Physiotherapy - Research Publications

Permanent URI for this collection

Search Results

Now showing 1 - 10 of 928
  • Item
    No Preview Available
    Circus activities as a health intervention for children, youths, and adolescents: a scoping review protocol
    Coulston, F ; Cameron, KL ; Spittle, A ; Sellick, K ; Toovey, R (LIPPINCOTT WILLIAMS & WILKINS, 2022-01)
    OBJECTIVE: This scoping review aims to map the evidence on circus activities described and/or evaluated as a health intervention for children, youths, and adolescents. Increased understanding of how these interventions work, and gaps identified, will allow researchers and practitioners to advance the science behind these approaches. INTRODUCTION: Circus activities are proposed in the literature as a health intervention, due to their variety, non-competitive nature, and potential to develop fundamental physical and social skills. For the purposes of this review, circus activities as a health intervention are defined as aerial, acrobatic, equilibristic, and manipulation skills taught to participants to maintain, improve, or modify health, functioning, or health conditions. INCLUSION CRITERIA: English-language evidence will be considered where circus activities as a health intervention are described and/or evaluated for participants up to 24 years of age, or who are defined as children, youths, or adolescents. Literature will be excluded where the focus of the intervention is clowning, magic, or drama games, or where circus activities are not the therapeutic part of the activity. METHODS: MEDLINE (Ovid), CINAHL Complete (EBSCO), Scopus (Elsevier), PsycINFO (Ovid), ProQuest Dissertations and Theses Global, and Google Scholar will be searched for peer-reviewed and gray literature. No restriction on dates, type, methodology, or setting will be imposed, but limits will include "human" and "English language." Screening and data extraction will be performed by two independent reviewers. Reference lists of included sources will be screened. Results will be presented in diagrammatic or tabular format, alongside a narrative description, under headings aligning with the research sub-questions.
  • Item
    Thumbnail Image
    Intervencoes para promover funcao fisica de criancas e jovens com paralisia cerebral: diretriz internacional de pratica clinica
    Jackman, M ; Sakzewski, L ; Morgan, C ; Boyd, RN ; Brennan, SE ; Langdon, K ; Toovey, RAM ; Greaves, S ; Thorley, M ; Novak, I (WILEY, 2022-06-21)
    Resumo OBJETIVO Fornecer recomendações de intervenções para promoção da função física de crianças e jovens com paralisia cerebral. MÉTODO Um painel de especialistas priorizou perguntas e desfechos importantes para o paciente. Usando o Grading of Recommendations Assessment, Development and Evaluation (GRADE), o painel avaliou a certeza das evidências e fez recomendações, com consultoria de especialistas internacionais e consumidores. RESULTADOS A diretriz compreende 13 recomendações (informadas por três revisões sistemáticas, 30 estudos randomizados e cinco estudos pré‐pós). Para alcance de objetivos funcionais, recomenda‐se que a intervenção inclua objetivos escolhidos pelo cliente, prática completa da tarefa em ambientes da vida real, suporte para empoderar as famílias e uma abordagem em equipe. Idade, habilidade e preferências da criança/família precisam ser consideradas. Para melhora da habilidade da marcha, recomenda‐se marcha no solo, que pode ser complementada com treinamento em esteira. Várias abordagens podem facilitar os objetivos relacionados ao uso das mãos: terapia bimanual, terapia de contensão induzida, treino direcionado a objetivos e abordagens cognitivas. Para auto‐cuidado, prática da tarefa completa, combinada com recursos assistivos podem aumentar a independência e reduzir a sobrecarga do cuidador. A participação em objetivos de lazer pode combinar prática da tarefa completa com estratégias direcionadas para barreiras ambientais, pessoais e sociais. INTERPRETAÇÃO Intervenção para promoção da função de crianças e jovens com paralisia cerebral precisa incluir objetivos escolhidos pelo cliente e a prática da tarefa completa dos objetivos. Os clínicos devem considerar as preferências da criança/família, idade e habilidade ao selecionarem intervenções específicas.
  • Item
    Thumbnail Image
    Best evidence for improving function in children with cerebral palsy: Success is within reach
    Jackman, M ; Sakzewski, L ; Morgan, C ; Boyd, RN ; Brennan, SE ; Langdon, K ; Toovey, RAM ; Greaves, S ; Thorley, M ; Novak, I (WILEY, 2022-02-23)
    This letter to the editor is on the Clinical Practice Guide by Jackman et al. on pages 536–549 of this issue.
  • Item
    Thumbnail Image
    Hip and groin pain prevalence and prediction in Elite Gaelic Games: 2703 male athletes across two seasons.
