Physiotherapy - Research Publications
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ItemGenioglossus reflex responses to negative upper airway pressure are altered in people with tetraplegia and obstructive sleep apnoea(WILEY, 2018-07-15)KEY POINTS: Protective reflexes in the throat area (upper airway) are crucial for breathing. Impairment of these reflexes can cause breathing problems during sleep such as obstructive sleep apnoea (OSA). OSA is very common in people with spinal cord injury for unknown reasons. This study shows major changes in protective reflexes that serve to keep the upper airway open in response to suction pressures in people with tetraplegia and OSA. These results help us understand why OSA is so common in people with tetraplegia and provide new insight into how protective upper airway reflexes work more broadly. ABSTRACT: More than 60% of people with tetraplegia have obstructive sleep apnoea (OSA). However, the specific causes are unknown. Genioglossus, the largest upper-airway dilator muscle, is important in maintaining upper-airway patency. Impaired genioglossus muscle function following spinal cord injury may contribute to OSA. This study aimed to determine if genioglossus reflex responses to negative upper-airway pressure are altered in people with OSA and tetraplegia compared to non-neurologically impaired able-bodied individuals with OSA. Genioglossus reflex responses measured via intramuscular electrodes to ∼60 brief (250 ms) pulses of negative upper-airway pressure (∼-15 cmH2 O at the mask) were compared between 13 participants (2 females) with tetraplegia plus OSA and 9 able-bodied controls (2 females) matched for age and OSA severity. The initial short-latency excitatory reflex response was absent in 6/13 people with tetraplegia and 1/9 controls. Genioglossus reflex inhibition in the absence of excitation was observed in three people with tetraplegia and none of the controls. When the excitatory response was present, it was significantly delayed in the tetraplegia group compared to able-bodied controls: excitation onset latency (mean ± SD) was 32 ± 16 vs. 18 ± 9 ms, P = 0.045; peak excitation latency was 48 ± 17 vs. 33 ± 8 ms, P = 0.038. However, when present, amplitude of the excitation response was not different between groups, 195 ± 26 vs. 219 ± 98% at baseline, P = 0.55. There are major differences in genioglossus reflex morphology and timing in response to rapid changes in airway pressure in people with tetraplegia and OSA. Altered genioglossus function may contribute to the increased risk of OSA in people with tetraplegia. The precise mechanisms mediating these differences are unknown.
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ItemNo Preview Available'Willingness to Pay': The Value Attributed to Program Location by Pulmonary Rehabilitation Participants(American Thoracic Society, 2020-01-01)
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ItemTask-specific gross motor skills training for ambulant school-aged children with cerebral palsy: a systematic review(BMJ PUBLISHING GROUP, 2017-08-01)
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ItemThe Highway of Life: Social Virtual Reality as a Reminiscence Tool(Oxford University Press (OUP), 2020-01-01)A large body of research demonstrates the positive impact that reminiscence activities can have on older adult wellbeing. Within this space, researchers have begun to explore how virtual reality (VR) technology might be used as a reminiscence tool. The immersive characteristics of VR could aid reminiscence by giving the sense of being fully present in a virtual environment that evokes the time being explored in the reminiscence session. However, to date, research into the use of VR as a reminiscence tool has overwhelmingly focussed on static environments that can only be viewed by a single user. This paper reports on a first-of-its-kind research project that used social VR (multiple users co-present in a single virtual environment), and 3D representations of personal artifacts (such as, photographs and recorded anecdotes), to allow a group of older adults to reminisce about their school experiences. Sixteen older adults aged 70-81 participated in a four-month user study, meeting in groups with a facilitator in a social virtual world called the Highway of Life. Results demonstrate how the social experience, tailored environment, and personal artifacts that were features of the social VR environment allowed the older adults to collaboratively reminisce about their school days. We conclude by considering the benefits and challenges associated with using social VR as a reminiscence tool with older adults.
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ItemNo Preview AvailableHow are early post-stroke exercise interventions developed? A systematic review(SAGE PUBLICATIONS LTD, 2018-08-01)