIA+) community report negative experiences in physiotherapy due to cis/heteronormative assumptions, discomfort about touch, observation and undressing, and a lack of practitioner knowledge on TGDNB health. TGDNB individuals have reported positive experiences when accessing general physiotherapy that has inclusive environments, respectful and knowledgeable practitioners, and a collaborative biopsychosocial approach to care. Methods: 20 TGDNB individuals aged 18–38 who accessed a gender-affirming physiotherapy service in Wellington, Aotearoa New Zealand participated in the study. Semi-structured interviews were conducted with participants via videoconferencing software. An inductive approach to reflexive thematic analysis was undertaken. Results: Four key themes and five subthemes were formed in the analysis. Themes were: 1) ‘Binding and my health’; 2) ‘My choice in holistic and person-centered care’; 3) ‘Experiencing safe and inclusive care with knowledgeable physiotherapists’ through safe communication, practitioners having knowledge on TGDNB health and considering potential discomfort; and 4) ‘Inclusive environments help me feel safe’ via safe environments and safe and warm referrals. Conclusion: TGDNB individuals valued gender-affirming physiotherapy from practitioners who were inclusive, knowledgeable, and emphasized holistic and person-centered approaches to care. Key components of gender-affirming physiotherapy included practitioners addressing binding-related health issues (where appropriate and relevant), having specific training in TGDNB health, promoting autonomy, using inclusive language and fostering welcoming environments.
Designing a Self-Guided Digital Intervention for Self-Management of Shoulder Pain in People Living With Spinal Cord Injury: A Tutorial on Using a Person-based Approach
(JMIR Publications, 2026-01-05) Stavric, Verna; Saywell, Nicola L; Kayes, NM
Shoulder pain is prevalent in people living with spinal cord injury. Technology and digital rehabilitation tools are increasingly available, but this has not yet included the provision of a self-guided exercise intervention focused on managing shoulder pain for people living with spinal cord injury. We drew on the person-based approach (PBA) to intervention development to design a Shoulder Pain Intervention delivered over the interNet (SPIN) to address this gap. However, in preparation for the design process, we found very few published examples of how the PBA had been operationalized. The aim of this paper is to provide a detailed explanation of our approach and how we operationalized the PBA in the design of SPIN to maximize relevance and engagement. Our design process followed the key PBA steps, combining additional evidence and theoretical components. Each step ensured that guiding principles were formulated and followed to maximize the probability that SPIN would be fit for purpose. We followed 3 steps: (1) we drew on themes from preparatory research (existing and primary) to identify the key behavioral issues, needs and challenges, and existing features to form the basis of SPIN design; (2) we formatted guiding principles that included articulating specific design objectives to provide a framework to identify system requirements; and (3) we selected and refined intervention features using existing literature, behavioral theory, and tools such as the “Behaviour Change Wheel.” We have designed SPIN by incorporating a deep understanding of the users’ needs and best available evidence to maximize engagement and positive outcomes. In this paper, we have made clear how we operationalized the PBA phases, including how existing evidence, theory, tools, and methods were leveraged to support the PBA process. In explicating our process, we have provided a blueprint to guide future researchers using this approach.
Prognosis in Entry-Level Physiotherapy Programs: An Australian and New Zealand Framework for Developing Knowledge and Skills for Musculoskeletal Practice
(Elsevier BV, 2026-05-07) Mullen, Nicholas; Ashby, Samantha; Beales, Darren; Bisset, Leanne; Forbes, Roma; Ford, Jon; Hing, Wayne; Jones, Mark; Kennedy, Ewan; Leahy, Edmund; Milanese, Steve; Reid, Duncan; Saraceni, Nic; Osmotherly, Peter
Question: How should prognosis in relation to musculoskeletal disorders be incorporated into the curriculum of entry-level physiotherapy programs within Australia and New Zealand? Design: Consensus group methodology using the nominal group technique. Participants: Twelve members considered experts in the fields of musculoskeletal physiotherapy and entry-level education in Australia and New Zealand were invited to participate. Method: The nominal group technique method implemented involved three specific stages. In stage one members were provided with pre-reading material related to the topic of prognosis. They were instructed to generate ideas and feedback related to this material. Stage two involved an online consensus group meeting to discuss the ideas and feedback generated from the pre-reading material. Consensus statements were also generated within this meeting. Stage three involved rounds of iterative feedback and refinement of the consensus statements. Results: Four consensus statements were generated including the definition of prognosis; the purpose of learning about prognosis; recommendations for incorporating prognosis into entry-level curriculum; and what elements of prognosis should be taught and assessed. Conclusion: Prognosis is a complex but essential concept to incorporate within entry-level physiotherapy curriculum. Entry-level physiotherapy programs should be explicit in the teaching and assessment of the knowledge and skills relating to prognosis. This framework may assist educators in incorporating prognostic content throughout their curriculum.