    Carolan, D ; Richter, C ; Thorborg, K ; Franklyn-Miller, A ; O' Donovan, J ; McDonald, C ; King, E (Wiley, 2022-05)
    OBJECTIVE: Hip and groin pain is highly prevalent in sub-elite Gaelic Athletic Association (GAA) athletes, but its prevalence at the elite level is unknown. The aims of this study were to report hip and groin pain prevalence in elite male athletes, to report changes in Copenhagen Hip and Groin Outcome Score (HAGOS) across two seasons and to assess if previous hip and groin pain or pre-season HAGOS could predict future hip and groin pain. METHODS: During the 2017 and 2018 pre-season male Gaelic Players Association (GPA) playing members were invited to complete two questionnaires. The first questionnaire collected demographic information including age, GAA code played (Gaelic football or Hurling) and prevalence of hip and groin pain in the previous season. The second questionnaire was the HAGOS. Step-wise logistic regression models were fitted to HAGOS subscales, to examine if pre-season HAGOS subscale scores could predict future hip and groin pain. RESULTS: The prevalence of hip and groin pain across the elite GAA cohort was 38%. Hip and groin pain in the previous season was the strongest predictor of future hip and groin pain (r2 =0.19, AUC=0.73, 95% CI 1.76-2.27) whereas pre-season HAGOS subscale scores had limited and no additional predictive ability (AUC 0.05-0.18). CONCLUSIONS: Hip and groin pain prevalence is high in elite male GAA, with one in three athletes reporting pain. Previous season hip and groin pain is the strongest predictor of future hip and groin pain, while pre-season HAGOS scores have limited ability to predict future hip and groin pain.
  • Item
    Thumbnail Image
    Nasal Resistance Is Elevated in People with Tetraplegia and Is Reduced by Topical Sympathomimetic Administration
    Gainche, L ; Berlowitz, DJ ; LeGuen, M ; Ruehland, WR ; O'Donoghue, FJ ; Trinder, J ; Graco, M ; Schembri, R ; Eckert, DJ ; Rochford, PD ; Jordan, AS (AMER ACAD SLEEP MEDICINE, 2016-01-01)
    STUDY OBJECTIVES: Obstructive sleep apnea (OSA) is common in individuals with tetraplegia and associated with adverse health outcomes. The causes of the high prevalence of OSA in this population are unknown, but it is important to understand as standard treatments are poorly tolerated in tetraplegia. Nasal congestion is common in tetraplegia, possibly because of unopposed parasympathetic activity. Further, nasal obstruction can induce OSA in healthy individuals. We therefore aimed to compare nasal resistance before and after topical administration of a sympathomimetic between 10 individuals with tetraplegia (T) and 9 able-bodied (AB) controls matched for OSA severity, gender, and age. METHODS: Nasal, pharyngeal, and total upper airway resistance were calculated before and every 2 minutes following delivery of ≈0.05 mL of 0.5% atomized phenylephrine to the nostrils and pharyngeal airway. The surface tension of the upper airway lining liquid was also assessed. RESULTS: At baseline, individuals with tetraplegia had elevated nasal resistance (T = 7.0 ± 1.9, AB = 3.0 ± 0.6 cm H2O/L/s), that rapidly fell after phenylephrine (T = 2.3 ± 0.4, p = 0.03 at 2 min) whereas the able-bodied did not change (AB = 2.5 ± 0.5 cm H2O/L/s, p = 0.06 at 2 min). Pharyngeal resistance was non-significantly higher in individuals with tetraplegia than controls at baseline (T = 2.6 ± 0.9, AB = 1.2 ± 0.4 cm H2O/L/s) and was not altered by phenylephrine in either group. The surface tension of the upper airway lining liquid did not differ between groups (T = 64.3 ± 1.0, AB = 62.7 ± 0.6 mN/m). CONCLUSIONS: These data suggest that the unopposed parasympathetic activity in tetraplegia increases nasal resistance, potentially contributing to the high occurrence of OSA in this population.
