Physiotherapy - Research Publications

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    Validation of a two-stage screening model to predict moderate to severe obstructive sleep apnea in chronic tetraplegia
    Graco, M ; Cross, S ; Thiyagarajan, C ; Shafazand, S ; Ayas, N ; Schembri, R ; Booker, L ; Nicholls, C ; Burns, P ; Nash, M ; Green, S ; Berlowitz, D (Taylor & Francis, 2017)
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    Role of Hip Injury and Giving Way in Pain Exacerbation in Hip Osteoarthritis: An Internet-Based Case-Crossover Study
    Fu, K ; Makovey, J ; Metcalf, B ; Bennell, K ; Zhang, Y ; Asher, R ; Robbins, S ; Deveza, L ; Hunter, DJ (WILEY, 2019-06)
    OBJECTIVE: To evaluate the association between hip injury/giving way and hip pain exacerbations in patients with symptomatic hip osteoarthritis (OA). METHODS: We conducted an internet-based case-crossover study to assess hip injury and giving way for hip pain exacerbation. Eligible participants with symptomatic hip OA were followed up for 90 days and asked to complete online questionnaires at baseline and 10-day intervals (control periods). They also logged on to the study web site to complete questionnaires for an episode of a hip pain exacerbation (case periods) defined as an increase of 2 points in pain intensity compared with the baseline rating on a numeric rating scale (range 0-10). The relationship of hip injury and giving way to the risk of pain exacerbation was examined using conditional logistic regression. RESULTS: Of 252 patients recruited into the study, we included 133 patients (53%) who provided data from both case and control periods. Hip injury during the last 7 days increased the risk of hip pain exacerbation (odds ratio [OR] 2.74 [95% confidence interval (95% CI) 1.62-4.62]). The hip giving way during the last 2 days was associated with an increased risk of hip pain exacerbation (OR 2.10 [95% CI 1.30-3.39]) and showed a significant relationship between the number of hip giving way events and the risk of hip pain exacerbations (P < 0.001). CONCLUSION: Hip injury and episodes of the hip giving way were significantly related to pain exacerbation in patients with symptomatic hip OA. Methods to prevent exposure to injury may help to reduce the burden of pain in patients with hip OA.
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    Genioglossus reflex responses to negative upper airway pressure are altered in people with tetraplegia and obstructive sleep apnoea
    Wijesuriya, NS ; Gainche, L ; Jordan, AS ; Berlowitz, DJ ; LeGuen, M ; Rochford, PD ; O'Donoghue, FJ ; Ruehland, WR ; Carberry, JC ; Butler, JE ; Eckert, DJ (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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    'Willingness to Pay': The Value Attributed to Program Location by Pulmonary Rehabilitation Participants
    Burge, A ; Holland, AE ; McDonald, CF ; Abramson, MJ ; Hill, CJ ; Lee, AL ; Cox, NS ; Moore, R ; Nicolson, C ; O'Halloran, P ; Lahham, A ; Gillies, R ; Mahal, A (American Thoracic Society, 2020-01-01)
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    Impact of an Allied Health Prehabilitation Service on Haematologic Cancer Patients Receiving Intensive Chemotherapy with Autologous Stem Cell Rescue: A Single Centre Observational Study
    Crowe, J ; Denehy, L ; Edbrooke, L ; Loeliger, J ; Joyce, T ; Prickett, C ; Martin, A ; Francis, J ; Khot, A (Elsevier BV, 2021-03)
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    How are early post-stroke exercise interventions developed? A systematic review
    Kramer, S ; Kaffenberger, T ; Cumming, T ; Bernhardt, J ; Johnson, L (SAGE PUBLICATIONS LTD, 2018-08)