Systematic Review and Meta-Analysis of Outcomes in Workers’ Compensation Patients Following Knee Surgery
(Elsevier BV, 2026-05-06) Xia, Weisi; Mullen, Michaela; Johnstone, Ryan; Devane, Peter; Reid, Duncan
Background: An increasing volume of orthopaedic procedures are being performed worldwide, particularly in the working age population. Workers’ compensation (WC) is an insurance framework designed to support workers who are injured or become injured and has been associated with poor outcomes following a number of orthopaedic procedures. This systematic review aims to investigate post-operative outcomes in WC compared with non-workers’ compensation (NWC) patients following knee arthroplasty and arthroscopy. Methods: A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. MEDLINE, EMBASE and Google Scholar databases were assessed from inception to 9th August 2025. Meta-analysis of WC undergoing knee arthroplasty was performed using Review Manager v5.4.1 using a random effects model. Results: An initial 513 records were initially identified. Eight retrospective observation studies were included, consisting of five studies investigating arthroplasty and three studies investigating knee arthroscopy. Meta-analysis of the arthroplasty studies showed a significantly reduced Knee Society knee (MD = -16.14, P=0.002) and function (MD = -12.08, P<0.00001) scores, reduced range of motion (MD = -5.99, P=0.0002) and increased complications (OR = 5.83, P=0.03) in the WC group. There were reduced return to work rates or prolonged time off work. Moderate to high individual risk of bias were evident in the reviewed studies. Conclusion: WC status is associated with poorer Knee Society scores, reduced range of motion and increased complications following knee arthroplasty. However, the strength of evidence is low to moderate with serious biases with caution advised on its interpretation.
Australian Podiatry Research in Gerontology: A Bibliometric Analysis
(Wiley, 2026-04-30) Menz, Hylton B.; Azhar, Ameer Nor; Bergin, Shan M.; Tehan, Peta E.; Carroll, Matthew
Background: To conduct a bibliographic analysis of English language research pertaining to gerontology by Australian researchers. Methods: A Scopus database search was conducted to identify all Australian gerontology articles published by podiatric authors in English from 1970 to 2024. Bibliometric analysis was performed using an open‐source tool based on the R language. Citations,journals, authors, institutions, and countries were described. Publications were manually categorised according to research type,level of evidence and funding source. Results: The search strategy yielded 81 eligible articles, which received a total of 5024 citations and were published by 174authors in 39 journals. The most frequent journal was Gait and Posture (12 articles; 15%), and the most published institution was La Trobe University (affiliation of 102 authors). Most of the Australian gerontology articles published by podiatrists focussed on aetiology (n = 48; 59%) and only six articles (7%) provided level I evidence. Thirty articles (37%) reported no research funding. Conclusion: Gerontology remains an underrepresented focus within Australian podiatry research. Despite attracting relatively high citation rates, this field suffers from chronic underfunding and limited research capacity. Investing in dedicated funding and expanding the gerontology research workforce within podiatry is essential to drive innovation, address the growing needs of an ageing population, and strengthen the evidence base for clinical care.
Evaluation of the Usability of and Engagement With an Osteoarthritis e-Learning Program Developed for Healthcare Professionals
(Elsevier BV, 2026-04-03) Gray, B; Kobayashi, S; Bowden, JL; Hinman, RS; Bennell, K; Burgess, A; Briggs, AM; Duong, V; Barton, C; French, H; Cunningham, J; Slater, H; O'Brien, D; Persaud, J; Gallardo, N; Allen, K; Hamilton, DF; Holden, MA; Huffman, KF; Miller, KA; Quicke, J; Skou, ST; Tan, BY; Toomey, C; van der Esch, M; Hunter, DJ; Eyles, J
Objective: This study aimed to describe the development and evaluation of an OA eLearning program for healthcare professionals. The evaluation objectives were to measure the usability of, and engagement with, this program and assess the perceived feasibility, acceptability, appropriateness and user satisfaction among OA healthcare professionals. Methods: A feasibility study was conducted, involving registered healthcare professionals, who regularly manage people with OA. Following baseline questionnaires, participants were asked to complete at least four OA eLearning modules over 10 weeks, followed by a 23-item evaluation questionnaire. The primary outcomes were usability and engagement with the OA eLearning program. Secondary outcomes included feasibility, acceptability, appropriateness, and satisfaction. Results: The 31 eligible participants reflected a broad range of professional experiences, nationalities and settings. Program usability, engagement with content, navigation, presentation and overall satisfaction were rated as either very good or good by at least 84% of participants. Participants considered the program to be acceptable, feasible, and appropriate, with some areas for improvement in navigating the program. Conclusions: The OA eLearning program shows promise in supporting healthcare professionals to deliver evidence-based care. While the findings from this study will inform a randomised trial, the OA eLearning program is well positioned to enhance clinical education and practice.