  • Item
    Thumbnail Image
    Prolonged Eyelid Closure Episodes during Sleep Deprivation in Professional Drivers
    Alvaro, PK ; Jackson, ML ; Berlowitz, DJ ; Swann, P ; Howard, ME (AMER ACAD SLEEP MEDICINE, 2016-01-01)
    STUDY OBJECTIVES: Real life ocular measures of drowsiness use average blink duration, amplitude and velocity of eyelid movements to reflect drowsiness in drivers. However, averaged data may conceal the variability in duration of eyelid closure episodes, and more prolonged episodes that indicate higher levels of drowsiness. The current study aimed to describe the frequency and duration of prolonged eyelid closure episodes during acute sleep deprivation. METHODS: Twenty male professional drivers (mean age ± standard deviation = 41.9 ± 8.3 years) were recruited from the Transport Workers Union newsletter and newspaper advertisements in Melbourne, Australia. Each participant underwent 24 hours of sleep deprivation and completed a simulated driving task (AusEd), the Psychomotor Vigilance Task, and the Karolinska Sleepiness Scale. Eyelid closure episodes during the driving task were recorded and analyzed manually from digital video recordings. RESULTS: Eyelid closure episodes increased in frequency and duration with a median of zero s/h of eyelid closure after 3 h increasing to 34 s/h after 23 h awake. Eyelid closure episodes were short and infrequent from 3 to 14 h of wakefulness. After 17 h of sleep deprivation, longer and more frequent eyelid closure episodes began to occur. Episodes lasting from 7 seconds up to 18 seconds developed after 20 h of wakefulness. Length of eyelid closure episodes was moderately to highly correlated with the standard deviation of lateral lane position, braking reaction time, crashes, impaired vigilance, and subjective sleepiness. CONCLUSIONS: The frequency and duration of episodes of prolonged eyelid closure increases during acute sleep deprivation, with very prolonged episodes after 17 hours awake. Automated devices that assess drowsiness using averaged measures of eyelid closure episodes need to be able to detect prolonged eyelid closure episodes that occur during more severe sleep deprivation.
  • Item
    Thumbnail Image
    Periodic limb movements in tetraplegia
    Peters, AEJ ; van Silfhout, L ; Graco, M ; Schembri, R ; Thijssen, D ; Berlowitz, DJ (TAYLOR & FRANCIS LTD, 2018-01-01)
    OBJECTIVE: To establish the prevalence of Periodic Limb Movements during Sleep (PLMS) in patients with tetraplegia, controlling for obstructive sleep apnea. To explore whether demographic and injury characteristics affect PLMS. STUDY DESIGN: Retrospective cohorts. SETTING AND PARTICIPANTS: One hundred seventy-three participants with acute (<12 months) and 92 with chronic (>12 months) tetraplegia who underwent full overnight diagnostic sleep studies. INTERVENTIONS AND OUTCOME MEASURES: Two hundred sixty-two sleep study recordings were included. A randomly selected subgroup of 21 studies was assessed for PLM during wakefulness. Data were analysed according to the current American Academy of Sleep Medicine guidelines. RESULTS: Of the participants, 41.6% (43(15.7) years and 14.9% female) had a motor and sensory complete lesion. Sleep was poor with both OSA (87.8% with apnea hypopnoea index ≥ 5) and PLMS (58.4% with PLMS per hour PLMSI > 15) highly prevalent. There was no difference in the PLMSI between those with OSA (36.3(39.8)) or without (42.2(37.7), P = 0.42). PLMS were evident during REM and NREM sleep in all of the 153 patients with PLMSI > 15. All 21 participants in the subgroup of studies analysed for the PLM during quiet wakefulness, exhibited limb movements. None of the modelled variables (injury completeness, gender, OSA severity or time since injury) significantly predicted a PLMSI > 15 (P = 0.343). CONCLUSION: In conclusion, this study confirms the high prevalence of PLM in tetraplegia and the presence of leg movements in NREM and REM sleep along with wakefulness after controlling for OSA. No associations between the presence of PLMS and patient characteristics or injury specific aspects were found.
  • Item
    Thumbnail Image
    Relationship between autonomic cardiovascular control and obstructive sleep apnoea in persons with spinal cord injury: a retrospective study.
    Fang, X ; Goh, MY ; O'Callaghan, C ; Berlowitz, D (Springer Science and Business Media LLC, 2018)
    STUDY DESIGN: Retrospective study. OBJECTIVE: To determine if there is an association between obstructive sleep apnoea (OSA) and blood pressure (BP) pattern or heart rate variability (HRV) in people with spinal cord injury (SCI). SETTING: A state-based spinal cord service in Victoria, Australia. METHODS: We identified 42 subjects who had ambulatory BP monitoring (ABPM) within 6 months of a diagnostic sleep study at Austin Hospital between 2009 and 2014. Markers for autonomic function, including circadian BP pattern and HRV were extracted from the ABPM study database. Apnoea/hypopnoea index (AHI), arousals/hour and oxygen desaturation index were extracted from the sleep study database. Subjects with a nocturnal systolic BP dipping more than 10% of daytime value were defined as dippers, between 10 and 0% were non-dippers and those with a higher night than day systolic BP were reverse dippers. Severity of OSA is classified as non-OSA (AHI < 5), mild (AHI 5-15), moderate (AHI 15-30) and severe (AHI > 30). RESULTS: Subjects (n = 42) were predominantly male (85.7%), aged 44 ± 15.4 (mean ± SD), with a BMI of 24.4 ± 5.7 (mean ± SD) and mainly tetraplegic (92.9%). There was no difference in AHI, oxygen desaturation index or arousals/hour between dippers, non-dippers and reverse dippers. None of the HRV parameters differed between dippers, non-dippers and reverse dippers. No differences were found in 24 h, night-time, daytime or nocturnal dip in BP between subjects with non-OSA, mild, moderate and severe OSA. CONCLUSION: We found no relationship between BP pattern or HRV and the severity of OSA in persons with SCI.
  • Item
    Thumbnail Image
    Tetraplegic obstructive sleep apnoea patients dilate the airway similarly to able-bodied obstructive sleep apnoea patients
    Hatt, A ; Brown, E ; Berlowitz, DJ ; O'Donoghue, F ; Meaklim, H ; Connelly, A ; Jackson, G ; Sutherland, K ; Cistulli, PA ; Lee, BSB ; Bilston, LE (TAYLOR & FRANCIS LTD, 2020-11-11)
    Context/objective: Obstructive sleep apnoea (OSA) develops soon after cervical spinal cord injury (SCI) at rates higher than the general population, but the mechanisms are not understood. This study aimed to determine whether OSA in SCI is associated with altered pharyngeal muscle dilatory mechanics during quiet breathing, as has been observed in the non-SCI injured with obstructive sleep apnoea.Design: Cross sectional imaging study.Setting: Medical research institute.Participants: Eight cervical SCI patients with OSA were recruited and compared to 13 able-bodied OSA patients and 12 able-bodied healthy controls of similar age and BMI.Interventions and outcome measures: 3T MRI scans of upper airway anatomy and tagged-MRI to characterize airway muscle motion during quiet breathing were collected for analysis.Results: Considerable variation in the patterns of inspiratory airway muscle motion was observed in the SCI group, with some participants exhibiting large inspiratory airway dilatory motions, and others exhibiting counterproductive narrowing during inspiration. These patterns were not dissimilar to those observed in the able-bodied OSA participants. The increase in airway cross-sectional area of able-bodied control participants was proportional to increase in BMI, and a similar, but not significant, relationship was present in all groups.Conclusion: Despite the limited sample size, these data suggest that SCI OSA patients have heterogeneous pharyngeal dilator muscle responses to the negative pressures occurring during inspiration but, as a group, appear to be more similar to able-bodied OSA patients than healthy controls of similar age and BMI. This may reflect altered pharyngeal pressure reflex responses in at least some people with SCI.
  • Item
    Thumbnail Image
    Perceived sleep problems after spinal cord injury: Results from a community-based survey in Switzerland
    Buzzell, A ; Chamberlain, JD ; Schubert, M ; Mueller, G ; Berlowitz, DJ ; Brinkhof, MWG ; Jordan, X ; Reynard, F ; Baumberger, M ; Gmuender, HP ; Curt, A ; Hund-Georgiadis, M ; Hug, K ; Freitag, C ; Joggi, D ; Landolt, H ; Muenzel, N ; Brach, M ; Stucki, G ; Fekete, C (TAYLOR & FRANCIS LTD, 2020-01-25)
    Objective: To investigate the burden of sleep problems within the Spinal Cord injured (SCI) community with respect to the general population (GP) in Switzerland. The study further explored potential predictors for receiving treatment for sleep problems after SCI.Design: Cross-sectional study.Setting: SCI community in Switzerland.Participants: Individuals diagnosed with an SCI, aged 16 years or older that permanently reside in Switzerland (N = 1549).Interventions: Not applicable.Outcome measures: Perceived sleep problems within the SCI community and GP. For those with sleep problems and SCI, an indicator for having received treatment was measured.Results: 58.8% of survey participants indicated having a sleep problem; 69.4% of those with a sleep problem did not indicate receiving treatment. Amongst people living with an SCI, individuals between the ages of 46-60 years (adjusted Odds Ratio, OR = 3.07; 95% CI 1.54-6.16), participants reporting severe financial hardship (OR = 2.90; 95% CI) 1.69-4.96, and those that indicated having pain (OR = 5.62; 95% CI 3.52-8.98) were more likely to have a chronic sleep problem. In comparison to the Swiss GP, the prevalence of having a sleep problem was 18% higher among persons with SCI, with the largest discrepancy for males with paraplegia between the ages of 46-60 years (Prevalence ratio, PR = 1.28; 95% CI, 1.21-1.36).Conclusion: Individuals with SCI experience more sleep problems compared to the Swiss GP. Findings from this study suggest that clinical screening for sleep issues targeting high risk groups is needed to reduce the large prevalence of non-treatment in individuals with SCI.