Home-based Respiratory-gated Transcutaneous Auricular Vagus Nerve Stimulation for Rheumatoid Arthritis - A Feasibility Study
(Springer Science and Business Media LLC, 2026-03-23) Parikh, Ankit; Lewis, Gwyn; GholamHosseini, Hamid; Ng, Kristine Pek Ling; Kluger, Michal; Almesfer, Faisal; Chang, Wee Leong; Rice, David
Introduction/objectives: Rheumatoid arthritis is a chronic autoimmune disease that primarily affects the joints, causing pain, inflammation, and long-term joint damage. Transcutaneous auricular vagus nerve stimulation (taVNS) is a promising non-pharmacological intervention for managing pain and inflammation, particularly when delivered in the exhalation phase of respiration. However, until now, the lack of portable equipment has meant the respiratory phase effects have not been evaluated outside of the laboratory or in a home setting. The primary goal of this study was to determine the feasibility of a future clinical trial of home-based respiratory-gated taVNS in people with rheumatoid arthritis. Methods: This was a single-arm, non-randomised feasibility trial involving 12 individuals with active rheumatoid arthritis. Participation involved 12 respiratory-gated taVNS sessions at home and three laboratory visits for outcome assessments (day 1, day 8, and day 15). Feasibility outcomes focused on recruitment rate, intervention adherence, acceptability questionnaires, and adverse events. In addition, outcome measures related to pain, psychological distress, and key inflammatory biomarkers were assessed. Results: Feasibility outcomes demonstrated an acceptable recruitment rate, high adherence (90% session completion), excellent usability (9/10), and acceptability (average score 66%, general score 87%), with no severe treatment-emergent adverse events. While single-armed and not powered to determine efficacy, medium to large pre- to post-intervention reductions in pain interference, grip pain intensity, psychological distress, and tumour necrosis factor-alpha levels were observed, with minimal changes in other outcomes. Conclusion: An adequately powered, randomised controlled trial of home-based respiratory-gated taVNS in people with rheumatoid arthritis is feasible and safe. Key Points: To the best of our knowledge, this study is the first to evaluate the feasibility of homebased respiratory-gated (RG) transcutaneous auricular vagus nerve stimulation (taVNS) for the treatment of rheumatoid arthritis (RA). Feasibility outcomes demonstrated high adherence and excellent usability ratings with few treatment-emergent adverse events reported. Home-based RG taVNS using the developed system is safe and feasible to evaluate in an adequately powered, controlled trial.
Healthcare Provider Perspectives of Various Signs and Symptoms for Diagnosing Degenerative Cervical Myelopathy: Results of an International, Multidisciplinary Survey
(Wiley, 2025-12-03) Burn, Lance; Rujeedawa, Tanzil; Lalkhen, Abdul; Martin, Allan; MacDowall, Anna; Kwon, Brian K; Zipser, Carl M; Treanor, Caroline; Anderson, David B; Martin-Moore, Esther; Guest, James; Harrop, James S; Milligan, Jamie; Furlan, Julio C; Margetis, Konstantinos; Wood, Lianne; Onofrei, Ligia V; Vialle, Luiz R; Ito, Manabu; Kotter, Mark; Fehlings, Michael G; Lee, Michael WY; Hutton, Mike; Harel, Noam Y; Yurac, Ratko; Chauhan, Rohil; Dugan, Sheila; Kalsi-Ryan, Sukhvinder; Stacpoole, Sybil; Blizzard, Tammy; Boerger, Timothy F; Solberg, Tore K; Lantz, Justin M; Davies, Benjamin; Tetreault, Lindsay
Introduction/Aims: Diagnosis of degenerative cervical myelopathy (DCM) is frequently delayed. A lack of awareness and standardized screening criteria have been identified as major contributors. The objective of this study was to conduct a survey of international experts to determine the value of various signs and symptoms in diagnosing patients with DCM. This study forms part of a three-step initiative that aims to develop pragmatic screening criteria for DCM. Methods: An open voluntary English-language Likert scale survey was disseminated among international networks of experts in DCM. Respondents were asked to rank each sign or symptom on a scale of 0 (not important at all) to 10 (extremely important); a mean value of ≥ 6.5 was set a priori as the threshold to consider a feature as having significant diagnostic value. Results: Fifteen symptoms and 12 signs were ranked as having significant diagnostic value. The most highly ranked symptoms are primarily related to abnormalities of the upper limb, hand function, and gait. The top-rated signs included pathological reflexes as well as impairment of motor function, gait, and coordination. Features ranked as significant were largely consistent across professions, levels of experience, and continental regions. Discussion: The integration of expert stakeholder opinion with evidence from existing literature strengthens the clinical framework for identifying key clinical features of DCM. These 27 features will be discussed at an international consensus meeting to establish a standardized clinical screening toolkit that can be used by frontline healthcare professionals to detect patients with DCM.
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.

Browse

Recent Submissions